Remembering to Take Pills

It can be a challenge to remember to always take prescribed medicines.  When I first was given one prescription, it was no problem.  Adding a second was still okay, but adding a third made it a little hard to remember which pills I’d taken.

My solution was two-fold.  For my prescriptions, I’d take all three bottles down from the cupboard and set the bottles in front of me.  I’d open one bottle, take that medicine, then move the bottle off to the left.  Next I’d open the second bottle, take that medicine, and move the second bottle off to the left.  Finally, I’d open the third bottle, take the final medicine, and put everything back in the cupboard.  It worked great for the prescriptions, but I was so tired of opening bottles and swallowing pills that the other part of my solution was to stop all supplements (vitamin C, calcium…)

When these three medicines were to be taken only with morning and evening meals, the dancing-bottles system worked reasonably well.  When a mid-day dose was added, things got a bit more complicated.  I very quickly realized that I needed a way to confirm that I’d taken every dose.  With a family history of osteoporosis, I also suspected that I needed a way to get calcium back into the mix of pills I was swallowing.

It was simple enough to make a little chart and print a list of everything I needed to take.  I’d tape the list to my kitchen cupboard where my meds were stored, and use a highlighter to mark off every dose as I took it.  Problem solved.

After a while, though, opening all those bottles every day got tedious.  About that time, our superhero, RA Guy, did a post about a pill sorter he was using, and I got one to try.  It was easy to see why he liked his – I sure liked mine.  Instead of opening all those bottles daily, I only needed to open them once a week.  When I filled it the fourth week, I knew it was time to visit my friendly pharmacist again.

Nothing lasts forever, though.  Unfortunately, some of the pill compartments have started to pop open, spilling my pills all over the counter (or onto the floor, and a few times even down the sink).  If I had fewer or smaller pills, I’d buy another box like what’s wearing out.  I suspect, thought, that I need something with larger compartments.

Looking at replacement options,  I found a fairly elaborate one (pictured at right) and contacted the company selling it.  This has the features I like about my current pill-boxes (four separate compartments per day, every day is individually removable), but holds an entire month’s worth of medicine and has slightly larger compartments than what I currently have.  It also includes an alarm; if (like me) you’re sometimes tempted to skip lunch, that alarm calls you to come eat so you can take your prescriptions.  The down-side is that it takes a whole lot more space than the flat little boxes I use now.  I’ve found a local supplier, so even got to see the thing 3D.  Price is what’s holding me back right now (well, price and trying to figure out where I’d have space to put the thing – it’s not exactly inconspicuous).

Whether it’s a single-compartment box at the corner drug-store, a more elaborate box like I’m using now, or the mammoth one I’m considering next, I highly recommend a pill-box to help keep track of multiple medications.

Disclosure:  I have not receive any compensation for expressing this opinion – however, I’d be willing to accept a gift of one of these awesome looking pill boxes and giving it a workout so that I could write a thorough review after putting it through its paces.

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*Sorry, don’t recall who sent me a link to the fancy pill organizer. I’d give credit if I knew.  Feel free to speak up in the comments.

Senna Leaves

I truly hate what sulfasalazine does to my gut, but as a DMARD it helps my feet tremendously.  Fond as I am of remaining ambulatory, I deal with the med’s unpleasant side effect.

Dr. Synonymous has a particularly relevant post up, and it brought to mind something I read in an Open Mic comment a while back, in which Whitecoat shared a recipe:

Reminds me of an old recipe I used to use for constipation in cancer patients on opiates.

2 cups finely chopped raisins
1 cup finely chopped dates
1 cup finely chopped prunes
1 box senna leaves (finely chopped)*** (SEE FOOTNOTE)

Mix all ingredients together. Add small amounts water until mixture can be flattened out into small pan. Cut into small bars. Cover each bar in graham cracker crumbs. Freeze on cookie sheet then put frozen bars in bag in freezer. Eat them with a large glass of water.

I have a lot of ingredients in my kitchen that others have said aren’t normal staples, but senna leaves isn’t one of them.  Dates I always have.  Raisins, usually.  Prunes. Ummm – only in mid-August when they’re fresh off the tree.

