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Alto Pharmacy Technician

Alto Pharmacist

At Alto, we’re obsessed withour missionto improve quality of life for everyone who needs the help of medicine. Our mission guides us in all we do and every decision we make. 

Services that reduce travel and encourage social distancing are now more essential than ever, not only for vulnerable populations but all of us as members of our communities. Alto’s free same-day doorstep delivery ensures you have safe and reliable access to medications in this time of uncertainty. 

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From enjoying a holiday staycation to finally tackling a long-awaited project, here are ten ways we can make the most of being stuck home for the holidays.

The Unexpected Benefit of Being Stuck Home for the Holidays

Our holiday cheer has taken a hit this year. We’ve found ourselves stringing up lights on the heels of a country-wide surge in COVID-19 infections. The CDC has advised that the safest way to celebrate the holidays is with members of our own households. We’d already reckoned with the loss of office holiday parties and made peace with socially-distanced Santa, but the idea of confining our holiday festivities to our own four walls has taken some time to sink in. 

We won’t pretend it will be easy to wish loved ones “Happy Holidays” from afar. Yet, if the true spirit of the season is rooted in togetherness, what better way to honor it than protecting those we love and our community at large? 

After all, there might be benefits to skipping this year’s daylong road trip to mom’s house and no longer feeling obligated to attend an endless list of holiday soirees. When have we ever ended a year with so much extra time? From enjoying a holiday staycation to finally tackling a long-awaited project, here are ten ways we can make the most of being stuck home for the holidays.

Take a day to give your home space an upgrade. Moving around the furniture can be surprisingly impactful, but won’t send you running to the store or blowing your budget.

Use this time to learn a new skill or delve into a topic that intrigues you. For best results, choose a class that you can complete over the course of several days. You might try Harvard and MIT founded edX, which lists free courses from top-ranked universities. To flex your creative muscles and learn a new craft, try Skillshare, which offers a Premium membership but also thousands of free classes. 

If you’re craving a couch marathon, but feel like you’ve watched the entire TV lineup over the past several months, consider revisiting an old favorite and looking for details you’ve never noticed before. 

Remind yourself that this current reality is temporary and one day we’ll be free to travel again. Plan the first trip you’d like to take, giving yourself time to really explore your ideal location in-depth. 

Not your ideal holiday activity? Well, consider this: if you’re anything like the majority of us, the backs of your cabinets could hold items you haven’t seen in years. You’re almost certain to uncover a few surprises. 

If you’ve ever thought longingly about a weekend of yoga and meditation, creative writing and painting, or connecting with nature, this may finally be your moment. Simply choose a time frame, plan a gentle agenda, and prep your meals ahead of time. Don’t forget to let loved ones know that you’re trying to unplug, so you can keep calls and texts to a minimum.

Why not devote some time to your favorite housemate this holiday season? The challenge of working out the trick is a great bonding experience, provided you use plenty of patience and positive reinforcement. For some great tips, check out this article on Dogster. 

Whether you go for classic (Monopoly), wholesome (Candyland), quick-thinking (Taboo), or hilarious (What Do You Meme?), a night of games with your family, partner, or roommates is sure to entertain. If you live alone or want to include more people in the fun, set up a virtual game night. Many popular games have online versions you can use. 

Have you dreamed of visiting the Smithsonian or wandering the halls of the Louvre? Many of the most famous museums in the world now offer online tours that will make you feel like you’re in the room.

Whether you choose to spend your time being productive or relaxed, on a set schedule or simply winging it, there’s one activity we don’t recommend: going to the pharmacy. If you have new prescriptions or refills to pick up, there’s no need to drive to the pharmacy and wait in line. Instead, leave your prescriptions to us and cue up the next module in your online course or episode of TV. We’ll hand-deliver your medications right to your door, then stay on call to answer your questions and provide support. It’s the gift of time—all year long.

We’re wishing everyone a safe and happy holiday season. 

If you’re considering IVF or freezing your eggs and unsure of what to expect, this article will break down the basics and offer suggestions for how to prepare. 

IVF and Egg Freezing: What to Expect and How to Prepare

These days, egg freezing and IVF, or in vitro fertilization, are fairly common routes on the journey to parenthood. Yet, that doesn’t mean these fertility treatments are always an easy road. While both treatments helped millions of women conceive, they can require a significant investment of emotion, resources, and time. 

In vitro fertilization is a type of fertility treatment where:

The retrieved eggs are combined with sperm outside of the body in a laboratory 

The embryos (fertilized eggs) are then placed into the uterus with the potential outcome of a pregnancy. 

The main difference between egg freezing and IVF is the timing. Rather than attempting to get pregnant right away, egg freezing gives you the option to store your unfertilized eggs for a later time. When and if you decide you are ready to have a baby, your eggs will be thawed in the lab and the rest of the IVF process will be completed. Freezing healthy eggs at a younger age allows women more flexibility in their family-planning timelines.  

The initial screening and prescribed medications are very similar for IVF and egg freezing. After completing an initial ultrasound and bloodwork, your doctor will prescribe fertility medications to stimulate follicle growth. Follicles are fluid-filled sacs in your ovaries that potentially contain an egg. Your prescription will involve self-injecting hormones on a precisely timed schedule and regular check-ins for additional ultrasounds and bloodwork. For a more detailed understanding of the timeline and medications used during an IVF cycle, see our article,  IVF Medications: Schedule and Side Effects Explained. 

Once your follicles have reached maturity, your doctor will gently guide a thin needle through your vaginal wall and use suction to draw the eggs from the follicles. The 15-45 minute procedure is minimally invasive, and you’ll be sedated to ensure there’s no pain. The retrieved eggs are either frozen and stored for later use or placed in a petri dish with sperm cells so fertilization can take place. The fertilized eggs, or embryos, are then transferred to your uterus through a quick, non-surgical procedure using an ultrasound-guided catheter.  

