One of my regular reads Yes and Yes did an interview recently: True Story: I had an abortion Like many of the commenting readers, the kicker for me comes right about here:
I was using protection. I was on the pill. Something my doctors never told me until my appointment at Planned Parenthood was that if you use the same pill for a long time without a break or switching brands, there's a chance your body will adapt to the hormones and you will be able to get pregnant. That's what happened to me. After 5 years on the same pill, taking it the same time every day, it stopped working.
BubbaheyWHA?
Back when my awesome CNP started me on azathioprine, we discussed the side effects. She stressed repeatedly the need for multiple birth control methods, since this was a drug that could cause birth defects. She didn't go into specifics, so obviously I imagined something along the lines of thalidomide because I am a morbid, morbid lady, and I took birth control pills somewhat frantically.
That was back in 2003. (Recently I had a year-long break from the Pill because I couldn't really afford to fill a scrip for it,* but I'm back on it now.) In the intervening years, I had another doctor who told me in our initial meeting that as long as I took folic acid daily with the rest of my pill platter, any fetus that might spring suddenly into my womb would have no problem. I asked him again a year into our relationship as gastro-and-ass patient, and this time, he hemmed and hawed and said that if I was planning to get pregnant, we should discuss other options. So.
And so. Even with the various gastro discussions, I'm still not precisely sure what birth defects are associated with azathioprine. I believe at one time I read something about polydacty, or problems with fingers fusing or babies maybe growing extra fingers. Clearly I'm very well informed and qualified to talk about this. But I still take aza (and A. and I still use a wild and colorful variety of birth control methods) and I still think that one day, I might want to have a kid. Is the only way to take a pile of Devil Pred for nine-ten months? Is that stuff really safe for a fetus? Is any medication? Would I have a choice? Would it be vain to create a child under such conditions when there are so many healthy children given up for adoption?
Man, I wonder why A. doesn't like to talk with me about having kids? I do like a good light conversation on my gut health versus the future of our genetic pool. Or maybe that's an oxymoronic debate.
*Still the most stupid excuse ever. Because an unplanned kid, that would be a whole barrelfulla economy!
Showing posts with label imuran. Show all posts
Showing posts with label imuran. Show all posts
Sunday, January 2, 2011
Wednesday, February 24, 2010
Money schmoney! And a tiny bit of good news.
Warning: what follows is not a glowing recommendation. However, no actual names are mentioned in this post, so I guess it doesn't matter.
My current medical insurance requires that, for the best possible benefit, I order my prescriptions through a mail-order pharmacy. I have had previous plans require this, and while it is not and never will be convenient, it generally works okay with plenty of planning and plotting. So much of having ulcerative colitis seems to revolve around planning and plotting (whether it be meals, pills, or the strategic locations of toilets) that I find it a bit easier than I would have, say, before my diagnosis.
Anyway, so I went to a brand-new gastro, Dr. C, down here in Texas. So far, she's fantastic: very thorough, very intent and open to discussing my current state of illness, and she wrote me some prescriptions just before I left with the husband for the Christmas holidays. I told her about the mail-order pharmacy - we'll call them, oh, how about Schmedco - and she said, All right, I'll write you one for the local pharmacy, and one three-month prescription* for the mail-order that you can put in later, when you run out.
This sounded great to me. So I folded up the three-month scripp and stashed it away for later, and took the one-month scripp to the nearby CVS. Let me point out here that the scripps were written identically APART from the supply amounts requested.
CVS filled the scripps. I got what I had asked Dr. C for: the 50 mg tablet version of azathioprine, and a 750 mg capsule of balsalazide disodium. It was amazing. We had a spontaneous song and dance number around the wine aisle, and then my sweetheart and I jumped in the car and headed up to Minnesota and family for the holidays.
Deedlie-doo to the future: A. and I returned, I started running low on meds, I dug out the three-month scripp, filled out the Schmedco paperwork and mailed it in.
A week or so later: I received the pills in big mailers.
"Yay!" I said.
Then I opened the mailers. My jugs of balsalazide were all present and accounted for, and I set them aside. Then I looked at the other bottle. The label said: Azathioprine (Azasan), 100 mg, take one pill daily!
