Wednesday, March 27, 2013

Slaying the Medication Worry

Medication dispense times per day: 7

Four days of Robert's pills
Total number of pills to give per day: 25

Medications to keep filled on time: 9

The consequences of screwing this up: severe (increased and/or prolonged seizures, physically hurt from increased falls, increased memory and balance problems). 

Worst case scenario: I don’t even want to think about it.

My number one concern about Robert moving in is, by far, Robert’s medication.  (Keeping the freezer stocked with Rocky Road ice cream is a close second).

I was kind of freaking out about it but a friend asked me, “Don’t you think you can do better than New Home has?” 

Good point.

I, at least, won’t make arbitrary changes to his medication schedule so that it fits better with my schedule (a nurse at New Home actually did this when Robert first moved in there with awful consequences).    

Making sure I had Robert’s medications lined up properly and in time for move-in was one of the first items to tackle on my checklist.  My hope was that we could use the same pharmacy as New Home so the transition would be seamless.  I knew they delivered and thought that would be helpful. 

I called Robert’s current pharmacy only to learn they only work with care facilities.  I asked for advice on how to transfer the prescriptions to a new pharmacy and was told to get new prescriptions written by the doctor and fill them at the new pharmacy.

I had already previously filled prescriptions for Robert at a pharmacy near our house which is a familiar pharmacy since my husband uses it.  This was very helpful as they already had Robert in their system with all of his insurance information.

While simultaneously plowing through the other items on the move-in checklist, I called his doctors, New Home and our new pharmacy and asked for information on how to seamlessly transfer his medications.  

With each call, I got a new piece of information. 

Have his GP write brand new prescription orders.
Have his GP and neurologist write new prescription orders.
The doctors can call the pharmacy with the orders and cut out the “paper” step.

Medications were confirmed with each doctor.

After a few days, there was a follow up call from neurology about the brand name prescriptions Robert is supposed to have.   

In the meantime, I called New Home to ask what medications they would still have and how much would be sent with Robert when he moved out.  I wanted to be sure I had a couple of weeks of medication in case the pharmacy couldn’t fill the order immediately.  They assured me I would have at least two weeks of some medications and one month supply of some others.  They sent me a detailed list of what medications and how many I would have for Robert. 

Call me crazy, but I was doubtful.

The pharmacy called last week.  Medications were ready for pick up!

I was excited but this didn’t sound right.  It is 10 days before Robert moves in and they already have prescriptions ready?

I went to the pharmacy and, sure enough, three of his medications were ready.  One was eye drops which, of course, doesn’t cause me any concern whether I have those or not but the other two were seizure medications. 

One of the medications they had filled was the generic version and, after being questioned about why I “preferred” non-generic, I explained it was not a preference at all.  Robert’s neurologist deemed it medically necessary for him to have the brand name only.  The clerk was extremely curious about Robert’s seizures and epilepsy so I took the opportunity to educate him about it and could tell the crowd of people behind me were listening and learning too. 

Either that or they were wishing I’d stop being picky about the medications and holding up the line.

I left the generic medication at the pharmacy for the pharmacist to get clarification from the neurologist.  I only had the Depakote and eye drops but it felt wonderful to bring home the medications!  Before putting them in the cupboard my husband had cleared out for just this purpose, I checked the Depakote bottle and peeked inside. 

Uh oh.  These pills are grey, not pink.

I looked at the label expecting it to say “Depakote” but it had an “ER” added to it. 

I did a quick search on Google and found that ER is sometimes mistaken for DR but these are not interchangeable.  After calling New Home to verify Robert gets the “DR” version and not the “ER” version, I called the pharmacy back. 

The clerk who answered the phone told me there wasn’t a difference.  I politely but firmly told her there was.  

She put me on hold. 

She quickly came back on the phone and told me they would have the correct prescription ready in twenty minutes and asked if any had been taken yet.  Nope, that’s why I’m doing this early.

Working out the bugs without the nasty consequences.

The Depakote was figured out and the next day, other medication was filled with the brand name (Klonopin). I talked to the pharmacy about when the others would be ready.  I jotted down the refill dates on my nifty spreadsheet that I created for the medications (yes, I said “nifty”).  A friend sent me the spreadsheet she uses for her husband’s medications and I added a few columns to mine. 

Next up: figuring out how to give Day Program the medications they give Robert through the week. I assumed they didn’t want his pills in a baggie.

The pharmacy told me they would be able to give me a bottle with a medication label and I can fill it with the amount of meds Day Program needs from the monthly supply I get from the pharmacy. Works for me. 

For the house, my plan is to put one week of Robert’s medications into a multi-day pill container.  He takes so many, it’s actually going to take two large containers to fit them all.  Hubby gave me an idea of how to organize them which works perfectly (the row of 7 days will equal the 7 medication times per day).  Each row will be for one full day.  I labeled them with the medication times so no matter who is giving Robert his meds, the days and times are clearly labeled. (Clearly may be overstating it since my handwriting is awful). 

I am feeling much more in control of the medications and have much less worry about it. 

Slaying the medication worry:  Priceless

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