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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 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 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 or in-app secure messaging.

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 in-app messaging or phone at 1-800-874-5881.

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. As you finalize your holiday plans this year, look for opportunities to avoid falling into familiar patterns of stress. To help you get started, we’ve compiled our best advice for staying healthy and enjoying the spirit of the season.

The month of December is often rife with temptations to overcommit, overindulge, and overspend. It never hurts 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. 

Put a lot of pressure on yourself to create picture-perfect holidays? You’re not alone — for many, holiday perfectionism plays a big part in seasonal stress. But it doesn’t have to. You can still enjoy your celebrations even if everything doesn’t go as planned. In fact, there’s a good chance you’ll enjoy them even more.

Challenge yourself to let this season be a little less than perfect. Experiment with ways to keep your favorite traditions alive while cutting a few corners, or giving other family members the opportunity to take on more this year. 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 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 nights 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 that increases 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.

Expressions of gratitude cause our brains to release dopamine and serotonin, two mood-enhancing brain chemicals that promote feelings of pleasure and reduce stress. Try not to dwell on what didn’t go as planned this year, or how this holiday season compares to others. Instead, focus your attention on what you’re grateful for. Whether you recount happy moments from your day or share appreciation for the people you encounter, relishing the good things is a powerful stress reliever.

Be sure 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.

Alto is here to help you take good care this holiday season. Our free, same-day delivery eliminates the additional stress of long pharmacy lines over the holidays. We're open seven days a week and our team of pharmacists is available to answer any questions from 9 am – 12 midnight ET Monday – Friday, and 10 am – 9 pm ET on weekends.

Reach out any time through in-app secure messaging or by phone at 1-800-874-5881.

Editor’s Note: This post was originally published in December 2020 and has been updated for accuracy and completeness.

In honor of World Kindness Day on November 13th, let’s explore the science behind why kindness may be one of the effective medicines of all. 

Why Kindness May Be the Best Medicine

“If you want others to be happy, practice compassion. If you want to be happy, practice compassion.” - Dalai Lama

You know those warm and fuzzy feelings you get after performing a good deed? It turns out that they’re backed by science. Known as “helper’s high,” your brain’s pleasure and reward centers actually light up whenever you show kindness to someone else. This phenomenon suggests that deep down, we’re wired to be kind. It’s an idea that feels exceedingly hopeful in today’s divided world.

The next time you feel down, know that the lift you need may be one act of altruism away. Though fascinatingly, the benefits of kindness extend far beyond the mind. From lowering blood pressure to reducing pain, acts of compassion can have measured effects on our physical health and longevity. In honor of World Kindness Day on November 13th, let’s explore the science behind why kindness may be one of the effective medicines of all. 

Studies have shown that when we engage in altruistic behavior—putting the well-being of others before our own without expectation of anything in return—we release a cascade of feel-good chemicals—from oxytocin (the “love hormone”) to serotonin (the “happy chemical”) to dopamine (known to produce a feeling of euphoria). These mood-boosting chemicals are said to soothe stress and ease depression, as well as help you feel joy, bond with others, and experience pleasure. 

There have been many studies illuminating a clear link between feelings of social belonging and greater longevity. According to the American Psychological Society, people who volunteer have lower mortality rates and another study found volunteering slowed the progress of cognitive decline. Interestingly, the studies suggest that it’s not just the act of volunteering that matters, but the intent to help others as well. Those who feel they’ve made a positive impact on their community are more likely to live a longer, healthier life. 

We have long connected our emotions to our hearts, and what an intuitive association this has turned out to be. We now know that loneliness can increase our risk of cardiovascular disease and, conversely, kindness can strengthen our physical hearts. When we experience an act of compassion or care, we often say it “warms our hearts.” That’s likely due to the release of oxytocin, the “love hormone” that we mentioned earlier. Oxytocin contributes to blood vessel dilation, which reduces blood pressure and improves heart health. Best of all, even just witnessing a good deed can be enough to produce this cardioprotective effect. 

A series of studies published in 2017 found that the areas of the brain that react to pain seem to be deactivated by the experience of giving and volunteering. Furthermore, the more meaningful people felt their good deeds were, the less they experienced pain. Engaging in acts of kindness produces endorphins, the brain’s natural painkillers. Secreted by the nervous system in response to stress, endorphins function similarly to opioids. You might know them best for their role in “runner’s high”—the sense of euphoria that occurs after strenuous exercise. 