IVF may include a variety of other parties at each stage. In some cases, an egg donor undergoes the egg retrieval process. The resulting embryos are then transferred to the intended parent’s uterus. Sometimes a gestational carrier carries and delivers a child for another couple or person. The embryo is created via IVF using the eggs and sperm of the intended parents or donors and then transferred into the gestational carrier’s uterus. In all of these cases, the sperm used to fertilize the eggs may come from either a male partner or donor. Your unique fertility journey may or may not include one or more of these variations.

From a biological standpoint, the American Society for Assisted Reproductive Technology recommends being at a healthy weight and avoiding smoking or alcohol use. It’s also important to mentally prepare, as this journey may take more than one cycle and be physically demanding on your body. Here are a few tips to keep in mind when it comes to your emotional well-being: 

Don’t let staying “stress-free” stress you out 

During any type of fertility treatment, it’s natural to feel anxious or apprehensive. You are emotionally invested in the outcome, after all. So the standard advice to avoid stress during IVF may only serve to catch you in a cycle of worrying about your worries. It’s true that stress isn’t good for your health and it negatively impacts your quality of life; however, recent studies have offered reassurance that your stress level is unlikely to affect your chances of IVF success. 

We recommend that you include stress-relieving techniques in your fertility self-care plan, but it’s important to know that some stress is expected and perfectly okay. Rather than trying to avoid anxious thoughts altogether, try to acknowledge whatever hopes and fears arise, then work to let them go through practices that help you feel calm. The key here is to be gentle with yourself. Try light, low-impact movement practices like yoga, walking, or tai chi, or lay in bed and listen to a guided audio meditation. There are meditation programs that focus specifically on supporting the fertility journey, like Expectful and Circle + Bloom, as well as free fertility meditations on Insight Timer. 

If possible, we suggest surrounding yourself with caring individuals who can provide emotional support or assist with injections when needed. Talk about your feelings with your loved ones. And If you know someone else who has gone through egg freezing or IVF, perhaps you can schedule a weekly phone chat or walk through your neighborhood. 

Finding this type of support isn’t always easy, however. If you’re feeling isolated or struggling to find someone to confide in, know that you are part of a community of women who share similar challenges. Your fertility clinic may offer counseling or support groups, or you can find one through Resolve, the National Fertility Association. No matter your circumstances, you don’t have to navigate fertility and family planning alone. 

Many people also find support through blogs and online communities centered around fertility and IVF, like IVF Babble and Pregnantish. While these can be excellent resources, be mindful that not everything you read online will be completely factual or apply to your unique circumstances. Your doctor or pharmacist should be your source for any medical advice. The stories others share will range from joyful to heartbreaking, so check in with where you’re at emotionally before you start browsing. Remember: whether good or bad, these are the experiences of others. Your journey will unfold in its own way. 

Because treatment can change from one day to the next, it’s helpful to have a pharmacy partner that can be just as flexible and deliver medications as needed. For that reason, we recommend selecting a pharmacy that offers free, same-day delivery and expert guidance on fertility medications. 

Alto’s fertility pharmacists are accessible by phone, text, or messaging in our mobile app. We understand that protocols can change with little notice, which is why you will always receive a confirmation and updates from us after we receive your prescription. You can also view your delivery status in our mobile app until our courier team hand-delivers your medications. You can even designate a safe place for us to place your medications for contactless delivery (we can facilitate contact-free signatures as well). 

For more tips on how to select your pharmacy, read “What to Consider When Selecting a Fertility Pharmacy.” 

The IVF journey can be challenging, but we’ll be with you every step of the way. Alto’s dedicated fertility specialists are here to answer your questions, guide you through your first injections, and work with your physician to ensure your egg freezing or IVF treatment plan is followed correctly. Visit us at alto.com/fertility or reach out via phone, text, or the app to learn more. 

Following prevention guidelines like mask-wearing, social distancing, and handwashing is still the surest way to stay safe. In addition, here are seven strategies to follow during the COVID-19 pandemic if you have asthma.

Seven Strategies for People with Asthma During COVID-19

As COVID-19 infection rates surge across the country, asthma is making its way into news headlines. Research published in the Journal of Allergy and Clinical Immunology at the end of November suggests that people with asthma may be at reduced risk of contracting the coronavirus. 

The researchers stressed that further study is needed, and possible explanations are still being explored. But the news may be welcome for people with asthma—a chronic lung condition that causes inflammation in the airways—who are facing an additional threat to their lungs from COVID-19, which primarily affects the respiratory system.  

This singular study is no reason to relax on preventative measures, however. The CDC has warned that those with moderate-to-severe asthma who do contract COVID-19 may be at a higher risk of serious complications, including asthma attacks, pneumonia, and acute respiratory distress.

Following prevention guidelines like mask-wearing, social distancing, and handwashing is still the surest way to stay safe. However, in addition to doubling down on these efforts, here are seven strategies to follow during the COVID-19 pandemic if you have asthma:

Right now, prevention is still our best defense against serious illness from COVID-19. Though rising infection rates may mean that restrictions will tighten in the short term, eventually, the gradual phases of reopening will begin again. Remember that most reopening guidelines center on those who are not at a higher risk of COVID-19 complications. Anyone who is considered high risk due to age or an underlying medical condition, including moderate-to-severe asthma, should continue to take extra precautions as reopening in their area unfolds and adhere to the CDC’s recommendations for their specific condition. 

The coronavirus can survive on some surfaces for hours or even days; however, surface transmission does not seem to pose nearly as significant a risk as person-to-person contact. Nevertheless, the CDC advises cleaning high-touch surfaces regularly. 

This recommendation can present an issue for people with asthma. Many chemical sprays used to clean indoor spaces can trigger an asthma attack—a sudden onset of inflammation in the airways that can cause difficulty breathing, coughing, wheezing, and chest tightness.  

