Wheedling for my fix

By Mir
September 8, 2008

I began menopause unceremoniously at the tender young age of 33, thanks to a total hysterectomy. (Sorry for the rhyme, there; I tend to get all poetic when we chat about my uterus.) After having spent the majority of my lifetime at the mercy of everything that can possibly go wrong with those stupid organs (endometriosis! adenomyosis! infertility! ruptured ovarian cysts! hypermenorrhea, and I hope you’re not eating if you click on that link!), I was not one of those women who approached the surgical suite weeping for the loss of my womanhood, or anything like that. I believe the last words I said to my doctor before the anesthesiologist put me under were “Take it all out and don’t look back.”

I was ready, is my point. (I’ll take menopause for $200, please, Alex! What is The Lesser of Two Evils? YESSSSSSSSSS!)

And I’ve dealt with the fact that my internal thermostat is now permanently broken and I am always too hot, and I’ve dealt with the reality that unless I go on an all-calcium diet I’m a very likely candidate for osteoporosis, I’ve been through a breast cancer scare and the associated suggestion that I might have to stop taking hormones. But the thing that continues to drive me absolutely bananas is the insanity surrounding BUYING my estrogen.

I like estrogen. It makes me feel pretty. And, you know, less neutered. It helps keep my bones strong and prevents me from growing a beard and also keeps me from going completely insane, because—like most people who enjoy a double-X chromosome pair—I need some estrogen to stifle any murderous urges that may occur. (Those with an XY chromosome pair generally subvert this urge by watching football.)

My medical team prepared me for the endless carnival of excitement that is Finding The Right Hormone Dose And Delivery. I started off my journey on a combination estrogen-progesterone patch, and with that came relentless nausea until I was switched to an estrogen-only patch. Then I switched from that patch to a different one, and used it happily for a long time. I was super duper lucky (as I nearly always am!) and developed an allergy to the adhesive used on the patch, and so went on the hunt for a new hormone method. Later, I briefly switched to a hormone ring that caused me to have panic attacks, and finally, I switched to a topical estrogen gel, which is what I use now.

Is it a royal pain in the butt? Yes, yes it is. But I knew that it would be.

What I was NOT prepared for is the utter joy of going through all of this while trying to get said hormone treatments covered by my HMO.

Oh, they’ve been with me every step of the way. In the beginning, there were the problems with math. Later, when I switched to the gel, my insurance stopped covering it at all, and for years I used a Canadian mail-order pharmacy to keep myself well estrogenated. The good news is that my current insurance does cover the gel, but the bad news is that my local pharmacy screws up every single time I refill it.

For the last three months, every time I’ve gone to refill my hormones, they’ve only had one container instead of two. Now, it used to come in a larger size, so the prescription is written for one pump of 100 (100 what? I have no idea—grams? molecules? follicles?). Now that the only way you can get it is in a pump of 50, it stands to reason that I should be given TWO pumps to equal the original amount, which is a 1-month supply.

Apparently I am the ONLY PERSON IN TOWN who uses EstroGel. (I AM SPECIAL!) The pharmacy only ever keeps one container in stock, and then when I call for a refill they put it in a bag for me and then get completely confused when I come to pick it up and point out that this is only half my refill. They NEVER call to tell me they need to order more, don’t come pick it up yet. They NEVER seem to remember me, even though clearly I must, by this time, have CRAZY ESTROGEN LADY tattooed across the top of my file.

For months, I have gone to pick it up, been given just the one package, have patiently explained that this is only half my prescription, have then been told they’ll order the other one and I should come back in a couple of days.

I have been patient. I have tried to be understanding.

Yesterday I went to pick up my refill and was greeted at the pharmacy by a sweet young thing. I greeted her and gave her my name. She went and retrieved my prescription bag and pulled out—you guessed it!—a single container of EstroGel.

“Okay, here’s the EstroGel,” she said. “Anything else for you today, Ma’am?”

I sighed. “Um, yes, actually. That’s only one container. There should be two.”

“Oh, I’m sorry, Ma’am,” she chirped, all apologies, “Did you have a second prescription?”

