"Treat the disease, you win some, you lose some. Treat the patient, you always win."
~Patch Adams~

Sunday, September 16, 2012

A cautionary tale-----

Hope everyone has had a great week and is enjoying the second half of the weekend. Very cloudy and gloomy here in NC, it would be a good day to settle in and read or knit. I have far too much to catch up on, however, for that luxury today (including catching up on the blog) so at the end of the day, I am hoping to feel very accomplished!

I sometimes think I am jinxed with compounding pharmacies. I have detailed the multiple issues I have had with both Town Center Pharmacy and Fireside Pharmacy in Palm Desert, CA. Messed up orders, having to ship hormones back to them to get replacements (at my expense) when they are the ones who messed up, and so on. My last prescription of progesterone cream from Town Center Pharmacy was awful, whatever base they used "shredded" all over my arms, and I more than once had to change outfits because the progesterone shards got all over what I was wearing. This time I didn't even bother to contact them; not worth the effort, they have blown me off on more than one occasion and it's not worth getting upset about anymore.

Got my latest batch of progesterone at Greenfield Pharmacy in Vista, CA (Dr. Carr uses them for hormone pellets and has been very satisfied with their quality). I called them on Tuesday, 9/4, inquired about the price for my progesterone, and placed the order (they had to call and get it transferred from Town Center Pharmacy). They promised to call me back as soon as the order was filled and get my credit card number (word of advice, don't leave your credit card number on file with a pharmacy, I learned the hard way after several screw ups!). I hadn't heard from them by Friday, 9/7, so I called and asked if the hormone was ready. The person I spoke with told me "well, it often takes a couple days to compound". If that's true, a couple days would have meant it was ready on Thursday. She put me on hold and when she came back said the pharmacist was working on the prescription right then (uh, huh), got my credit card information and that was it.

The two bottles of progesterone arrived last Thursday in separate envelopes). First of all, the prescriptions were labeled as being filled on 9/5/2012 (Wednesday), so by the time I called the prescriptions had been filled for two days. Why lie about something so easy to catch? Wouldn't it be just easier to say "ooops, I'm so sorry we didn't call you, let's get this taken care of right away!" I'm so sick of the compounding pharmacies lying over stuff that any patient with working brain cells can figure out!
The minute I looked at the label (always, always check your hormones/meds as soon as they arrive or before you leave the pharmacy!) I knew the directions were not written out the way I know Dr. Carr prescribes progesterone, and I quickly went to check what my old bottle of progesterone said (the one from Town Center). That bottle says:

Apply 1 gram (1/4 tsp) four times a day.

In the past, most of the prescriptions have said "...4 times a day to forearms." I've taken the bioidentical progesterone for 6 years, and so I know how to administer the hormone.

The bottle from Greenfield says:

"Apply 1/4 teaspoonsful (sic) 4/days as directed by MD."

This bothers me greatly, because I think these directions could very easily be misinterpreted to make a patient think they only needed to take the progesterone for 4 days, not 4 times a day. Big, big difference. I emailed Dr. Carr to give him a heads up, and he contacted the pharmacy. I intend to write to the pharmacy (they don't have a website that I can locate) and also express my concern.

Bottom line: if you are starting with a new physician, hormone specialist or any other healthcare provider, make absolutely sure you clearly understand how much (also should be noted that there were no measuring spoons with this order of progesterone, and the applicator they sent with the bottle is useless and confusing), how often, and where the medication should be applied. I've seen numerous instances of mix ups in this area----one woman was putting her testosterone on right on top of her progesterone, thus effectively cancelling each other out, another woman had no idea how to open the bottle of progesterone to correcly dose (she was exposing the progesterone to more air than necessary), and a third was way overdosing on testosterone. In every instance (and there are many more I could cite) this was a clear lack of communication somewhere in the triangle of healthcare provider--patient--compounding pharmacy. If what is written on the bottle of hormones/medication does not absolutely, exactly match up with what you were told by the doctor (or what you understood from the doctor)---do not hesitate to call the doctor's office, ask to speak with a pharmacist, or both. This is your health you are dealing with, and worth the effort to check and double check.

On the upside, I tried the new progesterone and the quality seems to be fine, it rubs well into my arms and does not have the shredding issue I had with the batch I used this summer from Town Center Pharmacy. Their response to my conerns about the label instructions will determine my future association with them.


  1. The place I use in Sherman Oaks, CA is Michael's pharmacy. The first time they told me to apply 1/4 tsp of the testosterone when it was 1/8 so I overdosed for the first month causing me to catch up quickly to normal levels. The rest of the time it has been fine and I take progesterone,testosterone and bi-est.. Goes on smoothly and the directions are fine. They even have the two-sided measuring spoon.Unfortunately though most of it cannot work that well if your thyroid is messed up which it turned out mine was. The trial and error is hard but Dr.Carr is on it.Supplements have helped my high blood pressure especially the l-arginine DR.Carr had me take.Still working on it though. Bone density has not been a problem since I have always taken vit.D.Glad I didn't order from Palm Desert..

    1. THanks for the comment! The same woman who had problems using the progesterone and testosterone right on top of one another had exactly the same issue with her first bottle of testosterone, it said 1/4 tsp instead of 1/8 of a tsp.....Town Center in PD messed it up.