"Darn!" I said. It was the wrong type of azathioprine. I normally took 2 per day of the 50 mg pills; but maybe I could check with Dr. C and take this instead. They were probably interchangeable, right? I mean, azathioprine is azathioprine, no matter how it's processed into tablet form. Right?
Then I looked at the bill.
"FUCK," I said.**
Yes, therein lies the difference! How silly of me not to have considered that the handy one-pill nature of generic Azasan would necessarily cost a nice thirty dollars more!
Now I can hear what you're saying. Thirty dollars? Bitch, thirty dollars? Just pay it. You've got money, right?
Well, no. I don't have much cash. AND THAT'S NOT THE POINT, ANYWAY.
What's the point? Well, I called Schmedco. The pharmacist I spoke to said a lot of things, but her main argument she kept returning to was, "The prescription is written for 100 mg a day."
"Yes," I said, "but couldn't that be interpreted in multiple ways? Technically I take 100 mg per day, I just take it in two pills rather than one."
AND, I added silently while giving the phone the finger (also silently, I think), if you get a prescription where there could be multiple interpretations, wouldn't it make sense to call the patient and check? Since you have ample ways to contact me? Especially when there's a considerable (to my poor ass) price difference? AND HEY, isn't it interesting that I had this filled using my Schmedco card at a local pharmacy, and they managed to interpret the scripp in the 2 - 50 mg/day, CHEAPER way? AND ISN'T IT FUCKING FASCINATING that since you have access to my Schmedco record with all of my Schmedco history, you could have accessed this information and seen that I had previously had a prescription filled this way?
"No," she replied. "I'm sorry, but that is the only way we will interpret a prescription written this way. That is the only way we can interpret it."
I choked then. And I said I would have Dr. C send a more specific prescription. And that's when she asked me if I took the azathioprine only occasionally, for flare ups. #%&@^!$%^!~
Flash forward to today! I got a new scripp faxed in by Dr. C, and I emailed Schmedo, asking them how I could return the unwanted medicine. Yes, laugh, laugh, all of you, at my sweet naivete. Here is their response:
To [Peppery]:
Thank you for your online inquiry. I apologize for any inconvenience
this may cause. Once a medication has been dispensed it cannot be
returned to stock to be re-dispensed. If returned, opened or
unopened, the medication will be destroyed. If you would like to send
this back for disposal you can do so, or you can contact one of our
[pharmacists] to find out how to dispose of the
medication yourself. Since this prescription was filled from a valid
prescription from your physician and was billed in accordance with
your plan, there will be no credit if the medication is returned.
[Fuck you very much],
[redacted]
Schmedco representative
So. I am pissed. Man, it's a good thing I have this blog so I can expose those bastards and make them pay for their evil!
-
In the interest of common sense, A. suggested I just pay for it and keep it on hand for emergencies. I asked if he meant the kind of emergency where I don't have that vital thirty dollars I needed to pay the cell phone bill, so I miss a call from that institution regarding a life-changing job interview and thus work at my pitiful library technician job for the rest of my days.
"Well, yeah," he said. And then he got me a cookie. What a nice husband.
-
In the department of Good News, I heard back about a librarian position. I've got an interview scheduled for next week. Wish me luck!
*In case you're lucky enough to be unfamiliar with mail-order pharmacies, the ones I've come into contact with work this way. For example, Schmedco offers you a prescription copay of say, $10 for a month's worth of a certain drug at a local pharmacy, and then they also offer you a copay of $20 for a three-month's supply of that same drug, provided you purchase it through their mail-order setup, which is based...somewhere. That's it.
**This was probably never intended to be a family blog. There's just too much shit everywhere. But this FUCK is pretty warranted.
My current medical insurance requires that, for the best possible benefit, I order my prescriptions through a mail-order pharmacy. I have had previous plans require this, and while it is not and never will be convenient, it generally works okay with plenty of planning and plotting. So much of having ulcerative colitis seems to revolve around planning and plotting (whether it be meals, pills, or the strategic locations of toilets) that I find it a bit easier than I would have, say, before my diagnosis.
