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Alto Pharmacy Technician

Alto Pharmacist

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Join us in delivering our industry-leading pharmacy care to millions of people across the country. As a member of the team, you’ll play an integral role in improving our customers’ quality of life and redefining what’s possible in pharmacy.

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With one in ten Americans living with type 1 or type 2 diabetes and more than 88 million adults living with prediabetes, many more people have a connection to diabetes than it may seem. And whether you are living with diabetes yourself or care about someone who is, or if you simply want to know more about diabetes prevention, there’s no shortage of information to learn or actions to take. Thankfully, there are a variety of resources that can help, from online support groups and events to diabetes education programs and advocacy materials. Explore our diabetes resource round-up below to get started.

Diabetes Resource Round-up

With a mission of improving the lives of everyone affected by diabetes, the American Diabetes Association (ADA) is a comprehensive hub for diabetes research, education, advocacy, and support. The national organization also has local offices throughout the U.S. where you can learn about community resources and events.

Beyond Type 1 and Beyond Type 2 are global online communities for individuals living with diabetes, powered by a nonprofit organization (also named Beyond Type 1) that funds a variety of diabetes research and projects.

Focusing on type 1 diabetes, JDRF is a leader in research and advocacy and a destination for type 1 diabetes support and community. Like the ADA, JDRF has many chapters across the U.S. that offer opportunities to connect locally with those affected by type 1 diabetes.

Founded by an endocrinologist living with type 1 diabetes himself, Taking Control of Your Diabetes is a resource hub for individuals and families affected by diabetes as well as medical professionals seeking to stay informed of the latest developments in diabetes care.

ADA engagement platform, with opportunities to take action and raise awareness

Association of Diabetes Care & Education Specialists (ADCES) legislative action center

Beyond Type 1 community table, a monthly conversation series

ADCES diabetes education program directory

JDRF type 1 diabetes daily management page

Getinsulin.org, an insulin access resource

Johnson & Johnson Patient Assistance Program

Lilly Cares Foundation Patient Assistance Program

Novo Nordisk Diabetes Patient Assistance Program

ADA tips on nutrition, fitness, mental health, and more

ADA free type 1 diabetes self-care manual

JDRF type 1 diabetes health insurance guide 

Project Power, the ADA’s free virtual after-school diabetes prevention program for children

ADA summer camps and year-round programming for children with diabetes

ADA resources on school safety and diabetes

With a dedicated diabetes support team, Alto has deep expertise in diabetes management. Our extensive library of diabetes-focused content offers the information you need to manage the condition and live an active life. Here are a few of our top reads:

What’s the Difference between Type 1 and Type 2 Diabetes?

New Diabetes Diagnosis? Here’s What to Know

How to Manage Your Child’s Type 1 Diabetes Diagnosis

We make it simple to manage your diabetes, with free, same-day delivery right to your doorstep, temperature controlled packaging, and automatic savings investigations. And our dedicated diabetes team is here to offer individualized support and walk you through your first insulin doses.

Reach out via text or phone at 1-800-874-5881 or in-app messaging to learn how Alto can be a partner in your diabetes care.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.

To automate a manual, error-prone pharmacy workflow, we turned to event streaming. Here’s what we learned from one of the first Kafka use cases at Alto.

How We Used Kafka to Build an Event-Driven Automation Pipeline and Scale Our Pharmacy

Imagine this: You're at the doctor’s office, and your doctor just wrote you a new prescription. Minutes later, before you even check out with the receptionist, you already have a notification from Alto Pharmacy on your phone that your prescription is ready. All you have to do is pick the date and time that works best for your free courier delivery.

This is the future we’re building at Alto: a future where a prescription can be transcribed, billed, and verified by a pharmacist in five minutes, flat. To get there without dramatically increasing Alto’s head count, we need to automate much of the process, starting with the first step: transcribing, or intaking, a prescription.

As a pharmacy, we receive prescriptions in many different forms. Some are sent electronically, in a structured format, but others are handwritten, phoned in, or even faxed. To represent all of these forms in a single table, we previously required every incoming prescription to be transcribed by an Alto team member, who would answer questions like:

Whom is this prescription for? Is this customer already in our system?

Where did this prescription come from? Who wrote it?

What is the relevant prescription information (medication to dispense, quantity, days supply, directions, etc.)?

This manual process is both time-consuming and prone to human error, which, if uncaught, could impact our ability to process the prescription downstream. Furthermore, at our busiest times, it could take up to two hours for a team member to get through the pending intake queue — unacceptable if we hope to have prescriptions ready to schedule before people even leave their doctor’s office. 