Aside from the leaves and graham crackers (which I also don’t stock), this is really just a bunch of dried fruits that you don’t want to feed large quantities of to a toddler still in diapers.   I wondered if the key is just dried fruit washed down with a big glass of water.  I also wondered if it would work to swap out different ingredients, since I have many other kinds of dried fruit.  It does.  Dried cranberries, dried cherries, dried apricots… doesn’t seem to matter.

It’s pretty tasty, regardless of the reason you’re eating them.  Next time I’m going to put everything through a food processor (or at least a grinder) to change the texture.

Posting will be light, as I have two teenagers leaving for Guatemala next week and there’s still tons to do to get ready for their trip.

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Senna is an herbal laxitive.  Like all herbs, it acts as a medication.  It should not be used by people taking warfarin/coumadin, digoxin/lanoxin, or diuretics.  If you are taking any medications (herbs, supplements, prescriptions…) talk to your doctor before trying senna.

Emergency Prep & Drugs

Flood, earthquake, tornado, hurricane, terrorist attack… The list of possible disasters isn’t very long.  That doesn’t mean it isn’t important to prepare.

One small line in most emergency preparation lists suggests including an extra month of prescription meds in your emergency kit.  I wondered idly how one might go about doing that, but when nobody in my family was regularly taking prescriptions it wasn’t an issue.  Now it is pertinent.

The problem isn’t with believing it’s a good idea to be prepared.  The problem is the difficulty of obtaining the extra month’s worth of meds.

1.  Insurance will not pay for early fills.  If you want to get an extra month, the cost will be entirely out-of-pocket.  That might not be a problem for one or two less expensive medications, but it’s a big deal if the cash price of your monthly trip to the pharmacy is nearly $3,000.

2.  Even if you pay cash so that you can have an extra month on hand, there’s still a problem.  Prescriptions allow a specific number of refills.  If you pay cash to get that extra month early, you run out of available refills at the pharmacy a month early.

I’ve jerry-rigged a solution.  I do not wait 30 days to refill my meds.  For a while now, I’ve refill my prescriptions every 27 days.  The first month, that got me three extra pills.  The second month, I added three more for a total of six extra pills.  The third month, I was up to nine extras, and so on.  For some weird reason, every now and then the insurance company says it’s too soon to refill and I’ve had to wait the full thirty, but this usually works.  Doing it this way, within a year, you’ll have a managed to stockpile an extra month’s worth of most prescriptions.

This doesn’t work with methotrexate, Enbrel, or anything else that’s filled for four weeks instead of one month.  Having skipped my Enbrel when I was sick, I know that when dealing with the stress of a disaster, I don’t want to be without that particular prescription.  However, since I was already well into the process of trying to accumulate an extra month’s worth for my emergency kit when I got sick, I filled the prescription at the regular time anyhow (despite not being out).

It’s a good thing I did!

Add insurance change to the list of potential emergencies

They had the audacity to send out a letter last month with instructions that we should refill prescriptions before the end of the month (on our old insurance) because it would take a while to get everyone into the new insurer’s computer system, and it probably wouldn’t be possible for the pharmacy to verify coverage for a few days.  I could picture getting laughed out of the pharmacy if I tried that, so didn’t bother.

Next the insurer said they should have everyone processed by the 10th, but we could just pay cash and then submit a request for reimbursement.  I didn’t think that would be needed, since I last filled on the 10th and would just be stretching things out to the full thirty days.  Unfortunately, the 10th came and went without new insurance cards.  My dear husband, concerned that I wouldn’t be able to get my prescriptions, was duly impressed when I said that I supposed this counted as an emergency, and explained my strategy to him as I dug into my emergency supply.

It was nice to be prepared.  It wasn’t nice to need it, but it worked out.  I had to pay cash to get my mtx last week, because there’s no extra stash on that one.  The rest of my prescriptions, though, I’ve been able to take normally, without the stress of wondering when those insurance cards are going to show up.  The tiny effort needed to be prepared was well worth it.

Do you include a month’s worth of prescriptions in your emergency kit?

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For more information on disaster preparedness: