Detecting Breast Cancer Early

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Performing regular breast self-exams can make all the difference in women’s health.

 

That’s why adult women are often advised to perform a breast self-exam at least once a month.

October is National Breast Cancer Awareness Month. Here’s what you need to know about detecting breast cancer.

The first step you can take is to know how your breasts normally look and feel. These tests may not be perfect, but breast cancer self-exams can help women stay on top of their health by watching for any changes and bringing them to a doctor’s attention.

However, performing a breast self-exam does not take the place of regular mammograms and other screening tests. Because mammography can detect tumors before they can be felt, screening is very important for early detection. And early breast cancer detection has been linked to higher chances of survival. Speak to your doctor about how often you should be screened for breast cancer.

Breast Cancer Signs and Symptoms

The most common symptom of breast cancer is a new lump or mass. A painless, hard mass that has irregular edges is more likely to be cancer. However, breast cancers can be tender, soft or rounded. In some cases, the mass may be painful. Regardless of the specifics of the mass, report any new breast mass, lump, or change to your health care provider to have it evaluated further.

Other possible symptoms of breast cancer include the following:

  • Swelling of all or part of a breast, even if no distinct lump can be felt
  • Skin dimpling that may be similar in appearance to an orange peel
  • Breast or nipple pain
  • Nipple retraction (nipples that turn inward)
  • Redness or thickening of the nipple or breast skin
  • Nipple discharge (other than breast milk)

How to Conduct a Breast Self-Exam

Step 1: Stand in front of a mirror with your shoulders straight and your hands placed firmly on your hips. According to BreastCancer.org, you should check your breasts for changes. Bring any changes — like dimpling or bulging of the skin, nipple changes, redness, rash, swelling and soreness — to your doctor’s attention.

Step 2: Bring your hands together straight above your head. In this position, check your breasts for changes. Also look for any fluid discharge from the nipples.

Step 3: Lie down and put a pillow beneath your right shoulder and your right arm behind your head, the National Breast Cancer Foundation recommends. With the first few fingers of your left hand, make small, circular motions around your right breast and armpit, feeling for lumps. Make sure to use a firm and smooth touch. Keep your fingers flat and together. Repeat for the left breast.

Step 4: Perform another exam while standing in the shower. Check for any lumps or other changes by pressing your breasts and armpits with the pads of your fingers. Cover the entire breast, using the same technique listed in step 3. If you notice any changes, tell your doctor as soon as you can, but don’t panic. According to the National Breast Cancer Foundation, around 8 out of 10 lumps on the breasts are actually not cancerous.

When Is the Best Time to Perform a Breast Self-Exam?

According to Johns Hopkins Medicine, women should perform a breast self-exam around the same time every month. The timing becomes important because breast tissue is affected by the normal hormonal fluctuations in women’s bodies. Performing a self-exam at the same time each month can help women differentiate between a normal change and something that feels different.

For example, women who have not gone through menopause are recommended to perform their breast self-exam toward the end of their menstrual period. The end of the menstrual cycle is the time when the breasts are the least tender and the changes in hormones are less likely to affect the breast tissue. Women who have gone through menopause are recommended to select a day of the month and consistently perform their self-exam on that particular day.

 

 

Citation:
National Breast Cancer Foundation, “Breast Self-Exam”BreastCancer.org, “The Five Steps of a Breast Self-Exam”American Cancer Society, “Breast Cancer Signs and Symptoms”Johns Hopkins Medicine, “Breast Self-Exams”Lee Caplan. Delay in Breast Cancer: Implications for Stage at Diagnosis and Survival. Front Public Health. 2014; 2: 87.

How COVID-19 Is Affecting Flu Season

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Wearing a mask, washing your hands, social distancing and other precautions may be preventing the spread of more than just COVID-19.

 

Cases of the flu appear to be lower this year than in previous years, according to the Centers for Disease Control and Prevention (CDC). And that is likely because of all the precautions the public is taking to prevent COVID-19.

After communities adopted widespread measures to combat the spread of COVID-19, the number of specimens submitted to labs for flu testing went from a positivity rate of more than 20 percent to a rate of just over 2 percent, the CDC reported.

Why? Because many of the same measures used to prevent COVID-19 have the same preventive effect against the flu, health officials said. After all, they are both viruses that attack the respiratory system.

