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Not sure of what to do with this year’s "fall back" as Daylight Savings ends? Here’s our best advice for savoring the moment.

How to Savor Your Extra Hour When Daylight Saving Ends

Easing Into the End of Daylight Saving Time

This Sunday night, something peculiar—though not unexpected—will take place in most parts of North America. At 2 a.m., while most of us are fast asleep, daylight saving time will end and our clocks will jump backward by an hour. 

Most of us know the drill. We’ve been observing this tiny time warp twice a year for our entire lives. We usually grumble as we “spring ahead” in March and lose a precious hour with our pillows, then reap our reward in November when we blissfully “fall back” into bed for an extra hour of sleep. 

Thankfully, we now find ourselves nearing the eve of the more popular daylight saving transition. Instead of prepping for a bout of morning fatigue, we’re considering how to invest the extra hour we’ll gain before dawn. Not sure of what to do with this year’s windfall? Here’s our best advice for savoring the moment.

Many of us feel such constant pressure to be productive that fatigue has become our baseline. We’re balancing household chores, after-school activities, and stolen moments of self-care on top of our already packed schedules. Not surprisingly, according to the CDC, we’re a sleep-deprived society—one in three Americans regularly clock less than the recommended minimum of 7 hours a night. 

If just the thought of “wasting” your extra hour in bed sets you on edge, then that’s your cue to stay tucked in. While a single hour of sleep is unlikely to refill your energy stores, it might provide a much-needed reminder of how good it feels to rest. If your circumstances allow it, turn off your alarms and notifications and enjoy rediscovering your natural waking time. It’s no accident that daylight saving time ends on a Sunday. 

For those early risers with a precisely set inner alarm, sleeping in simply may not be in the cards. That’s okay, there are still plenty of ways you can make your extra hour indulgent. Whether you enjoy a cup of coffee in silence as your family sleeps or take a leisurely sunrise stroll through your neighborhood, do your best to minimize distractions and focus on a single simple pleasure for one hour. 

A Few Tips to Help You Regain Your Rhythm 

Whether you’re an early bird or a night owl, your body contains an incredibly accurate internal clock. Known as your circadian rhythm, it ticks away each day and controls the release of hormones that regulate your mood, hunger, and sleep. Because this inner timekeeper is sensitive to external cues, it’s easily thrown out of whack. Here are a few ways to stay on track after this week’s time change.

Your internal clock is mainly regulated by one very important external cue—sunlight. Make it a point to get some sunshine in the morning and throughout the day to help your circadian rhythm reset. 

Your feeding and fasting cycles also contribute to your body’s sense of time. Try to eat your meals on your usual schedule, even though it will feel like you’re eating an hour late. It may help to keep a few snacks on hand to curb any hunger pangs. 

You may find that the last hour of your workday feels particularly long after the time change. If you can, save some light tasks for the end of the day until your body adjusts.

If you usually walk, run, or bike in the evenings, make sure to plan for an earlier sunset. Your normally well-lit route may be much darker, so be sure to wear lights or reflective accessories when you head out.

The darker evenings can be a downer for some. Plan for evening activities that will add a little post-sunset brightness, whether that means a bubble bath, a home cooked meal, or family game night. 

If your sleep schedule is disrupted, you might consider taking a low dose of melatonin in the evening for a brief time. This hormone helps regulate your circadian clock by signaling to the body that it’s dark and time for sleep. Though melatonin is sold over the counter as a dietary supplement, it can cause drowsiness and may interfere with some medications, so be sure to check with your healthcare provider or pharmacist first. Our pharmacists are available to talk over any supplements or medications you’re curious about via phone, text, or in-app chat.

Thankfully, the time change for daylight saving is fairly minor. Many of us will savor our extra hour of sleep, then continue our day feeling unaffected. But if you’re among those who do experience adverse effects, don’t be alarmed. With the help of these tips, your body should adjust to the new cycle of dark and light over the coming days. 

It’s about time you switched to a better pharmacy. Our team is available to answer your questions and help you make the transfer by phone, text, or through 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 another qualified health provider with any questions you may have regarding a medical condition.

It’s important to be vigilant for symptoms of cardiovascular disease. But if your heart was on the decline would you know the warning signs? From the subtle to the serious, let’s take a look at some of the ways your body could be sounding the heart health alarm.

Heart Health Warning Signs to Watch Out For

Unfortunately, not everybody has a tell-tale heart. Sometimes, when trouble is brewing within your chest, the signs can be surprisingly subtle. The heart might send an SOS with barely a whisper or offer clues that it’s pumping less effectively in areas of the body where you don’t expect them. 

Chest pain is a classic sign of heart trouble. If the pain comes on suddenly, especially if it’s accompanied by dizziness, sweating, nausea, or shortness of breath, it’s time to call 911. You could be having a heart attack and you don’t want to hesitate.

While this sensation may be felt as a sharp or stabbing pain, it can also present as a tightness or pressure. Many people have described the feeling of a heavy weight on their chest. However it presents, any sudden and overwhelming feeling in your chest is cause for alarm. Be sure to seek medical attention right away.

It’s important to note that chest pain doesn’t always center on the heart. It’s common for pain to radiate to the jaw and neck or even into your back or arms. While pain in the center of the chest is the most common sign of heart trouble for both men and women, women are more likely to experience radiating pain signals than men (although men experience them too). 