If possible, ask someone else in your household to disinfect surfaces and objects for you. If you need to take care of it yourself, be sure to choose disinfectants that are less likely to trigger an asthma attack. The Environmental Working Group (EWG) provides recommendations for green cleaning products and includes asthma safety ratings. 

When using cleaners or disinfectants inside, open as many doors and windows as possible. Use only the amount of product recommended on the label and follow the instructions carefully. It can also help to use wipes or a dampened towel rather than a spray to avoid inhaling aerosols while cleaning. 

The CDC recommends keeping an emergency supply (30 days’ worth) of your asthma medications on hand so you don’t risk running out if you need to quarantine, become sick, or otherwise can’t make it to the pharmacy. 

If you fill your prescription with Alto, we want to assure you that we are fully prepared to deliver your asthma medications throughout the COVID-19 pandemic. We offer free, contactless drop-offs with every single prescription, so you’ll receive your refills on time from the comfort and safety of home. 

There has been misleading information circulating online about inhaled corticosteroids (i.e. Flovent, Qvar, Pulmicort, and Asmanex)—a standard asthma treatment—possibly increasing the risk of contracting COVID-19. At the same time, other articles suggest ICS as a potential treatment for COVID-19. 

Experts are clear: there is not enough evidence to prove these assertions, and discontinuing treatment or misusing medications poses a real danger to people with asthma. If you have any concerns about your medications, continue to use them as prescribed, and reach out to your healthcare provider. Alto’s pharmacists are also on call to answer your questions by phone, text, or in-app chat. 

The symptoms of an asthma attack (wheezing, shortness of breath, chest tightness, and coughing) bear some similarities to the emergency warning signs of COVID-19 (trouble breathing, pain or pressure in the chest, confusion, and bluish lips or face)

If you’re experiencing asthma symptoms that do not respond to your treatment plan or symptoms that could indicate COVID-19 infection, seek immediate medical attention. For more information on the common symptoms of COVID-19 and other seasonal respiratory illnesses, read “Cold, Flu, or COVID-19? Your Seasonal Symptom Guide.” 

Find Ways to Cope with Stress and Anxiety

We are living in undoubtedly stressful times. Stress and strong emotions can be asthma triggers, so it’s essential to find ways to cope with anxiety during the pandemic and beyond. 

It’s impossible to avoid stress altogether, so don’t fall into a pattern of stressing about your stress. It’s much more helpful to regularly check-in with your emotional state and take steps to course-correct when you begin to become overwhelmed. 

Meditation, movement, healthy sleep habits, and social connection are effective ways to become more resilient during stressful situations. You might also consider practicing mindful breathing or another relaxation technique that you can use to calm your body and mind during a stressful situation. Your chosen method can be as simple as gradually lengthening and deepening your breathing or mentally telling each part of your body to relax. 

Leaning on the support of friends and family can help reduce stress and provide a sense of safety. However, if stress and anxiety become difficult to manage, don’t hesitate to reach out for professional help. The CDC offers this list of resources for finding a counselor in your area. 

When it comes to medical advice, rely on your healthcare provider, not the internet. Our understanding of how the coronavirus works is changing every day, so falling down a rabbit hole of outdated information could cause unnecessary anxiety. Stick to reputable, timely sources like the CDC, and always consult your doctor if you have any concerns.

Our team of patient care pharmacists at Alto is also available to chat if questions come up. We’ll make sure that you’re always able to access the medications you need throughout COVID-19—with free home delivery. Reach out any time via text, phone call (1-800-874-5881), or in-app messaging.

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.

Here’s our best advice for coping with the stress of uncertainty and keeping the spirit of the season alive from home. 

Staying Healthy During a Challenging Holiday Season

The holiday season has a way of stirring up equal parts stress and cheer. We eagerly anticipate cherished traditions and festive gatherings while taking on a dizzying array of tasks—from shopping to decorating to making travel plans. 

But this year, we’re not simply falling into familiar patterns of holiday stress. As experts urge us to limit holiday gatherings due to a new wave of COVID-19 infections, many of us are contemplating whether we should hold tight to our traditions or honor a simple holiday at home.  

The month of December is often rife with temptations to overcommit, overindulge, and overspend. This year, we have a rare opportunity to simplify our to-do lists and cut ourselves some slack. Rather than trying to do it all, find ways to incorporate your favorite traditions without piling on the stress. 

If you love the spirit of gift-giving but feel stressed about the financial burden, you might try crafting homemade presents or setting up a family gift exchange. Similarly, if you daydream all year about the holiday meal but feel hopeless about cooking it yourself, consider supporting a local restaurant offering your favorite dishes to-go. 

We put a lot of pressure on ourselves to create picture-perfect holidays. But our upcoming celebrations may look very different from past years. Challenge yourself to let this season be a little messy. Experiment with ways to keep your favorite traditions alive and cultivate the spirit of togetherness from afar.

Sure, you might burn your first attempt at grandma’s famous cookies, or your family video call might cut out, but try to see the beauty—and the humor—in this year’s small setbacks. After all, laughter has been shown to decrease stress hormones and positively impact overall health. 

The holidays coincide with the darkest days and coldest weather of the year. Seasonal affective disorder (SAD) is a mood disorder triggered by the winter gloom that can cause depression, fatigue, and social withdrawal, despite the season’s insistence on holiday cheer. 

If you find yourself with a case of the winter blues, research has shown that bright lighting can uplift your energy and mood. Try to expose yourself to sunlight every day. The sun’s rays stimulate the production of serotonin—a brain chemical known to increase feelings of happiness and well-being. 

You may also want to consider stringing up your holiday lights, even if you’re not expecting company. Psychology experts confirm that brightly colored lights and festive decorations can have a positive effect on our mood. 

It’s natural to feel a sense of loss over missed family traditions, but try not to dwell on what this holiday won’t have. Instead, focus your attention on what you’re thankful for this year. 