Automating intake required close collaboration between three teams:

Data Science, who built the decision-making algorithms 

Data Engineering, who served up the results of those algorithms

Product Engineering, who used those results to automatically intake prescriptions 

To allow the teams to operate in parallel without toe-stepping — and in the language most suitable for each (the Data Science and Data teams prefer Python, while product engineers work mainly in Ruby) — we separated the code into two environments: 

1. Data Prod Interface (DPI), where the code for generating automation results lives

2. Wunderbar (our proprietary pharmacy operations platform), where the code for requesting and using those automation results lives

The key question: to establish robust communication between these two environments, should we use an API-based approach, or an event-driven one? Each has its pros and cons. 

Legacy approach everyone at Alto is familiar with

Existing enforcement of strong types and data

Difficult to scale with increased data & requests

Requires ongoing authorization / authentication

Infrastructure relevant to other business areas

Automatic retries, reprocessing, and queueing

Our existing infrastructure currently utilizes a hefty API-based structure, so there was a natural tendency to go down this path, but we knew that beginning to migrate services towards an event-based architecture with Kafka at its heart would help us in the long term.

Kafka is a framework implementation developed by LinkedIn, now open-source with the Apache Software Foundation. It aims to provide a unified, high-throughput, and low-latency platform for handling real-time data feeds. 

Alto uses Amazon Web Services as our cloud provider, and luckily, they offer an out-of-the-box managed solution for Kafka, MSK. To configure Kafka with our system, our infrastructure team worked with AWS to set up managed instances to comply with our business requirements. Our Infrastructure team will share more details about this work in an upcoming blog post. 

Kafka offers many benefits. The asynchronous nature of the message system allows for retries, reprocessing, and queueing as well as easy recovery from outages. In addition, the infrastructure work done for setting up the managed cluster would be a one-off workstream. When complete, we’d be able to re-use the same setup and configurations across various business needs to streamline other projects that leverage Kafka. 

Setting up for success: defining a strict contract

One element we had to get right from the start was the data contract. As we send messages between DPI and Wunderbar, we need to ensure messages are produced with the correct schema, so that downstream consumers know what to expect.

Protocol Buffers, or Protos, is an open-source, cross-platform data format used to serialize structured data. Developed by Google, Protos allow you to define how you structure your data once and then use generated code to easily write and read the structured data in a variety of different languages. 

At Alto, we’ve been using Protos for the past few years to speed up development with auto-generated code and ensure data continuity between our Ruby on Rails backend and JavaScript / React / React Native frontend. Protos may seem antithetical to JavaScript and Ruby since they’re both dynamically typed languages, but in practice, they have saved us countless hours of debugging and back-and-forth Slack messages. 

For this project, we turned again to Protos to define the schema for messages produced by DPI and Wunderbar. We defined IntakeAutomationRequest and IntakeAutomationResult messages in Go and generated the types (Sorbet, Flow, etc.), which both DPI and Wunderbar now refer to when producing or consuming messages.

Because Wunderbar is already configured to run on AWS and houses our existing intake logic, it was easy enough to send a prescription to DPI for automation. Where we would normally create a task for an operations team member to manually transcribe the prescription, we instead produce a message to our “request automation” Kafka topic using the ruby-kafka library.

Our consumer, instantiated in an executable that runs on a dedicated worker, consumes messages from a “receive automation” Kafka topic. First, the consumer verifies that a given message corresponds to a prescription we previously sent to DPI. Then, it persists any automation results included in that message. If the automation results are sufficient, we skip intake altogether. Otherwise, we create an intake task to be handled by an operations team member.

Because this project was among our early use cases for Kafka, we wanted to be prepared for the worst-case scenario: we produce a message requesting automation results, and for whatever reason—maybe DPI is down—we don’t hear back. For us, we defined a reasonable time frame as fifteen minutes, in order to avoid building up a large backlog of work that would have to be offloaded back onto our operations team.
To this end, we store metadata about the automation lifecycle in an intake_automation_results table, which includes timestamps representing when we sent a message to DPI and when we received a response back. A cron job runs every minute to check that table for rows where received_at is blank, and sent_at was more than fifteen minutes ago. If this occurs, we flag the prescription to be manually intaken by an operations team member.

The diagram below illustrates our intake automation architecture.

Intake automation is now live at Alto. We’re seeing prescriptions fly through in just a few minutes — during which time our automation creates a user profile if one doesn’t already exist, links the new prescription to that profile, and finds and bills the user’s insurance; a pharmacist reviews the prescription for clinical accuracy; and the user receives a text message to schedule their delivery. This single flow, prior to intake automation, once took up to four hours to complete!

