Staying compliant
Q. I've recently had a kidney transplant and taking all these immunosuppressant drugs is really complicated and time-consuming. The hospital gave me a list of my drugs and the times I have to take them, some with food and others hours after I eat without food. It's all very confusing. Why can't I just take them once a day? It's really getting me down. How did you do it?
A. I know that taking all those pills can seem like a burden. They are powerful drugs and without them your new kidney will reject and you will lose it. You don't want that to happen, so you must follow your doctor's specific orders. You can't skip a day and try to make it up the next day. The level of specific drugs in your body must be kept constant day in and day out to insure the success of your transplant. That's the reason for the exacting schedule.
Here's what I do to make the job seems less burdensome. I bought a small, clear plastic box that is partitioned into several compartments. These boxes are inexpensive and easy to find, usually in drug, hardware or fishing tackle stores. Then I labeled each compartment (on the box cover) with paper stickers with the name of each drug and the time and I had to take it. For example: Prograf: 3 capsules 8 AM & 8 PM with food. I usually abbreviated the legend because the stickers are small and space is limited. So it would be Prgf. 3 cap. X2 @ 8 wf.
Each morning at breakfast, I load up my pill box for the day, take those pills that are required in the morning with food and put the box in my pocket or somewhere I can easily reach it when it's time to take the remaining pills. This system requires a bit of organization at the beginning, but it becomes routine after a few weeks. It's much easier than having to carry all your meds with you everywhere you go.
In fact, I put all my meds, the specific dosages, and the times I have to take them on a list in my computer. I keep a printout of the list in the kitchen with drug containers holding my month's supply of each drug. The list is always there in case I forget the dosage, frequency or special instructions for taking a drug. I update the list as my doctor changes dosages or prescriptions. It's easy once it is on the computer. And I bring that list to my doctor's office for regular visits. I give him a copy for his records. That way I don't have to carry all my meds to his office each time. He really appreciates having an up-to-date list in my file. I also use the list when visiting my dentist or other non-kidney-related doctors. That insures that they will not prescribe drugs that will cause adverse reactions to the immunosuppressants. The drugs I am allergic to or have had very bad side effects with are also on my list.
I can hear you thinking, oh sure, David makes this sound really easy. He must be an organization freak. Well I have to admit I am a bit anal, but I do take 14 different drugs daily. That can overwhelm anybody, including me. We all forget things. It's human to do so. So why not give my system a try. After awhile it ceases to be a burden, and becomes just another, but important, task like brushing your teeth.
Now, not everything has to be run as if you are an efficiency expert. Sometimes nature can help you along. I have high blood pressure, and I've discovered that if I take my pills at specific times each day, my BP stays at normal levels, regardless of what activity I'm doing. I take four BP tablets a day: two pills of one medication at 9am and 9pm, and two pills of a different medication at 5am and 5pm. I could set my alarm clock at 5am, but my cats inevitably wake me every morning around 5am. They are hungry and want to be fed. So, I get up, half asleep, shuffle into the kitchen, open a can of cat food for them and take a BP pill for me. They are happy and I shuffle back to bed for another two hours of perfect sleep. What could be more symbiotic. I told my doctor about this, and he chuckled and said, "Whatever works."