Our brains are programmed to reward us when we’re kind. But the stress and busyness of life can wear us down and leave us out of practice. If the benefits we’ve covered are just what the doctor ordered, these simple acts of service can help uplift you and everyone around you. Just remember—a single act of kindness will only take you so far. For best results, you'll want to get a daily dose. The more regularly we practice kindness, the greater and more enduring the rewards.

Give a genuine compliment to someone you encounter.

Allow other cars to merge into your lane while driving.

Write five encouraging comments on social media.

Volunteer to walk dogs at an animal shelter or for a neighbor. 

Start a friendly conversation while waiting in line. 

Kindness is one of the rare acts that benefit ourselves and others simultaneously. As you build better relationships, a better community, and a better world, you’ll be building a happier, healthier self inside and out. 

Let us show you how we can uplift your pharmacy experience and become your partner in managing your medications. Our team is available to answer your questions from 9 am – 12 midnight ET Monday – Friday, and 10 am – 9 pm ET on weekends; reach out by in-app secure messaging or phone.

We offer the latest advice on how you can access the medications and services you need while protecting yourself from infection with COVID-19.

Navigating HIV Treatment and Prevention During COVID-19

Living with HIV during the COVID-19 pandemic

It’s been over six months since the first stay-at-home orders swept across the country, and we’re just beginning to replace widespread uncertainty about the coronavirus with real-world data. There’s still much we don’t know about how COVID-19 affects those living with HIV, but researchers are working quickly to glean insights from cases over the past months. 

Though our understanding is continually evolving and the data is limited, experts believe that people with HIV who are receiving treatment have the same risk for COVID-19 as the general population. We do know, however, that people with weakened immune systems are more likely to get severely sick from COVID-19, which underscores the already vital importance of preventing new HIV infections and ensuring access to treatment. 

If you are at risk of HIV infection or living with HIV, we encourage you to not put prevention or treatment on hold. It’s also crucial that you stick to the plan outlined by your doctor as closely as possible, especially by taking your medications correctly and on time. As your pharmacy, we’re here to help you overcome any challenges in maintaining your regimen that may arise. Let’s walk through the latest advice on how you can access the medications and services you need while protecting yourself from infection with COVID-19.

Is COVID-19 illness more severe in people living with HIV?

As we mentioned, when HIV is being treated, it does not seem to increase the risk of infection or severe illness. Those who are living with HIV and not on treatment or virally suppressed, however, may be at greater risk of COVID-19 complications. Additionally, older people living with HIV and those with other underlying health conditions may also be at greater risk of serious illness from COVID-19. It’s important to take precautions to protect yourself from COVID-19 infection by following CDC guidelines, such as wearing a mask, social distancing, and washing hands and high-touch surfaces often. 

We know that people living with HIV are more vulnerable to respiratory infections when their HIV is not well managed. That’s because their weakened immune systems may be unprepared to deal with an invading virus. For this reason, it’s incredibly important to continue your antiretroviral treatment (ART) as prescribed. If you are having difficulty continuing your treatment for any reason, talk with your healthcare provider right away.

What additional precautions should people living with HIV take?

The most important actions you can take for your health are to continue your HIV treatment and avoid potential exposure to the coronavirus. Follow the preventative guidelines outlined by the CDC to protect yourself and others from getting sick. Additionally, you should take the following precautions:

Keep your regular medical appointments and discuss ways you can reduce your risk of exposure to COVID-19 during your visits. Use telehealth services whenever possible; your doctor can advise you on the remote options available to you.

Keep at least a 30-day supply of your HIV medications on hand as well as any other medications or supplies you need to manage your health. If possible, ask for a three-month supply and choose a pharmacy that offers home delivery to avoid spending time in close contact with others while standing in lines. (Alto’s couriers will hand-deliver your medications to your doorstep, so you never have to worry about mail delays either!)

People living with HIV are at a higher risk of serious flu-related complications, make sure all your vaccinations are up-to-date, especially your flu shot.