Going from zero to one is quite a feat, and it wouldn’t have been possible without an event-based approach. Now that intake automation has laid the groundwork, we know that Kafka will only continue to provide exponential value to Alto as we grow and migrate more of our services to this event-based architecture. 

Interested in learning more about engineering at Alto? Follow us on LinkedIn.

Inhalers and nebulizers are both effective at delivering medications for respiratory conditions like asthma and chronic obstructive pulmonary disease (COPD). A nebulizer is a device that transforms a liquid medication into a fine mist which is then inhaled into the lungs through a mouthpiece. While nebulizers take longer to deliver medications than inhalers, their accurate dosage delivery is often a good fit for children living with asthma and other lung diseases, and many adults find them helpful as well. Here’s what to know if you’re considering using a nebulizer.

What to Know About Nebulizers

Three types of nebulizers can be used to treat asthma, COPD, and other lung diseases like pulmonary fibrosis.

Jet nebulizers transform liquid medication into an aerosol or fine mist using an air compressor. They are the most common type of nebulizer.

Mesh nebulizers use a fine mesh to create an aerosol from the liquid medication. They are the newest type of nebulizer and emit the smallest particles.

Ultrasonic nebulizers create an aerosol through high-frequency vibrations. They are typically used in hospitals or at doctors’ offices.

There are different models of nebulizers, including portable, battery-run nebulizers that can be taken with you on the go and larger tabletop nebulizers that require an electrical outlet. These devices can deliver a variety of medications, including quick-relief medications that treat acute symptoms of lung diseases as well as longer-term maintenance medications. They may even be used to deliver more than one medication at once.

Your healthcare provider can advise you on the best method of medication delivery for your individual treatment plan. As you explore your options, be mindful of the key differences between nebulizers and inhalers.

Inhalers deliver medication quickly, but they require enough coordination to inhale and spray the medication at the same time. Some individuals, particularly young children, may find it challenging to properly use an inhaler. This can result in not receiving the full dose of medication.

To receive a dose of medication from a nebulizer, all that’s required is to breathe normally. However, nebulizers will take at least five to ten minutes to fully deliver the medication. You may want to ask your doctor which type of device they recommend for treating acute symptoms during an asthma attack or COPD flare-up.

If you and your doctor have decided that a nebulizer is a good fit for your needs, learning about proper use and cleaning of the device is a key part of managing your health. It will also ensure that you are taking your medication as prescribed. Be sure to follow your doctor’s instructions and review the manufacturer’s instructions for your nebulizer before using it for the first time, as there is some variation among these devices.

All nebulizers have a medicine cup, a mask and/or mouthpiece, an air compressor, and plastic tubing to connect the compressor to the medicine cup. Always wash and dry your hands before using your nebulizer and make sure that all the pieces of your nebulizer are clean. Pour the correct dose of your medication into the medicine cup and connect the tubing to the air compressor and medicine cup. Turn on your nebulizer and ensure that it’s properly working. You should see a fine mist coming from the mask or mouthpiece.

Once you see a mist appear, your nebulizer is ready for use. To inhale your medication, secure the mask over your nose and mouth or put the mouthpiece in your mouth. Sit upright and breathe normally. Taking slower breaths can help the medication enter your airways. Continue to breathe normally until the medication is gone from the cup.

Bacteria and other germs can grow inside of a nebulizer that has not been properly cleaned, so it’s important to clean your device after every use and disinfect it once a week.

After you’ve finished using your nebulizer, wash the mouthpiece or mask and the medicine cup in warm soapy water and let them air dry. For weekly disinfecting, soak these pieces in a vinegar solution for 30 to 60 minutes, or for the amount of time specified by your doctor or in the manufacturer’s instructions. Your doctor may provide you with a disinfectant solution, but if not, you can mix one part white vinegar with three parts hot water. After the pieces are done soaking, let them air dry. Put these pieces in a plastic container or bag and store it in a cool, dry place.

As part of nebulizer maintenance, you should replace the plastic tubing on a regular basis. Ask your healthcare provider how often to replace the tubing.

When deciding whether a nebulizer is a good fit for your needs, be sure to consider your health insurance benefits. Most insurance plans have separate medical and pharmacy benefits in addition to a Durable Medical Equipment (DME) section. Many nebulizers fall under the DME category of your policy. There may be restrictions on the brands, suppliers, or types of nebulizers that are available, and it’s important to check with your specific policy to understand what will be covered and under which sections.