Expressions of gratitude cause our brains to release dopamine and serotonin, two mood-enhancing brain chemicals that promote feelings of pleasure and reduce stress. Whether you recount happy moments from your day or share appreciation for the people you encounter, remembering that good still exists during difficult times is a powerful stress reliever. 

Limiting this year’s holiday gatherings is one way to prioritize your and your loved ones’ health. However, it’s also essential to make time for self-care practices that reduce the physical effects of stress. 

In the short term, stress actually boosts the immune system. When our bodies are in fight or flight mode, we’re more prone to injuries that we need to heal quickly. It’s chronic stress that eventually puts enough strain on the body to have the opposite effect: increasing inflammation and reducing our ability to fight off infection. 

Make sure to get adequate sleep, stay active, and eat well. Not only will these habits help keep your immune system strong, but they also support physical and emotional resilience. A deep breathing practice can help you lower stress hormone levels and boost your resistance to infection. 

There are many deep breathing techniques, but the crucial element is to move beyond shallow chest breathing and allow the air coming through your nose to fill your lungs until your lower belly rises. You can practice while lying down or standing in line at the grocery store for an instant dose of relaxation.

Many of us are making difficult choices this holiday season. Just remember that we may be back to packed social calendars and travel itineraries by next year. The choices we make now will support many wonderfully chaotic holiday seasons to come. 

We want you to stay safe and avoid long pharmacy lines this holiday season, so we offer free, contactless delivery with every prescription. If you have questions, our team is available 9 am - 9 pm PT Monday - Friday, and 10 am - 6 pm PT on weekends; reach out via phone, text, or the app.

Staying Healthy During a Challenging Holiday Season 

As you gear up for a flurry of gift-giving and family video calls, there are a few important healthcare items to prioritize on your ever-lengthening to-do list. 

Your End-of-Year Health Checklist

The holiday season can descend with the sudden force of a blizzard, seemingly blanketing the world in twinkly lights and festive cheer overnight. Though this year we can’t gather together in the usual ways, many of us are still anticipating a hectic season full of reimagined traditions. As you gear up for a flurry of gift-giving and family video calls, there are a few important healthcare items to prioritize on your ever-lengthening to-do list. 

If you have money in a flexible savings account (FSA), it won’t roll over at the end of the year, meaning any unused funds will be lost. Make sure to spend those dollars before the deadline on December 31st. If you have prescriptions that are ready to be refilled, that’s a great way to use your available funds. 

Don’t forget—your year-end FSA receipts are available for easy download under “Payment Details” within the Alto app and your online account. No need to hang on to unruly paper receipts. We’re keeping track of your prescription spending details for you.  

Even if you’re not traveling for the holidays this year, the final weeks of December can be a whirlwind. Take stock of your prescription medications now to ensure that you’re covered through the season’s celebrations. If you have a refill due around holiday time, you might consider setting up your delivery window a little early to avoid forgetting in the midst of your holiday fun. 

If you’re planning for extended travel and need to adjust your refill dates accordingly, reach out and let us know as soon as possible. We will do our best to coordinate with your insurance so you can focus on getting from point A to point B. 

Many of us look forward to the onset of the new year as a chance to start fresh or make healthy changes. However, those changes may be less welcome when they involve your medical costs. Here are two variable to keep in mind that may affect your healthcare spending in the new year: 

With most health plans, your deductible—the amount you are responsible for paying out of pocket before your insurance starts covering the costs—resets on January 1st. As you put together your holiday budget, you may want to plan for a temporary uptick in medical costs until your 2021 deductible has been met. 

Insurance companies often update their medication coverage and pricing at the start of each year. We’ll always show you your out-of-pocket costs before you confirm your delivery window and we’re here to help you re-examine your options if you have any concerns. 

Don’t let last-minute prescription worries diminish your holiday cheer. Take care of these end-of-year details now so you can immerse yourself in the spirit of the season—no matter where it takes you. As always, we’ll be here to help coordinate refills, schedule deliveries, and find the lowest price on your medications. If you need support, we’re just a call, text (1-800-874-5881), or in-app message away. 

In this article, we’re going to focus on the where, why, and how of storing your insulin medication safely.

Taking Care of Your Insulin

For those living with type 1 diabetes and for many with type 2, taking insulin is a part of daily life. That’s because people with diabetes either do not produce insulin on their own or their bodies cannot use it effectively. For more on the role insulin plays in the body and essential facts about how it’s used as medication, we recommend reading, “Understanding Insulin: The Basics.” In this article, we’re going to focus on the where, why, and how of storing your insulin medication safely.

Insulin is one medication you can’t just toss into your medicine cabinet. That’s because insulin is a protein dissolved in water. Like any protein, your insulin can spoil if it isn’t kept cool. However, unlike the mystery food container at the back of your fridge, spoiled insulin won’t make you sick. The danger is that your medication may be rendered ineffective, causing your blood glucose levels to climb higher than you expect. 

For that reason, most of the storage guidelines detailed below revolve around temperature and expiration date. The bottom line: treat your insulin more like a perishable food item than your run-of-the-mill medicine stash. 

You should always store new or unopened insulin in the refrigerator (at a temperature between 36°F and 46°F). Take a peek at the expiration date listed on your medication and place it in your refrigerator as soon as you can. It’s important to discard your insulin once it reaches its expiration date, even if it is unopened.  

To ensure your insulin is not subject to temperature fluctuations in the refrigerator, getting a temperature sensor may be a good idea. Also, try to store your insulin on the center shelf—the area most consistent with the thermostat setting—rather than on the top shelf or door compartments.

Whenever you receive a new type of insulin, review the instructions for your specific prescription with your pharmacist. If you fill your prescription with Alto, you can check your medication’s details and instructions at any time in the Alto app or your online account. Plus, our care team is always a quick text, in-app chat, or call away.