“No, just the one,” I said. “But it’s for two pumps. One is only a two-week supply. There should be a second one. Let me guess: You only have one?”

This was where her face changed, slightly. She looked down at the bag, then over at the computer, then back at me again to say, “Ma’am, we can only give you what the prescription is written for. I can’t give you a second one. It’s written for one container.”

[There is a way that young people in the south say “Ma’am” that says, “I was raised to call you ma’am and I will do it because I’m a good kid, but each usage will drip with just a little disdain to make it clear that—while I am addressing you politely—I am actually picturing running you over with my car.”]

“The prescription is written for one container of a size which no longer exists,” I corrected her. “Now it comes in that half-size, and so in order to fill the prescription properly, you need to give me TWO of those. Look at the order history, please. I always get two.”

Her gaze went back to the computer. When she looked up again, her face made it clear that the gloves were about to come off. “MA’AM,” she said, very firmly, clearly using all of her What To Do When An Addict Tries To Bully You pharmacy training, “PLEASE. You only get one container. You have only EVER gotten one container. I can’t just give you another one, Ma’am. This is all you get.”

I couldn’t help it; I started to laugh. It was that or punch her in the face, really, and the former seemed slightly less rude and much less likely to get me arrested. “Okay,” I said. “You’re right, I just IMAGINED getting two of those containers every month for the last YEAR. I made it up! Because I’m ABUSING ESTROGEN!” She, by the way, was not laughing. And the more horrified she looked, the harder I laughed. “May I please speak with the pharmacist?” I finally managed, wiping my eyes.

She fetched the pharmacist, and I explained the problem. The two of them retreated and I managed to ascertain through a combination of lip-reading and the young tech’s wild gesticulations that she was telling the pharmacist what a CRAZY, DELUSIONAL BULLY I am.

“It’s written for ONE HUNDRED!” the tech huffed in conclusion, ready to be congratulated for her staunch ability to Just Say No to hormone-addled estrogen-seekers.

The pharmacist removed the container from the prescription bag, looked at it, and then showed it to the tech. Then she pointed at where it clearly says CONTAINS: 50 down at the bottom.

The tech turned crimson. The pharmacist sent her away (she slunk off quite willingly) and the pharmacist went back into the supply area and then emerged.

“I’m so sorry about that,” she said, sounding like she might actually be sorry. “Unfortunately, we only have the one container. I’m going to need you to come back for the other one after I order it.”

Of course.

I took a deep breath and explained that since switching to this pharmacy they have never been able to fill my prescription without incident. That I have had to make a minimum of two trips (and sometimes three!) for every refill. That they often call and tell me to pick up when it’s not ready, that they NEVER call to tell me it’s NOT ready. That I have to argue with a tech nearly every time I come. And that I never found it particularly embarrassing to be on hormone replacement before I started using this store, my neighborhood pharmacy, where now I am made to feel like a complete freak every. single. time. I go in.

The pharmacist pushed the bag across the counter to me. “Just take this one,” she said. “No charge. I should have the other one here tomorrow and I’ll call you myself. I’m really sorry.”

I could tell you that it was too little, too late, and that I’m changing pharmacies again (the one I used across town never had this problem). But I’m a little too busy huffing the (FREE!) gel directly out of the pump to think about that right now. Who wants a hit?

61 Comments

  1. Nancy R

    Hey, at least they might remember you now!

  2. Lori

    Ah, the joys of regular pharmacy visits!

  3. Megan

    At the very least it should be pretty and sparkly and smell like something very, very nice. Not vanilla though ’cause fake vanilla smell makes me ill. Maybe a whiff of lemon grass? A nice clean lavender?

    Oh and a bow. They definitely should give you the other half with a great, ginormous silk bow.

  4. RuthWells

    Way to kick butt!

  5. Rachel

    I think the pharmacy you have been using is either located in Grand Forks, ND; or is the same store chain as the one I use. It wouldn’t be CVS, would it? Just saying…

  6. Aimee

    Hee! I’m going to be sitting here all day imagining you huffing (!) estrogel and calling is preshussssssssss.