Alto makes it easy to stay on top of your asthma or COPD treatment, with free hand-delivery, automatic savings investigations, and easy medication management tools through our website and app. And our team of pharmacists is always here to answer your questions by phone, text, or chat. Reach out via text or phone at 1-800-874-5881, or in-app messaging.

Inhalers and nebulizers are both effective at delivering medications for respiratory conditions like asthma and chronic obstructive pulmonary disease (COPD).

Whether traveling domestically or abroad, arriving at your destination with the medication you need is rarely as simple as packing it in your suitcase. From TSA compliance to temperature control, there are many factors to consider when traveling with medication — not to mention getting enough of a supply for the whole trip (plus extra, just in case).

Managing Your Medications While Traveling

Planning is key to managing your prescriptions and staying on top of your health needs while you’re away from home. Follow these tips to prepare for your next trip.

Research your destination’s medication laws

Many medications that are legal in the U.S. aren’t allowed in other countries. And it’s not only prescription medications: even over-the-counter treatment options may not be permitted in some destinations.

To avoid any unwelcome surprises while going through customs — or any missed doses — confirm that your medications are legal in the country you’re visiting. As a starting point, check with that country’s U.S. embassy. Consider that some countries may only allow a 30-day supply for certain medications and/or require you to carry an official prescription or additional information from your doctor with you. If you learn that your medication is not allowed at your destination, contact your healthcare provider to discuss your options.

There are legal considerations to be aware of even if you are traveling within the U.S. For example, you may be able to fill certain prescriptions out of state if you lose your medication or forget to order a refill before your trip, but the laws vary by state and there are often restrictions on controlled substances. Do your research in advance and make sure to prepare for any scenario.

Make sure you have enough of your medication

Unforeseen changes can happen when traveling, so it’s important to have more than enough medication on hand. Aim for an additional week or two’s supply. Allow yourself plenty of time to fill your prescription(s) before your trip. Depending on when you are due for a refill, you may need to request an early refill authorization from your insurance company — sometimes referred to as a vacation override — in order to get your medication in advance. (Alto can help with this!) 

In addition, make sure you’re prepared in the event that you misplace your medication during your trip. Write down the generic names of your medications, which may be more commonly available at pharmacies in other countries.

Lost luggage can be more than an inconvenience if your medication is in your checked bag, so always pack any important medications in your carry-on. This does mean you’ll have to be mindful of security requirements, particularly if carrying liquid medication. The U.S. Transportation Security Administration (TSA)’s current limit on liquids, gels, and creams in a carry-on bag is 3.4 ounces (100 milliliters), but there are exceptions for liquid medications. For the easiest travel experience, inform the TSA officer that you are carrying more than 3.4 ounces of liquid medication before your screening process begins, and be aware that additional screening of your medication may be required.

Keep your medications in their original packaging to avoid any issues when passing through security or customs. You may want to bring an official prescription or other documentation of your medical condition as an additional precaution, especially if you take a controlled substance or are traveling abroad.

Many medications lose their effectiveness if held at extreme temperatures, which is another reason to put your medication in your carry-on, as a plane’s luggage compartment can be very cold. If you take a medication that requires refrigeration like insulin, make sure you have what you need to hold your medication at an appropriate temperature.

Many people with diabetes use insulated medication bags to refrigerate insulin when traveling. Read ‘How to Prepare a Diabetes Emergency Kit’ for more information on the diabetes essentials to bring on a trip.

If you’re traveling far from home, anticipate how time zone changes may impact your medication schedule. Before your trip, ask your doctor how to handle the time zone shift and what to do if you accidentally miss a dose — some medications have more flexible timing of doses than others. 

Getting a last-minute refill before a trip is low stress with a flexible pharmacy partner like Alto. We offer free same-day delivery seven days a week, with the convenience of choosing the best delivery window for your schedule. And we’ll work with your doctor, your insurance (if applicable), and any third party savings programs that you may qualify for to ensure your medications are as affordable as possible

Reach out any time via text or phone at 1-800-874-5881, or in-app messaging.

Since certain types of cancer treatments and procedures can temporarily or permanently impact both male and female fertility, it’s important to have a discussion about fertility with your oncologist as soon as possible. Read on to learn more about fertility preservation options and financial resources for those recently diagnosed with cancer.

Fertility Preservation Options After a Cancer Diagnosis

A cancer diagnosis can bring much uncertainty. If you are considering having children in the future, you may be wondering how your options for cancer treatment will affect your reproductive health. Fertility preservation treatments like egg or sperm freezing can bring peace of mind during this potentially overwhelming time, allowing you to leave open the possibility of starting a family after cancer treatment.

