What Does My Cholesterol Number Mean?
We received a question from one of our readers: When my total cholesterol, good and bad chol are all within range -can triglycerides by 140? How is it figured out??
My answer:
Hi! These lab results can be really confusing 
A general rule of thumb for most patients to figure out your cholesterol is…
Total Chol = LDL + HDL + (TG/5)
so… if LDL =120
HDL = 40
TG =140
total chol = 188
So, yes, it can happen. Just so you know, TG =140 isn’t a bad reading. Also, even though guidelines say that you do not need to fast for a cholesterol test…trigylcerides can be affected by what you eat before you get the test.
I hope this clears it up a bit for you -if you have any more questions or questions about other lab values -just drop us a line
I Can’t Get Enough Blood for my Glucometer!
Here is a question we received from a woman with diabetes…
I am diabetic and i am not bleeding enough to take my blood sugar had to prick my self 6 times to get enough? I had to prick myself 6 times to get enough blood; blood sugar was 437 why was i not bleeding almost nothing. Please help, Amy
My answer:
There are a few reasons that you are unable to get enough blood.
1. Some people have thicker skin and need to change the setting on the lancet device to go deeper
2. If you test in the same area, something like scar tissue can temporarily make the skin thicker in that area.
3. When you have diabetes, blood circulation decreases to the extremeties (specifically fingertips)
4. When your blood sugar because very high (>350) your body tries to get rid of the extra sugar by peeing it out -which makes you dehydrated and more difficult to bleed for the blood test.
Hints to make it easier:
1. If you are pricking your finger -it can work better to prick slightly to the side of the finger pad instead of in the middle.
2. If you are pricking your finger -rub your fingers/hands together to get the blood flowing
3. In the future you can get a machine that allows testing in alternative places (like arm) instead of just finger testing.
437 as blood sugar…
Drinking water can help flush out some of the extra sugar.
You may want to call your physician about using some short acting insulin to help decrease it now.
If it becomes higher >550, you will need to contact your physician/ER because it can lead to some serious issues like -HHNS (Hyperglycemic hyperosmolar non-ketotic syndrome) which is a fancy name for too much sugar in the blood.
Take care and good luck!
Where can I Find Primatene Mist Inhalers?
Primatene Mist inhalers were the only OTC inhalers left on the market…now they are slowly being taken off the market. This is because since 2006 all CFC (chlorofluorocarbons) inhalers have been taken off the market. This is because CFCs are considered bad for the environment. It has been harder and harder to find pharmacies that carry Primatene Mist inhalers since and now it will be completely impossible to get your hands on one after 12/31/2011.
What to do now? There are no other OTC inhaler options. All other options are prescription only. Most likely, an albuterol inhaler (by prescription) will be the most appropriate alternative. Here are some options to help with paying for the inhalers: Proair assitance program, Proventil coupon, Xopenex coupon and Ventolin assistance program.
HFA inhaler switch: HFA inhalers feel quite different then the old inhalers. The old (CFC) inhalers had a propellent in them so people could “feel” the drug when using it. The new HFA inhalers have a finer mist so often patients complain they can’t taste/feel the medicine going in….be assured, the medicine is still being delivered!
If you think your HFA inhaler is broken -please see the article My HFA Inhaler is Broken
How do you feel about Primatene Mist inhalers being taken off the market? How do you feel about the new HFA inhalers? We would love to hear from you –please leave a comment!
Lipitor is Available in Generic!
It has been a while coming but here it is….Lipitor is available in generic -atorvastatin!!
Atorvastatin is now the strongest generic available. It lowers LDL (bad cholesterol) more then any other generic available. The most used statin medications are simvastatin (generic), Crestor (brand) and Lipitor. If you physician switches you from one of the other statin drugs, expect a change in the strength of the medications. For example, simvastatin 40mg =atorvastatin 20mg and Crestor 5mg =atorvastatin 20mg.
Just a heads up, the price won’t change drastically for at least 6 more months. This is because only one manufacturer releases a generic to begin with. We have to wait for a few manufacturers to come out with the generic to drive down the price. The Lipitor $4 co-pay card can continue to be used at least through 2012…currently Lipitor.com states that it will be usable through 12/31/2012.
Have you used the $4 Lipitor co-pay card? Or generic atorvastatin? Please leave a comment, we would love for you to share your experience!
Treatment for Ingrown Toenails
We received this question recently:
I have an ingrown toenail. It’s hurting less and the top is white. I do not want to go to a doctor. Is this ok? My mom said that I just have to keep cutting it and it will just work itself out. Is there any way I can prevent this in the future?
I don’t think I need to get it dug out. I’m not just saying that, it hurts less. I was wondering, can I do the cotton ball thing with an ingrown toenail? My nail is (i think) in the process of growing out
My answer:
Hi Emma,
In the future, make sure you only cut the toenail straight across and not too short.
Good luck!
P.S. Yes, I think you should try the cotton thing. As long as you can get a piece inbetween the nail and skin…then you can use the piece of cotton!
How to Use Tampons
We received this question from one of our younger members…
When it is time to take the tampon out -it should come out smoothly…if it feels difficult to take out -it may be too early (don’t use too high of an absorbency or try to take out as soon as you put it in). Your period and body fluids coat the tampon and allow it to slide out easily.
As for having the tampon stuck inside -almost 99.9% not going to happen but if you happen to be the .1%, you can use your fingers to remove it (seems weird but quite doable!).
Make sure you do not leave the tampon in too long -you should be changing it about every 4 to 5 hours and make sure you use as low as an absorbency level (regular or teen) as needed.
Take care and GOOD LUCK!
My Period Hurts!
