Saturday, May 16, 2009

Medical management

You are looking at one day's worth of Tyler's medications. One of my Saturday chores is to get his pills ready for the week. There are 17 pills from 7 different prescriptions + vitamins. (Missing are the omega 3 supplements, because the only ones I have left are ridiculously huge and he doesn't like them.) Looking at this makes me especially grateful for the incredible medical insurance we have through my work. We have 100% prescription coverage. At my previous job, while we had very good coverage, we still had to cover a portion of prescription costs. We were averaging about $250-300 per month on Tyler's meds alone.

Probably the most important role I play in my husband's mental health is the role of manager. I manage his medications, making sure he remembers to take them and ensuring that they keep coming. I contact his doctors when he needs refills (his nurses all know me by name and have finally FINALLY stopped asking for him when they call the house), take charge of any new prescriptions he brings home. I put together a spreadsheet with all his medications, including dosage and frequency, so he could simply take a printed list to each doctor's appointment. It is too much to remember without a cheat sheet.

I manage his appointments. I make them and reschedule them. I take him to them and most often, I go into the visit with him. (With the exception of his therapists and shrink.) I do this because he does not deal well with doctors. He doesn't always remember everything, and they tend to treat him either like he's stupid or he's crazy. Case in point - a couple of weeks ago, he saw a nurse practictioner for allergies and a head cold. That is specifically what I told them the appt was for when I set it up. While I did go with him to the appt, I stayed in the waiting room. Mostly because my own injured knee was killing me. I wish I had gone back. Somehow the NP got it into her head that Tyler didn't have allergies (really? Did you notice the red watery itchy eyes? The sneezing? No?) but did have a staph infection (that would be skin irritations from having shaved his beard and you know, acne). So instead of listening to him about the congestion, the drainage down his throat, the coughing up of phlegm (the size of silver dollars he told me this AM), she wrote him a prescription for a skin infection. That he doesn't have. It's not just that he doesn't get the treatment that he needs in situations like this, it's that he completely shuts down. And spirals down. Because of this run-in with a jackass, he was down for the rest of the day. And refused to see anyone else.

It is easier when I go with him.

Everyone needs an advocate, and none more so than those with mental illness. It is too easy for a harried (or not) medical practictioner to not pay attention, to not get beyond what they're told, and get to the heart of the issue. My husband will not tell most doctors what they need to know, not without prodding. Because he does not trust them. Because he has had so many instances of doctors not giving a rat's ass.

Without an advocate, it is very easy to become so overwhelmed by the pills, the doctors, the appointments, insurance, so easy that many depressed people simply don't do it. Don't take their meds, not enough or on schedule. Don't go to the doctor unless they absolutely cannot avoid it. Don't go to the shrink or therapist because they cannot deal with the office policies or personnel.

I am an advocate. I am his advocate.

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