Before a full-blown heart attack occurs, the heart might send warning signs in the form of more subtle pain for months or even years. If you have pain in your upper body that comes on with exertion and subsides with rest, it could be an indication there’s an issue with your heart. On the other hand, some heart attacks happen without any of these warnings, so don’t assume your pain is innocuous just because it’s happening for the first time. 

Your heart is a pump. When it isn’t functioning properly, less blood reaches your lungs and muscles, causing you to become tired and out of breath more easily. We all get breathless after a set of jump squats or a sprint, but if you find that your threshold is noticeably diminished—for example, becoming very tired or out of breath after walking up a flight of stairs or carrying groceries—it’s time to talk to your doctor. Additionally, if you experience breathlessness while lying down or otherwise at rest, it’s definitely a sign to get checked out.

Strange Sensations or Swelling in Your Limbs

If your blood vessels have become narrowed due to a buildup of fatty deposits, it can reduce the circulation of blood to your arms and legs. When this happens, you might experience pain, numbness, weakness, or coldness in your limbs. Much like chest pain, if the sensation worsens with exertion and subsides upon rest, it may be of particular concern. But tell your doctor about your symptoms no matter what.

On the flip side, when blood flow slows down, the blood returning to the heart can get backed up, causing a build-up of fluid in the tissues. If you have unexplained swelling in your feet, ankles, or legs it could be a warning sign of heart failure, so let your doctor know. 

If your heartbeat feels irregular or rapid, it’s not necessarily a reason to be concerned. That fluttery feeling could be caused by anxiety, dehydration, or even too much caffeine. However, it could also be a sign that your heart is attempting to play “catch up” after falling behind. Take note of what else is going on when you feel this sensation. If your heartbeat suddenly becomes rapid while you’re at rest or has frequent bouts at an oddly irregular pace, it could indicate that your heart is struggling. Tell your doctor about your symptoms. 

We all sweat, but usually we can attribute it to the blazing sun or a tough workout. Sweating is a normal, healthy function that helps the body cool itself down. However, if you break out into a cold sweat for no apparent reason, it could be a sign of a heart attack, especially if it is accompanied by any of the other symptoms mentioned here. If unexplained sweating starts suddenly and you don’t feel right, call 911 right away.

A little snoring here and there is totally normal. However, if you’re regularly waking up your whole household or making choking or gasping noises in your sleep, it could be a sign of sleep apnea—a condition where you stop breathing for brief moments throughout the night. According to John Hopkins Medicine, sleep apnea is associated with high blood pressure and an increased risk of heart attack. If you frequently wake up short of breath or your loved ones have resorted to sleeping with pillows over their heads, it’s a good idea to schedule a checkup. 

Most of the time, trouble achieving or maintaining an erection is a problem with circulation or blood pressure. According to the Mayo Clinic, erectile dysfunction could be an early warning sign of heart disease. While there may be other factors at play, your doctor should investigate the possibility of heart issues before recommending treatment. 

Your heart sometimes has a roundabout way of speaking up, so it’s important to know what you’re listening for. The earlier you detect the warning signs of heart disease, the easier it will be to treat. If any symptom or sensation is causing you concern, talk to your doctor, especially if you have a family history of heart disease, smoke, or have other underlying risk factors such as high cholesterol, high blood pressure, or diabetes. Heart disease is the number one cause of death in the United States year after year, but experts believe it is about 80% preventable. There are lifestyle changes, treatments, and medications that can help. 

If you and your doctor decide to explore treatment options for heart disease, know that our team will be standing by. Our pharmacies are stocked with the full assortment of heart health medications your doctor might prescribe and our cardiology specialists are available to answer your questions with a simple text, call, or in-app message. We offer same-day delivery on all your medications so you don’t have to miss a beat while you ensure that your heart stays steady and strong. 

Every year, we look forward to October, when we get a whole month to honor the extraordinary work of the pharmacists and pharmacy technicians at Alto and around the world.

Celebrating National Pharmacist Month at Alto

Every year, we look forward to October, when we get a whole month to honor the extraordinary work of the pharmacists and pharmacy technicians at Alto and around the world. National Pharmacist Month is a time to celebrate the many ways that pharmacy professionals positively impact their communities. At Alto, we get an intimate look at how pharmacists improve the health and well-being of others every single day through their expertise and exceptional care.

This year’s theme is “Essential Providers, Accessible Care,” recognizing the vital roles that pharmacists and pharmacy technicians are playing on the front lines of healthcare during the COVID-19 pandemic. From the common cold to chronic disease, pharmacists are always there to answer important health questions and make sure medications are not only accessible but used safely and effectively.

National Pharmacist Month is a great time to show your appreciation for the pharmacy professionals who help with your medications. It’s also an opportunity to learn more about the depth of their expertise. For example, did you know that becoming a pharmacist requires a doctorate degree? Pharmacists are not only experts on medication management, they also serve as patient educators, perform laboratory studies and health screenings, and act as skillful problem solvers. Whether we’re facing an acute issue or a chronic condition, many of us turn to our pharmacists to suggest supplements, over-the-counter medicines, or lifestyle adjustments that can help us feel better. 

In addition to our month-long celebration of pharmacy professionals, the third Tuesday of October has its own special designation: National Pharmacy Technician Day. On this day, we recognize the unique and invaluable contributions of pharmacy technicians. A critical part of any healthcare team, pharmacy technicians work closely with pharmacists to make sure patients get the medications they need. Technicians not only assist in the preparation and distribution of medications, but they also work directly with community members to collect patient information and help process billing claims.

