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aura

Difficulties with med compliance

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It might be a bit 'old granny' but I have a pillbox. Actually it's called an 'anabox'. 7 detachable segments with am lunch pm night and an extra compartment just in case. I put my am and pm meds in there along with all my vitamins I take with my lunch. They are beside my bed so I can't forget them.  It's quite a big box ha ha! 

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I set out my meds in groups so I can see them, and know the times I need to take them.  Sometimes I forget them even though I am sitting right there staring at them.  But overall it makes it easier because they are laid out rather than having to remember to take them out of the pill container when I need to take them.

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It is still fresh in my mind how awful it was to be in the black pit of infinite pain and longing for death. Whenever I have a bad day I freak out that I may be going back to that awful place. So I guess it is fear that keeps me compliant. I have my meds on my dresser in my bedroom so when I get up and get my clothes I take my morning meds and when I get undressed at night I take my night meds. I am enjoying my life in a quiet way now and I don't want to upset that for anything.

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I'm not bipolar so you can take this with a grain of salt, but what keeps me med compliant is because except for a brief period of remission, I've never felt better off meds than on. I can't recall a time except my childhood and this brief period of remission where I I would fantasize about going back to by getting off meds. Most of my memories of being off meds are horrible.

Furthermore, I have been lucky to have found meds that don't give me a whole lot of side effects.

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I told my pdoc about my compliance issues yesterday - I had mentioned them to her before to some extent, but they had not sunk in with her previously. She agreed with my tdoc's strategy of having me log every single time I take my meds and having me always take my night meds at 10 pm (so the quetiapine will have made me go to bed by 11:30 pm) and my morning meds at 8:40 am (i.e. right before I leave for work), every single day. I still wish I were able to go to sleep and get up whenever I wanted to on weekends when my daughter is not around, but now I am not allowed to. Sigh.

Edited by Closure

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As far as the difficulty taking meds on a schedule or remembering meds, I have alarms set on my phone. I set them up with the option of "snoozing" them for 15 minutes up to like 5 times or something, so if I can't take them for some reason exactly at the scheduled time, I keep getting reminders until I do take them. 

When I can identify that I am thinking about being non-compliant but before I actually stop taking your meds or adjust them without permission, it helps me to tell my therapist this and have him ask me whether I'm still taking them as prescribed. For me, sometimes just the internal shame of having to tell him "no" is enough to keep me from making that decision. I've also gone over with my therapist my own some of the negative consequences that I've had in the past from not being med-compliant (or not being proactive in communicating with my pdoc when I have new or breakthrough symptoms) so he can remind me of these if I do start to be non-compliant. I also have a friend who has seen me through some of both my worst depressions and some of my weirder hypomanias, who isn't afraid to tell me, "do you not remember when..." and mentions various things she's seem me do or say in the past as a way of reminding me that being off-meds or improperly medicated does not work well for me.

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It can take a bit to get a regular schedule going, especially with BP. I had my meds blister packed by the pharmacy (which was a free service, some charge for it, many don't anymore) so I knew exactly when to take what, they had a description of each pill, what it did, when it was taken, on the side of the blister pack.. It's a huge waste of space though. Eventually I stopped having the pharmacy pack them, they gave me various pill boxes, and I would take my meds (which come in labelled pill bottles, with basic "Take 2 pills in the morning" on them, not packages with logos) and sort them into the pill box weekly. I acquired enough promo pill boxes that I get my meds monthly, and sort them out for myself. I keep my meds in a locked med box (my cat knocks stuff over, so its useful, I keep one key with my car/house/etc keys, another in with my crochet hooks) and fill the pill boxes after I get my monthly Rx.

I'm compliant now, but I used to play with doses, take at the wrong time, stuff like that. It can take a while to get used to it. And side effects suck. I'm so used to it now (started the whole "cocktail" thing at age 17, am 32 now) its habit. But I'm terrible for not eating with some meds. Like Latuda.. I'd go buy a milkshake or something, or drink a huge glass of milk and eat a bunch of granola bars. Same with Geodon. I just wasn't hungry. I rarely eat when I get up, then I'd feel sick all day. You kinda have to "train yourself".

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On 01/12/2016 at 6:34 PM, Eilatan said:

It might be a bit 'old granny' but I have a pillbox. Actually it's called an 'anabox'. 7 detachable segments with am lunch pm night and an extra compartment just in case. I put my am and pm meds in there along with all my vitamins I take with my lunch. They are beside my bed so I can't forget them.  It's quite a big box ha ha! 

