Refilling Clozapine

Refilling Clozapine

I take a lot of medications; most I take daily, and some are taken as needed. I keep very close track of my medications and when they need to be refilled. It’s a big task, but I make sure I’m on top of it all. I have a problem filling my Clozapine prescription every month. I have to do monthly blood work. The pharmacy won’t fill the Clozapine without the blood work results. Filling this prescription is an issue every single month.

Every month, the lab forgets to send the pharmacy my results. It’s always a huge hassle. Even though I filled out the paperwork, I still have to convince the lab to send my results over. I shouldn’t have to call the lab every time. At least I’ve found a way to make the phone call easier and shorter.

I refill my prescriptions about a week early (they can be filled from approximately 3 to 7 days early depending on the script). If I start early (at the 7 day mark), then it’s okay if they run into a problem. I learned this the hard way. Running out of prescriptions is not fun.

Feeling Useless; I’ve Felt Like This Before

The past few days have been pretty rough. My husband hasn’t been feeling well, and we don’t know what’s wrong. At first, we thought it was just the flu. Some blood work came back, and we’re afraid it may be an autoimmune disease, liver disease, or something else more serious. So now, we’re waiting for more blood test results. I hate waiting.

The past few days have been hard for me, even though I’m not the one that’s ill. I keep trying to find ways to help my husband feel better, but there’s nothing that I can do to help. It reminds me of when I was a kid. My dad was diagnosed with cancer when I was 12 or 13. He was pretty sick fairly often, especially from chemo and dialysis. I remember hanging around my dad when he was sick and feeling completely useless. He wasn’t feeling well and there was nothing I could do to help. That same feeling is coming back now. My husband isn’t feeling well, and nothing I do is helping.

Problems Filling A Prescription

Problems Filling A Prescription

This is the third time in a row that I’m having problems getting my Clozapine prescription filled. The lab automatically faxes my blood test results to the pharmacy, but for some reason, the pharmacy cannot find them. Yesterday, the pharmacy told me they didn’t have the results without even knowing my name. Then I told them my name and said that the test results normally go straight into my file. Less than a minute later I was told again that they don’t have the test results.

I called the lab and left a message for them asking them to resend my blood work to the pharmacy. Today, I will call the lab again just to make sure they got my message, and then I will call the pharmacy again. If I’m still having difficulties, then I will just show up at the pharmacy and ask to speak to the pharmacist. I really wish it wasn’t this difficult getting my Clozapine script filled.

Difficulties At The Pharmacy

Difficulties At The Pharmacy

Yesterday, I dropped off my weekly Clozapine prescription at the pharmacy. I asked the pharmacy technician if she could check to see if my lab work had come in. I told her that it gets faxed over from the lab every week, and that someone from the pharmacy normally puts a copy in my file. She looked at me weird, and said, “We don’t do blood work here.” I explained to her again, that I get my blood work done at a lab and then the lab sends my blood work to the pharmacy so I can get my prescription filled. She still didn’t understand; she told me again, “We don’t do blood work here anymore.”

Wow, I was surprised at how ignorant this woman was. If she had just taken 30 seconds to listen to my explanation, then she would understand. At this point, she went to the back of the pharmacy with my prescription. When she came back up front, I asked if she found my blood work results. Her response was, “I don’t know, I didn’t look.” I was so baffled that I just decided to leave instead of try to get this woman to understand me. I asked her to please call me if there were any problems filling the prescription.

Luckily, they were able to fill my prescription. The pharmacist must have found my blood work in my file. I think they’re finally getting used to receiving my blood work results and having me filling my weekly Clozapine prescription there. The pharmacy technician I had this odd interaction with was new, so I can understand her being confused; however, if she had just listed to my explanation, she would have understood easily.

Clozapine Refills Are Getting Easier

Clozapine Refills Are Getting Easier

Every week I get my blood drawn to check for any possible side effects from taking Clozapine. The medication can cause many serious side effects, and the blood tests are there to catch the issues before they get too serious. My blood work results are finally all within normal limits. At one point, they got so bad that my pharmacist said they may not be able to continue filling my Clozapine prescriptions. We still have to keep an eye out for any issues since I’m increasing the medication slowly. I’m still doing weekly blood work, but I’m almost half way through it. At six months, I get to switch to every other week. At least it’s something to look forward to.

It’s also been getting easier to get my Clozapine prescriptions filled. I haven’t had to call the pharmacy and see if they have my blood work results, which is what I have had to do up until the last two weeks. I haven’t had to call the lab to have them fax over the results again either. The pharmacist is also no longer questioning my blood work  because my results are finally normal. I’m glad this is finally getting easier, it’s about time. All I  have to do now is hand the pharmacy my prescription, and 30 minutes later my medication is ready to be picked up.

Clozapine Prescriptions

Clozapine Prescriptions

My psychiatrist mailed me two months worth of prescriptions. These scripts, for Clozapine, will get me from my 200mg dose up to my target 400mg dose. Each script is for one week worth of medications (because I still have to do the weekly blood work). He sent me everything that I would need to get through the next two months. The scripts are pre-dated, so I can’t fill them until Wednesday of each week.

I will be starting the increase soon, either Wednesday or Thursday of this week. I’m a little concerned about the possible side effects, but I mostly think it will all work out.I’m increasing my dose slowly to hopefully avoid side effects. I guess only time will tell.

I can still contact my psychiatrist any time I need, but hopefully everything with the dosage increase will go smoothly and I won’t have to. My next appointment with him is on August 25th. Until then, I can contact him via email or text if necessary. He will still get my weekly blood work results. If he sees a problem with my blood tests, then he will contact me.

