Brendan Gates

I bought my Livestrong bracelet in the Summer of 2004, right when they came out. I was caught up in the Lance Armstrong hype with him beating cancer and then triumphantly returning to win cycling’s toughest event. It was an impressive story, and you weren’t cool if you didn’t have one of the yellow bands on your wrist. So I bought one. The smallest one I could find, on account of my child-sized wrists.

Fast forward one year and like many people, I still had the bracelet on. Then something changed in my life. I had been feeling off for a few months, leading up to an episode where I temporarily lost vision in one eye and talked my way into an unscheduled visit with my primary care physician. Based off my pale skin and symptoms of sluggishness, he opted to check me for testicular cancer – pointing to my bracelet and saying “I’m sure you’ve heard of this disease”. That scared me a little bit. I couldn’t have cancer, could I? Later that night he called me with blood work results to insist that I check into a hospital immediately, as my blood counts were universally low. I did that, and woke up the next morning to a new doctor telling me to prepare for a fight with leukemia. That scared me more than anything has ever scared me.

It turns out that I didn’t have leukemia. Further testing revealed that I had (and still have) aplastic anemia. It’s pretty rare, so there aren’t a whole lot of inspirational books written by survivors. Instead, I was given a copy of Lance Armstrong’s book It’s not about the bike: My journey back to life. That book made a real difference for me. It’s right up there behind the care of my doctors and the support from my loved ones, for what I credit with how I was able to deal with the illness.

Almost overnight my bracelet changed from something trendy to something very different. It no longer had anything to do with cycling, or Nike, and had everything to do with me beating my own illness.

Now it’s 2013, and I’ve had the Livestrong bracelet on day and night for eight and a half years. I took it off once just to prove that I could, but other than that it’s been on my wrist every single day. Lance Armstrong is also now a confessed cheater. And his Livestrong foundation has been under attack over the last couple years for what it’s really brought to the fight against cancer.

I don’t care that Lance cheated. And I never really identified with Livestrong as an organization that supported me, since I didn’t have cancer. I don’t doubt that they helped many, many people. But it’s time for me to move on. My illness has been in remission for several years now, and the bracelet is just something that I’ve kept wearing out of habit.

So I’m taking it off. This doesn’t diminish what the bracelet meant to me at one time, nor what Lance Armstrong did for me. I just don’t need to wear it anymore. And if anybody asks, I’m still going to recommend that book.

I don’t seem to have great luck with my pharmacies.

Last fall Walgreens gave me the wrong drugs for a month. I’ve also consistently run into issues with them either not having my full prescription available when I show up, or with the wrong doctor being called to approve my refills. So I decided to go straight to the source, and try mail ordering my drugs from my Pharmacy Benefit Management (PBM) company.

That PBM is Express Scripts. I placed the order via their website on 5/29. It arrived this morning, 49 days later. Is it just me, or is that a really, really bad turnaround? If my book from Amazon takes 49 days to get to me, I’ll probably be pretty annoyed. If my prescription drugs take 49 days to get to me, I could be pretty dead.

So what was the hold up? It wasn’t the shipping. The package shipped UPS Next Day Air from Arizona yesterday and showed up on my doorstep at 10am today. It also isn’t likely to have been my doctor, since I’ve been taking these drugs for 5 years now and getting refill approvals is a routine matter. Walgreens usually has the order ready in 24-48 hours; even when there have been questions or Walgreens had trouble reaching my doctor I never had to wait more than 5 days.

The truth is, I have no idea why it took 49 days for my trunk of pills to arrive. I sent two emails to the Express Scripts Patient Care Team specifically asking what the holdup was, and if I needed to contact my doctor or resubmit the order. Both emails were greeted with apologies and vague bolierplates about possibly needing to get approvals and how my patience was appreciated. They also listed their standard interval, which was that it could take up to 2-3 weeks for the order to reach me. Even that probably padded estimate of 21 days seems way too long to me, but they still missed it by a mile (in this case a mile = 28 days).

Express Scripts is headquartered in my hometown, and I have family and friends who work there, so this rant is certainly not personal. I wanted nothing more than for the transaction to go smoothly. I was going to place the order and have it arrive a week or two later, and I was going to be so happy with the process that I would ditch Walgreens and permanently convert to the masterful mail-order method. Not so much. I guess I’ll try Target next.

If you want to see what 1080 pills look like crammed into a chilled styrofoam trunk, I put pictures up on my Flickr account here.

Walgreens emailed me yesterday to tell me that it would take a few days to fill the prescription I ordered. Actually, I would have loved it if they were that specific. “We’ll let you know… Call the store if you have a problem with that” was the gist of the non-specific note I received.

So I went to the store. Mostly because I wanted to get some cold medicine, but I figured that I could ask the pharmacist when my prescription would be ready while I was there.

While I was in line, I noticed my phone had just buzzed. I didn’t recognize the local number, and I probably couldn’t have answered it fast enough before voicemail picked up anyway. Besides, the pharmacist seemed to be finishing up whatever was keeping him from me.

It was the same pharmacist I always dealt with. Beardy, we’ll call him. He’s a year out of pharmacy school, and he has the bedside manner of a puppy that’s convinced you’re going to punch it in the face at any moment. I explained to Beardy that I had gotten the email, and I wanted to know if I needed to go to the other Walgreens to get my fix. He typed my name into his computer and seemed to wince at what he saw.

Beardy: I just left you a voicemail.
Me: Great! So you beat me to it, I guess…
Beardy: ….
Me: So, do I need to go to the other Walgreens?
Beardy: We gave you the wrong prescription last month.
Me: What?
Beardy: …I sent a fax to your doctor already
Me: Um, okay
Beardy: …and your refill this month will be at no charge.
Me: Great. That $10 co-pay I save will do me a lot of good when I’m dead.
Beardy: [weeps] Please don’t yell at me!

Okay, so I made up the last two lines there. But the rest is for reals. Walgreens gave me the wrong prescription last month. A month, I might add, that proved to be more symptomatic that other months in recent memory. And for my trouble, I get essentially a $10 coupon.

What exactly was the mixup? The prescription I take is cyclosporine, and there are two-formulations of the drug. Modified and Non-modified. I take the modified formulation, which is more bioavailable (i.e. more potent) than the Non-modified formulation. Last month, Beardy and crew gave me the Non-modified version, which effectively cut my dosage strength down. It’s basically the same thing as if I had taken the correct version of the drug, but fewer pills each time.

I didn’t notice the error myself, partially because past prescriptions were all delivered in familiar branded-boxes. Last month’s however, had been removed of packaging and all put into a non-branded orange bottle. The other reason I didn’t notice was because I didn’t want to. The “wrong” pills were smaller and less stinky. It’s too bad I don’t get to keep them.

Anyway. I’m still waiting to find out when I’m going to get my refill, of presumably the correct formulation of my daily drug. CVS Pharmacy, anybody?