Both pharmacists and pharmacy technicians are essential in providing us with access to safe and effective treatment when health issues arise. This year, more than ever, we are grateful for their steadfast dedication to your care. 

In honor of the 116 incredible men and women who perform these vital roles at Alto, here are five facts you may not know about the pharmacy profession:

October 12th is Women Pharmacists Day! About 55% of pharmacists are women, making pharmacy a predominantly female field. 

Pharmacists are the most frequently visited healthcare providers in America. They can be found working in a variety of settings—from hospitals to the neighborhood pharmacy—and we turn to them most often for health advice. 

The world’s oldest prescriptions were etched into tablets around 2100 B.C

Benjamin Franklin is considered one of the founding fathers of pharmacy. He helped to establish the first public hospital and hospital pharmacy in the United States. 

Agatha Christie, the crime novelist, worked as an apothecary’s assistant, or what we would now call a pharmacy technician. Her interest in medicine was apparent in much of her writing, inspiring her many plot lines about poisoning and disease. 

We at Alto could not be more proud of our incredible pharmacists and pharmacy technicians. Through your skills as educators and guides, you uplift the health and well-being of the communities you serve. 

Want to express your gratitude to the pharmacists at Alto? You can reach out by phone, text, or through the app to say thanks and brighten their day. 

Dr. Lisa Sterman, M.D., MPH, is an expert in the field of HIV medicine who has been in private practice in San Francisco for over 20 years. She kindly agreed to sit down and talk with us about pre-exposure prophylaxis (PrEP), an HIV prevention method that's available by prescription.

HIV Health Spotlight: A conversation about PrEP with Dr. Lisa Sterman

This interview has been edited for length and clarity.

Dr. Lisa Sterman, M.D., MPH, is an expert in the field of HIV medicine who has been in private practice in San Francisco for over 20 years. After obtaining her Master’s in Public Health, she completed her training in medicine and HIV at UCSF. She’s been involved in clinical research for HIV medications and has worked in the community as an educator and advocate, including serving on the Board of Directors for the San Francisco AIDS Foundation, for many years. 

Dr. Sterman kindly agreed to sit down and talk with us about pre-exposure prophylaxis (PrEP), an HIV prevention method that's available by prescription. The most important thing she wanted us to know? This conversation is for everyone.

Can you tell us a little about how you got started in your field?

It’s been a long road. I started working with HIV in the ’80s. I was at college in Berkeley, and I do a lot of rock climbing. My friend and rock climbing partner was a nurse at SF General, at their famous HIV ward. I knew I wanted to go into medicine and she said, “You should come volunteer on our ward.” It was the ‘80s, so it sounded totally controversial and dangerous and I was like, “I’m in.” That’s my personality, so that's how I got started. Really, it was the doctors and nurses there that inspired me to go into HIV. They were just incredible. 

What’s something everyone should know about PrEP?

Everyone needs to know that there is a pill that prevents HIV. So many people haven’t even heard of the concept. Nearly everyone is eligible with a short screening set of labs, so talk to your provider and find out if you might want to consider PrEP.

A lot of people may think, “I’m not at risk” or, “that’s not my group of people.” The way I teach it is: if you’ve ever had sex, you’re at risk for HIV. If you’ve ever shared drug needles, you’re at risk for HIV. Everyone should know their status. 

Editor’s Note: To learn more about PrEP and how it works, see our article, “All About PrEP for HIV Prevention.”

If you’re using condoms every time you have sex, would you still recommend PrEP? 

Yes, condoms break or fall off, and then you can have exposure. They are not 100%. I would say we’ve come as far as we can with condoms, that piece of HIV prevention efforts is great, and this is the next step. Condoms may prevent or reduce the risk of other STIs, but they are not the only or appropriate way to protect yourself from HIV if you are at higher risk for HIV.

Some groups of people at risk for HIV can’t always ask their partner to use condoms. They may not have the power in the relationship or they may be under pressure because they’re exchanging sex for commodities like housing, money, food, shelter, or drugs. PrEP helps empower many people who are at risk and can be taken without a partner’s knowledge or consent. In this way, some groups of people have a better chance of protecting themselves against HIV.

How can you go about talking to a doctor about PrEP? 

It would be nice if doctors asked every patient the right questions. I ask anybody who walks through my door, “Do you have risks for x, y, and z?” Part of that is taking a sexual history, but not every provider is going to do that. For a motivated patient who wants to go out and find a PrEP provider, there are great websites like pleaseprepme.org where you can find providers that do video calls, or for other folks, a trusted relationship with an in-person provider. There are more conservative areas in the US where you might perceive yourself to be at risk for HIV, but you can’t talk about who you are having sex with, who your partners are having sex with, or how you exchange all those things. If you worry about feeling stigmatized by your provider, there are other resources out there. It’s just that a lot of people don’t know about them.

Need help finding a PrEP provider? Try: 

If you decide to use PrEP, what does the process look like? 

We need to verify that you’re HIV-negative, but we’ll probably send you off with a prescription for PrEP at the initial appointment. If you’re at high risk, we want to get the medication into you before we even necessarily know the results of your HIV test. We’ve come to find that a rapid start to HIV prevention is important. We don’t want to miss the opportunity to protect someone during the week when their labs are being done. There is very little risk in taking a week’s worth of PrEP even if you are HIV positive.