In an article published by the journal Nature, an epidemiologist with the National Center for Immunization and Respiratory Diseases said the flu is less contagious than COVID-19. Health officials expected a decrease in the flu and other respiratory viruses after everyone started social distancing and wearing masks, but the decline in flu cases was sharper than they thought.

The flu vaccine also played a part in reducing flu cases this season, the CDC noted.

“Influenza vaccination of all persons aged ≥6 months remains the best method for influenza prevention and is especially important this season when SARS-CoV-2 and influenza virus might cocirculate,” according to the agency in its Morbidity and Mortality Weekly Report.

The Nature article pointed out that the number of people receiving the flu vaccine in the US has been going up for several years. Last year, more than 50 percent of the US population older than 6 years old got the flu vaccine.

Health experts also pointed out that other viruses seem to have been slowed by pandemic safety measures. For example, respiratory syncytial virus and several viruses tied to the common cold saw steep declines around the world.

What does this mean for future flu seasons? According to the CDC, “Some mitigation measures might have a role in reducing transmission in future influenza seasons.”

Speak with your health care provider about how to protect yourself from COVID-19, the flu and other viruses.

 

Citation: Nature, “How COVID-19 is changing the cold and flu season”
Centers for Disease Control and Prevention, “Decreased Influenza Activity During the COVID-19 Pandemic — United States, Australia, Chile, and South Africa, 2020”

Medicines and Pregnancy: What You Need to Know

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Pregnancy is a very special time in a woman’s life. However, because some medications are safe during pregnancy and others are not, it can also be a confusing time.

 

If you are pregnant and need to take medications, you are not alone. According to the US Food and Drug Administration (FDA), 50 percent of women report taking at least one medication during pregnancy.

Some women have to take medications for diabetes, thyroid issues, high blood pressure, or pregnancy-related issues like morning sickness or constipation. Because not all medications are safe to take during pregnancy, the best thing you can do if you are not sure is ask questions. Ask your pharmacist or obstetrician all the questions you have before you take any medications during pregnancy.

Even supplements labeled as herbal and natural may not be safe to take while pregnant, so ask before you start taking them.

Be sure to ask the following questions:

  1. Will I need to change my medicines if I want to get pregnant?
  2. How might this medicine affect my baby?
  3. Will I need to take more or less of my medicine during pregnancy?

Ask your obstetrician which prenatal vitamins are the best option for you, as well as how much folic acid you need. To find out how much folic acid is necessary to prevent birth defects, check out “Folic Acid and Pregnancy.”

Always read the label on the medication. The warnings will likely include something like, “If you are pregnant, ask a doctor before use.” If you are not sure, it is best to always ask your doctor. And even if you read online that a certain medication is safe, it is always best to confirm with your doctor.

Not all medications are safe to take during pregnancy. For example, nonsteroidal anti-inflammatory drugs (NSAIDs), such as naproxen (Aleve) and ibuprofen (Motrin, Advil), are not recommended during pregnancy.

A few generally safe options are listed below, but you should still ask your health care provider before taking any medication during pregnancy:

  • Allergies: antihistamines like Zyrtec and Claritin
  • Common cold: Tylenol, Vitamin C
  • Congestion: neti pot (use only distilled water), saline nasal spray
  • Headache: Tylenol

Speak with your pharmacist or obstetrician before taking any new medication, herbal supplement or vitamin.

 

Citation: US Food and Drug Administration, “Medicine and Pregnancy”

Cholesterol: What Are Your Numbers?

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Understanding cholesterol is the first step in managing your cholesterol levels.

The best way to know your cholesterol level is to have a fasting blood test known as a lipid panel. A lipid panel examines total cholesterol, LDL (low-density lipoprotein), HDL(high-density lipoprotein) and triglyceride levels. These categories are examined below.