  7. Leandra

    I sang that first line to the tune of “I am the very model of a modern major general”. Does that make me weird?

    Wouldn’t it just be easier on everybody if your doctor rewrote the prescription?

  8. Jenny

    Being right is awesome.

  9. Sheila

    I’m going to start watching the headlines, looking for news of a shocking arrest on a school playground: Crazed Yankee Woman Caught Peddling Substance to Area Schoolgirls. Because in limiting your supply, I’m sure that’s what the pharmacy is trying to prevent- covert estrogen distribution.

    You had us fooled with all your talk of hormone-free milk, Mir. But that pharm tech was so onto you.

  10. Trisha

    How funny! You estrogen addict you!

  11. Em

    I’m imagining some transvestite black market where a man who would rather be a woman comes in for estrogen, giant lacey underpants and false eyelashes. And I picture it in your pool shed. I’m right, aren’t I? For shame, Mir. For shame.

    Also, the first thing anyone dealing with medication learns is the 5 rights – right patient, right dose, right med, right frequency and right route (for example, it said analgesic but you WERE supposed to take it orally) so I believe that tech should have sulked away in shame. Especially when you were explaining it right to her face. I wonder what her punishment was… sorting pills by color, memorizing all of the labels (that would be fitting), testing the unlabeled pills to see what they were ;-)

  12. Kristin (aka Krisco)

    You could almost be in New Mexico with that kind of customer service! You know, the customer is always wrong, and by the way they are really annoying me by showing up here at my workplace at all….I’m sorry to hear that kind of joy exists elsewhere too!

  13. MomCat

    After reading about that, I could use a hit. Hand it over with all haste!

  14. BethRD

    You may have covered this already, but is there any way to get your doctor to write you a new prescription for two of 50 instead of one of 100?

  15. tori

    I would swear you are following me around, observing what happens, changing details slightly and then writing about it. Yesterday I went to get my eyedrops that I will use every day for the rest of my life. I open the tiny tube, use one drop in each eye and then throw it away. I do this twice a day. There are 30 days in the month (prescription wise anyway) so I would need 60 lttle tubes in order to use as directed. I got 30. And had the same conversation with the staff. Ultimately I got mine for free this time too.

  16. Niki

    I have a similar situation with a prescription that is partially paid for by a drug company’s “assistance” program. The card is in their system, but their system does not pick it up automatically. Every time I pick it up, I have to tell them (before they ring it up) that there is a secondary insurance in the system. They sigh, look it up, adjust it, print a new form, then have to call a manager to override the price. They know me on sight, yet not one of them can think to do this when they get a refill notice – though I have now taken it for 2 years! Takes no less than 20 minutes, every time, to pick up a prescription that is ready. Which needs to be refrigerated, and sits on the counter for those 20 minutes. My oldest was with me last time, and couldn’t believe I had to go through this every time for a prescription that was ready. What could I say – I enjoy spending time there?

  17. Astrogirl426

    I wonder, if I say what you said to the pharmacy where I get my meds, would they give me a two week supply free? Oooh, what I could do with some free Effexor (yeh, I know, not as much fun as estrogen. But it does make me feel less-batshit crazy, so that’s a good thing).

    So glad the tech at least had the sense to slink off with all the shame she deserved.

  18. Jamie AZ

    I guess I should feel lucky to use a mail-order pharmacy for my continual meds as they seem to get the 90-day supply right without my contant intervention. What a hassle for you! Can you get this through an insurance-sponsored mail order pharmacy instead?

  19. Maki

    I hate when things like this happen; my hubby needs seizure meds and sometimes he has to go back and force just like you do. Now, they call and said it’s ready, but still we have tons of hassle to go through often times for meds that he needs!!! I hate some of Pharm tech’s attitude too where they think they’re better than you. Oh good luck with your refill routine!

  20. Katie in MA

    Another hit? Of Estrogen? When I’m already weepy? What are you on – crack?!

    :)

  21. ML

    I’ve had this happen a thousand times!! Birth control, anti-depressants, etc…Does it ever happen for a decongestant??? Why must they F with the stuff that keeps us sane? And don’t get me started on the drver’s license office (apparently that’s Southern for a stand alone department of the DMV) where you’ll have to drive across town to get a sticker that says you paid your car tax at the county treasurers office before I can update the address on your license. Aaaaaaagh!