There are several ways that cancer treatments can affect your fertility, including the following:

Surgery to treat cancer of a reproductive organ — such as in the prostate, testes, ovaries, or cervix — may lead to infertility.

Chemotherapy-induced changes in hormone levels can lead to early menopause for women and decrease sperm production in men.

Radiation therapy near the reproductive organs, abdomen, pelvis, or spine may damage eggs or sperm cells depending on the dose and level of radiation.

Hormone therapy used in the treatment of breast cancer and other types of cancer may affect fertility, though these effects are often temporary.

The extent to which these cancer treatments may impact your fertility depends on your personal health history — including your age and baseline fertility — and the duration and dosage of treatment. Your care team can provide a clearer sense of what to expect based on your health and treatment plan.

Many individuals of reproductive age choose to freeze their sperm or eggs for future use before beginning cancer treatment.

Sperm freezing is a fairly simple process in which a person’s sperm is collected, analyzed by a doctor, and, if viable, frozen in vials with cryoprotectant agents and stored for future use.

In the egg freezing process, fertility medications stimulate egg production and maturity. The eggs are retrieved in a minimally invasive procedure and then frozen and stored for future use. There is also the option of freezing embryos, which are eggs that have been fertilized with sperm.

There are several ways that you can use your frozen sperm, eggs, or embryos to have children biologically in the future after cancer treatment. Intrauterine insemination (IUI) is a process that allows you to use your frozen sperm and have it placed into your partner’s or a surrogate’s uterus.

In vitro fertilization (IVF) is a process in which eggs and sperm are fertilized and then placed into the uterus with the potential outcome of a pregnancy. Women who have previously undergone cancer treatment might use this process to have their frozen eggs or embryos implanted into their own uterus. If using eggs rather than embryos, there will be the additional step of fertilizing the eggs with a partner or donor’s sperm. If you had a hysterectomy to remove all or part of your uterus during cancer treatment, you can have your embryos implanted into a gestational carrier’s uterus.

Given the urgency of cancer treatment and the important timing of fertility medications during an egg freezing cycle, you will likely have to make quick decisions about fertility preservation, often within a few days of receiving a diagnosis. Your oncologist may refer you to a fertility specialist called a reproductive endocrinologist who can answer questions about cancer treatment and fertility and help you understand your fertility preservation options. It isn’t uncommon to begin taking fertility medications the same day as your consultation with a reproductive endocrinologist. 

If your oncology team does not know that fertility preservation is a priority for you, do not be afraid to take the initiative in starting the conversation. Be sure to get clarity on how moving forward with the fertility preservation process might impact the timing of your cancer treatment and what your oncologist recommends. Depending on your treatment plan, you may also want to ask about radiation shielding, which can be used during cancer treatment to protect the ovaries or testicles and limit how much radiation they are exposed to.

It’s important to take the financial aspects of fertility preservation treatments into account when planning for the future. While these treatments are significant financial investments, there are resources that can alleviate some of the costs of treatment, including programs designed specifically for those in cancer treatment and survivors.

If Alto is your fertility pharmacy, your fertility medication protocol likely includes medications manufactured by EMD Serono or Ferring Pharmaceuticals. Both companies offer financial assistance for individuals whose fertility has been affected by cancer treatment.

EMD Serono donates fertility medications to eligible cancer survivors diagnosed during their reproductive years through the Livestrong Fertility Discount program. Start the application process on Livestrong’s website to learn if you are eligible.

Ferring Pharmaceuticals provides some fertility medications at no cost for individuals pursuing fertility preservation before cancer treatment. To be eligible, you must be a female U.S. citizen or permanent resident with a cancer diagnosis who has not received chemotherapy within the previous six months. To apply, learn more about Ferring’s Heartbeat program online, or call 1-888-347-3415. (Residents of Arkansas, Massachusetts, or New Jersey can call 1-877-252-0553.)

Read our previous post on financial planning for egg freezing.

A fertility pharmacy partner you can rely on

Since 2016, Alto has supported more than 50,000 fertility journeys. We understand that fertility treatment is a significant investment — physically, emotionally, and financially — and we see ourselves as a partner in your health.

We offer free, same-day delivery seven days a week and temperature controlled packaging to ensure that your fertility medications always arrive in the right condition. And our fertility-trained pharmacists are available until 9 pm PST (12 midnight EST) on weeknights to offer any support you need.

Reach out via text or phone at 1-800-874-5881 or in-app messaging to learn more. You can also request a price quote online.