So, you would start PrEP and then we’d follow up in a week to go over your labs. We’d treat any STIs, make sure your renal function is normal, and then we’d continue these tests on a regular basis while you’re on PrEP. The standard protocol is every three months. Some patients with

very high risk of STI exposures may need more frequent testing for other STIs.

I think the key is to make sure everyone knows it’s out there and for everyone to be able to have that conversation with a healthcare provider they feel comfortable with. People need to understand where they are at risk and where they are not. PrEP for HIV is not for everyone. We think about PrEP as having “seasons of risk.” A person’s need to use it may come and go depending on what their lifestyle is like. You need to be having an ongoing conversation about how your risk changes over time. 

How do you think Alto can be helpful to people on PrEP? 

Alto is a wonderful way for people to access their meds, especially during COVID. It’s convenient. It shows up when you need it. For PrEP and HIV meds I can have them provide all sorts of support for the patients. Everyone is knowledgeable—I’ve worked with some of Alto’s pharmacists in other capacities. I’ve had great experiences with Alto and I think my patients would say the same. 

Is there anything else you’d like to tell our community?

Your relationship with your healthcare provider is so important. If you don’t feel like you can tell them everything that is going on, you need a new provider. If you’re feeling stigmatized and someone is not supportive of your lifestyle, then switch, if possible, to an online pharmacy or a community health center that works with the LGBTQ community and get your PrEP that way. Any online pharmacy that handles PrEP will have someone sensitive to these communities, lifestyles, and risk factors.

Even though I do everything I can to encourage an open dialogue, I don’t always get all the information out of people either. Sometimes people feel embarrassed, but we can’t support someone if we don’t know what they’re doing. The first step is to have a healthcare provider that you really trust. The second step is to be really honest with that person. Help them help you prevent HIV.

For more information about Dr. Lisa Sterman and her practice, you can view her profile here. 

HIV Health Spotlight: A conversation about PrEP with Dr. Lisa Sterman 

In honor of National Coming Out day our Proud Employee Resource Group sat down with Altoid Nicholas Satow, Partnerships Manager HIV/PreP, to learn about his own personal experience and his advice for others on coming out.

Coming Out with Pride: Nicholas Satow Shares His Story

This year marks the 32nd anniversary of National Coming Out Day, a time to support lesbian, gay, bisexual, queer, and transexual individuals. In honor of this awareness day our Proud Employee Resource Group sat down with Altoid Nicholas Satow, Partnerships Manager HIV/PrEP, to learn about his own personal experience and his advice for others on coming out. ERG’s are voluntary, employee-led groups that foster a diverse, inclusive workplace aligned with organizational mission, values, goals, business practices, and objectives.

Q: Tell us a little about your coming out experience. When did it happen and who did you first tell? 

A: My coming out story starts with the story of my best friend. We met in third grade and were just 15-years-old when she came out to me. She was a star basketball player and met a girl from an opposing high school team 45 miles away. We quickly turned 16, and without our parents’ knowledge, we were driving 90 miles round trip every weekend to go see her girlfriend and hang out with a group of kids who didn’t know anyone from our school district. The 45 miles of distance made her feel safe from our friends and family finding out about her double life.

Leading a double life and constantly hiding our whereabouts started to wear on us. Especially for her after family and friends started becoming suspicious. Who is this girl you’re always on the phone with? Why are there so many miles on your car? Where are you going? Her fear of being outed or disowned started to build as rumors began to circulate between friends and family.

It was a Saturday night, and we were halfway through our 45 mile drive home. She broke down in tears and started to share terrifying thoughts she’d been having. She said she couldn’t take the pressure of the double life anymore and the rumors circulating at school. She felt extremely overwhelmed, isolated, and scared. Thoughts of teenage suicide and stories I had heard of queer teens taking their own lives started to consume my mind. Even though I wasn’t ready to come out of the closet yet, I knew in that moment my friend needed me more than ever. I felt responsible for her loneliness and selfish for making her go through this journey alone. She said, “I can’t take this anymore. I can’t live like this,” Staring at the road ahead, I said, “You need to stay strong. You make me strong.” I turned and looked at her and said, “I’m gay, too.” This was the first time I said those words out loud. It was terrifying and relieving at the same time. It was the first time I felt authentically me. 

It’s 15+ years later, and we’ve helped each other get through many scary thoughts and tough times, come out of the closet to friends and family (sometimes while sitting side-by-side) and navigate difficult romantic relationships as we learned what it was like to be a young gay person in Cleveland, Ohio.

Q: How did you feel as a result of coming out? 

A: After coming out to my best friend, I felt a sense of relief and companionship. Our double lives became more of a shared experience and a lot easier to manage, knowing we had each other to rely on. I also started to feel more comfortable coming out to other friends. At 18, I came out to all my friends. At 22, I came out to my parents and family.

Q: What resources, support groups, or communities did you rely on when coming out? 

A: At the time, I wasn’t aware of any resources or support groups, so this wasn’t something I utilized. Another best friend’s older brother was gay, so I learned a lot from him, and he took me out to introduce me to the community and become comfortable in my own skin.

Q: What advice would you give to others? 