Clozapine Blood Work Change

Clozapine Blood Work Change

Since the beginning of April, I have been getting my weekly Clozapine blood work done on Fridays. A couple of weeks ago, somehow the day that I pick  up my prescription changed. Instead of picking up my filled prescription on Sundays or Mondays, I’m picking it up on Thursdays.

Since I now pick up the script on Thursdays, it seems a bit ridiculous  to get my blood work done on Friday. I’m going to start by changing my blood work days to Mondays. Depending on how things go, I will either stay with Mondays or change to Tuesdays.

All I know is that my psychiatrist and pharmacist should be getting current blood test results. Right now, by getting blood work done on Fridays and prescriptions filled on Thursdays, none of my results are technically current. I’ll see how Mondays go for a while; I have an appointment right now for Monday at 2pm.

Psychiatry Appointment

Psychiatry Appointment

Late tomorrow afternoon, I have an appointment with my psychiatrist. I’m really nervous about this appointment. He is going to go over my Clozapine blood level with me and change my dose. I’ not really worried about that, but I have just decided that I don’t want to do ECT anymore. I’ve been thinking about this for a while now, but I finally made my decision (I think). Right now I’m going every four weeks. So at the very least, I could just start by taking an extra month off and seeing how that goes. If it’s a disaster, then I can think about going back on it.

I wrote down on paper what I want to say to him because I don’t normally stand up for my opinions.I don’t like any type of disagreements. Since I wrote it down, then I know I will be able to say exactly what I want to say. I’m going to tell him, ‘I am no longer willing to do ETC treatments. The stress on my body, the memory loss, and the loss of words in conversations is too much for me. It has been this way for a while. I tried putting it off, but I can’t wait any longer. I’m not willing to do the Ketamine treatments at this time.’ Hopefully I can stick by what I say. There’s a better chance of that happening since I wrote down what to say.’ I’ll let you all know how it goes.

Clozapine Refill Frustrations

Clozapine Refill Frustrations

I started my Clozapine rechallenge on April 3rd; I have now been taking it for close to 8 weeks. My doses have increased slowing over that time. I’ve had some side effects, but nothing that can’t be managed or dealt with. Some of the side effects have gone away over time and others I’ve learned to deal with to the best of my ability.

I just had my Clozapine level taken and the results finally came back yesterday. My level came back at 80, which is very low. I’m assuming that my doctor is going to be increasing my dose, but I’m not sure. I don’t really know where he wants my Clozapine level. A low level is between 50 to 150 ng/mL, 200 to 300 ng/mL is a medium level, and 350 to 450 ng/mL is a high level. I’m pretty sure that the therapeutic level begins 100, which I haven’t reached yet.

Every week I seem to have problems with my blood work and filling my prescription. People at the pharmacy tend to lose track of my blood test results, which they need in order to fill my prescription. I have finally learned that if and when the pharmacy says they haven’t received my weekly blood work, I just need to tell them to look in my file. I thought getting my script filled would be easier now that I’ve figured out that part. However, this week’s prescription has been difficult for another reason. First, my doctor wanted to wait for the Clozapine level results so he knew how much to prescribe. I normally get my script filled on a Sunday or Monday. It’s now Thursday, so I can’t last much longer without a refill. My doctor has called the prescription in twice to the pharmacy. He said that he was on hold for 10 minutes just to leave a message. I’ve called the pharmacy 3 times today regarding this script, and it still isn’t filled.

I don’t know why it’s so difficult to get this prescription. It seems to add a great deal of anxiety to my life every week. I’m actually taking Valium just to deal with this situation. I wonder if it does more good than harm.

Waiting Is The Hardest Thing To Do

Waiting Is The Hardest Thing To Do

Right now, I’m waiting, and I’ve been waiting for days. I’m waiting for the results to my Clozapine level blood work. The results to this test will tell my doctor whether or not he wants to increase the dosage of my Clozapine. I’m currently at 200 mg every night. I did the blood work on Friday. My normal weekly blood work was completed on Friday, but the Clozapine level takes longer to come back. I just don’t know how long; I even tried to figure out how long it would take by researching it online, but I came up empty-handed. I told my psychiatrist that I’m in a depression. I informed him that I’m sleeping too much, I’m overeating, I feel worthless and empty, and I’m easily irritable. He told me to hang in there; we are waiting for the results of the Clozapine level. Once we have the results, then we can figure out our next step.

So now I’m just waiting. I’m waiting for my blood test results, I’m waiting to find out what change my psychiatrist wants to make, and I’m waiting to start feeling better. When you’re waiting for something, every moment seems to drag on and on. I’m just trying to get through this, one moment at a time, but how much longer do I have to wait? Even if my psychiatrist decides to add a new anti-depressant, we all know that it takes 4 to 6 weeks for the medication to start working, if it’s going to work at all. So that’s more waiting. No one should have to wait this long to feel better.

I’m compliant with anything I’m told to do by my doctors. However, I am getting sick and tired of it all. I wouldn’t mind the waiting, if I knew that there were going to be positive results. I also wouldn’t mind the waiting if I knew that the positive results that I was going to get would be more than just temporary. We all know that no medication to treat bipolar disorder is permanent. Every time we try a medication, our bodies react differently; we almost never react the same way twice. How a medication works varies depending on our current mental state, the medications we’re currently taking, and any treatments we’re currently undergoing.

I just wish there was an easy answer to treating bipolar depression and mania. There should be an answer, an easy way to help us, where we don’t have to spend most of our time waiting. My bipolar disorder is very gray, nothing is absolute, and everything is questionable. I wish my bipolar disorder was more black and white, I wish it had easier, faster, and more accurate answers.