The CDC recommends maintaining a healthy diet, aiming for 8 hours of sleep every night, and taking steps to reduce stress. 

If you start to feel sick, especially if you have a dry cough, fever, fatigue, and/or a loss of smell or taste, stay at home and contact your doctor immediately so you can determine your next steps. You will need to self-isolate to avoid spreading the coronavirus to others as you await instructions from your doctor. For this reason, we strongly recommend having a plan in place for if you get sick, including keeping 30 days’ worth of medications, food, and other supplies on hand.

How can I get tested for HIV during the COVID-19 pandemic?

It’s as important as ever to know your HIV status. If you’re at risk for HIV, talk to your healthcare provider about your options for getting tested. The CDC has stressed the importance of continued access to HIV testing and encourages people who are at risk for HIV infection to get tested in ways that support social distancing and stay-at-home orders (when they are in place), such as self-testing when possible. They have created this resource that lists self-testing services by state. You can also find in-person testing locations here. 

I’ve lost my insurance. How can I continue to get my HIV medication?

As we face this public health crisis, record numbers of people are also losing their jobs and employer-based coverage. If you’re currently uninsured or cannot afford your out-of-pocket costs, there are resources that can help. HIV.gov puts out this list of toll-free helplines that can help you find programs and services in your state to lower your treatment costs. They also list a variety of federal resources here. 

The AIDS Drug Assistance Program (ADAP), which is part of the Ryan White HIV/AIDS Program was created to help cover the cost of HIV-related prescription medications for people who have limited or no prescription drug coverage. Eligibility may vary by state, so find out more by using the ADAP Directory to identify your local program. 

How can I continue to access PrEP during the COVID-19 pandemic?

If you are at risk of HIV exposure, protecting yourself needs to remain a top priority. PrEP, or pre-exposure prophylaxis, is an HIV prevention method that's available by prescription. We explain more in our article, “All About PrEP for HIV Prevention.”

If you are already taking PrEP, talk to your provider about the possibility of telehealth options for the time being and see if you can get a prescription for a 90-day supply of PrEP. To find an in-person or online provider, visit one of the following websites:
PleasePrEPme.org
Greaterthan.org

If you need help paying for PrEP, there are assistance programs available that can cover the costs. PleasePrEPme.org maintains a comprehensive list of available resources here. 

What are some ways to cope with stress and anxiety right now?

It’s normal to experience heightened emotions during times of stress. And, unfortunately, some of the actions we are taking to protect ourselves, such as social distancing, can negatively impact our emotional well-being. Here are some ways you can protect your mental health and cope with the stress and uncertainty of the COVID-19 pandemic.

Unplug when you need to. It’s important to stay informed, however, the constant cycle of news reports and social media updates can become all-consuming and overwhelming. Take breaks from your devices when necessary and try to focus on reliable news sources and avoid social media accounts and websites that may be spreading rumors or false information.

Find soothing activities and practice them daily. Maybe you turn to a calming classic like meditation when you need to recharge or perhaps nothing makes you happier than whipping up a batch of chocolate chip cookies from scratch. Whatever helps you unwind is good for your emotional well-being and overall health. 

Stay on top of your health and wellness. Stress can disrupt your usual healthy habits. Try to move your body frequently, incorporate healthy foods, and get a full night’s sleep. You may not succeed every day and that’s okay. Just do your best to keep up your healthy habits most of the time. 

Seek help if you need it. If feelings of fear, anger, sadness, worry, or numbness interfere with your responsibilities for several days in a row or if you find yourself turning to unhealthy coping strategies like drugs or alcohol, please reach out for help. The CDC offers this list of free and confidential resources.

We are committed to ensuring you receive your HIV medications safely and on time throughout the COVID-19 pandemic. Our pharmacy locations are fully stocked, our couriers are ready, and our pharmacists can assist with coordinating early refills and longer fills. We offer free, contactless delivery, plus ongoing access to support and advice.  

Our HIV speciality team is available to answer your questions 9 am – 12 midnight ET Monday – Friday, and 10 am – 9 pm ET on weekends. Download the mobile app for secure messaging or call 1-800-874-5881. 

