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A little bit goes a long way

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  • A little bit goes a long way

    Clearly this is something this customer was not told when she picked up a script for some sort of medical cream or ointment.

    I went to the pharmacy today to pick up a couple of prescriptions, and had to wait behind an elderly lady who was arguing with the pharmacy tech at the register. This tech is an awesome gal who's been really good to me over the past couple of years she's been working there, and is generally awesome to pretty much everyone. She waved hello at me as I got in line behind the elderly lady. I smiled and waved back

    EL: Elderly lady
    AT: Awesome tech (Indian lady with an awesome British accent, I can hear it in my head as I type this)

    EL: Well, I just don't understand it. What are you going to do about this?
    AT: What do you want me to do about it, ma'am. I've already explained to you, this is an insurance thing. You should call them directly.
    EL: ------
    AT: ------
    EL: ------
    AT: Do you want to speak to the pharmacist?
    EL: Yes.
    AT: OK. Let me have you move to that window over there, and I'll have the pharmacist speak to you about this. (The pharmacist is also an awesome lady who does her best to help patients get what they need).

    At this point I move up. AT says, "Hi, Panacea. What can I do for you today?" I told her what meds I needed refills on and asked if I could wait. She smiled and said, sure no problem, so I wandered over to another aisle to look over some nutritional supplements I was thinking about getting.

    The Elderly Lady argued with the pharmacist for awhile about her medication.

    Pharmacist: Yes, ma'am I do see that the instructions say to use daily, in the evenings specifically. But the tube is supposed to last you an entire month, and the insurance won't authorize us to dispense another one for another couple of weeks.

    EL: This is unacceptable. I am completely out. See? See the old tube? I have to have a new one today.
    Pharmacist: There's nothing I can do about the insurance company ma'am. You'll have to go through them.
    EL: I want you to do something about this today.
    Pharmacist: Well, I can call your doctor and see what he says. We can ask him to contact the insurance company and see what he can do. Or you can pay cash.
    EL: I can't pay cash.

    I wandered away at that point, and when I came back to pick up my meds the EL was gone.

    The Elderly Lady wasn't too terribly sucky, just insistent. Which brings me to the point of this post and why it is here and not in Sightings.

    If your doctor prescribes a medical ointment for whatever purpose, be sure to ask for very specific instructions on how to apply it, and exactly how much to use. Because the insurance company will generally not authorize a new tube if you use it up too quickly unless it's a life or death med (other than nitroglycerin paste, I can't think of anything that would be).

    Typically speaking a little bit goes a long way. You don't have to glob on so much that you have to wash the rest of it off your hands when you are done. In most cases a little bit on the finger tips, and rub it into the skin as directed is all you need.

    Some topical pastes/ointments/gels/creams require a very specific amount and you may even need to use a paper applicator to measure out how much to use--use no more no less. Nitro paste is one like that; it is measured in inches.

    Ask for specific directions from your doctor. A lot of times they just write the script and do no teaching on how much to use. They may not even know. If they have a nurse, she might depending on what the med is. It is her job to educate patients about medications.

    If neither the doctor or the nurse know, ask the pharmacist when you pick it up from the pharmacy or take it to the pharmacy and show him/her if you are given a sample n the doctor's office.

    Because odds are, the insurance company refused to authorize a refill for the Elderly Lady.
    They say that God only gives us what we can handle. Apparently, God thinks I'm a bad ass.

  • #2
    Thank you so much for saying this! I wish that patients would realize this more often!

    Luckily, in my state, there is mandatory First Fill Counselling that helps with a lot of the people who would just glob it on.

    One time we had a lady who put a lotion that she was supposed to use from neck to toes all in her hair! And then she called to complain that she was out...

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    • #3
      I never knew they made nitro paste! What is it used for?
      Success is not final, failure is not fatal: It is the courage to continue that counts.-Winston Churchill

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      • #4
        Quoth ralerin View Post
        I never knew they made nitro paste! What is it used for?
        Treatment of angina. I don't see it prescribed in the community as much as I used to since they developed the nitro transdermal patches. But we still use it in the hospital a lot for the treatment of acute angina. If the patient doesn't respond, we move to a nitro drip.

        It comes in a tube like toothpaste with a pack of application papers. The paper has a measuring line in sections of up to 3 inches. 1/2 to 1 inch is the usual dose (you squeeze the tube and run the line of paste along the measurement).
        They say that God only gives us what we can handle. Apparently, God thinks I'm a bad ass.

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