Since injecting cold insulin can be uncomfortable, it’s okay to keep the open vial, cartridge, or pen you are currently using at room temperature (between 56°F and 80°F) for about a month. 

In general, you will need to discard your insulin 28 days after opening it, but be sure to check the information provided with your specific medication or reach out to your pharmacist to confirm. Label your vial, cartridge, or pen with the date you first open it so you’ll have no problem remembering when it’s time to throw it away. 

Always check both the original expiration date listed on your medication and the date of opening before every use. Do not use expired insulin. You should also inspect your insulin before every use, looking for any changes in color or clarity as well as any crystals or clumps. If you notice changes or have any doubts, use a new vial, cartridge, or pen. 

While you’re on the move, it’s still essential to keep your insulin from getting too hot or too cold. You want your insulin to remain between 36°F and  80°F. Keep in mind, even if the temperature outside isn’t extreme, your insulin can quickly heat up if left in a parked car or intense sun.  

If your insulin has been frozen or exposed to extreme heat, you should not use it—even if it has cooled back down or thawed. There’s a high probability that your insulin will be ineffective, and a blood sugar spike could catch you off guard. 

Carry your insulin with you in an insulated bag (remember—treat it like perishable food) and keep all your medication supplies in your carry-on if you’re traveling by plane, train, or bus. It’s always a good idea to make sure your prescription label is visible, especially if you’ll be going through airport security.

No one wants to stand in line at the pharmacy month after month. But insulin’s temperature sensitivity doesn’t lend itself well to being shipped through the mail—you don’t want it spending hours sitting on your doorstep or the back of a mail truck.

When you choose Alto for your prescriptions, we’ll deliver your insulin by hand using temperature-controlled packaging. You can choose a delivery window when you know you’ll be available to receive your package and place it in the refrigerator right away. We’ll monitor your medication’s temperature as it makes its way to you, and you can track our progress the whole way via text message or the app. Best of all, our delivery service is completely free. 

We’re here to make managing your insulin prescription easy. Our team is available 9 am - 9 pm PT Monday - Friday and 10 am - 6 pm PT on weekends; reach out via phone, text or the app.

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

Managing your health during the pandemic is a long game. Here are five important heart health strategies to put into play during the COVID-19 pandemic.

Your Heart Health Playbook During COVID-19

What We Know about Heart Health and COVID-19

We mostly hear about how COVID-19 affects the lungs. But any serious viral infection can put stress on the heart by forcing it to work faster and harder as the body mobilizes to defend itself. Even more troubling, COVID-19 infection can cause blood clots in the heart’s arteries or attack and weaken the heart muscle itself. 

Anyone who is already managing high blood pressure or heart disease should take the potential for damage to their cardiovascular system seriously. Just don’t let vigilance and caution spiral into fear. While the gravity of the link between COVID-19 and cardiovascular health should not be understated, there are proactive ways you can support your heart and protect yourself from infection. 

Remember—managing your health during the pandemic is a long game. It’s crucial that you continue to take your medications as prescribed and receive necessary medical care. With this in mind, here are five important heart health strategies to put into play during the COVID-19 pandemic.

Five Heart Health Strategies During COVID-19

For months now you’ve been wearing a mask, social distancing, and avoiding crowded areas whenever possible. We know it hasn’t been easy, but keep it up. According to Penn Medicine cardiologist Helene Glassberg, MD, “The number one thing is to continue what you're doing, which is staying at home when possible, practicing safe distancing, and seeking medical attention if you're having problems.” Dr. Glassberg also recommends exercising caution as states experiment with loosening restrictions, advising, “Stay the course for as long as you can to stay well.”

There have been conflicting news reports involving some blood pressure medications and COVID-19. Despite what you might have read, don’t stop taking your medications without consulting your doctor. Not only is that never a good idea, but several recent studies indicate that there is no cause for concern when it comes to these medications. 

The confusion stemmed from the fact that two common classes of blood pressure drugs, known as angiotensin-converting-enzyme (ACE) inhibitors and angiotensin-receptor blockers (ARBs), affect the same pathways in the body that the coronavirus takes to reach the lungs and the heart. Multiple types of both medications are available—commonly prescribed ACE inhibitors include lisinopril, captopril, and benazepril, while common ARBs include losartan, valsartan, and azilsartan. 

For a while, experts were unsure if these shared pathways meant that these medications might either help or harm people with the virus. According to Harvard Health, three different studies have found no evidence of harm for people infected with COVID-19 who continue to take ACE inhibitors and ARBs. While there is still research to be done, experts recommend that people already taking these medications should continue to do so. 

The same advice goes for any medications or lifestyle interventions that your doctor has prescribed. If anything, it is more important than ever to remain diligent with your cardiac care plan and stay in communication with your doctor. 

The prospect of sitting in the waiting room at the doctor’s office can be anxiety-provoking right now. While avoiding the doctor might feel like a safe choice in the short-term, skipping your appointments or ignoring symptoms could mean putting yourself at risk of serious health issues like heart attack and stroke, and increasing the danger of complications should you be exposed to COVID-19. 

Talk with your doctor about what safety measures have been put in place to protect you from COVID-19 exposure during your visits. Together you can assess the risks and create a plan to continue monitoring your blood pressure and heart health. Telehealth, which allows you to meet with your doctor via phone or video, may be an option and is often covered by insurance. 

If you pair virtual doctor visits with free hand-delivery of your prescription medications through Alto, you can avoid both the waiting room and long lines at the pharmacy. Transferring your prescriptions to Alto is easy and free—we’ll take care of the work for you. We’ll ask you to choose a convenient delivery window, and one of our couriers will bring your medications straight to your door at no additional cost. We can even provide completely contactless delivery if you prefer. 