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

The month of June marks Pride, a time to recognize and support lesbian, gay, bisexual, queer, and transexual individuals. In honor of this awareness month, our PROUD Employee Resource Group* sat down with Nicholas Satow, Partnerships Manager HIV/PrEP, to learn about his own personal experience and his advice for others on coming out. 

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

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.

How did you feel as a result of coming out? 

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.

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

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.

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. 

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

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

*ERG’s are voluntary, employee-led groups that foster a diverse, inclusive workplace aligned with organizational mission, values, goals, business practices, and objectives.

Coming Out with Pride: Nicholas Satow Shares His Story 

Nicholas Satow (center) with Camp Lightbulb leaders

If you’ve been stuck in a cycle of wired nights and exhausted days, your body and mind need help remembering how to relax. These strategies can help you break free from unhealthy sleep patterns and finally get some solid shut-eye. 

Too stressed to sleep? These strategies can help.

Stress and sleep can form a pretty vicious cycle. No matter how physically exhausted we feel when our heads hit the pillow, we just can’t seem to quiet our racing minds. Then, after tossing and turning our way through the night, we’re way too fatigued to function at our best. This leads to more anxiety...and on and on and on. 

Stressors like anxiety and worry send our bodies into “fight or flight” mode. Normally, this state of hyperarousal fades away once the threat is gone. But chronic stress causes our nervous system to continually work on overdrive, pumping out hormones that keep us revved up and alert even when it’s time to sleep. 

In the world of mindfulness, we hear a lot about “present moment awareness.” That’s because it’s the one place your stress doesn’t live. If you’re anxious about something, you’re either fixating on a past scenario or worrying about a future event. You’re so stuck looking forward or backward that you can barely focus on the task at hand. The practice of mindfulness is meant to break these toxic thought patterns by helping you become aware of when you’ve drifted from the present moment. In this way, it can actually stop stress in its tracks. 

Try listening to a guided mindfulness meditation as you transition out of “work mode” in the evening or while lying in bed if you can’t sleep. The Insight Timer app is a fantastic resource for free meditations, or try Calm, one of the most popular apps for meditation and sleep. If your employer offers access to Modern Health you might also try their “Body Scan for Sleep” in-app meditation.

Remember—you can’t change the past or control the future, no matter how many times you turn a situation over in your mind. Your best bet is to try to live where your stress cannot. 

If you often find yourself dreaming about a stressful project or jolting awake with a worrisome thought, a simple journaling practice can help. If your mind is swirling with worries as you fall asleep, you could be carrying that mental load into your dream state. Before you go to sleep, spend some time writing out whatever is on your mind. List out items on your to-do list and journal about any anxieties from your day. The simple act of writing it down will signal to your brain that it’s okay to let it go. That way, your brain can go about its nightly tasks and leave you to sleep in peace.  

According to the American Psychological Association, the body tenses up during a stressful event as a way of protecting us from pain or injury. With chronic stress, however, our muscles never drop their guard and remain continuously tightened. If you’ve ever woken up stiff and groggy after a full night’s sleep, your tense muscles could be the culprit. Try gently encouraging them to relax with a simple nightly body scan. 

Focus your attention on an area of your body and mentally tell it to soften and relax. Begin with the area behind your eyes, followed by your jaw, your neck, and each of your shoulders. Continue like that, relaxing one area of your body at a time. You may find you drift off effortlessly before you’ve made it all the way through. 

It’s important to set up a relaxing atmosphere that will prime your body and mind for deep sleep. Turn off your electronics and keep the lights dim as you get ready for bed. If you sleep near a window, make sure that your curtains are drawn to shield you from any outside light or simply hang a blanket or sheet. The National Sleep Foundation recommends keeping the room temperature between 60 and 67 degrees Fahrenheit for the most sleep-conducive environment. 

If you’re in a busy house or area, white noise or ambient music can help mask any disturbances. The Relax Melodies app lets you create your own unique mix of relaxing music and sound, and the Slumber app has a whole library of sleep-inducing stories and soundscapes. Lastly, if you really want to set the mood for sleep, try a diffuser or pillow mist with relaxing essential oils such as lavender or chamomile. Details like these will be especially helpful as you adjust to the time change at Daylight Savings Time. When your mind associates your bedroom with the feeling of being drowsy, you can hit the pillow a little earlier throughout the week and still easily fall asleep. 

