Dear Walgreens Specialty Pharmacy

Your “service” stinks and I hate you!

If I take a prescription to my local pharmacy before 8 p.m., the pharmacist orders my meds and I can pick them up the next day. Simple, straightforward, reasonable.

Your pharmacy, Walgreens, is a different story.  After speaking with your representative, I faxed you my prescription on Wednesday afternoon.  You should have phoned me promptly to arrange delivery of my meds. What happened?

  • Wednesday:  nothing
  • Thursday:  nothing
  • Friday:  nothing
  • Weekend: nothing
  • Monday: you contacted my doctor

Why would you contact my doctor on Monday when you were supposed to contact me last Wednesday? Will you be compensating my doctor’s office for the time they must expend in dealing with your ineptitude?

I am only ordering from you because my insurance refuses to pay my local pharmacy, and I can’t afford $3,000 every four weeks.

You should have delivered my medicine by now, but I have nothing. Your service is deplorable.

As far as I am concerned, everyone should avoid Walgreen Specialty Pharmacy, because Walgreens Specialty Pharmacy is difficult to work with and does not fill prescriptions in a timely manner.

Life Goes On

First, a big thank you to the people at Healthline for their kind words, and including ∞ itis in their list of Best Rheumatoid Arthritis Blogs of 2014.  Thanks also to those readers who continue to follow despite my sporadic posting of late.

To those who emailed and asked how I’m doing, well… I’ve been better, but I’m on still on the top side of the grass. Our family has now met our annual $1,500 deductible on two family members.

My shoulders have been bothering me for quite some time (even worse than usual), and then my back joined in. For a while my back was so bad that the muscles would spasm any time I moved. The first time was quite scary, and I wondered if I was having a heart attack. Fortunately, that was not the case.  The pain, however, made getting into and out of bed impossible, so since December I’ve been sleeping in a recliner.  With flexeril and rest the muscles finally stopped spasming, but I still have not been able to sleep in my bed.

Based on my discussion with my rheumatologist’s PA (which is a whole ‘nother rant), I thought the treatment was going to be a referral for PT and a quick steroid taper; then the MD came in and decided that all we needed was spine x-rays. I swear that doctor has ordered more x-rays than I ever thought I’d see in a lifetime.

It doesn’t seem to be asking too much to feel well enough to live my life with some semblance of normalcy. Rheumatologists tend to focus on different things than I do. She’s wondering if what I have is PsA instead of RA (which I have thought from very early on), and recommended a biopsy of my rash.  When I reminded her that the dermatologist said a biopsy isn’t necessary because it’s definitely nummular dermatitis, not psoriasis, she suggested a second opinion.  However, it will not affect my treatment one way or the other; it’s just to satisfy her academic curiosity.

Umm… No.  All procedures have risks.  If she wants to foot the bill to satisfy her curiosity, then we could discuss the risks involved, but I’m not going to take on additional risk and expense when it won’t make any difference in my treatment.

This means that I left the rheumatologists office still feeling crummy, with orders to be irradiated again, and quite frustrated about this entire situation.  My family physician saw me a week later, injected one of my shoulders with kenalog, ordered an x-ray (!) of said shoulder, and wrote a referral to PT.  Interestingly enough, the shoulder injection made my back feel better.  The physical therapist suspects that the back pain is due to compensating for my shoulder issues.

Thanks to PPACA, my insurance is so fussy about PT that there have been numerous complaints filed with the insurance commissioner. I can only have five or six visits, then have to have a new evaluation and wait for them to decide whether or not to approve another handful of visits.  This means that every time a person starts to make progress, they then go two weeks without PT, negating all benefit of the previous visits.

It’s all quite frustrating.  In the past, three or four weeks of PT were all that was needed for me to feel much better — at least enough that I could be released to do exercises on my own at home.  Now, my shoulders hurt worse, and in more places, and the biceps have both started hurting, too (which the PT says it because the biceps are doing work that the rotator cuff muscles should be doing). I’ve even started having trouble with one of my elbows, which makes the PT wonder if something is torn. I really don’t need the expense of an MRI on top of everything else!

Apparently, the fact that I’ve been doing some gardening despite “claiming” that my shoulders hurt is an issue for the insurance company.  It’s not like I’m swimming or rock climbing! I’m making sure that my family will have food to eat!

Despite RA, I still have a life. My two sons still at home played basketball this winter, followed by baseball this spring. Now the high school is gearing up for summer basketball and the baseball coach wants the kids to play $500 summer ball which conflicts with $150 basketball. My younger son is also playing on a year-round select basketball team.  If you think that means I have been driving from one sporting event to the next and wondering if I need to get a job to pay for all this, you’d be right.  Due to these sports, somehow I also ended up in the high school booster club.  Last season there were some decisions made with which I disagreed, so now I’m juggling meetings on top of everything else, trying to have a say in what happens.

And life goes on. I’m still figuring out how to cope, how to do things with the least expenditure of energy (so that I’ll have energy left for fun things like watching my kids’ sports teams), and how to have a full, un-whiney life with RA.

Easy Gardening – Potatoes

Potato PatchWhen growing anything, my ideal plant is one that can be put into the dirt and ignored until I want something from the plant.  When growing vegetables, potatoes are close to perfect.  It can be as easy as putting them in some dirt, then ignoring them until 2-5 months later when you want to eat potatoes.