When inflammation persists, it no longer serves a helpful purpose. This type of inflammation, also referred to as chronic inflammation, occurs when your body consistently acts like it’s under attack, releasing white blood cells indefinitely. In the long term, an elevated white blood cell count can affect other organs such as your heart, lungs, and kidneys. Research has also found a connection between chronic inflammation and other chronic diseases including heart disease, diabetes, cancer, Alzheimer’s disease and Crohn’s disease.

Inflammation, Explained

Acute inflammation is the body’s natural way of fighting infections and injuries as part of the healing process. When you have an injury, blood flow increases as your body instinctively releases white blood cells, proteins, and other inflammatory chemicals to protect the wounded area. This leads to redness, swelling, and pain at the site of injury. The body reacts similarly when you have a virus or cold, but in these instances, the blood cells and inflammatory chemicals are released throughout the whole body rather than to one spot. This type of inflammation is good for you, as it allows your body to heal.

But when inflammation persists, it no longer serves a helpful purpose. This type of inflammation, also referred to as chronic inflammation, occurs when your body consistently acts like it’s under attack, releasing white blood cells indefinitely. In the long term, an elevated white blood cell count can affect other organs such as your heart, lungs, and kidneys. Research has also found a connection between chronic inflammation and other chronic diseases including heart disease, diabetes, cancer, Alzheimer’s disease and Crohn’s disease.

Read on for more information about the causes and symptoms of chronic inflammation and how to prevent or treat it.

Causes and symptoms of chronic inflammation

Several known factors can trigger chronic inflammation:

Lifestyle factors including obesity, diet, smoking, alcohol use, stress, and sleep disorders

Autoimmune diseases like type 1 diabetes or lupus, in which the body mistakenly attacks itself

Long-term exposure to pollution, industrial chemicals, or other toxins

Some individuals with this type of inflammation experience fatigue, fever, and joint and muscle pain. However, while there are clear physical signs of acute inflammation, chronic inflammation does not always have visible symptoms.

Your doctor can help determine if you have chronic inflammation. They will likely ask about your symptoms and perform a physical exam as a first step. They may then order additional tests to detect inflammation. These tests look for various indications of inflammation in your body, but they cannot formally diagnose inflammation or any other health condition. Rather, they provide a more comprehensive picture of your health so that your doctor can recommend the best next steps.

Potential tests your doctor may recommend during this process include a C-reactive protein (CRP) test and/or an erythrocyte sedimentation rate (ESR) test. A CRP test identifies your blood levels of CRP, a protein produced in your liver. Chronic and acute inflammation have both been linked to high levels of CRP.

An ESR test examines how quickly your red blood cells sink to the bottom of a test tube, with higher rates of settlement pointing toward more inflammation. Doctors often recommend this test when there is a possibility of high inflammation.

Sometimes these tests may help your doctor diagnose an inflammation-linked condition, such as rheumatoid arthritis or type 2 diabetes.

Chronic inflammation and other health conditions

There is a connection between chronic inflammation and many other health conditions. Inflammation can occur directly as the result of rheumatoid arthritis, which is both an autoimmune condition and an inflammatory disease. If you have rheumatoid arthritis, your immune system attacks your joints — often in your hands, writs, and knees — which leads to inflammation. There is also a direct link between inflammation and other inflammatory diseases, like ulcerative colitis and Crohn’s disease.

Inflammation has also been linked to heart disease and diabetes, but research into this connection is ongoing. While inflammation is more common in individuals with these health conditions, there is not yet definitive evidence that inflammation by itself directly increases your risk for these conditions.

Inflammation in the walls of your blood vessels has been linked to atherosclerosis, the accumulation of fats, cholesterol, and other substances in your arteries. In the long term, atherosclerosis increases your risk for a heart attack or stroke.

Since obesity, smoking, and physical activity are all risk factors for inflammation, heart disease, and diabetes, the overlap of these risk factors likely plays a role in the connection between the conditions. The good news is that a single healthy choice can lower your risk for all three diseases at once.

Your healthcare provider will recommend treatment based on the type of inflammation you have, however not all cases of chronic inflammation require medication.

Two types of medications are commonly used to lower both acute and chronic inflammation: nonsteroidal anti-inflammatory drugs (NSAIDs) including ibuprofen (Advil®), aspirin (Bayer®) or naproxen (Aleve®) and oral steroids including prednisone (Deltasone®, Prednicot®), methylprednisolone (Medrol®), and dexamethasone (Decadron®, Dexasone®). Steroid injections can reduce inflammation in a specific joint or muscle and are often used to treat rheumatoid arthritis.