  22. Nelson's Mama

    Situations like that are the reason I drive across town to do business at our only locally owned drug store – SERVICE!

  23. Sharon

    Well, you are developing a relationship with your pharmacist, which probably wasn’t a priority in the beginning. About estrogen – When I told my acupuncturist I was giving estrogen cream another try, by prescription from my doctor, she said it was very important that I continue to also use natural progesterone cream, which is available at health food stores. Otherwise I’m using “unopposed estrogen” and if you research the term it will give you the details.

  24. All Adither

    What a pain in the freaking ass. I’m pretty compassionate and understanding about mistakes. But when they happen one billion times, I lose my patience. Why can’t some people be a little proactive?

  25. Karen

    Your estrogen addiction is really getting out of hand. What will the neighbors think when they hear about it? Oh Mir, I am so sorry! That is as embarrassing as asking your first boyfriend to go buy tampons.

  26. Rebecca

    You addict, you! I was on the road to crazyville dealing with pharmacies like this one. Started using Target Pharmacies and it’s a beautiful dream. Recently, I went to fill a RX for one of my kids and they only had one tube of the cream he needed. They said I could pick it up the next day. I forgot about it, and a week later it arrived at my house via UPS.

  27. The Other Lori

    Ummmmm, I’m fairly certain that the pharmacist is skurred of you. She probably thought you needed a hit and gave you the free gel as part of a drug-terrorist negotiation tactic.

  28. Sara

    So if you only get one pump then, are you “partially estrogenated”?

  29. Melissa

    I also went through this (with bcp) at my chain pharmacy yesterday, where I’ve been getting the exact same prescription for over 3 years…half the time I have only one in the bag. What kills me is, when I point this out, they say “Oh yes, that’s noted in the computer.” Then why, why, why are you doing it wrong? ARRRRGGGGGGHHHHHH.

  30. Randi

    Estrogen – nasty stuff. With my PCOS, estrogen makes me an emotional, unstable woman…oh…wait…guess that’s not so different from every day ;)

  31. Jackie@agsoccermom

    Your story reminds me of the time they shorted my mother in law 2 pills. They wouldn’t refill her prescription for 2 more days and she was clearly out. She grabbed the pharmacist by the collar and said give me my 2 pills or else. He gave her the 2 pills and she has never been shorted again. LOL.

  32. Beth

    @Rachel: I forgot Osco got bought out by CVS — GdFx is my home town and my mom still moans about that!

    Mir — I hear and feel you on this one. My Lexapro is prescribed at 1.5 pills a day. Standard dosage? 1 pill a day. You wouldn’t believe the hoops we had to jump through to get the prescription written correctly so the pharmacy could get the insurance company to pay it.

    And people wonder why we say our health system is busted???

  33. dad

    As we speak, there is probably Y’less chromosomed team of federal narcs reading up on your file and preparing a raid.

    Be advised: the only defense is sarcasm. They’re dead meat.

  34. lindsay

    I have the same issue with birth control – doc writes a prescription for 12 months to be filled 1x every 6 months. They ALWAYS only have one box for me and reorder the other 5, and tell me to come back in a couple days. It is so weird, but I have a hot pharmacist so it kind of makes the extra trips worthwhile. Perhaps you should just try to find a hot pharmacist since the visit frequency is guaranteed to be higher than normal?

  35. Fran

    What is wrong with these people? If there is one thing that should foremost on the minds of every single freakin’ pharm tech is Never, and I mean never get between a woman and her estrogen…and I mean never.

  36. Michelle

    I really wonder what the girl was thinking you might do with a double dose of estrogen. Poison your husband? Feminize your son?

  37. LiteralDan

    I hope I don’t have go through something like this if I ever have to have MY uterus removed.

    …Hold on one second, my wife says she needs to tell me something very important right now that she’s been meaning to tell me for a long time. Be right back to finish this comment.

