Wednesday, October 29, 2014


I had a patient crying in therapy today. Her surgery is not what she expected. No one told her how difficult the recovery would be (the surgeons rarely do). She thought it would be a walk in the park. I had to be the bearer of bad news- the time in the cast is often the honeymoon period, when there is very little pain. When the cast comes off, you find out what is really going on.

And it is the unexpectedness and urgency of my provigil problem that has completely thrown me. I thought I had this figured out. First when I was getting it from overseas. Then- and I had time to figure it out- from Costco. And it was generic. The price could only go down. I was already cutting down my therapy to every other week to afford my Provigil.

I was caught off guard, just like my patient. I didn't know about the massive price increase until I was down to my last few pills, not even a week's worth. I just panicked and had a tantrum and got depressed.

And I still am- panicking and tantruming and being depressed. And I really don't want to be this way, but I don't know how not to be this way. I am back to seeing my therapist once a week- this is already costing me money! I should be trying to get in with my psychiatrist a little bit sooner- but I keep waiting, thinking I will hear something. Because until I know what the decision is, I don't even know what I need to see him for. I don't know if I will need to be looking at other stimulants or not.

Right now the lowest price I can find for Provigil is $520, and it just dropped last week, so it probably won't drop again for awhile. In theory I could pay it for a while- but starting in January I have no out of network benefits and I have an out of network psychiatrist and therapist. Something would have to give.

My last two therapy sessions my therapist has asked if I had to go the the hospital. And I have to admit, the thought has crossed my mind as well. But I just don't think there is anything they can do for me there- it would just annoy me. And I just want to go to work. I think that if I were to be in the hospital twice in a little over two years- that would be too depressing to bear. So I have upped my Zyprexa, which has helped some, and am taking more klonopin than I'd like- but still not a lot (I'd rather be taking none).

I just keep thinking- if I can keep going until the weekend. I don't know what then. Crash, I guess. My last hour at work today I felt so depressed I thought I would pass out, if that makes any sense. But I keep going because it takes less effort than to reschedule patients and tell my boss I am leaving early (and why), etc. So I just keep going.

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