Total cholesterol:

  • A measure of the total amount of cholesterol in your blood
  • Based on the HDL, LDL and triglyceride numbers

LDL cholesterol:

  • Majority of the body’s cholesterol
  • Delivers cholesterol to the body
  • Known as “bad” cholesterol because having high levels can lead to plaque buildup in your arteries

HDL cholesterol:

  • Absorbs cholesterol and carries it back to the liver, where cholesterol is removed from the body
  • Known as “good” cholesterol because having high levels can reduce the risk for heart disease and stroke

Triglycerides:

  • Type of fat found in your blood, which your body uses for energy
  • High levels of triglycerides with low HDL cholesterol or high LDL cholesterol can increase heart attack and stroke risk

To prepare for your lipid panel, you must “fast” (not eat or drink anything) for at least eight hours before the blood test. You can drink water during the fast. Discuss specific fasting requirements with your doctor or laboratory.

To get an idea of what your results might mean, see the chart below:

Total Cholesterol Level Total Cholesterol Category
Less than 200 mg/dL Desirable
200-239 mg/dL Borderline high
240 mg/dL and above High
LDL (“Bad”) Cholesterol Level LDL Cholesterol Category
Less than 100 mg/dL Optimal
100-129 mg/dL Near optimal/above optimal
130-159 mg/dL Borderline high
160-189 mg/dL High
190 mg/dL and above Very high
HDL (“Good”) Cholesterol Level HDL Cholesterol Category
Less than 40 mg/dL A major risk factor for heart disease
40-59 mg/dL The higher, the better
60 mg/dL and higher Protective against heart disease
Triglycerides Triglycerides Category
Less than 150 mg/dL Normal level
150-199 mg/dL Borderline high
200-499 mg/dL High
500 mg/dL or higher Very high

Speak with your health care provider about your numbers and how best to manage your cholesterol.

Stress-Free Summer

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Summer isn’t only about swimming and vacations — it can be a stressful time for many people. If you are stressed this summer, try these five tips.

Stress is part of everyday life. In fact, sometimes it’s normal and not all bad. It can actually motivate people to prepare or perform. For example, stress may boost your performance when you take a test. It can even save lives in some situations.

However, stress can negatively affect your health. It can take a toll on your physical and mental well-being. If stress becomes chronic — meaning it lasts for too long — it starts to affect many systems in your body, such as your immune system. People under chronic stress tend to be more vulnerable to illnesses like the flu or common cold.

Over time, continued strain on your body from routine stress may lead to serious health problems, such as heart disease, high blood pressure and diabetes. Because no one’s life is completely stress-free, it is important to know how to manage stress this summer and all year long.

1) Learn Your Stressors

Learn your triggers, or stressors. Stressors may include family, work and relationships.

If you cannot pinpoint your stress, try writing in a journal when you are feeling stressed and then looking for a pattern. This can help you avoid stressors in the future. For example, if you know a health problem is stressing you out, speak with your health care provider. He or she can help you better manage your health and, as a result, reduce your stress.

By reducing your stress, you are, in turn, helping to prevent the negative toll stress can have on your health — a win-win.

2) Take Care of Your Body

Make sure you are eating well-balanced meals, getting enough sleep and exercising daily. Hunger can worsen stressful situations. Do not skip meals, and always have healthy, energy-boosting snacks on hand. In addition, avoid high-sugar snack foods. Instead, opt for vegetables, lean proteins, fruits and whole grains.

A lack of sleep can also compound stress. Try to get at least seven to eight hours of sleep per night so your body and mind are well-rested. Also, try to limit alcohol and caffeine intake. These substances may aggravate stress or anxiety. Instead, try drinking more water.

Staying active is also an important part of reducing stress. When you exercise, the brain releases chemicals that make you feel good. Did you know dancing and golfing count as exercise? Find something you enjoy and aim for at least 30 minutes on most days of the week. Find an exercise partner to keep you motivated.

Be sure to ask your health care provider before starting an exercise program, as not all exercise programs are safe for everyone.

3) Do Something You Like

When you are feeling stressed, do something you enjoy, such as baking, gardening or dancing. This can help you relax and take your mind off of what’s stressing you out.

4) Relax

Meditation, yoga, tai chi and other gentle exercises are all relaxing activities that can reduce stress. Try to schedule regular times for these activities.

Also, try taking slow, deep breaths or slowly counting to 10. The best part about deep breathing is that you can practice this technique almost anywhere and at any time. To do this, follow these steps:

  • Sit still or lie down. Next, place one hand on your stomach and place your other hand over your heart.
  • Inhale slowly until you feel your stomach rise. Hold your breath for a moment.
  • Exhale slowly. Feel your stomach fall. Repeat.

