anti-malarials

I started taking Mefloquine. Three weeks before we departed for post.  Mefloquine isn't generally recommended for those who have suffered from depression in the past, but it is the only anti-malarial safe for pregnancy, and this time last year we'd fully intended that I'd be pregnant.

Until we got here.

One look at the haze of the Harmattan and I couldn't bear the thought of bringing a baby back to Abuja.  I absolutely believe in a woman's right to choose when it's the right time for her to become a mother, so I respect the many people who have added to their families here, but I knew this wasn't where I wanted to start mine.

I thought I'd stick with the Mefloquine anyways since it was the easiest option.  It's offered free through the med unit and you only have to take it once a week.

That lasted for about two months.  At the time I was pretty sure it was exacerbating my depression, but looking back on all that we were going through at the time: an international move to a dangerous, third-world country, away from our family and friends and Target, and with it the culture shock of a new home, a new country, a new job and new friends, I'm wondering if maybe it wasn't the Mefloquine that was making me blue.

So back in early March I switched to Doxycycline.  Doxycycline is an antibiotic, and while it doesn't cause the crazy dreams or shit-for-sleep that Mefloquine does, it does cause some killer nausea, especially if you're already prone to motion sickness.  Also, from my completely unscientific research, I deduced that it's generally recommended not to take antibiotics for more than six months consecutively since they kill everything in your system - the good bacteria with the bad bacteria.  And if the sales numbers of Traditional Medicinal's Smooth Move Herbal Tea are any indicator, you'd see a spike between March and four days ago.

Finally on Friday I decided that I was sick of feeling sick every single day.  I ran out of another box of the tea and I figured I'm already depressed this holiday season, so WTF, I'm going back to the Mefloquine.

There is a third option.  While the med unit will write you a prescription for Malarone, they don't keep it on hand, and you have to come out of pocket to pay for this drug.  I first attempted my foray into Malarone in June, but for some reason the insurance company had my birth date wrong and no one at Coventry felt the need to tell me my prescription couldn't be filled.  So I wait the six weeks I'm told it will take for the prescription to be filled and mailed to me and nothing.

After too much time on hold with Coventry, I thought I got my birth date changed.  The patient people in the med unit resubmitted the prescription, patient little me waits six more weeks and still nothing.  The idiots at Coventry couldn't figure out how to change my birth date the first time I sat on hold and so I had to call them.  Again.

Finally this time it appears the monkeys Coventry hired have learned how to differentiate between a 3 and a 4 on the keyboard.  So the med unit submits the prescription again and Coventry denies the claim.

Can you tell my why it was so freaking important that you had my birth date correct if you were going to deny the claim anyway?

At this point it's November.  I see the claim is denied and I assume that means I should be getting the prescription and a bill.

Last week I got a letter in the mail.  I have to provide payment information before I can get my prescription.

So tonight, after I finally get through to a human being who WON'T STOP TALKING, I give her my credit card number and she tells me how much this prescription for the malady that exists in the country where we live because of my husband's employer, who will only pay for the cheap drugs that have shitty side-effects, is going to cost me every three months.

$479.

So you choose.  Malaria; depression, nightmares, inability to fall into a deep sleep; nausea, intense heartburn, complete and utter irregularity; or $479 every three months.

Merry Freaking Christmas.

TPI Reports

So in case anyone who reads Joey's blog was wondering about my medical clearance, I still don't have it.  After all those trips to the Iowa Clinic (see earlier post), the government is not satisfied.  The first urinalysis had a trace of blood and so did the second (which is totally normal in runners as running on an empty bladder causes slight friction and seeing as I run almost every day it would make sense to find blood), so they required a cytology and visit to a urologist.  So after I peed the third time and the report revealed that (gasp!) everything was fine, I don't have cancer and there is nothing unusual, I was able to cancel my visit to the urologist (thank GOD). 
 
Unfortunately, the cytology report isn't enough to explain away that box I checked for depression.  Ugh Why Did I Do That?!?!  For future reference, for anyone who has to fill out government forms, lie lie lie lie lie.  If you are honest when you fill out the forms you are creating a world of pain for yourself.  So first they sent a TPI report.  Yes, for all of you Office Space fans, it is really called a TPI report.  We asked our friend Michon, who is the PA at Preventative Health (the clinic we used to have an interest in), if she would fill out the form for me.  Which is no easy task, by the way.  This freaking form is about twenty questions, each one of them dumber than the previous, about my treatment and diagnosis and support system and give me a freaking break.  At the bottom of the form it asks that the answers be put in narrative form and submitted to the government.  Well, the nurse from the State Dept contacted Joey and asked that I call her.  Apparently, even though it says so on the form, they do not want a narrative, they want the TPI report.  And they want it from every doctor, psychiatrist, psychologist and therapist I have seen in the last ten years for my depression.  I told her A) I do not have depression anymore B) I know how to handle it (avoid annoying people like her) C) It was caused by growing up, I feel good about myself, am not on medication, love to run and do yoga and I haven't seen a doctor for it in over a year so I'm not sure how the information they provide would be relevant.  Her answer?  "I really need those TPI reports."  OMG!  She just said that the nurses try to collect as much information as they can to get everything ready for the providers who make the decision.  I told her that it's going to take time to get into the doctor and then it's going to cost money because we have a high deductible plan and she just said, sorry that's they way it is and then she told me she'd email me the TPI reports again. 

I called the Iowa Clinic for my records - I have to come in and sign a release and then it will be 7-10 days for their Medical Records department to get them to me.

Oh the frustration!