A: The best advice I’d give to LGBTQIA+ youth is to find a support system of like-minded individuals and come out when you feel it’s safe to do so. If you’re in an environment where you feel your mental or physical safety could be jeopardized, don’t come out until those dangers are gone. If being disowned, financially cut-off, or assaulted is a possible reality, make sure you have somewhere safe to go where your basic needs can be met. There will always be people who won’t accept you for who you are, but there will be even more who will support you. You just need to find that community. 

Q:  Why is it important for you to work at a company that values diversity in all forms?

A: Companies that support diversity help us evolve into a more accepting society. When people are exposed to colleagues who are different from them, they get to know each other on a personal level and start to realize that we are all more similar than different. I believe these experiences translate into the way people treat others outside of work and how they raise their children.

At Alto, we believe in a world where every perspective matters and that diversity fosters creativity and creates innovation. We welcome candidates of all backgrounds, skill sets, and experiences. To learn more, read Why We Prioritize Diversity at Alto. 

For more information on how to make your workplace safe and equitable for all, read 11 Simple Ways You (Yes, You!) Can Make Your Workplace More LGBTQ Inclusive. 

If you or someone you know is considering coming out, we encourage you to review these resources: 

Parents, Families, and Friends of Lesbians and Gays (PFLAG) Recommended Reading: Coming Out

Coming Out with Pride: Nicholas Satow Shares His Story 

Nicholas Satow (center) with Camp Lightbulb leaders

Rather than letting every cough or sniffle cause a panic, let’s sort through the most likely symptoms of the three respiratory illnesses to look out for this season: the cold, flu, and COVID-19.

Cold, Flu, or COVID-19? Your Seasonal Symptom Guide

For most of the year, we’ve had one virus on our minds. But as cold and flu season moves into full swing, an onslaught of new symptoms could sow confusion. Rather than letting every cough or sniffle cause a panic, let’s sort through the most likely symptoms of the three respiratory illnesses to look out for this season: the cold, flu, and COVID-19.

We can usually get an idea of what the flu season holds in store for us by studying recent flu activity in the Southern Hemisphere. This year, reported infection rates were 99% below normal, which epidemiologists credit to the fact that people were wearing masks, social distancing, and washing their hands frequently. The same precautions that prevent the spread of the coronavirus will also stop the flu (and the common cold too).

Still, experts are urging everyone to get their flu shot this year. More people getting sick could cause more than just confusion over symptoms. It could put a strain on testing supplies and medical care. Getting your flu shot will not only make you less likely to get sick with the flu, but it can also reduce the severity of your symptoms if you do get sick.

There’s a reason we call it “the common cold.” According to the American Lung Association, most adults come down with two to four colds per year. With more than 200 viruses that can cause the common cold floating around out there, it’s not all that surprising. Here are the main symptoms most cold sufferers can look forward to: 

The CDC reports that a cold usually begins gradually with a sore throat and a runny nose and then progresses to include coughing and sneezing. It is rare for cold symptoms to include fever, and diarrhea is not considered a symptom of a cold. 

There is no cure for the common cold, but most people recover within 7-10 days. The best way to feel better is to rest and drink plenty of fluids, although over-the-counter cold medications can help ease your symptoms. Since colds are contagious, try to be mindful and cover up when you cough or sneeze. 

The flu tends to hit us like a ton of bricks. Unlike the more gradual onset of a cold, flu symptoms are known to appear suddenly and with force. Along with a tell-tale fever often comes headaches, body aches, and a general feeling of exhaustion. 

The CDC reports that the following symptoms are common with the flu:

Vomiting and diarrhea (more common in children)

You may have noticed that the common cold shares some of these symptoms. Deciphering the differences is not always cut and dry. Generally, it’s that “hit by a bus” feeling that differentiates the flu. If you’re suddenly sidelined by a fever, chills, aches, and pains, you’re probably not dealing with a cold. It’s important to note, however, that not everyone experiences fever with the flu. 

Your healthcare provider can determine if you have the flu with a simple swab test. As with a cold, you should drink plenty of fluids and try to rest. You should feel better after a few days. Antiviral drugs can be used to reduce symptoms and shorten the amount of time you are sick. Antiviral medications are available by prescription only and work best when started soon after you get sick. When you send your prescription directly to Alto, we can make sure you get your flu medication delivered safely to your home that very same day. 

Here’s where our symptom detective work gets really tricky. Not only are the symptoms of COVID-19 all over the map, many of them closely mimic those of the flu. The coronavirus has confounded experts by showing up in strange and disparate ways. The only true way to know if you have symptoms of coronavirus infection is to get tested, but there are a few red flags to watch out for.

What’s so confusing is that COVID-19 is a respiratory illness like the cold and flu, but it’s not only a respiratory illness. Experts consider it to be a multi-organ disease. Symptoms may appear from head to toe, range from mild to severe, and often come on gradually. While there isn’t a clear set of symptoms that always distinguishes COVID-19, these four seem to be the most common:

The CDC also lists the following symptoms of COVID-19:

Shortness of breath or difficulty breathing

Interestingly, a sudden loss of smell or taste seems to be emerging as a defining symptom of coronavirus infection. While it doesn’t occur in every patient, some studies have indicated that nearly 65% of people with COVID-19 experience this symptom. Additionally, while you may be accustomed to having your temperature checked when you visit a restaurant or store, fever is a common symptom of COVID-19, but by no means always present. About 55% of all infections are accompanied by a fever. 