If this doesn’t help, try taking a quick timeout to meditate or listen to music. Stepping back from problems and performing these relaxation techniques may clear your head.

5) Ask for Help

Stay connected with people you can count on for support. Ask friends and family members for help. Speak with a health care professional like a physician or therapist if you need professional help.

Everyone faces stress occasionally, but it can be managed. For more tips on how to manage stress, speak with your local pharmacist.

Do You Drink Enough Water?

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Are you drinking enough water? Sometimes, it can be hard to tell whether you’re getting enough water to stay healthy.

People tend to forget the health benefits of water, but it’s important to remember that water benefits your body in many ways.

Drinking water gets rid of waste through urination, sweating and bowel movements. Water protects joints and keeps the body’s temperature normal. It also protects the spinal cord and other sensitive tissues in the body.

Drinking too little water can lead to dehydration. Dehydration symptoms include the following:

  • Dizziness
  • Nausea or vomiting
  • Muscle cramps
  • Dry mouth
  • Fast heartbeat

Dehydration can become severe. If you experience the following symptoms of severe dehydration, seek emergency medical attention immediately:

  • Confusion
  • Weakness
  • Loss of consciousness

If your body is dehydrated and can’t cool itself properly, you can experience heat illness. This involves three stages: heat cramps, heat exhaustion and heat stroke.

On average, the recommended daily fluid intake for men is about 15.5 cups (3.7 liters) for men and 11.5 cups (2.7 liters) for women.

However, the recommended daily water intake is different for everyone — water consumption is not one size fits all. Factors like how hot and humid it is outside, how much you exercise, your sweat rate, how active you are and pregnancy will determine how much water you should drink.

That’s why it’s important to speak with your health care provider about the amount of water you should drink every day.

When you’re determining how much water to drink every day, remember that fluids can come from sources other than water. An estimated 20 percent of daily fluid intake actually comes from the foods you eat. In fact, some foods can provide a significant amount of fluid. Some vegetables and fruits, such as watermelon, are almost 100 percent water by weight.

Even if you don’t like the taste of water, there are many ways to get your recommended daily fluid intake. Here are some ideas to increase your intake:

  • Add lemon or cucumber slices to water to make the taste more appealing.
  • Add electrolyte drink mixes to water.
  • Drink flavored sparkling water.
  • Drink low-fat milk, teas or low-sugar juices.
  • Eat fruits and vegetables that contain a lot of water, such as watermelon, spinach and celery.

How to prepare your children for a healthy school year

Summer is more than halfway over, and that means another school year is approaching. How should you prepare your kids for school?

Here are some important health issues to be aware of as you get your children school-ready.

Head Lice

These parasitic insects are mostly found among human hairs. They feed on blood from the scalp. They are highly contagious and spread through head-to-head contact. Classic symptoms include constant scratching of the head that does not subside, small red bumps and a rash. If you notice any of these symptoms, inspect the scalp for any tiny yellow or brown lice eggs or for grayish-white, sesame seed-sized lice.

Talk to your health care provider to come up with a plan to best treat your child and household. Treatment can vary, depending on your child’s age and what you have previously tried.

Before school starts, tell your child to avoid head-to-head contact, not to share personal items that touch the hair, and not to lie on things or places used by someone with lice. Finally, check the school’s return policy, which in most cases only requires one topical treatment before returning to school.

Back Problems

Even with lockers at school, increasing school loads are forcing children to carry heavier bags. If your children’s bags look too heavy, there may be cause for concern.

When carrying heavy shoulder bags, there is uneven weight on the shoulders. While the short-term effects of soreness may be nothing unusual, in the long term, a heavy shoulder bag can contribute to the spine curving sideways, a condition known as scoliosis.

On the other hand, backpacks pull you backward instead of sideways. This can contribute to a condition called kyphosis, also known as a hunchback, due to the effort to hunch forward while carrying the backpack.

Bags should be less than 10 percent of the carrier’s body weight. If a heavier bag is unavoidable, try using larger straps or carrying shoulder bags closer to the body and alternating sides.

Vision Problems

Vision change happens frequently in children and can lead to problems with behavior and attention in the classroom. Because simple vision screenings at school cannot detect the actual health of the eyes, you may want to have your kids take a complete eye exam before school starts.