Don’t Drop the Ball on Your Healthy Habits

Even though we’ve been at it for months, staying motivated to keep up healthy habits from home can still be a struggle. The stress and anxiety so many of us are feeling right now may affect our energy levels or cause us to lose interest in our usual activities. When facing distressing news reports or personal hardship, it’s tempting to self-soothe in various unhealthy ways. It’s okay to indulge sometimes, but try not to slide too far into less healthy coping mechanisms for the sake of your heart and your emotional well-being.

Cooking heart-healthy meals at home can boost your overall wellness and serve as a creative outlet. The American Heart Association created this resource for making smart shopping choices on a budget and offers a library of recipes to suit any skill level or craving. Staying active is equally important. If you find it difficult to work out from home, try thinking outside the box of what you’d normally consider fitness. For example, giving your kitchen a good scrub will get your heart rate up, and seeing your countertops sparkle will most likely relieve some stress. If you prefer to keep it simple, a brisk walk around your neighborhood is an effective choice that can help you feel connected to your community from a safe distance. 

Unfortunately, heart attacks and strokes don’t take a break when a global pandemic strikes. Do not delay getting emergency medical care because you fear going to the emergency room due to COVID-19. Heart disease is the number one cause of death in the United States, even now, and the hospital is the safest place you can be if you think you are experiencing a heart attack or stroke. Call 911 immediately at the first sign of trouble—the American Heart Association offers this resource for identifying a heart attack or stroke. We also recommend reading our article, “Heart Health Warning Signs to Watch Out For.” 

We are fully prepared to deliver your heart medications safely and on time throughout the COVID-19 pandemic. Our pharmacy locations are stocked, our couriers are standing by, and our pharmacists are on-call to answer questions and assist with coordinating refills or requesting longer fills. We offer free, contactless delivery with every single prescription so you can rest easy at home knowing that everything you need is on its way. 

Mike McClay has spent the better part of two decades working in Silicon Valley. Here, he chats with software engineer Akash Gupta about the road from Software Engineer to VP, what it’s like to work in digital health, and his best advice to both independent contributors (ICs) and managers. 

Get to Know Alto’s VP of Engineering, Mike McClay

I'd love to first understand a bit about you personally. What do you like to do in your off time? What’s something most people don't know about you?

I grew up in Orange County, which is pretty suburban, so that afforded us a lot of time outdoors as a family. A life goal of mine is to do a solo hike of the John Muir Trail. The route starts in Yosemite Valley and heads south to Mt. Whitney. It’s about 225 miles and typically takes a few weeks to complete.

Currently though, I have a two-year-old and a four-year-old, and we have another baby on the way, so my outdoor activities tend to be much shorter and closer to home. I got into road biking about 10 years ago and transitioned to mountain biking a few years back when my family moved to Marin. Being able to get out onto the local trails a couple times per week is an amazing opportunity to get a great workout in, and unplugging does wonders.

Finally, a ton of family time with my partner and kids. A big reason I decided to join Alto is because it provides a great balance of simultaneously being a high growth startup but it’s also a company that has an eye on culture and achieving work-life balance. At Alto, we're playing to win, and we’ve got a lot of things to get done, but there's a lot of support and representation for people with families with kids. It's nice to be able to work hard towards an incredible mission but also not have to sacrifice too much on the family front; so outside of work, I’m mostly focused on spending quality time with my family getting outdoors, getting to the beach, and things like that.

That's very exciting, having another child on the way. How has COVID-19 impacted your responsibilities of being a VP Engineering and a father?

Life is a lot harder during COVID, though I say that with a fair amount of awareness of the privilege my family and I have. On the home front, we are constantly trying to find that balance of keeping the kids entertained and learning but also doing it in a safe way that protects everyone. My wife and I are pretty fastidious about keeping the house organized and clean but that’s relaxed quite a bit during this time; there’s a lot of resetting of expectations, and I try to do as much as I can to support my wife.

Professionally, probably about half of our engineering team has interviewed and onboarded since the shift to remote work in March, and I’d say we are still iterating and adapting each month to work better in a fully remote environment. It’s been incredible to see our teams adapt to this new style of work, and while it’s not quite the same as our in-person environment was, it’s been really cool to see the team grow and have our organization make a bigger and bigger impact for our patients each month.

I'd love to talk about some of your past experiences. You went to the University of California, Berkeley (Go Bears!), then Expedia, then Uber, and now you're at Alto. What prompted each of those transitions?

Yeah, I’m kind of an outlier in the tech world in that I’ve only worked at 3 companies since graduating undergrad in 2004. I think I’ve been fortunate to find myself at companies that have had no shortage of growth opportunities and that led me to stay for considerable amounts of time at both Expedia and Uber. 

Towards the tail end of my tenure at Expedia, I was managing the engineering team of a start-up that Expedia had acquired, and I knew in my heart that I wanted to move to a much smaller company. I spent a few months talking to a bunch of early stage start-ups but hadn’t found anything that felt right yet.

At the urging of my recruiter, I took a call with a company called Uber, which had seemed way too “big” for what I was looking for in that the engineering team was about forty people. Despite the role feeling different from what I was expecting, I was excited by the mission and the team, so I made the leap. Fast forward six years or so and it was an amazing ride, full of a lot of ups and definitely some learnings, but it was a truly formative experience for me.

Uber ultimately got to a point where I struggled a bit to pinpoint the impact I was making, and things overall at the company just felt slow. I wanted to work on something that was even more mission-driven, and one of my colleagues insisted that I chat with Alto. I was introduced to Jamie (Alto’s CTO). We talked over a number of months and found Alto’s needs and the challenges I was looking to solve aligned in a great way. So that's why I ended up joining.

Each of the companies that you’ve worked at have had large operational components. What are some of the key pieces to creating a strong partnership in a tech-enabled company?

What I would definitely say is that the tooling and the product that we built for ops at Uber was, at the time, world-class; it was just beautiful. Design was a first class citizen in our operational tooling because the workflow of our ops team was so critical to our company’s success. 