The rule of thumb is this: if you think your symptoms could be COVID-19, you should act as if you’ve been infected until you can be tested. Call your doctor right away and self-quarantine while you monitor your symptoms and wait for further instructions. It’s crucial that you take every precaution to ensure you don’t transmit the virus to anyone else.  According to the CDC, you should also be on alert for more dangerous symptoms, which include trouble breathing, pain or pressure in the chest, bluish lips or face, confusion or incoherence, and an inability to wake or stay awake. Seek emergency medical care if any of these symptoms occur.

Coronavirus infections tend to last longer than the flu, but those with mild cases should recover on their own in about two weeks. Even if you have only mild symptoms, you need to call your doctor and self-quarantine immediately. With more severe cases, doctors may provide patients with intravenous fluids, medicines to reduce a fever, or oxygen to help with breathing.

If all you know is that you’re feeling terrible, give your doctor a call. Generally speaking, if you’re sniffly, sneezy, and slightly rundown, you’re probably battling the common cold. If you suddenly come down with a fever or chills, body aches, and heavy fatigue, the flu may be to blame. However, with COVID-19 so tricky to identify, it’s vital that you rule it out whenever troubling symptoms crop up. 

If you have questions about which medications can help you deal with your seasonal symptoms, our pharmacists are standing by. And if you do come down with the flu, we can hand-deliver your antiviral medication quickly and safely, while you stay home and get that all-important rest. 

Want Alto by your side this cold and flu season? Our team is available 9 am - 9 pm PT Monday - Friday and 10 am - 6 pm PT on weekends; call or text 1-800-874-5881 or download the mobile app for secure messaging.

We combed through the latest advice from the experts to give you some actionable steps that may help protect your health.  

Managing Diabetes During COVID-19

Pre-existing condition. These two words have echoed across news broadcasts and government briefings about COVID-19, stirring up fears in those living with chronic disease. But as we’ve gathered data and learned more about the novel coronavirus, a clearer picture has emerged. We now better understand how people with underlying medical conditions like diabetes can take careful precautions to decrease their likelihood of getting sick. 

According to the ADA, it does not appear that people with diabetes are more likely to get COVID-19. They do, however, have a higher risk of developing serious symptoms and severe complications that require hospitalization if exposed. This increased risk makes prevention and early detection critical. 

If you are living with diabetes, it’s important to focus on what you can control right now. In addition to following the CDC’s prevention guidelines, which include wearing a mask, washing your hands frequently, and avoiding unnecessary social contact, you can manage your risk by planning ahead. With this in mind, we combed through the latest advice from the experts to give you some actionable steps that may help protect your health.  

The world is full of very real stressors right now. It’s easy to let healthy habits slip when you’re anxious or under pressure, however, it’s more important than ever to stay on top of your health. The ADA advises that your risk of experiencing severe illness from COVID-19 is likely to be lower if your diabetes is well-managed. Dr. Janaki Vakharia, MD, clinical fellow in the Endocrinology Division at Massachusetts General Hospital, explains, "Studies have reported that patients with well-controlled diabetes who have been hospitalized for COVID-19 have a higher rate of survival. Better controlled diabetes is also associated with lower markers of inflammation, which may explain this better rate.” 

Do your best to stick to the care plan you’ve created with your doctor—keep taking your insulin and/or other medication, test and track your blood glucose, exercise at home, and maintain a healthy diet. Make sure you have enough medication on hand to last you several weeks and continue your doctor’s appointments virtually if telemedicine is an option. 

In his FAQs about Diabetes + COVID-19 for Johns Hopkins Medicine, Mohammed Al-Sofiani, MBBS, MSc, writes, “I strongly encourage all people with diabetes to make sure that they have enough supply of insulin and all the tools they typically use to manage their glucose...I also encourage people with diabetes to avoid going to the clinics or pharmacies unless it is for urgent matters.”

You should never have to risk your health to obtain your insulin and other medications. That’s why we offer free contactless delivery when you fill your prescription through Alto. Simply let us know where and when to drop it off, and we’ll make sure your medications and supplies arrive safely. 

We’re about to enter cold and flu season. More viruses going around means more chances of getting sick so experts are urging everyone to get a flu shot. This year, a sore throat or runny nose could produce more anxiety than usual, but try not to let yourself slide into fearful thinking. Stay home and report your symptoms to your doctor, especially if you experience a fever, dry cough, or shortness of breath. There is a wide range of symptoms associated with the onset of COVID-19, but the CDC offers this list as well as an interactive coronavirus self-checker. Mild symptoms can often be managed and monitored from home, but don’t make that decision without your doctor. 

If you develop any emergency warning signs for COVID-19, seek medical attention immediately. According to the CDC, these emergency signs include difficulty breathing, chest pain or pressure, confusion or inability to arouse, or bluish lips or face, though they stress that severe symptoms of any kind should be immediately reported to your medical provider. 

Preparing for the possibility of getting sick is especially important right now. The ADA recommends having enough supplies to last you several weeks in case you are symptomatic and unable to leave your home. If you do get sick and your doctor has recommended that you remain at home, take that as good news and try to focus your attention on resting while keeping an eye on your glucose levels and symptoms. 

Remember—any infection, including COVID-19, will likely cause your blood glucose levels to start rising. It’s important to pay close attention to your blood sugar, continue taking your medications, and drink plenty of fluids to prevent dehydration. If your blood sugar becomes hard to manage and your body doesn’t have enough insulin, you are at risk of developing diabetic ketoacidosis (DKA). The ADA advises that if your blood sugar has registered high (greater than 240mg/dL) more than twice in a row, you should use an over-the-counter kit to test your urine for ketones. If ketones are present, call your doctor right away. 