For sports and outdoor activities, make sure your child wears proper, well-fitting eye protection. Also, teach your child to follow the 20-20-20 rule when using digital devices. This means taking 20-second breaks every 20 minutes and looking at something 20 feet away during the breaks.

Most health insurance policies cover pediatric eye exams. If you notice any vision problems in your child, such as squinting, headaches, holding books close to the face or a short attention span, schedule an appointment with an optometrist.

Stress is part of everyday life. In fact, sometimes it's normal and not all bad. It can actually motivate people to prepare or perform. For example, stress may boost performance when you take a test. It can even be life-saving in some situations.

However, stress can negatively affect your health. It can take a toll on your physical and mental well-being. If stress becomes chronic — meaning it lasts for too long — it starts to affect many systems in your body, such as your immune system. People under chronic stress tend to be more vulnerable to illnesses like the flu or common cold.

Over time, continued strain on your body from routine stress may lead to serious health problems, such as heart disease, high blood pressure and diabetes. Because no one’s life is completely stress-free, it is important to know how to manage stress. Read the following tips to learn how to cope with stress.

1) Focus on Positive Thoughts
One way to manage stress is to change your mindset. Try to maintain a positive attitude by replacing negative thoughts with positive ones. For example, instead of thinking, “I can’t do this,” try thinking, “I will do the best I can.” Try to accept that you cannot control everything. Instead, decide what must get done versus what can wait. Although it may be difficult, learn to say no to new tasks, especially if they will make you feel overwhelmed.

2) Learn Your Stress Triggers
Learn what triggers your stress. Try writing in a journal when you are feeling stressed and then looking for a pattern. This can help you avoid stressors in the future. For example, if you have determined that a health problem is stressing you out, speak with your health care provider. He or she can help you better manage your health and, as a result, reduce your stress. By reducing your stress, you are, in turn, helping to prevent the negative toll stress can have on your health — a win-win.

3) Take Care of Your Body
Make sure you are eating well-balanced meals, getting enough sleep and exercising daily. Hunger can worsen stressful situations. Do not skip meals, and always have healthy, energy-boosting snacks on hand. A lack of sleep can also compound stress. Try to get at least seven to eight hours of sleep per night so your body and mind are well-rested. Also, try to limit alcohol and caffeine intake. These substances may aggravate stress or anxiety. Instead, try drinking more water.

4) Relax
Try a relaxing activity like meditation, yoga, tai chi or another gentle exercise. Try to schedule regular times for these activities. When you feel stressed, try taking slow, deep breaths or slowly counting to 10. If this does not help, try taking a quick timeout to meditate or listen to music. Stepping back from problems and performing these relaxation techniques may clear your head.

5) Ask for Help
Stay connected with people you can count on for support. Ask friends and family members for help. Speak with a health care professional like a physician or therapist if you need professional help.

Everyone faces stress occasionally, but it can be managed. For more tips on how to manage stress, speak with your local pharmacist.

Citation:
National Institute of Mental Health, "5 Things You Should Know About Stress"
Anxiety and Depression Association of America, "Tips to Manage Anxiety and Stress"
American Heart Association, "3 Tips to Manage Stress"
Image Courtesy of Juan Moyano | Dreamstime
 

Three Steps to Dealing with Infertility in New York City

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New York City is a big place with fast-movers, quick-talkers, and a lot of movement. And when it comes to an issue as personal as infertility, sometimes we need someone to slow the pace and have our hands held ever-so-slightly as we make our way through the process. So, here’s our quick guide to dealing with infertility in a city that moves probably way too fast.

  1. Step one: Research. It may seem like an obvious first step in dealing with infertility, but to many, it’s not. You’ll want to do some of your own research to find out why you’re not able to conceive. Get your computer out, talk to fertility experts, etc.
  2. Step two: Seek advice on where to get the best treatment in New York City. You’d be surprised if you open up about the topic how many friends of friends you may know who have dealt with infertility and can share advice. Having someone you know who is familiar with the New York infertility pharmacies and doctors will help you a lot.
  3. Step three: Prepare yourself. There’s always risks associated with infertility treatment and no matter what happens at the end of the tunnel, you should be ready to embrace the results at the of your fertility journey.
  4. Bonus Step: Fertility problems can be one the most difficult medical challenges on an emotional level. Keeping a positive attitude is helpful in getting through the emotional challenges of infertility. Some some that means stepping outside the city to get some fresh air and a more zen state of mind.