Stress can be tricky, so you may need to experiment a bit to find what works for you. If you just can’t seem to break the cycle and a lack of sleep is negatively impacting your mental health, talk to your doctor. There are therapies and medications that can help with insomnia and other sleep disorders. If your doctor does recommend a prescription sleep aid, we’ll be here to help. Let our team take care of the details while you focus on rest.

Ready to take the stress out of your prescriptions? Our team is available to answer your questions through in-app secure messaging or phone.

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.

Too Stressed to Sleep? These Strategies Can Help. 

A new diabetes diagnosis can come as a shock—and then comes the avalanche of information. Here are a few things you should know now to feel empowered about your health.

Managing Your New Diabetes Diagnosis

A new diabetes diagnosis can come as a shock—and then comes the avalanche of information. While it’s completely understandable to feel overwhelmed, we assure you, your confidence will grow as you get a good grasp on the basics. Here are a few things you should know now to feel empowered about your health.

There are many genetic and environmental factors that played a role in your diagnosis. Having diabetes means your body isn’t functioning as it should, and that is not your fault. What matters is what you can do to improve your outcome going forward. 

Diabetes isn’t curable, but it is absolutely manageable. With care and consistency, you can live a long and healthy life. Though there can be very serious consequences if the disease progresses without treatment, know that these outcomes are largely avoidable. Commit now to following your treatment plan and learning everything you can about your diagnosis. You won’t be alone—our pharmacists and care specialists will be there to help. Your lifestyle will play a large role in managing this disease and that’s great news. It means you have power over your future health.

At first, keeping track of your health stats may make your head spin. Know that it gets easier, and soon you’ll be a well-versed pro. To start, the National Institutes of Health (NIH) recommends getting to know three important numbers:

A1C - This blood test will provide insight into your blood sugar levels over the past few months so you’ll know if your treatment has been working. 

Blood pressure - Diabetes puts you at a higher risk of heart disease, so it’s important to keep this number in a healthy range.

Cholesterol  - Diabetes and high cholesterol often go together, which can further increase your risk of heart disease. 

Your doctor can help you understand what your target numbers should be and how you can stay within a safe range. Your goal numbers will be unique to you, so be sure to fully discuss them with your healthcare provider and set up a plan for regular testing and checkups. 

You’ll likely need to test your blood sugar on your own, either throughout the day or from time to time. This will help you determine how your medications, specific foods, and certain types of exercise impact your blood sugar levels, as well as other factors like stress. Your doctor will let you know how often you should test and what your target range should be. 

Logging your results will help you notice patterns and see your progress. The Diabetes Teaching Center at the University of California, San Francisco offers a free, printable logbook that can help you get started. You can also use an app like Glucose, or mySugr which will take care of much of the work for you, allowing you to set reminders and view trends over time. 

In most cases, you’ll need to take medication. With type 1 diabetes, you’ll require some form of insulin therapy—either injections or an insulin pump. Treatment can be quite varied for type 2 diabetes. You may need insulin, oral medications, both, or none at all. Your doctor may also prescribe medications for high blood pressure or cholesterol.

It’s important to know that type 2 diabetes is a progressive disease, and your treatment may change over time. However, changes in your prescription are not an indication that you’re failing somehow. Your goal should be focused on maintaining normal blood sugar levels and keeping those important numbers in a healthy range, not on which medications you’re taking. 

We know this is a lot to take in, so the patient care pharmacists at Alto can provide you with a free consultation to discuss your medications. From answering questions about side effects to helping you set up dosage reminders, we’ll help you feel confident and informed. 

Food and exercise affect your blood sugar levels, so you’ll need to pay close attention to both. It’s not just about what you eat, but the size of your meals and the balance of carbohydrates, protein, and fats. You don’t need to cut out carbs completely, but you’ll likely need to learn to count them to make managing your blood sugar easier. The CDC offers a great breakdown of how this works and enlisting the help of a registered dietician can take some of the pressure off as you learn. 

Like the rest of your care plan, this will become more and more effortless with time. At least for now, we recommend finding resources with recipes that are designed specifically for diabetes. The American Diabetes Association’s Food Hub and Eating Well’s Diabetes Diet Center are excellent places to begin. 