Continuing to take your insulin and other medications must be your top priority, so be sure that you don’t risk running out. According to ADA, the leading manufacturers of insulin and other supplies are not reporting any impact on their manufacturing and distribution capabilities due to COVID-19. There have been, however, widespread reports of mail delays that could affect the timely delivery of mail-order prescription drugs. 

When you fill your prescriptions through Alto, we’ll coordinate your refills automatically, then one of our couriers will hand-deliver them to your home. Your prescriptions will never change hands during the delivery process and you can designate a safe place for your courier to leave your medications for contact-free drop-offs. 

Finally, if like so many you are currently experiencing unemployment, loss of insurance, or economic hardship, there are options to get help. The ADA offers this list of resources and the team at Alto is always here to help you find options that can save you money. Reach out to us at any time via text, phone call (1-800-874-5881), or in-app messaging.

So many of us are feeling anxious and uncertain right now, and that can interfere with our ability to sleep well, manage stress, and practice self-care. Be sure to keep in touch with the people you love and talk to them about your fears. Joining an online community for people with diabetes can also help you get the emotional support you need. 

We're here to support you through COVID-19 with free home delivery. Our team is available 9 am - 9 pm PT Monday - Friday and 10 am - 6 pm PT on weekends; call or text 1-800-874-5881 or download the mobile app for secure messaging.

Switching to Alto is easy and takes only a few minutes. Here's what you can expect to know about savings, free same-day delivery, and access to our expert pharmacists.

How Do I Transfer a Prescription to Alto?

It really is possible. In just a few minutes, your days of standing in line at the pharmacy could be over for good. From now on, your refills will arrive safely at your doorstep exactly when you need them — no more wondering if they’ll make it on time or if they’re even on their way. And you’ll have ongoing support from a team of pharmacists through private chat or text, helping you feel comfortable discussing any health concerns freely. 

You can switch to Alto in minutes using our app, by going online at alto.com, or by calling Alto at 1 (800) 874-5881. 

We’ll contact your current pharmacy to arrange the transfer right away. It may take a few business days to receive your prescription from your old pharmacy, but we’ll keep you up to date along the way. As an alternative, you can ask your doctor to send a new prescription directly to Alto.

Not only are the services we provide at Alto completely free, but we’ll also do our best to identify ways to save you money. It’s true—your copay stays the same when you switch to Alto and there are absolutely no hidden delivery or service fees. We’ll investigate coupons, copay cards, and other savings options in order to find you the best price — we’ve saved our patients more than $23 million on their medications! 

Once your transfer is complete, we’ll reach out with a text or call to schedule your free delivery. You select the delivery date and window that works best for you, and you can follow your courier in real-time as they make their way to your door. Your medications will be hand-delivered by a member of our local courier team. In most instances, you can designate a safe place for your medications to be left in the event you are not home or if you prefer contact-free delivery. 

Finally, if you’re wondering if we carry your medication, the answer is yes. We fill all types of medications, including specialty, over-the-counter, brand, and generic. And if you have questions about your medications, our pharmacists and patient care team are just a text, chat, or an email away - Monday through Friday 9 am - 9 pm PT and Saturday and Sunday from 10 am - 6 pm PT.

If you’re excited about the benefits of switching to Alto — whether it’s the potential savings, free same-day delivery, or easy access to expert pharmacists — there’s no reason to hesitate about transferring your or your family’s prescriptions. We’ve designed the process to be quick and easy. 

Ready to make the switch to a better pharmacy? Our team is available 9 am - 9 pm PT Monday - Friday and 10 am - 6 pm PT on weekends; call or text 1-800-874-5881 or download the mobile app for secure messaging.

How Do I Transfer a Prescription to Alto? 

Our pharmacists share a few tricks that can save money, time, and avoid confusion later on. Let’s walk through the ideal prescription experience one step at a time. 

How to be a prescription overachiever!

You’ve just been handed a new prescription by your doctor. While you could have it sent to the nearest pharmacy, pay what they tell you is owed, and take the medication without question, a prescription overachiever knows a few tricks that can save money, time, and avoid confusion later on. 

If straying from business as usual sounds like a hassle, we’ll let you in on a little secret. We consider ourselves the ultimate prescription overachievers—nothing brings us more joy than taking care of the details for you. From savings investigations to free drop-offs, there are some serious perks on the table. Let’s walk through the ideal prescription experience one step at a time. 

Don’t let the concept of “doctor knows best” deter you from asking questions. Every time you get a new prescription you should be sure you understand what, how, and why. 

You’ll always have access to a team of experts at Alto, but it’s still important to have this initial conversation with your doctor. If you’re unsure what you should be asking, here’s a solid start: 

Why is this medication the best choice for me?

What would happen if I don’t take my medication correctly?

Don’t be afraid to seek as much clarity as you need. This information will help you stick to your plan and there are no wrong questions when it comes to your health. 

2. Decide where and how to get your prescription filled 

While you could take your prescription to the nearest pharmacy and wait in line, a busy retail atmosphere may prevent you from getting much one-on-one time with your pharmacist. Mail-order options offer convenience but can be problematic if you need your prescription right away. Thankfully, at Alto, we’ve built a better pharmacy experience.