New York has dozens of qualified fertility clinics, with some being the best fertility clinics in the world. That doesn’t mean you’re guaranteed a treatment that works, but there is one thing certain every fertility treatments are a major investment financially and emotionally. Always remember that you can only do so much, so prepare yourself emotionally for any chance of unsuccessful fertility treatments that may be coming your way. For some, that means knowing in advance how much you are willing to invest in your fertility journey, and what kinds of treatments you’re willing to do.

Thanks to advances in science we have created a solution to every family out there who can’t have their own family; there’s meditation, In Vitro, surrogacy, and adoption. Each of those processes could be tedious and require extreme patience. If you chose the IVF route, and you’re lucky if on your first treatment, everything goes perfectly. But for some, there are health risks and even more unsuccessful treatments sorting out to adoption.

Don’t rely solely on fertility treatments — you also have to do your part by keeping a good physical and emotional health. Patients who have generally good health and take care of themselves before and after their treatment are more likely to succeed in the treatment. And, obviously, those who don’t take care of their bodies before and after the treatments can’t expect the same results.

A final tip: Reach out and seek support from fertility support groups like:

  • Women’s Infertility Support Group
    Surviving and Thriving with Infertility
    RESOLVE Fertility/ART support group
    Mind/Body for Infertility

Being a part of these kinds of groups will help you along the way of accepting and understanding and maybe this time start figuring out how to live a healthy life, they are the ones who will pave you the way of understanding that there maybe other good healthy options other than trying out the treatment 27 times. It doesn’t hurt to talk about what you are going through to the people who are also going through the same thing.

How Specialty Pharmacy Services in NY Are Changing

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Specialty Pharmacies focus on specialty and rare medications that treat infertility, Chrons disease, HIV, HEP C, and other illnesses. In 2016, pharmacies dispensed about $115 billion in specialty drugs, according to industry expert Adam Fein, PhD, President of Pembroke Consulting, Inc. and CEO of the Drug Channels Institute, a blog that provides analysis of pharmaceutical economics and distribution trends.

And while the specialty pharmacy industry is rising, with some estimates targeted to $240 by the end of 2017, the industry is shrinking, with fewer and fewer specialty pharmacies to chose from outside of the big box chains.

“In New York especially, we’re seeing many specialty pharmacies in NYC disappear,” says owner Ron DelGaudio. “With fewer savings programs from the pharma companies, it’s harder to compete with the big box chains.” In addition, some drug manufacturers are launching specialty drugs with narrow distribution networks, often to fewer than 25 pharmacies. Those pharmacies are usually larger ones, making it increasingly difficult for low-cost pharmacies to compete.

In the past, specialty pharmacies in NY could apply for “loyalty” programs from companies like Merck and Phizer. Now those cost-savings opportunities are also fewer and further between.

Local pharmacies are having to invest more time and money in studying the industry, healthcare trends, pharmaceutical trends, and trends in illnesses, to navigate which medications are most important for to keep on the shelves and reduce operational costs like relocating outside of New York City to the Brooklyn and Bronx areas.

“Over the next years you’ll find fewer fertility pharmacies in NYC,” says DelGaudio. “The box chains will stay, but for special savings, customers will have to look for pharmacies outside of the city.” The other option is mail and central-fill pharmacies, which today account for upwards of 70% of specialty medication fulfillment. That number is increasing yearly. “The difficult thing is that with many of these complex specialty medications, customer care is extremely important — you want to make sure you have a pharmacist who makes sure the drug works alongside your other medications, that you’re storing and handling it correctly, that you’re injecting it correctly — these are services a mail pharmacy will find more difficult to provide,” says Ronda Lopez, a pharmacist at Kings.

Our main focuses are continuing to improve patient care and keep down healthcare costs. Second to that, we’re constantly embracing and re-embracing the shifts in the market. For those of us in the industry we know that specialty drugs are usually all of the three H’s: High Cost, High Complexity, High Touch. We joke that staying afloat in the pharmacy industry requires the same – High Cost, High Complexity, and High Touch.