Ohman, this isn't something that should be 'old granny' to anyone; It's absolutely essential once you end up on multiple meds that you take different dosages of at different times of day. I have multiple of the damn things.

Best type I've found are the attached ones; Things that come in open containers tend to spill if tipped/knocked, which then knocks them open themselves, & you're playing 52 pill pickup. The days aren't as clear as coloured types, but honestly a set of coloured markers or paint/nail polish blobs would sort that if days being very-visible is vital. They can also be found cheap as hell, which helps.

Whisper

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I used to dry-swallow my meds after I took them directly from each container, measuring out my doses every time I took my meds. When my parents forced me to give up control over any more than a week's worth of meds at a time (due to OD risk), they gave me a med box, which has actually been working well (even though I now take too many pills at a time to dry-swallow them anymore, and even though actually filling the med box every week is an annoyance).

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1 hour ago, WinterTidings said:

Ohman, this isn't something that should be 'old granny' to anyone; It's absolutely essential once you end up on multiple meds that you take different dosages of at different times of day. I have multiple of the damn things.

Best type I've found are the attached ones; Things that come in open containers tend to spill if tipped/knocked, which then knocks them open themselves, & you're playing 52 pill pickup. The days aren't as clear as coloured types, but honestly a set of coloured markers or paint/nail polish blobs would sort that if days being very-visible is vital. They can also be found cheap as hell, which helps.

.....................

Wintertidings

Yes I find it absolutely essential too. Still dealing with feeling of old granny tho.... 

Trying to post a pic of the one I have. But I'm failing badly....

 

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I've been on my meds for two days and I'm already thinking about going off them for reasons including possible side effects and more, so I don't have advice but I do have solidarity to offer

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i'm replying based on title and not section, so if this question is strictly for those with bipolar, i'm not/don't. schizophrenics are also notorious for discontinuing, so that's where i find myself.

 

i just wanted to reply to your question about how you've overcome it. the short answer is that i haven't. HOWEVER, i have a small girl now and i also have medication management where i get a check in phone call at 10:00 PM nightly to remind me to take them. my morning ones are easier for me to psych (sic) myself up for.

other things that have contributed: i was on court ordered depot injections for two years. there's nothing like having your freedom removed to inspire you to take a look at whether it's worth it to keep fighting the fight and rejecting this diagnosis and the entire medical model.

also...i'm older today than i was the last time i discontinued. i mean, obviously. but my point being: i discontinued repeatedly through my twenties and thirties. then at, i think, 39 i got stuck on depot. two years later i have a small girl. one year after that, where i am today...i'm HIGHLY motivated to prioritize that small girl. i kinda lose my shit nightly and sit on the discontinuation fence. but i know if i take them, they'll eventually knock me out and in the morning i'll awake to a small girl. when i was younger, i hadn't ruined as much of my life. i lacked insight more. now that i have some degree of insight...all i see is potential wasteland on the already wasted land. so, it's not that i'm more "mature"...it's that i'm more war torn and weary and fighting the fight used to be a higher priority...now it is in direct conflict with having a small girl...so i've had to work to let it go.

it's hard though. really hard. i wish you well in navigating.

oh, and, as i said, since i'm not posting in my own section, if you want, i'm sure the staff would remove this for you. i get only wanting input from those of your own kind sometimes. no worries ;) x

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On 30/11/2016 at 6:58 AM, Closure said:

I am guilty of a somewhat different problem, that left to my own devices I cannot take my meds at a consistent time - either I don't remember my morning meds at all (I used to do this), or I don't remember to take my morning meds in the morning and instead take them at night (I did this a lot until quite recently), or I simply don't bother with taking meds in the morning at all and instead take all of my meds at night every single day (I did this for a long period), or I remember my morning meds but I take both my morning and night meds at quite erratic times of the day.

My tdoc is trying hard to get me out of this and into actually taking my morning meds and my night meds at the same times every single day, regardless of whether it is a workday or a weekend. Her solution is to have me write down in a log every single time I take my meds, and have me take said log to my tdoc appts so she can read it and tell me how I need to take my meds more consistently (as I have never taken them as consistently as she would like). This has succeeded in getting me to at least take my morning meds around the time I get up or shower every single day, which she wanted for starters, but which is not enough in her opinion.