Ask your doctor to send your prescription directly to us and we’ll reach out to set up your account. As soon as your medication is ready, we’ll send you a text or give you a call to schedule your free delivery. As a full-service pharmacy, we can fill all medications, including specialty, over-the-counter, brand, and generic. And you’ll have access to a team of experts who’d be happy to answer questions and discuss your concerns. 

According to a recent report from the Organization for Economic Cooperation and Development, on average, Americans spend about $1,200 on prescription drugs a year. However, if you know where to look, there are opportunities to get a better deal. Every time you send a new prescription to Alto, our team works tirelessly behind-the-scenes to find you the best price. We’ll automatically look for any savings, including prescription discounts, coupons, and assistance programs, then show you which option provides the lowest possible cost. If it turns out that paying out of pocket is cheaper than going through insurance, we’re going to let you know. So far, we’ve saved our patients more than $23 million on their medications. 

Now that you have your prescription in hand, it’s a good idea to review the details. Should you take it on an empty stomach or with a meal? Are there special instructions to keep in mind or side effects to expect? Understanding the facts can go a long way in reducing your risk of adverse effects. If any questions still linger, our patient care pharmacists are a simple text or phone call away. 

Whether you thrive on responsibility or you’re more of the “wing it” type, it never hurts to enlist a little help in sticking to your plan. Setting a recurring alarm will ensure you never miss a dose, so we went ahead and included one within the Alto app. If your prescription is ongoing, you can use calendar alerts to help you remember your refills or simply leave it to us! We’ll automatically reorder your medication before you run out and get in touch to schedule delivery. 

Questions may come up in the days and weeks to come, so be sure to have your healthcare provider’s contact information handy. If you experience any unusual symptoms or are unsure if a certain supplement will interact with your medication, don’t hesitate to check in with your doctor or the team at Alto.

Remember—being a prescription overachiever might sound like more work, but you don’t have to put in the extra effort when you have Alto on your side. We thrive on handling the details so you can stay focused on your health. 

Curious if your prescription could cost you less? Our team is available 9 am - 9 pm PT Monday - Friday and 10 am - 6 pm PT on weekends; call or text 1-800-874-588 or download the mobile app for secure messaging.

In this article we’ll share what a typical IVF schedule might look like, beginning with medications used to grow follicles, the egg retrieval process, and finally, transfer options.

IVF Medications: Schedule and Side Effects Explained

IVF, or in vitro fertilization, is one form of treatment that may help those experiencing infertility to conceive. In fact, at least 8 million babies born today are a result of this procedure. That’s remarkable when you consider the first successful IVF procedure was only conducted in 1978.  

In this article we’ll share what a typical IVF schedule might look like, beginning with medications used to grow follicles, the egg retrieval process, and finally, transfer options. Let’s take a closer look at how one might arrive at each step. 

What Medications Should I Expect with IVF? 

The IVF process itself requires considerable IVF medication use on a precisely timed schedule. For these reasons, it’s important to understand what you might be prescribed as well as any potential IVF medication side effects. 

On the first day of a patient’s menstrual cycle they will typically call to schedule a “baseline” visit for Day 3 of their cycle. This appointment includes an ultrasound and bloodwork. After this visit, if approved, patients will start hormone injections (commonly referred to as “stimulation meds” or “stims”). 

These injections stimulate egg production so a woman’s body produces many follicles in a cycle, not just one (follicles house eggs that contain all the hormones and fluids needed to make an egg mature). Patients with one or more follicles already grown may need to wait until their next period cycle or use a different protocol. 

Stims are typically injected between 6-9PM daily at a consistent time. 

Supportive/adjunctive medications include: 

Omnitrope -  A growth hormone whose main purpose is to help improve the quality of eggs. Not every patient will see this on their protocol. Typical use cases include poor responders to stimulation medications and women who have a decreased ovarian reserve.

As a result of injections it is normal for patients to experience soreness or mild bruising at the site of injection. Bloating, cramping, headaches, breast tenderness and in some cases, temporary allergic reactions are also common side effects. 

During this period patients will continue stims and may start what is known as “antagonists” to prevent premature ovulation (i.e. once eggs are released into the pelvic cavity they cannot be retrieved). These types of medications block the hormone (gonadotropin-releasing hormone-GnRH) that causes eggs to be released from the ovaries. 

Regular monitoring visits will likely include additional ultrasounds and bloodwork and occur around days four and six and every other day after. Visit results will then determine if nightly doses need to be changed or if an antagonist is necessary. In these cases, patients will often have leftover medications or need refills. 

Side effects are similar to those experienced during days one to four. Some patients also experience what is known as ovarian hyperstimulation syndrome (OHS). In this instance there is an overproduction of follicles that can cause extreme swelling or pain in the ovaries. Depending upon the severity, treatment may be cancelled until a future cycle. 

Patients will receive a final ultrasound and bloodwork to confirm if the follicle pack has reached maturity. If so, a “trigger shot” is assigned approximately 35-36 hours before retrieval to stimulate final growth spurt and ovulation. 

Trigger shots are hormones that support the normal development of an egg in a woman's ovary, essentially triggering the egg to go through a final growth spurt, and stimulate the release of the egg during ovulation from the follicles within 36 hours. 

In most cases, patients will discontinue all other medications and are given a deep sedation for the 15-45 minute retrieval process. Following the procedure it’s normal to feel mild cramping or experience some vaginal spotting. 

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