Thursday, November 29, 2012

The Importance of Actually Taking Your Meds

This morning was a bit hectic and I ended up skipping breakfast. That's when I typically take my modafinil pill. Right after lunch, I got a headache and started feeling really tired which is when I realized what happened. I couldn't get back to my office and by the time I did, it was really too late to be taking it unless I wanted to be awake half of the night. It's amazing how much different I felt. Tuesday and Wednesday were just awesome in terms of my energy levels. Today was completely the opposite.

So, the moral of the story, children, is that your meds don't do you any good if you forget to take them.

Monday, November 26, 2012

Drugs and Me

One of the most exciting things about getting multiple diseases is the drugs you get to take. Or something like that. There are plenty of people taking a whole lot more than I am, but just for kicks I thought I would outline what I am currently on.

We'll start with the big two; both are insulin. Without these I wouldn't live very long. You normals have a pancreas that kindly produces insulin for you. Mine no longer does. The first type of insulin is Lantus I take this once a day at night. It provides my basal rate of insulin. My body always needs insulin whether I'm eating or not. Lantus provides this. This is, of course, given by injection.

The other insulin I take is Humalog. This provides my bolus for when I am eating and need extra insulin to process it. I have to carefully balance my blood glucose levels. If it gets too low (if I take more insulin than I need for what I've eaten) then I risk becoming hypoglycemic. If it gets too low, I can go into a coma. I know when I'm getting low because my vision gets wonky and my brain gets foggy. Then it's time to drink some milk or juice (liquids are processed faster than solids). If my blood glucose gets too high, I risk becoming hyperglycemic. How do I know it's getting too high? My mouth is really dry, I'm thirsty no matter how much I drink, and I'm urinating. A lot. I have to check my sugar throughout the day and give myself more insulin as needed or eat more carbs as needed to keep it balanced. It gets old fast, but I sort of have to if I want to avoid being admitted to the hospital or, you know, dying.

Now we get away from stuff I inject and to pills. First up is lisinopril. Most people know this drug as something for high blood pressure. Thankfully that's not a problem I have. In fact, I don't know that I've every had high blood pressure. No, I take it for proteinuria. Thanks to diabetes, I have too much protein in my urine which can lead to kidney damage. The lisinopril helps protect them so I can keep 'em. Take a pill every day and keep my kidneys. I guess that seems like a fair trade.

This is one I finally got back on starting today (well, tomorrow). Like 80% of my fellow cohorts with multiple sclerosis, I suffer from serious fatigue. Even when I get a full night of sleep, I can struggle to be fully awake and alert throughout the day. Sometimes I'm sitting at my desk at work and seriously struggling to keep my eyes open. That makes being productive a struggle. Modafinil works against this, though I find it funny that scientists still don't understand how it works. Of course, they don't understand why people with MS have fatigue, either. The most common theory bandied about now is that the MS brain is constantly rewiring itself in order to most efficiently send signals where they need to go. Whatever the cause, fatigue sucks. And, however it works, Modafinil helps. I stopped taking it awhile back due to the cost. Just a couple of weeks ago, I checked with my insurance and Provigil (the name brand) would cost me nearly $600 for a 3-month supply. As it turns out, though, a generic was recently approved. That would cost me $18 for the same amount. That I can afford. So, my doc wrote me a script and starting tomorrow, I'll be taking one a day at least during the week. On weekends, if I can squeeze in a nap I might rely on that.

I'm not really big on supplements and this happens to be the only one I take. There is some evidence suggesting that a lack of vitamin D can contribute to contracting MS. There is also some evidence suggesting that taking a vitamin D supplement can help with the symptoms. It's not as if I can alter my diet to get more of it and I don't think my office will be located outdoors anytime soon, so I pop another pill every day.

So, those are the drugs I take. The insulin I have to take. The lisinopril is strongly recommended I take. The modafinil makes life easier. The vitamin D is completely optional and may or may not be helpful. I'm grateful that there are drugs I can take to keep me upright and I'm grateful that I'm not stuck taking 20, 30, or 40 different prescriptions like some people do. It would be nice to take something for the MS itself (rather than just symptoms of it), but even with good health insurance I would still be looking at hundreds of dollars a month in out of pockets costs. That's not something I can afford at the moment. All in all, though, I'd say I'm pretty lucky.