There’s Inconvenience…And Then There’s Incompetence

You know your level of irritation is high when you write “It’s midodrine, not fentanyl” in an email to your cardiologist bitching about the automated pharmacy screw-ups that have now left you without an essential medication for who knows how long.

He pushed it through on Tuesday. Since it’s not one that is kept in stock at my local Kaiser pharmacy, it takes them two days to get it in. I called on Thursday and the automated refill line informed me it had been mailed from the distribution center. WHAT THE SHIT. IT WAS SUPPOSED TO BE FILLED LOCALLY. MY CARDIOLOGIST SAID IT WOULD BE FILLED LOCALLY. As this pharmacy is not open on weekends, it wouldn’t have done me any good to go down there and have them order it because the earliest they would have it in is Monday.

I already called the 24-hour Kaiser pharmacy in the next town over to see if they have it in stock. After multiple phone system rerouting problems (more fun dealing with automation doing the exact opposite of what it was supposed to do when it was implemented), I spoke with a very pleasant tech** who said no, they don’t have it either; they too would have to special-order it.

Now, even though the mail-order system says 7-10 days, often I’ll have it in my mailbox before I even get the automated phone call from Kaiser telling me it’s been mailed. No such luck this time! (Of course.) It wasn’t there today. Fingers are crossed it will arrive tomorrow.

The thing is, this would all be solved if the automated system didn’t lock me out of the refills that my cardiologist previously authorized. I had to email him in the first place because Kaiser’s “convenient online ordering system” kept telling me “According to our records it is too soon to refill this prescription” and wouldn’t let me click the stupid reorder button.

While I’ve been taking it much faster than it was initially written for, this is with full knowledge and approval of my cardiologist. My bottle says five refills remaining. Midodrine is not a controlled substance. I should be able to access those refills.

This wouldn’t be an issue if I had my medications through CVS or a similar pharmacy. I know because a friend of mine spilled almost a whole bottle of their beta blocker on the ground. Since they had refills remaining on it, what did they do? They pulled up the CVS app and ordered another bottle. I was like, “Whaaaat? But but but…you can do that? You don’t have to call your doctor’s office first and explain what happened as if you’re five years old and then have them call the pharmacy to authorize an early refill for you?” (No, apparently they did not.)

Interestingly, I could refill my zofran almost as soon as I initially filled it, even though my PCP wrote it for a roughly three month supply. It’s been barely a month, and there it sits in the pharmacy center screen, being all “available for refill” and shit. It’s like it’s taunting me.

But midodrine? Which, in terms of its importance in my life, is equivalent to an anti-seizure medication? HAHA NOPE SCREW YOU KID.

I mean, don’t get me wrong, the nausea is pretty debilitating too, but there are alternative medications that can be prescribed if one is out of stock and my need is immediate. I don’t have that option with this one.

This is legitimately the medication I take before I’ve even left the pharmacy counter as I wait for my credit card to process because I’m in such rough shape without it. I’ll dry-swallow it if I have to (and it’s nasty) because it’s that essential.

I ran out yesterday. (Okay technically I have 60% of a single dose left but I’m saving that because I need to be functional tomorrow evening way to be overly technical people JEEZ.)

Now, I’ve only passed out twice today (this is what I mean when I say without my meds standing sucks), but that’s in part because I’m pretty good at dropping my ass to the floor as soon as I get the nice sparkly black bits in my vision. (I said pretty good. I didn’t say perfect.)

Also, I may or may not be mostly butt-scooting from room to room. (Living in a 350-square-foot shoebox can be handy at times.) I’m writing this post from my living room floor, and while my knees and spine hate me for it, my brain really appreciates not having to fight my legs to get enough blood.

We never should have become upright creatures. Bad news, all of it.

**Pro tip for my newly chronically ill folks: Always be nice to the pharmacy techs. ALWAYS. These are the people you are saving your niceness spoons for.

1) Given the opportunity, they will bend over backwards for you, and if you are a frequent flyer (hello!), that can be essential when you are feeling horrid and need something fast. If they know you as the friendly customer who genuinely respects and appreciates the work they do, they’ll help you out.

2) Even if you get the rare one that is terse with you, be nice anyway. It’s not you. It’s almost never you. They take a ton of abuse from customers and can only handle so much. You probably caught them on a particularly stressful day and they’re wondering if you’re a real human being or yet another grizzly bear in disguise. Spend the energy to smile at them. Why? See number 1. Trust me. It’s worth it.

3) If it seems like it is you, check your prescription. If it’s for a controlled substance, specifically an opiate or a benzodiazepine, and it’s written for a small number of pills, they might be looking at you a little askance. The drug-seeking patients who found a doctor willing to write them 10 vicodin just to get them out of their hair? That pharmacy tech sees them. All of them. Far more than you or I or even any doctor will see, because those people have to get those scripts filled somewhere.

I know, I know, it’s not your fault, but the nicer you are, the less they’ll think you’re one of “those people” and the more they’ll think you’re a reasonable human being who has a legitimate issue for which you’re being prescribed meds.

4) Of course, this doesn’t take into account the current access problems we’re having in the US regarding long-term opiate usage for chronic pain. This is one of the few times being in a closed system like Kaiser can be a good thing: if it’s prescribed, they give it to you.

On the other hand, pharmacies like CVS that have thrown chronic pain patients into withdrawals due to their bullshit internal checklists regarding doling out opiates? They can choke on a giant bag of dicks. A giant bag of dicks, for that matter. But still. Be nice to the techs, because they don’t create the policies, they’re just the first to be fired if the policies aren’t followed. It’s not their fault.

Why yes, I do indeed take a lot of pills. Why ever do you ask?

Why yes, I do indeed take a lot of pills. Why ever do you ask?


About Ian

Medically interesting. Disability advocate. Aerialist. Studying physiology with a focus on endocrinology and histology.
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