  38. Chuck

    I have found that using a pharmacy at the local grocery store works well for me…less busy than a Walgreen’s-type of pharmacy, and I can get shopping done while I wait for my prescriptions to be filled. Fortunately I don’t have to get any prescriptions on a regular basis (yet, anyhow.)

  39. Lucinda

    Not being from the south but having a dad who is, you have hopefully learned by now that the response to a dripping-with-disdain Ma’am is a sweet-as-sugar “bless your heart, but…”. Making it clear as sweetly as possible that they are clearly dim-witted.

  40. Barbara

    Perfect rendition, Mir! I can relate, but won’t – you tell it best.

  41. Flea

    I love my compound pharmacy. The progesterone cream theyt give me smells much better than the stuff I used to get.

  42. The Other Other Dawn

    Oh, those estrogen addicts. They’re the worst.

    Currently going through the Big M the regular way, I can’t imagine being surgically thrown into it. It’s tolerable when it sneaks up on you so that you gradually forget what it was like to sleep for longer than an hour at a stretch or wear the same outfit for longer than 15 minutes or not be hit with sudden, unfathomable fits of anxiety but to have it arrive all at once cannot be fun.

    I think the beard sounds good, though. My look needs an update.

  43. jennielynn

    Oh God, I’m laughing so hard my sides hurt. After I stop laughing, I’m gonna get an intervention together. Just say no, Mir.

  44. Krista

    Hi! My friend told me I had to read your blog today. I also had a hysterectomy three months ago and wrote about my experience. You said you felt poetic when talking about your uterus, and I actually wrote an ode to mine. Don’t pharmacy people tick you off?! You spend that much money on drugs and they can’t even remember your name! Crazy! We also did the Canadian Pharmacy – my son was on accutane for serious acne (not just vanity, but serious) and it was $435/mo here. Half the price in Canada. And he is acne free now. I really enjoyed and laughed at your blog. I will definitely visit again! To read “Ode to My Uterus” stop by:
    http://ohmyheck-tic.blogspot.com/2008/06/under-influence-of-pain-killers.html

  45. Amy

    I just found out today that I might get to have my own hysterectomy! Fortunately you’ve made it sound so fun, I can hardly wait!

  46. Laura D.

    I’d try for mail-order only at this point. Then again, that doesn’t always work either!

  47. Wendy

    I take only 3 weeks of my bc pills – I can’t ever be off the hormones because of my endometriosis. (Yeah for no periods!) So, every three weeks my pharmacy tells me I took my pills too fast and need to come back in 7 days. Every month my insurance company tells me they won’t cover it until I come back later. My dr. even wrote it in the dosing directions – and called my ins. company – and wrote it on the prescription sheet. I can’t believe I am the only one out there doing this by now! At least six years ago it seemed a bit more radical and I was slightly more tolerant…Sorry about all your frustration! I hope it gets better now…

  48. Kailani

    Seriously, how hard would it be for them to START stocking *two* bottles of the stuff…knowing you’ll be back in 30 days? Wouldn’t that make everyones life just a wee bit easier?!
    K

  49. Aisha

    My father worked at a big box pharmacy who will remain nameless. They had two of the worst pharmacists I’ve ever had the joy of having to deal with. I was on birth control and I had a variety of questions, seeing as I’m big on not having kids for a while. They ALWAYS blew me off. They were always so awful and rude and they, as well as most of the techs, never really took our questions seriously. ‘Oh, you’re kid has a sinus infection that put her at 102 degrees and she’s having a meltdown because her meds aren’t ready yet? Too bad.’ Put a bad taste in my mouth when it came to pharmacists, until I dealt with our local Krogers pharmacy. They helped me get a free inhaler this past spring.

    My point being, some pharmacists are way awesomer than techs. Techs have a superiority complex. I would join you in the huffing, but I’m too busy enjoying the smell of banana muffins and peanut butter cookies.

  50. ChristieNY

    Went through similar pharmaceutical joys (woes) with my rx for Estrace.