Anyway, so I went to a brand-new gastro, Dr. C, down here in Texas. So far, she's fantastic: very thorough, very intent and open to discussing my current state of illness, and she wrote me some prescriptions just before I left with the husband for the Christmas holidays. I told her about the mail-order pharmacy - we'll call them, oh, how about Schmedco - and she said, All right, I'll write you one for the local pharmacy, and one three-month prescription* for the mail-order that you can put in later, when you run out.
This sounded great to me. So I folded up the three-month scripp and stashed it away for later, and took the one-month scripp to the nearby CVS. Let me point out here that the scripps were written identically APART from the supply amounts requested.
CVS filled the scripps. I got what I had asked Dr. C for: the 50 mg tablet version of azathioprine, and a 750 mg capsule of balsalazide disodium. It was amazing. We had a spontaneous song and dance number around the wine aisle, and then my sweetheart and I jumped in the car and headed up to Minnesota and family for the holidays.
Deedlie-doo to the future: A. and I returned, I started running low on meds, I dug out the three-month scripp, filled out the Schmedco paperwork and mailed it in.
A week or so later: I received the pills in big mailers.
"Yay!" I said.
Then I opened the mailers. My jugs of balsalazide were all present and accounted for, and I set them aside. Then I looked at the other bottle. The label said: Azathioprine (Azasan), 100 mg, take one pill daily!
"Darn!" I said. It was the wrong type of azathioprine. I normally took 2 per day of the 50 mg pills; but maybe I could check with Dr. C and take this instead. They were probably interchangeable, right? I mean, azathioprine is azathioprine, no matter how it's processed into tablet form. Right?
Then I looked at the bill.
"FUCK," I said.**
Yes, therein lies the difference! How silly of me not to have considered that the handy one-pill nature of generic Azasan would necessarily cost a nice thirty dollars more!
Now I can hear what you're saying. Thirty dollars? Bitch, thirty dollars? Just pay it. You've got money, right?
Well, no. I don't have much cash. AND THAT'S NOT THE POINT, ANYWAY.
What's the point? Well, I called Schmedco. The pharmacist I spoke to said a lot of things, but her main argument she kept returning to was, "The prescription is written for 100 mg a day."
"Yes," I said, "but couldn't that be interpreted in multiple ways? Technically I take 100 mg per day, I just take it in two pills rather than one."
AND, I added silently while giving the phone the finger (also silently, I think), if you get a prescription where there could be multiple interpretations, wouldn't it make sense to call the patient and check? Since you have ample ways to contact me? Especially when there's a considerable (to my poor ass) price difference? AND HEY, isn't it interesting that I had this filled using my Schmedco card at a local pharmacy, and they managed to interpret the scripp in the 2 - 50 mg/day, CHEAPER way? AND ISN'T IT FUCKING FASCINATING that since you have access to my Schmedco record with all of my Schmedco history, you could have accessed this information and seen that I had previously had a prescription filled this way?
"No," she replied. "I'm sorry, but that is the only way we will interpret a prescription written this way. That is the only way we can interpret it."
I choked then. And I said I would have Dr. C send a more specific prescription. And that's when she asked me if I took the azathioprine only occasionally, for flare ups. #%&@^!$%^!~
Flash forward to today! I got a new scripp faxed in by Dr. C, and I emailed Schmedo, asking them how I could return the unwanted medicine. Yes, laugh, laugh, all of you, at my sweet naivete. Here is their response:
To [Peppery]:
Thank you for your online inquiry. I apologize for any inconvenience
this may cause. Once a medication has been dispensed it cannot be
returned to stock to be re-dispensed. If returned, opened or
unopened, the medication will be destroyed. If you would like to send
this back for disposal you can do so, or you can contact one of our
[pharmacists] to find out how to dispose of the
medication yourself. Since this prescription was filled from a valid
prescription from your physician and was billed in accordance with
your plan, there will be no credit if the medication is returned.
[Fuck you very much],
[redacted]
Schmedco representative
So. I am pissed. Man, it's a good thing I have this blog so I can expose those bastards and make them pay for their evil!
