The mashed potatoes of medication

My friend Ken tells a story about stopping into a mediocre diner while traveling. When the waitress brought his order, she told him, “The potatoes aren’t very good today, so I gave you extra.”

“Just what I wanted,” he recounts. “Bad food and more of it.”

I couldn’t help thinking of this as I replayed my visit to my doctor, where we danced a salsa for my insurance company’s amusement.

Four weeks earlier, I had been given samples by the same doctor. Within a week, after adjusting to unpleasant side effects, I felt good. Pretty soon I was feeling great, better than I had in … I didn’t even know when.

When I exhausted the samples and went to pick up my prescription, though, the evaluators employed by my health insurance company stepped in.

You don’t have prior authorization, the pharmacist told me. Hogwash, I said. I knew about this requirement and had given the phone number to my doctor’s assistant.

Bwahaha. Silly me for thinking a simple phone call from my doctor’s office would mean anything. No, I was asking for a Tier 3 medication, at the top of the price chart and with no generic. My insurance company would pay for it … after I had tried two other medications and failed to get any results with them.

Are you freakin’ kidding me?

Understand, I long have been of the mind that insurance companies don’t tell you the kind of care you’re allowed to have; they tell you what they’re willing to PAY for. You can have anything you want. You just might not be able to get someone else to pony up for it.

My rational response was biting me in the ass.

Unfortunately, said drug was a whopping $186 a month. Still, I was toying with the notion. In the meantime, my doctor thought there was something else I could try, and I grudgingly agreed to jump through the hoops. By now I had gone four days with no medicine and not only felt the effects of not having it, but was going through the reverse on side effects and getting the stomach pain and insomnia back.

Drug #2 was … OK. I wasn’t miserable. I didn’t have side effects. But I didn’t feel like tackling the whole world, either, like I was starting to feel on drug #1.

I duly reported this to my doctor, thinking he would switch me because, to my way of thinking, I was telling him this was ineffective. His response? “Take twice as much.”

Bad food and more of it?

“Two capsules might not be enough,” he said. “Call me next week. Maybe you need three.”

So, day two of double dosing. I WANT to want to kick the world’s ass … I just need some help to get there.

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