If you have an inflammatory disease, your doctor may recommend medications specifically used to treat that disease. Medication classes commonly used to treat inflammatory diseases include:

Disease-modifying anti-rheumatic drugs (DMARDs) like methotrexate (Rheumatrex®), sulfasalazine (Azulfidine®), and leflunomide (Arava®). These medications can slow the progression of rheumatoid arthritis.

Statins, a type of medication commonly used to treat high cholesterol. They have anti-inflammatory effects and can lower CRP levels.

You can also fight inflammation simply by what you eat. An anti-inflammatory diet includes antioxidant-rich foods like the following: 

Cherries, blueberries, oranges, and other fruits

There are also some foods that have been linked to higher levels of inflammation. If you have chronic inflammation, your doctor may suggest limiting your intake of the foods below as part of your treatment plan:

White bread, pasta, pastries, and other refined carbohydrates

Soda, fruit juices with added sugar, energy drinks, and other beverages high in sugar

Red meat and processed meat like hot dogs and sausage

At Alto, we’re committed to making it as simple as possible to prioritize your health and well-being and stay on top of your medications.  We will work with your doctor, your insurance (if applicable), and any third party savings programs that you may qualify for to ensure your medications are as affordable as possible. And our team of pharmacists is available to chat whenever questions come up about side effects or how to take your medication properly.

Reach out via text or phone at 1-800-874-5881 or in-app messaging.

All third party trademarks (including logos and icons) referenced by Alto Pharmacy remain the property of their respective owners. Unless specifically identified as such, Alto’s use of third party trademarks does not indicate any relationship, sponsorship or endorsement between Alto and the owners of these trademarks.

Working from home offers many benefits. The lack of commute to and from the office can mean more quality time with family, mid-day workouts, or a load of laundry over lunch. And with fewer distractions, the environment of a home office is a productivity boost for certain work styles.

How to Say Healthy While Working From Home

At the same time, some individuals may find it more difficult to concentrate outside of a physical office, and remote work can also impact your mental health. In a recent public opinion poll conducted by the American Psychiatric Association (APA), nearly two-thirds of the respondents reported feeling isolated or lonely at least sometimes as a result of working from home, while 17% said that they experience isolation and loneliness all the time. And a majority of the respondents who partially work from home said that they find it difficult to step away from work at the end of the day.

With remote work on the rise — the number of U.S. adults who work from home increased from 22% to 42% between 2019 and 2020 — it is important to prioritize your mental and physical well-being and create boundaries between work and social life. Here are steps you can take to stay sane and healthy while working from home.

A physical office space naturally incorporates structure into your day. Simply sitting down at your desk and seeing colleagues allows you to mentally shift into work mode. This is important for not only productivity, but also for work-life balance — just as you are able to jump right into your to-do list once you enter the office, the clear boundary between work and home means you’re less likely to revisit that list once the day is over. Plus, watching a coworker take a break may be a much needed reminder that it’s time to grab lunch or get some fresh air.

There are several ways to give yourself structure while working from home. First, mimic the experience of going to work. It may be tempting to stay in pajamas and check emails from bed, but many remote employees find it easier to concentrate — and to leave work behind at the end of the day — by creating a morning routine and using a designated workspace that’s not in your bedroom.

In addition, having a clear plan for the day can boost both productivity and mental health, as you will have carved out time for high-priority tasks and breaks. For some individuals, planning the day the night before makes it easier to jump into work the next morning, so consider incorporating this into your end of day routine if you find it helpful. There are a variety of ways to lay out what needs accomplishing, from organizing your day entirely on a calendar to using a task management tool. Increasing focus and productivity while working from home is all about finding the system that’s right for you.

It’s just as important to consider your personal preferences and work habits when planning breaks. The frequency of your breaks should correlate to how long you can maintain a state of deep focus. Taking breaks every 75 to 90 minutes may be realistic for some individuals, but others may find shorter bursts of work more helpful. The pomodoro method has become a common approach to time management. You will focus on a single task for 25 minutes then take a five minute break, repeating the pattern three more times before taking a 15 minute break.

Whichever system you choose for breaks, remember to use some of that time for physical activity. Exercise affects both your physical and mental health and may help reduce some of the stress and isolation that often comes with remote work.

Having a designated workspace can help you create boundaries between work and social life. Working from home can contribute to burnout, and using your bedroom as the office can often lead to a workday that stretches well past eight hours. If you can, make a workspace in another room. If you don’t have space to use as a designated home office, try the kitchen table or living room.