In addition to the testing we already described, you should plan to get a yearly physical and eye exam and see a dentist every six months. Diabetes complications can cause damage to your eyes, nerves, kidneys, and gums, but controlling your blood sugar and getting regular check-ups will help you detect any issues early and prevent these problems.

It’s important to let those closest to you know about your diagnosis. There will be times when you get frustrated or discouraged, so make sure you have someone to confide in when you need support. 

To get a better idea of what a happy and healthy life with diabetes can look like, join some of the many online communities that are available on almost every social media platform. Try searching “diabetes” within Facebook’s groups or exploring the American Diabetes Association’s online Support Community to start connecting with others who can truly understand what you’re experiencing. 

Lastly, if you think you might be experiencing depression, or your mental health is suffering in any way, please seek out help from a mental health professional. Ask your doctor if they can refer you to someone who specializes in chronic health conditions. Please don’t try to go it alone, there is so much support available to you. 

We know there’s a lot to unravel with a new health diagnosis, but this information is meant to empower you to thrive. While you undertake the task of learning and adjusting, we’d be happy to take care of your prescriptions—walking you through your first insulin injection to delivering medications right to your door. 

Interested in switching to Alto? We’ll handle the transfer. Our team is available to answer your questions from 6 am - 9 pm PT Monday - Friday, and 7 am - 6 pm PT on weekends; reach out by phone or in-app secure messaging.

The 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.

Women Leading the Way

On International Women’s Day, we’d like to celebrate the women of Alto. Every day, they care for patients, fill prescriptions, build products, and drive growth.

By the numbers, 63% of our employees, 40% of the executive team, and 60% of people leaders on product and engineering are women. In comparison, 20% of tech jobs are held by women and only 11 percent of executive positions at Silicon Valley companies.

This amazing representation was made possible by the company mission and values. The founders recognized that improving the pharmacy experience for a diverse population of patients meant Alto had to be a diverse company, capable of understanding and empathizing with everyone we serve.

Recruiting this talented mix of people has been one of our greatest successes, and today, our team has a broad representation of age, gender, race, sexual orientation, and socio-economic status. Diversity and inclusion is never a solved problem. We still and always will have room to improve, and will continue working hard to ensure D&I are prioritized as we continue to grow.

Focus at Alto: Providing the best care to Alto’s patients

Why did you join Alto? I was originally drawn to Alto for the opportunity to work at a pharmacy that was questioning the status quo and because, quite frankly, I could not possibly fathom how a pharmacy could have so many positive Yelp! reviews and I needed to see it with my own eyes. I quickly learned that the “Patients Come First” mentality was not just for show — it is brought to life every day through our incredible team and serves as the North Star for every strategic decision we make as a company.

Background: CVS Health, Walgreens, Northeastern

Focus at Alto: Keeping patient and provider information secure

Why did you join Alto? As a parent and patient, I am constantly frustrated by how hard it is to interact with doctors and data, in the name of security and privacy. I believe that we can secure patient data, protect their privacy and still make care accessible and convenient. I joined Alto Pharmacy because their passion for patients aligned so well with this belief. Alto feels like the kind of place I can be impactful. Also, the day I interviewed, they had a holiday cookie exchange and I’m a sucker for homemade baked goods.

Background: Mango Health, HP, Fortify Software, MIT

Focus at Alto: Building products that simplify medication management and improve health outcomes

Why did you join Alto? I love working on complex problems and creating user-friendly products to improve people’s lives. Everyone is a patient at some point in their lives, and we can make the experience so much better! The team here rallies around that mission, and approaches each decision with openness, rigorous intellectual honesty, and the desire to improve patients’ lives.

Background: Tesla, Boku, Intuit, QuestBridge, Stanford

FRANCES SCHENDLE, General Manager of Fertility

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A Holiday Guide to Health and Wellness

Why Kindness May Be the Best Medicine

Navigating HIV Treatment and Prevention During COVID-19

Coming Out with Pride: Nicholas Satow Shares His Story

Too Stressed to Sleep? These Strategies Can Help.

Managing Your New Diabetes Diagnosis

Women Leading the Way

Empowering Patients By Accelerating Healthcare Innovation

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