-
In the interest of common sense, A. suggested I just pay for it and keep it on hand for emergencies. I asked if he meant the kind of emergency where I don't have that vital thirty dollars I needed to pay the cell phone bill, so I miss a call from that institution regarding a life-changing job interview and thus work at my pitiful library technician job for the rest of my days.
"Well, yeah," he said. And then he got me a cookie. What a nice husband.
-
In the department of Good News, I heard back about a librarian position. I've got an interview scheduled for next week. Wish me luck!
*In case you're lucky enough to be unfamiliar with mail-order pharmacies, the ones I've come into contact with work this way. For example, Schmedco offers you a prescription copay of say, $10 for a month's worth of a certain drug at a local pharmacy, and then they also offer you a copay of $20 for a three-month's supply of that same drug, provided you purchase it through their mail-order setup, which is based...somewhere. That's it.
**This was probably never intended to be a family blog. There's just too much shit everywhere. But this FUCK is pretty warranted.
Wednesday, May 23, 2007
Don't you know I have the INTERNET?
Last Friday I saw my gastro.
We have a very formal relationship. I come in and sign my name at the sliding window, write out a check for my copay, page through a couple magazines, and then he summons me to the last office on the left. His office is very cold and clean, and it smells like freon even in the winter. He sits down behind his monstrous bare desk, which takes up half the room, and thumbs through a single manila folder with my name on it. On the window ledge there is a pop-out rubber model of a liver squashed atop a pile of intestines. A medication brand name is painted in pink across the liver. Otherwise, the ledge is bare.
This is good, I tell myself. This means he's probably not prone to leaving instruments inside patients. Which wouldn't matter since he won't be operating on me any time soon as he is not a surgeon. He turns some blank pages and looks up at me. He never smiles. If I make a joke, he pulls the non-laugher trick from Seinfeld. Oh. That's funny.
"So how are you feeling?"
I explain the sedated feeling I've been having for...well, for a while now.
"Hmm. I've never heard of that as a side effect." He steeples his fingers and stares off behind me. "Well. You could always drink a lot of caffeine. Coffee, Mountain Dew."
I tell him that once drunk, coffee spends a nanosecond inside me before bolting, and that I'm trying to stay away from soda as it is soda.
He writes me a new Imuran prescription, I go to the pharmacy downtown and spend fifteen minutes finding necessaries such as flip flops and Yuengling. I drive home and rip open the prescription bag and read the side effects blurb:
All I need is Google! That's all I need!*
(Granted, it is a ways down the page, under What side effects may I notice from receiving azathioprine (imuran)? Side effects that you should report to your prescriber or health care professional as soon as possible. Yep, that's it: unusual tiredness or weakness.)
On the positive side, he was encouraging about my idea to gradually lower the dosage of Imuran from 150 to 125, whereas my previous NP pretty much bitch-slapped the thought away.
*Okay, so as the Eckerd link is no longer happy, I've posted a new one.
Wednesday, February 21, 2007
Fear is the mind-killer, or, Screw the presentation, sir, you'll have to excuse me.
If there is anything good to be said about Ulcerative Colitis, (and those of you who consider "good" to mean any weight loss, sit down.) it would be the relaxation. At moments when the keys and the hamburgers are locked in the running car, which is stuck on the vibrating railroad tracks, when even A. is tearing his hair out or kicking kittens, I am so zen it is disgusting.
I used to have hissy fits over everything. The excitement! The drama! Can I cry or spill something? Hell, yes! And then we'll cry about spilled milk! (or popcorn. Whichever is handy.) I miss throwing things out windows, and having a reasonable excuse to gorge myself on cadbury mini-eggs.
So why have I turned over a new-fallen leaf with edges of infinity and the universe? Because any sort of stress starts the gut a-roiling. So far I'm doing pretty well at irritating A. with my mellowness in high-stress situations.
Tonight I have to give a speech about a well-known library computer system.
Gut: Heh heh.
Me: Er. What're you doing?