In addition to supporting your mental health, working in a space that’s set aside for work can help minimize distractions and maximize productivity, particularly if you live with family members or roommates. Young children or anyone who’s never worked from home themselves may not know to avoid interrupting you during your workday. You can set boundaries by informing everyone at home of your working hours and communicating your expectations.

The design of your workspace can also impact your emotional well-being and physiological health. Exposure to sunlight is linked to higher levels of serotonin, a hormone believed to regulate your mood and lower anxiety. If possible, use a workspace that gets a lot of natural light, and use part of your break time to soak up some sun. Add some greenery to your home office too — research has found that having plants nearby as you work can increase productivity.

Maintaining good posture while you work can prevent tightness in your neck or back pain. If working while seated, keep your feet flat on the ground beneath your knees. Avoid working from a chair that’s too tall and prevents your feet from reaching the ground. If you can, use an ergonomic office chair or a standing desk, which offers many health benefits. If using an office chair, remember that each person’s physiological needs are different, so take time searching for the right fit.

The repetitive motion of typing in a seated position has been linked to carpal tunnel syndrome — numbness and tingling in your hand, wrist, and/or arm caused by pressure on your median nerve. A hunched posture can put strain on your wrists and hands, so using an ergonomic chair or standing desk is already a step toward preventing carpal tunnel syndrome. Be mindful of your arm and wrist position as well. Work with your elbows bent by your side and keep your forearms stretched out in front of you parallel to the floor. Using an external computer monitor or keyboard can make it easier to maintain this position.

Working in silence by yourself can lead to greater concentration and productivity in some cases, but too much isolation and loneliness affects your mental health. An office environment allows for natural socialization and conversation throughout the day, and recreating this experience at home requires a bit more intention.

If you work on a team, use workplace messaging tools to maintain connections with coworkers. Take the initiative in setting up virtual or in-person events like happy hours. And if you’re located in the same area as your colleagues, schedule a coworking session in a local coffee shop. Remote work is also a great opportunity to expand your professional network by joining a coworking space.

It’s important to maintain other social connections, too. Schedule after-work plans with friends and family, and don’t forget to pause notifications and sign off for the day.

Let Alto support your health and wellness

Practicing good self-care while working from home involves prioritizing your physical health. Alto is here to support you with exceptional pharmacy care at every step of the way. We make it simple to stay on top of your medications with free, same-day delivery and medication management tools like reminders and auto refills in our mobile app.

How to Stay Healthy While Working From Home

If you take insulin daily to manage type 1 or type 2 diabetes, it’s important to choose a method of insulin delivery that fits your lifestyle and diabetes management needs. Many individuals who are often on-the-go find insulin pens to be most convenient given their portable size, discrete nature, and quick administration time. 

What to Know About Insulin Pens

Read on for more information about these devices, including the different types of insulin pens and what to consider when choosing one.

An insulin pen combines insulin and a syringe into a single device, allowing for a faster and easier administration than syringes. When it is time to administer an insulin injection, all you have to do is attach a new needle and dial the correct dosage on the pen. If you take multiple types of insulin every day, many insulin pen manufacturers offer color-coded pens or different designs to help you quickly identify each pen’s type of insulin.

While insulin pens simplify insulin delivery and how you measure your doses, you will still need to self-administer injections throughout the day. This is in contrast to an insulin pump, which automatically delivers doses of insulin at specific times. If you require many insulin injections each day, you may want to ask your healthcare provider if an insulin pump would be a good fit for your diabetes management needs.

There are two main types of insulin pens: disposable and reusable.

A disposable insulin pen contains a prefilled cartridge used for multidosing. You will discard the pen once the cartridge is empty or when the insulin expires, depending on the type of insulin you are using. These devices are sometimes referred to as “flex pens” or “quick pens.” Common brands include Lantus®, Tresiba®, Humalog®, Novolog®, and Basaglar®.

A reusable pen contains cartridges of insulin that are discarded once empty or when the insulin expires. You will replace the empty or expired cartridge with a new one and reuse the pen. These are sometimes referred to as “smart pens.” Common brands include InPen® and NovoPen®.

Follow the steps below to safely administer your insulin injections with a disposable or reusable insulin pen. A diabetes educator or healthcare provider can answer any questions and help you become more comfortable using the device.

1. Verify the expiration date of your insulin and do a visual check to make sure it has no clumps — most pens have a visible insulin reservoir. If the insulin is cloudy, roll the pen for a minute. (If the insulin is clear, you do not have to roll the pen.) If you take multiple types of insulin, make sure you are using the correct type.

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