    Fan-tastic. I hope the pharmacist starts stocking two of the 50’s from now on… but hooray for crimson colored techs and a freebie. :)

  51. Karen

    I had a complete hysterectomy in 1996. It was long overdue, and was one of The. Best. Things. I. Ever. Did. For. Myself. I was put on hormone replacement too, and took it for about two years. The first time I went to pick up my prescription after my health insurance expired, the price was more than double what it had been when I had insurance.

    I asked the pharmacist why there had been such a big price increase in just one month. The reason? My insurance provider had negotiated a smaller price. Which I could not have since I was no longer insured.

    I stopped taking the HRT that day. I have had no problems not using one, except for that pesky whisker that is determined to grow out of my chin. I have tweezers for that.

  52. Karen

    Oh, yeah, I forgot to tell you, that FabGrandpa has to take Synthroid daily. His prescription says righ on it “NO GENERICS” and we always tell them when we give them the prescription that we do not want generic, and what do we always get? GENERIC!!! The only way I knew it the first time is that the generic is one of those $4.00 Rx’s at Wal-Mart. As soon as they told me the price, I knew they had given us the generic. It is so agravating that this happens EVERY time. And they always say, “Well, generic is cheaper.” And your point is???

  53. carrien

    OH I’m glad she turned red and had to slink away in shame. ANd I’m glad you got half of this month free.

    Maybe they’ll get on top of things now?

  54. lindasands

    Man, I hate stupid people. And I hate that you have to be inconvenienced for their stupidity. You are a trooper for putting up with them for this long.
    Here’s your reward:
    If this is your same brand of Estrogel- you can save $20 using this coupon: http://iw.rtm.com/Estrogel/
    maybe you can even figure out a way to have your doctor ship your prescription to your house.
    like buying from here: http://www.inhousedrugstore.com/womens-hrt/estrogel-hrt.html

    does any of that help? Cause I’m into helping, you see?
    Linda

  55. jennP

    you gotta love those pharmacies that tend to make you feel like a criminal drug user when you go pick up something so simple!

    in my case, for example, i prefer get extra strength advil. this way, when i need it, i take one pill instead of two. Well out here, our extra strength advil is behind the counter! so the two times a year i get a container, i need to give my name, address, number, etc…!! i feel like a criminal for getting advil! (oh, its the same for Gravol!! which i bought once in my life)

  56. Sue @ My Party of 6

    I cannot.stop.laughing!!!! I would say this is my favorite WCS post – but there are so many hilarious ones, it’s definitely in a tie for first.

    And that pharmacy tech… well bless her heart. (Another Southernism offered through gritted teeth.)

  57. Pam

    This is priceless. As a nurse, and as a health consumer myself with an HMO that sucks eggs, I can relate. I once received 10 thyroid pills instead of 100 and it took 10 minutes to make the pharmacy tech understand that I did not sell 90 of them on the street in the 30 minutes it took me to discover the error and return.

  58. Holly

    Sorry. laughing really, really hard and my (6 yo) son keeping saying, “What’s so funny?” I hope you can get it straightened out.

  59. Shannon

    So, one pro of that all calcium diet you were speaking of? Lots and lots of cheese.

    I am currently fighting with my insurance company over their denial of coverage for my progesterone suppository. Why? They say I am using it for INFERTILITY. (gasp) Um, no, I started using it the second I became pregnant, so that I am able to, you know, continue to be pregnant. Which they should cover (pregnancy). It’s just the getting there that they don’t cover.

    Could your doctor right you a prescription next time for two 50 containers?

  60. Hecticmom

    Seriously – I go to the grocery store to get my drugs. I’m in a relatively large area, but because they aren’t so busy -and the pharmacists get paid well, they are intelligent and they KNOW WHO I AM! (it helps that we are all allergic to everything and we are there every other week.) Find a pharmacy that knows who you are – when you’re meds come in they will know it’s you and always order two.

    Find a place where they know who you are – make friends with them – and they will always have your drugs. (we get a LOT of drugs – trust me on this one.)

  61. dgm

    Hooray for estrogen! See, those pharmacy gals weren’t able to stand up to you because you are twice the woman they are (what with your two bottles and all). Advantage: Mir.

Things I Might Once Have Said

Categories

Quick Retail Therapy

Pin It on Pinterest