This is something that Jamie and I bonded over about Alto; our internal platform (called Wunderbar) powers the functionality that allows us to process our patient’s prescriptions in an efficient and effective way. Getting this right is critical for our patients, and the fact that we put so much time and energy into getting the technology platform right goes a long way to build a great working relationship with our operations team. 

Additionally, I’m passionate in general about operations since it’s often an area of the business that creates strategic advantages over competitors. And what I love about building software with operations is that it can’t be copied easily by competitors since there is no public surface area to observe. I view our task as an engineering team as getting to where we're crushing it as a business because we have nailed supporting operations with our product engineering work.

On that note, would you say Alto is an operations company, a pharmacy, or a tech company?

We aspire to a model of cross-functional leadership, whether it's between Engineering, Product, Ops, Growth, Marketing—whatever it is, the leads of areas and even the team members of each area need to be empowered to achieve the mission that they're setting out to do. If that's to enable, say, the flow of prescriptions coming through our system, maybe you could call that Ops-led, but at the end of the day, multiple functions have to come together to solve the problem. I almost want to call it vision-led.

There’s a time and a place where we need to be creating a faster horse, and there's a time and a place where we need to be thinking one to two years out about what the step up is from the faster horse: bringing the car into the situation, so to speak. Ultimately we need to be thinking on multiple time horizons at the company, and depending on the time and place and the strategy, you might see one function spiking up in terms of what we're rallying around versus another.

The engineering team at Alto has grown from eleven engineers and four managers when you started a year ago to more than fifty-five engineers with nine managers, directors, senior managers, and managers. What would you say has enabled that dramatic growth, and how do you plan on ensuring that that growth is well-managed?

For engineers, there are a lot of choices out there, and a big part of our hiring process is spent not only assessing technical skills, but also looking for signals that candidates align well with our patient-focused mission. From the beginning, we created an interview process that is fair and equitable, and that resonates strongly with our candidates. From there, we set out some really big goals that energized the team to push to make it happen.

I'm really proud that we've grown while maintaining a solid level-mix in terms of junior, mid-level, and senior engineers. Our engineering team is ~25% female, and while we only have single digit percentage points of representation of other underrepresented groups, representation is improving every quarter. Our goal over the next several years is for the team to achieve 50% gender representation and 30% from other underrepresented groups, so that our engineering team is representative of those we ultimately serve: our patients.

In order to make sure this growth is well managed, my philosophy is to hire or grow Engineering Managers well in advance of the acute need. On the manager side—and this was a big learning for everyone at Uber—we’d grow a team of fifteen to twenty engineers under a manager and not really have a great plan in place for how to bring in additional leadership and get the teams down to a right size of ten. When we approached that number, we'd battlefield promote someone and everything just felt strained. So I'm really proud of the fact that even at nearly seventy people now, we have a management team of nine that could actually support one hundred people pretty well. As the team continues to grow we’ll be making sure to stay ahead of the growth on the management side.

On that note, Uber has been reported to have an unhealthy culture. What have you learned from it to engender a more positive, inclusive culture at Alto?

Yeah, I’ve had a lot of reflection on this and a lot of learnings from my time at Uber. First, it’s that as a leadership team, we need to be vigilant about creating a team environment where team members feel they can do their best work. We need to always have great managers leading teams that are right-sized, and we need to have people-focused cultural values that help guide our behaviors and how we interact with one another. 

At Alto, half of our cultural values are focused on skills that foster an environment where folks can do their best work. Yes, we're thinking constantly about impact, but we make sure to hold ourselves to a high interpersonal bar. This type of behavior has also been institutionalized at Alto in our engineering career ladder. Culture amplification is one of the five skills engineers are evaluated against, and I think it’s a very strong signal into what we hold dear and how we want to roll here.

Finally, I’ve put a strong emphasis on making sure that interviews at Alto assess behavioral skills in addition to technical ones. We didn’t do this well at Uber for too many years, and I believe it led to some of the cultural negatives that you’ve likely read about in the news. To me, it’s critical that we hire really talented folks who can work seamlessly with one another. Getting signal on this during our interview process is a big part of growing a healthy engineering organization.

You've gone from being a Software Engineer to Tech Lead, Engineering Manager, Director, and now, VP. What advice would you give someone at each of those stages? What advice do you wish you had back then?

The main piece of advice I’d relay is to make sure that you spend enough time in each role to get solid proficiency. I’ve come across a number of folks in my career who look to move through roles as quickly as possible, and I think that doesn't allow for solid bases of knowledge to be built up. The foundation I built up in my experience as an engineer I believe resonates with engineers; I’m not just a people manager that helps coordinate minutiae. Additionally, a lot of the skill-building in these roles happens as you encounter various real life situations; the only way to accumulate experience is over time. So my advice is to be patient.

I would definitely encourage everyone to work at a company where there are clear career paths for both ICs and managers. You should never feel like you need to move into management to “grow in your career.” One of the first things we put in place after I joined Alto was a career ladder so that folks could reason about how they wanted to grow over time and come up with a growth plan with their managers.

Finally, don’t go too long in a role or at a company where you don’t feel challenged and don’t feel like you are growing. To me, growth and challenge are proxies for job satisfaction. I would say I've achieved it about 80 to 90% of the time in my career. If you're not in a place where you're feeling like you're growing, you should go somewhere else.

What would you say to someone considering working in digital health? What are some challenges and benefits in this space?

It's not so fraught with red tape that you can’t get anything done. There is a process to work through with HIPAA (Health Insurance Portability and Accountability Act) to ensure patient privacy; there is a massive set of opportunities that support all of the activity in the space; and there are seams where startups can begin disrupting entrenched players.