This is actually really hard for me, because my old pattern was to take my morning meds when I take a shower (on weekdays) or when I get up (on weekends) (or not take them at all) and to take my night meds when I go to bed (along with my morning meds if I have not taken them yet), and to go to bed at midnight and get up at 7 am on weekdays (she thinks 7 hours of sleep is not enough) and to go bed anywhere between 2:30 am and 4 am and get up anywhere from between 10 am and 3 pm on weekends (she thinks this is way, way too erratic). She now wants me to take my night meds at 10 pm, so I will actually want to go to bed by 11:30 pm (she seems like she would really want me in bed by 11 pm, though), and to get up at 7 am and taking my morning meds around 8:40 am - which I am okay with on workdays - but on weekends I have staying up late and waking up late far, far too ingrained, and if I take my night meds at 10 pm I certainly will not be able to stay awake past 12 am, and I would really want to stay asleep well past 8:40 am.

I do this as well. Often I can't seem to push myself to take meds in the "morning" (when I wake up, usually afternoon". I often feel shittiest then and swallowing a pill is unappealing and if they worked I wouldn't sleep all day and wake up feeling like this...

 

so I often take a bunch of pills at night and just skip some to avoid doubling up. I end up taking only half of my daily lithium dose that way.

taking meds is just one of the many things I'm no good at.

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On 12/17/2016 at 10:13 PM, mcjimjam said:

I do this as well. Often I can't seem to push myself to take meds in the "morning" (when I wake up, usually afternoon". I often feel shittiest then and swallowing a pill is unappealing and if they worked I wouldn't sleep all day and wake up feeling like this...

 

so I often take a bunch of pills at night and just skip some to avoid doubling up. I end up taking only half of my daily lithium dose that way.

taking meds is just one of the many things I'm no good at.

Both you and @Closure get me. If I don't have classes, I can take my meds anywhere between 1-3 PM and since I don't ever know for sure when I'm going to sleep (bad, I know), I usually take my night meds anywhere from 10 PM-2AM. It's kind of a disaster, and I've been on them like a week! I've already missed two days.

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10 hours ago, jacques said:

Both you and @Closure get me. If I don't have classes, I can take my meds anywhere between 1-3 PM and since I don't ever know for sure when I'm going to sleep (bad, I know), I usually take my night meds anywhere from 10 PM-2AM. It's kind of a disaster, and I've been on them like a week! I've already missed two days.

What I have found helpful with the multiple times to take meds (I take meds 4x/day) ... pill boxes for 2 times during the day, then what I do is set out the next 2 times I am supposed to take them so they are sitting right there.  I don't always take them at the same time either ... like you my sleep is not consistent, so I just do my best in terms of getting them in.  And sometimes I am late by a few hours too. But then it depends on the med as to whether I can afford to miss it or not.  Then rinse and repeat that every day. 

In general, I take meds within an hour before to an hour after when they are scheduled for.  There are no exact times I adhere to ... just ones at certain times a day.

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Yikes I guess I'm not very complient with my meds. I took them too much for a bit, then I skipped days like crazy until I was taking 200-300mgs of lamictal every three days, sometimes longer. Not great. Eventually I just stopped taking them. Months later and I've got a still completely full bottle of lamictal I was supposed to start a couple weeks ago. Oops. 

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3 hours ago, ohjustchillin said:

Yikes I guess I'm not very complient with my meds. I took them too much for a bit, then I skipped days like crazy until I was taking 200-300mgs of lamictal every three days, sometimes longer. Not great. Eventually I just stopped taking them. Months later and I've got a still completely full bottle of lamictal I was supposed to start a couple weeks ago. Oops. 

Be careful with the lamictal ... if you haven't been on it for awhile you'll probably start from the beginning to titrate up.  Ask pdoc about this and let him/her know because starting at a higher dose can be dangerous.

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7 hours ago, melissaw72 said:

Be careful with the lamictal ... if you haven't been on it for awhile you'll probably start from the beginning to titrate up.  Ask pdoc about this and let him/her know because starting at a higher dose can be dangerous.

Yup, I know. I'm starting over. 

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I'm going to answer this as two separate questions, practical and philosophical.

In practical terms, remembering to take meds, the daily pill box can't be beat. I have one for a.m. and one for p.m. Since I am such a creature of habit, I just keep my morning meds by my computer, my first stop in the morning, and my evening meds in a drawer of the coffee table, because generally the last thing I do at night is watch some tv with my husband. I know some people who set reminder alarms, and find that helpful.

Philosophically, I am willing to take meds because I've seen what happens if I don't, not only to my life but to the lives of people I love. I am well aware that I would long since be dead without my medications. Sometimes that seems like a good deal, but really I know it isn't. 

 

 

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