We received this question from one of our younger readers:
I have had really bad belly aches and diarrhea -will this go away when my period stops?
My reply:
Yes, it should go away when your period stops. You can also take some ibuprofen (Advil, Motrin) to help with the diarrhea and bellyache. Please see the article Why Midol? to learn about using Pamprin and Midol.
Your uterus is contracting, trying to push out the menstrual fluid which can be painful (ibuprofen can help).
During your period, your body makes something called prostoglandins which can cause diarrhea. Ibuprofen lessens the prostoglandins and helps get rid of the diarrhea.
Hope this wasn’t too much info!
Take care and feel better!
H. Pylori Treatment
Here is a question we received about H.Pylori:
Hi there! This question is NOT for me but for a friend…She has H. Pylori and this is the 2nd time that she’s had it…She doesn’t want to take the reflux meds because, for some crazy reason, it makes her lose hair…She really wants to know how else she can get rid of it…Also, her report now says that it’s “incidental,” does this mean that it’s not serious?
I was tested for it myself, but never had it (I have digestion problems, but not h. pylori)..
Thanks in advance!
My reply:
H.Pylori is a bacteria that can cause acid reflux (not everyone with reflux has H.Pylori).
It is imporant to treat H.Pylori because right now the reflux might just be annoying but later it can lead to more serious issues.
She can treat H.Pylori without using typical reflux meds (like Prilosec, Nexium, Aciphex…)
It depends on how old she is but she should talk to her doctor about getting the following prescriptions…
1. Flalgyl (metronidazole) 250mg
2. Tetracycline 500mg
3. Pepto-Bismol Chewable
When you take them together four times a day for 14 days they can treat H.pylori. It is the medicine that is in Helidac but it will be cheaper if the doctor writes them seperately.
Hope this helps and saves you some money!
Can I have Diabetes and Anemia?
Here is a question that we were asked by one of our younger subscribers:
Can I have diabetes and anemia at the same time? I already have anemia but my body started changing lately ,I started going to the bathroom a lot ,drinking lots of water ,and I feel really tired all the time! is it possible that I have diabetes? cuz I had anemia since like 4-5 months only but I used to live normally ,and I never drink that much of water in a day ,now I drink like ,7 or 8 bottles in a day !! i used to drink only 4 in a day ,,PLEASE HELP!!
My reply:
Yes it is quite possible to have diabetes and anemia at the same time. Actually people with diabetes have a higher risk of developing anemia.
Your symptoms of excessive thirst and increased tiredness can be due to many different causes- including diabetes. And the other poster is correct -the only way to be diagnosed with diabetes is to see your physician.
However, in your situation…
I am assuming that you have iron-deficiency anemia (because it is the most common type) – increased thirst and fatigue can be due to a worsening of your anemia. Other symptoms would be dizziness, rapid breathing and sweating.
So, my questions are…1) were you diagnosed by your physician with anemia? 2) did you start taking an iron supplement? 3) did you have your iron levels re-tested?
It sounds like you would need to contact your physician’s office or clinic to have your iron levels re-tested. Please be sure to do so because iron deficiency anemia is important to treat.
Please remember that iron levels can be too high -so you do not want to start taking an iron supplement or increase your iron supplement dose without contacting your doctor.
Just a note -it is best to take your iron pill with some soda or orange juice to help it be absorbed better. Avoid milk products within a few hours of taking the iron pill.
Also, if you were tested 4-5 months ago at your doctor’s office, it is unlikely that you developed diabetes within that time -even if you did the symptoms would not be so extreme.
I hope this helps!
Question of the Day
Here are a few questions that have been posted on Question of the Day. As I have said before, I really enjoy this page and all the random and funky questions that get asked -please keep ‘em coming! Leave a comment or question!
You’ve heard it before but it bears repeating – there are no stupid questions. We thought it would be fun to post random questions that we are asked throughout our work days and from this site. So, if you have any random questions J please leave us a comment or send us an email – nova@getpharmacyadvice.com or cate@getpharmacyadvice.com . We will talk about whatever you are interested in!
What ever happened with the inhaled insulin?!
Exubera, the inhaled insulin was taken off the market. It never quite took off because of the issues with correct technique of the patient along with irregular absorption into the lungs. There is a lot of research going on to find a way to deliver insulin without needles!
I heard there are bloodless glucose meters coming out, is that true? (I hope so!)
Perhaps one day, but not yet 
There was one bloodless glucose meter that was close but there were so many issues it is not available. Good news is that there is a lot of research going on with being able to test blood glucose through skin, breath, tears and saliva…but it is going to be awhile.
This question was a comment on the article Do all Diuretics Contain Sulfa?: I have to take Edecrin because I am allergic to all other diuretics but my insurance will not cover it…what can I do?
This is when insurance companies can become super frustrating! The best thing to do, if the insurance co has already said they do not cover it is to:
1) Request letter from your physician about your need for a specific medication and why (with specifics)
2) Contact your insurance company directly on phone, email and letter to request drug to be covered
3) Reach out to your insurance agent and request their help -that is what they are there for
Insurance companies can sometimes be difficult to deal with but the truth is we pay them for coverage. If this is your only option, they should cover it -however to get them to do so can be a long, tedious process.
We received a comment on the article Juice and Allegra: Why was Allegra taken off the market?
I don’t believe Allegra (fexofenadine) was taken off the market since its release. However, Seldane (terfenadine) was taken off the market because it interacted with some drugs to cause irregular heart rythmes (that could possibly lead to death). When Seldane was taken orally it was broken down into an active drug, fexofenadine. Fexofenadine was then released as Allegra. It has all the benefits of Seldane without the negative effects on the heart!