Gut: Me? Nothing at all. I don't do anything, you know. I just REACT. Especially to messy immune systems and foolish emotions.
Me: Uhum. But I'm calm. I am so calm I am the tiniest dew drop in the smallest fold of a rose petal.
Gut: Really? Rose petals? What about... The Big Speech? The Five Minute Time Limit? The Glowering Professor with itchy stopwatch thumb? Your Silly Pathetic Notecards?
Me: They are not pathetic. Lots of people use them.
Gut: Uh huh. Wow, things are really moving down here, if you get my gist...
Me: Shuttup! Shutit! I am calm! My mellow is not harshed!
Gut: Liar.
Me: holds belly.
Gut: Better relax, or who knows when I'll make my move?
It is hard to be relaxed all the time when your gut talks to you. Damn distracting.
I used to have hissy fits over everything. The excitement! The drama! Can I cry or spill something? Hell, yes! And then we'll cry about spilled milk! (or popcorn. Whichever is handy.) I miss throwing things out windows, and having a reasonable excuse to gorge myself on cadbury mini-eggs.
So why have I turned over a new-fallen leaf with edges of infinity and the universe? Because any sort of stress starts the gut a-roiling. So far I'm doing pretty well at irritating A. with my mellowness in high-stress situations.
Tonight I have to give a speech about a well-known library computer system.
Gut: Heh heh.
Me: Er. What're you doing?
Gut: Me? Nothing at all. I don't do anything, you know. I just REACT. Especially to messy immune systems and foolish emotions.
Me: Uhum. But I'm calm. I am so calm I am the tiniest dew drop in the smallest fold of a rose petal.
Gut: Really? Rose petals? What about... The Big Speech? The Five Minute Time Limit? The Glowering Professor with itchy stopwatch thumb? Your Silly Pathetic Notecards?
Me: They are not pathetic. Lots of people use them.
Gut: Uh huh. Wow, things are really moving down here, if you get my gist...
Me: Shuttup! Shutit! I am calm! My mellow is not harshed!
Gut: Liar.
Me: holds belly.
Gut: Better relax, or who knows when I'll make my move?
It is hard to be relaxed all the time when your gut talks to you. Damn distracting.
Monday, January 29, 2007
Generically yours.
These are the big ones. Well, not the horse pills, but these are the immuno-modulating-suppressing ones, the ones that do more than sit in your stomach or gut and quietly dissolve; these babies know pharmaceutical kung fu. (Unfortunately they only know the defensive moves, and my immune system is Bruce Lee, right before he breaks Chuck Norris's chicken neck. But still!)
Imuran, or azathioprine as it is generically and so so cheaply known, has been around since the 50s and has a couple other popular uses:
1. Transplant antirejection
2. Severe rheumatoid arthritis
It also can help you out if you have too much bone marrow, or you're just too damn healthy for your own good and need to catch a little pneumonia from time to time. Blood testing on a regular basis is required. I have since come to enjoy the feeling of a needle in the crook of my arm, which is good practice for when the time comes to break out the medical heroin.
Do not take these without food. It is a dry heave death wish, without Charles Bronson for comfort.
Friday, January 26, 2007
Format in error. Please begin again.
So I've been following other blogs. Postmodern Sass makes me laugh, but I'm not sure why. Maybe because she says it's all stories and not a really confessional or daily real-life happenings. (Or it could be? But not necessarily?) Obviously I watch Neil Gaiman's blog because he updates almost every day and talks about himself and his doings. (Notice the updating part is higher on my list.) I've fluttered around dooce and petite anglaise and neil kramer, and with each funny story my panic rises. Here is MY blog and there is absolutely nothing of interest on it.
Last night, as I sat on the toliet for the twentieth time of the day, wondering what to blog about and simulataneously wondering if this would end as an Enema Night (and how they deserve their capitalizations!) and meanwhile pondering the relegation of serious self-ponder to Emo kids, and likewise waiting patiently without straining for the, er, faucet to stop dripping...
Eureka! Ulcerative Colitis!
