Friday, January 7, 2011

Pills


 
About the best thing you can do for yourself, if you have a major mental disorder, is take your medicine. And the best thing to do with your medicine is to take it regularly, and never run out. Here are a few tips on how.

Let your pill counting be an every-night or every-morning ritual. Never go to bed without taking the last pills of the evening, and setting out what you will need the next day. You may be fuzzy in the morning, especially before coffee; it would be easy to skip one (or double up on the wrong one) and suffer for it later. I take quite a few, so I do need to specifically count how many of each item I need for morning, lunchtime and bedtime doses. While I’m counting, I glance in each bottle to make sure I have enough to last at least 3 more days. If one of the bottles looks low, I turn it upside down on my dresser so the next morning I will notice it. When I see an upside down bottle, that’s my short-hand for “Call the pharmacy, today!”

Your morning pills belong just an arms-length away from your pillow, maybe on a little saucer by a glass of water. When you get up, you can grab them and swallow them down without even looking or thinking about it. That’s what you want: an instant, automatic action. The pills for the rest of the day should have a tiny container of their own that lives in your purse or wallet or back pocket. ALWAYS. Never be caught anywhere without your pills.  If you are on public transportation and start to hear voices, you need your antipsychotics with you, to take right now, not in some drawer at home.

In fact, I recommend you have an emergency supply of one extra days’ worth that you keep on your person at all times. This doesn’t have to take a lot of space. Mine goes in the cellphone pocket of my wallet. In even the best-ordered life, the unexpected can happen and you can be stuck somewhere overnight or caught in a disaster with no access to the pills that will keep you sane and functioning until you get to safety. How are you going to handle it without your meds? If this sounds like too much to bother with, let me put it another way: would you rather carry a few extra pills, or explain things to the police?

‘Nuff said.

About pharmacies: pick a national chain if you can, one that will hold your computer records even if you are traveling to another state. It’s a good idea to check, before a vacation, that you have enough of each medication to see you through, including a couple of days’ worth for after  you get home. Try to give your pharmacy two days’ notice at least for refills. Things go wrong with distressing regularity. What if you have no more refills, and they need special authorization? What if they have to call your doctor or your insurance and don’t get an answer right away? Lots of things can go wrong with your order. For instance, maybe you’ve needed a little more medicine than usual – so now you’ve used up your prescription early, and the insurance company says it won’t pay for replacements till some time next week. Twice I was held up because the pharmacy was faxing the old office number of a doctor I hadn't seen for years! Naturally, he didn’t bother answering them. Or what if they’ve simply run out of supplies? Give your pharmacy a little lead time to sort things out. They will appreciate that you don’t breathe down their necks and rush them – and when there really is a special hurry, the people behind the counter will be more likely to be helpful and understanding if you’re usually not a pain.

But what if, despite everything, you do run out?

If you always go to the same pharmacy, and they know you, they will probably help you out. Explain that you need X days of emergency supply. Tell them why (in as few words as possible – they don’t need a long sob story). Be sure to show them the bottle you just emptied so they can verify that you really do have this prescription in this exact dosage. They will probably give you the small supply you need – possibly without charge. It really pays to be a regular customer. But even if you are new in town, if you show the bottle, you may be able to get help; especially if you can say “I’m seeing Dr. So-and-so in 5 days.” Give them the doctor’s number so they can verify that, too. Psychotropic drugs are very powerful and can be dangerous to the wrong person, so they’re right to be cautious in giving these things out to strangers.

Don’t put new pills into old bottles, though. I did this by mistake once. The old bottle read “one refill remaining”, so I thought I was alright. But it was actually time for a new prescription, and I didn’t have any refills left! I had to make a rush appointment and get an emergency supply. So when you get your medicines refilled, any leftovers should go into the NEW pill bottle. Throw the old one away.

One last tip: If you give them a list of your usual meds, Walgreen’s is capable of making out a comparison chart of the various Medicare Part D plans in your area, including a cost comparison. It pays to do this each December, during the time when patients are eligible to switch coverage.

Be serious, disciplined and reliable in the way you handle your prescriptions, so they can give you serious and reliable results.

Deborah Fruchey is the author of a general self-help book for psychiatric patients. Entitled  Is There Room For Me, Too?, it is available on Amazon.com and other online bookstores. It is also available as an ebook on Kindle and in Apple's iBookstore. Or you can request a copy from your local book vendor. See the attached link for an explanatory video, or visit Deborah at www.lafruche.net.