There’s also a massive opportunity to solve hard technical problems while achieving these amazing, mission-driven ends. I think sometimes it seems that those can be separated to where it’s almost mutually exclusive. While we don't yet have the volume nor traffic that you might receive at companies like Uber or Google, there are still meaty technical challenges that haven’t been solved before.

What disruption is good in healthcare and what may not be?

The good disruption comes in places where companies can plug into an existing experience that patients go through to solve a problem and figure out new ways to address that problem. In the pharmacy space, we are disrupting the brick and mortar pharmacy experience that is effectively in the business of selling you Coca-Cola while you wait for your medication. 

Bad disruption would be anything that goes against protecting a patient or their privacy. At Alto the engineering and security teams are tightly coupled so that we can best solve for the needs and privacy of our patients.

You mentioned technical challenges. What would engineers and other technical people get excited about in this space?

We don't yet have our architecture mapped out for scaling 100x on our business over the next couple of years, and it’s been really exciting to start to discuss our technical plans to enable that. At Uber, we went from a monolith to a full micro SOA (Service-Oriented Architecture)—both extremes that had quite a few problems as implemented. At Alto, we aim to find a better middle ground. 

Additionally, we need to think about what the pharmacy experience will look like five to ten years from now and start building some of the pieces that will work us toward that future. Safety and accuracy are incredibly important to us now, but at one hundred times our scale, we’ll need to be constantly innovating our technology so that we can minimize / eliminate errors in our operational process. 

We’re also bringing data silos together that have never been joined before. For example, as many as 50% of prescriptions are not picked up for retail pharmacies. Doctors have no idea which of their patients pick up medications or not. Insurers don't know what happens to patients after they take their medication. We are the interconnect between all of these customers.

As we grow, that data is going to grow inside of our systems. The information and the insights that we can derive from it is going to be incredibly powerful. But we're going to need a ton of awesome data analysis, products that allow us to collect the data while respecting patient privacy, etc. I'm really excited about that.

What are you most proud of from your time at Alto so far, and what are you most excited about in the next year?

What I'm most proud of is the team that's been hired. They are just amazing. Last year, we had a team of eleven engineers with such a large surface area: fulfillment, operations, customer app, customer website, our provider portal, etc. With so much to do across a team of that size, we were constantly making really hard prioritization decisions and were not able to tap into what we saw as our full potential.

Fast forward to today, we're now in a world where we have dedicated teams for surface areas, and we’re solidly parallelizing efforts. Seeing the bandwidth, the throughput that's going to be rolling out each quarter, is really cool. We're going to have orders of magnitude more output each quarter than we did a year ago. That's what I'm most proud of now.

What am I most excited about? There's the business aspect, expansion. We've really only covered six markets and are now looking at covering many, many more lives. The next couple of years are going to be a lot of fun.

Last question. Someone's considering working at Alto: Why should or shouldn't they join?

Alto’s at a stage where things are changing constantly. Folks who like dynamic environments will thrive here, as the work is challenging, and we are trying to solve problems that have not been solved before. Given that Alto operates within a multi-sided network, we have a lot of opportunity to create value, but it also means there are multiple players to think about when building a product. There's a richness to our patient, provider, and insurer base that makes it both challenging and exciting to make sure that we're finding the opportunities that deliver value to broad strokes of folks without leaving others behind.

Finally, engineers should join if they want to be part of a mission-driven company, enjoy working in an inclusive environment and diverse team, and like to be at the intersection of technology and the physical world, whether that's operations, delivery of things to humans, etc. If we succeed,  the way society thinks about health, prescriptions, etc, ten to twenty years from now will look very different because of the work we’re doing here. If that's inspiring to you, and you want to be part of that, you should join.

Interested in joining the team? Reach out to us on LinkedIn.

At Alto, we believe your medications should come to you—at the best price, on time, and with the ongoing support you need.

How Alto Delivers More, at No Additional Cost

At Alto, we believe your medications should come to you—at the best price, on time, and with the ongoing support you need. However, when we explain to people that we can save them money while providing free home delivery and easy access to expert care, we often encounter disbelief. In a world where we usually pay a premium for special care, how can Alto’s services really be free?

Traditional retail pharmacies often build hundreds of storefronts in a single metro area in an effort to lure customers through proximity. We, however, are taking a totally different approach. We’ve redesigned the pharmacy experience by building a single distribution center in each metro area. By reducing our overhead costs, we’re able to hire teams of patient care pharmacists who are always on-call to offer guidance and local couriers who will deliver your medications straight to your doorstep.  

What’s more, because we’re not using our resources to stock and equip a fleet of locations, we can invest in innovations that elevate your prescription experience. We built our own pharmacy software platform that enables our pharmacists and patient advocates to effortlessly perform price investigations and coordinate between doctors and insurance companies. We also developed the Alto app, which puts pharmacy care at your fingertips—from ordering refills to chatting with a pharmacist. 

In a traditional pharmacy setting, pharmacists are often required to fill prescriptions, work the register, answer phones, counsel patients, administer flu shots, and call doctors and insurance companies—all on a strictly timed schedule. We don’t believe that sets pharmacists up to provide the best care. At Alto, pharmacists work in two teams with close collaboration. Our production pharmacists can focus on the important task of medication preparation while our patient care pharmacists get to focus on you. Whether you’re concerned about a side effect or wondering if you should take your medication with a meal, you can talk through any issue with an expert who cares. 

By bringing our pharmacy to you, we’re able to offer you a better experience at no additional cost. From uninterrupted, one-on-one consultations with pharmacists to timely hand-delivery of your medications, we think “above and beyond” is simply what you should expect from your pharmacy. 

Need a Refresher? These Alto Benefits are Completely Free

Have you ever meticulously crafted an online dinner order only to cancel once you saw how all the delivery and service fees added up? We’re never going to put you through that type of frustration. When we say “free delivery,” we mean absolutely, completely, 100% free. There won’t be any additional fees sneaking up on you. Ever.

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