So I'll record all related doings : doctor appointments, meds, issues, single bathrooms vs. multiple stalls, ER trips, furtive purchases, diet restrictions, stress, the stress of consciously trying to be unstressed, and on. I have a fantastic fellow who is more supportive and all-ears than anyone I've ever met, but even he needs a break sometimes, and really, one audience just isn't enough for me. I need IBD-dedicates and sympathizers. You know who you are.
I was diagnosed in 2003 after a very trippy colonoscopy, during which I vaguely remember seeing the insides of my intestines on a little tv, but since I was lying on my side and doped with a lovely mix of demerol and Versed (you dog, you!) I don't remember much except the doctor saying, "Yes. See that? Umm-hmm" and that the lights were pretty dim considering they'd just been bright half an hour ago.
I remember immediately after the procedure, the nurses set me in a chair and someone whom I don't remember properly as I couldn't control my drool reflex, so naturally I was concentrating on that, someone sat next to me and patted my knee and explained things in a really fast whisper. The next thing I heard was my mother, saying my name.
"Are you...you're drooling, honey."
My folks came to visit for the procedure and took me out to eat afterwards. They ate, and I cried into my soup for thirty minutes...I'm not sure, but I think I really wanted more Versed. Then they took me home, and a week later I received a typed, formal letter from the doctor saying, yes indeed, I had ulcerative colitis.
Yay! Positive diagnosis!
So! First question (one that I've asked one nurse practitioner, and she scared the bejesus out of me in an attempt to comfort my fears) : does Imuran cause white brain lesions in some patients? I only ask because of a random study I came across while searching Ebsco at work. Also this morning I had my tea scooped and the water was boiling and I was ransacking the kitchen shelves looking for my mug, and then the living room and the bedroom, and then I came back determining to use a second but equally favorable mug, when I saw that my tea strainer sat upon the mug in question...
Definitely lesions, I think. Too bad Imuran somewhat works well. Sort of.
Last night, as I sat on the toliet for the twentieth time of the day, wondering what to blog about and simulataneously wondering if this would end as an Enema Night (and how they deserve their capitalizations!) and meanwhile pondering the relegation of serious self-ponder to Emo kids, and likewise waiting patiently without straining for the, er, faucet to stop dripping...
Eureka! Ulcerative Colitis!
So I'll record all related doings : doctor appointments, meds, issues, single bathrooms vs. multiple stalls, ER trips, furtive purchases, diet restrictions, stress, the stress of consciously trying to be unstressed, and on. I have a fantastic fellow who is more supportive and all-ears than anyone I've ever met, but even he needs a break sometimes, and really, one audience just isn't enough for me. I need IBD-dedicates and sympathizers. You know who you are.
I was diagnosed in 2003 after a very trippy colonoscopy, during which I vaguely remember seeing the insides of my intestines on a little tv, but since I was lying on my side and doped with a lovely mix of demerol and Versed (you dog, you!) I don't remember much except the doctor saying, "Yes. See that? Umm-hmm" and that the lights were pretty dim considering they'd just been bright half an hour ago.
I remember immediately after the procedure, the nurses set me in a chair and someone whom I don't remember properly as I couldn't control my drool reflex, so naturally I was concentrating on that, someone sat next to me and patted my knee and explained things in a really fast whisper. The next thing I heard was my mother, saying my name.
"Are you...you're drooling, honey."
My folks came to visit for the procedure and took me out to eat afterwards. They ate, and I cried into my soup for thirty minutes...I'm not sure, but I think I really wanted more Versed. Then they took me home, and a week later I received a typed, formal letter from the doctor saying, yes indeed, I had ulcerative colitis.
Yay! Positive diagnosis!
So! First question (one that I've asked one nurse practitioner, and she scared the bejesus out of me in an attempt to comfort my fears) : does Imuran cause white brain lesions in some patients? I only ask because of a random study I came across while searching Ebsco at work. Also this morning I had my tea scooped and the water was boiling and I was ransacking the kitchen shelves looking for my mug, and then the living room and the bedroom, and then I came back determining to use a second but equally favorable mug, when I saw that my tea strainer sat upon the mug in question...
Definitely lesions, I think. Too bad Imuran somewhat works well. Sort of.
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