Many people say that soil should be mounded up around potato plants.  This is called “hilling” and there are tools to make the job easier (which means it’s lots of work).  I’m partial to gardening methods that require the least amount of effort while yielding maximum results.  Carefully hilling extra dirt around my potato plants every week does not fall into the “least amount of work” category.  Fortunately, potatoes are much easier to grow than all the effort required to build a small mountain around every potato plant.

Growing Potatoes
First, realize that not all potato plants grow the same way:

  • determinate – grow in one layer, so there is no point in mounding soil around the plants; usually produce an early crop (70-90 days)
  • indeterminate – can produce multiple layers, so hilling soil around plants can significantly increase the yield; usually produce a late crop (110-135 days)

Early (determinate) potatoes can be sown about 4″ deep in very loose soil.  After the plant emerges, mulching heavily will help inhibit weeds and will protect the potato tubers from being exposed to sunlight.  Sunlight causes potatoes to turn green and toxic, so mulching is important.

Late (indeterminate) potatoes are good candidates for growing in potato towers/boxes.  The best plans I’ve seen for building a potato box are here.  Put soil down and toss in potatoes; cover with 4″ loose dirt.  When the plants are about six inches high, add three inches of soil or straw or hay or dry leaves (potatoes aren’t picky), leaving part of the plant exposed.  As the potato plant grows, continue adding new layers of soil/straw/leaves; new tubers will grow at every level that soil is added. Note that boxes are not necessary for late potatoes; these spuds can be grown in traditional rows, but you use more space to grow fewer potatoes so it makes sense to grow them in towers.

Fingerling potatoes are determinate, regardless of how many days it takes them to mature.

Harvesting
Unlike beans and zucchini that can get too big and tough if not harvested at exactly the right time, potatoes can be ignored.  When the potato plant is done growing, it will die.  Some people say to wait about two weeks for the potato peels to cure.  Others dig potatoes right away and let them cure in a cool, dry place.  The potatoes don’t care, and I refuse to be a slave to my garden (it serves me; I don’t serve it) so I harvest them whenever it’s convenient.

To harvest potatoes grown in a tower, simply unstack the tower and pick up the potatoes.  When you unstack the tower, it might be a good idea to have containers handy for the extra soil.

To harvest potatoes grown in rows, use a pitchfork to dig well out from where the now-dead plant was growing; gently lift the dirt to look for potatoes.

It’s possible to harvest new potatoes from healthy, green plants, just reach beneath the plant and dig around in the dirt.  I like to grab three or four baby (new) potatoes from every plant, leaving plenty to mature.

Soil
Do not waste manure or good, fresh compost on potatoes.  Doing so will produce fantastic looking leaves, but that is not your objective.  Save the compost for lettuce, corn, and other things that grow above ground.

Older soil (not freshly composted/manured) is great for tubers.  It needs to be loose, not compact (no clay).  It also needs to be well-drained.  Potatos will rot if the ground is too wet.

Seed Potatoes
Most potatoes from the grocery store have been chemically treated to inhibit sprouting.  Even if they get old and sprout, they don’t yield a good potato crop.  Visit a nursery and buy “seed potatoes,” which are untreated potatoes that have begun to sprout.  My favorite nursery sells seed potatoes in April (when it’s time to plant); in mid-May, when potatoes are supposed to already be in the ground, the price on seed potatoes drops to 50% off (and there is no problem with planting them late enough to get the price break).

The potato “seed” that is planted is really a sprouted potato.  At least two eyes are needed.  If you have a larger seed potato with many eyes, you can cut the potato into 2″ chunks and plant the chunks separately.  After cutting, let the potatoes sit for a day before planting; this will give the cut edges time to dry and form a seal so that the seed produces a new potato plant instead of rotting.  I prefer to use tiny seed potatoes that can be planted whole; it’s easier than cutting potatoes into chunks and having to wait a day to plant them.  I’m all about easier.

Which Kind to Plant
Choose potato varieties based on what you want to cook.

  • Baked potatoes, mashed, fried:  Choose potatoes with a very high starch content and low moisture content, which makes them ideal for baked and fried potatoes but mushy in potato salad.  These are known as “mealy” potatoes.  These potatoes tend to have a coarse-appearing skin and include Russets, Butte, Rose Gold, and Mountain Rose (to name a few).
  • Soup, potato salad, casseroles, scalloped potatoes:  Choose potatoes with a low starch and high moisture content.  These are perfect for boiling because they don’t absorb much of the cooking liquid.  Low-starch potatoes are known as “waxy.”  The moisture content is too high to make good bakers or fries.  Waxy potatoes tend to have a very smooth skin.  Varieties include Purple Viking, All Blue, Onaway, and Red Norland.

All-purpose potatoes have an in-between moisture and starch content.  Experiment to see which varieties you prefer. Yukon Gold, Peruvian Blue, German Butterball, Yellow Finn, Superior, Kennebec, Red Cloud, Bintje, Elbe, Caribe, and Katahdin are a few of the all-purpose varieties.

The waxy/mealy categories have no correlation whatsoever to whether the potatoes are determinate/indeterminate.  Ideally, a garden would have a few rows of mealy early potatoes, a few rows of waxy early potatoes, and a tower or two each of mealy & waxy late potatoes.  Throw everything in the ground and cover with about 4″ of soil.  About 3-4 weeks later, mulch rows if you haven’t already.  Add soil to towers every 2-3 weeks after that, depending on how quickly your plants grow.  It takes very little work.