The Absurdity of Healtchare

I learned a bit about how ridiculous the healthcare system is recently.

I had been taking Adderall just 2 or 3 times a week due to the side effects, so I was looking for something else to take during the other days. After some research I decided to Nuvigil (Armodafinil) a “wakefulness-promoting agent.” Once the patent of Provigil (Modafinil) expired, the company created Nuvigil to continue their profits. However, I had been on Provigil years earlier and read that Nuvigil is similar yet different in ways that made me want to give it a shot.

I asked my primary doctor which kind of doctor would prescribe it, and he told me neurology deals with that. I went on my insurance companies website, called some neurologists and asked if they prescribed Nuvigil. One did, and I set up an appointment. We met, I explained to him my situation, and he told me that I’m a great candidate for Nuvigil. Excellent! I didn’t realize it would be that easy. “There’s just one problem,” he says. “Insurance won’t cover it if I prescribe it, so call your psychiatrist or rheumatologist and I’ll guide them through prescribing it.” I’d never heard that one before, but I was hoping it would be an easy task.

I called my rheumatologist first since the neurologist claimed he knew the guy. My rheumatologist calls back and says “Sorry, but it would be better if you ask your psychiatrist.” Then, my psychiatrist explains to me that it’s very difficult to fight with the insurance companies to get them to prescribe a drug like this. Why? Well, they will say “Why not just take Adderall every day?” because it’s cheaper. They might cover if it I claimed Adderall didn’t work for me and stopped taking it, but I didn’t need a replacement – just something else I could take during the rest of the week. Insurance’s option for me is to either take Adderall every day or not at all, and neither of those options work.

This let me know that even if you find a doctor willing to prescribe you a drug, it doesn’t mean the insurance companies are going to go for it. It’s just yet another hurdle in the path of getting better. This situation was just one of many that opened my eyes to the fact that the healthcare system isn’t designed to make sure whatever the patient needs to feel better is done, no. It’s designed to make a profit, like everything else.

So what did I do? I kept looking, and discovered there is a legal alternative called Adrafinil that can be purchased without a prescription. Adrafinil converts to Modafinil in the body.

This entire situation, despite being a huge hassle and a game of hot potato with my doctors, taught me some valuable lessons about how to navigate our flawed healthcare system.

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Dealing with Doctors

Not getting anything out of doctor visits? There are things you can do.

Anyone with a mysterious chronic illness is familiar with the disappointing routine of seeing doctors. They run their tests, can’t figure out what’s wrong, try different medications that don’t help, then don’t know what to do. There are some things you can do to get the most out of your appointments.

The visit

We’ve all had doctors that are always in a rush. They hurry you along, asking you to get to the point, and they’re out of there before you know what happened. You are paying for their time, and this is your health and your life at stake here. Warn the nurse if you have a lot to say before the doctor sees you. This way he’ll know and can deal with his other patients first, giving you all the time that you need. You need to speak up and address everything on your mind.

Doctors know far less than what you would think – it’s up to you

Doctors are used to dealing with only the most common of problems. They don’t know what to do for anyone coming in with an unconventional illness. They will run their tests, find nothing wrong, maybe try a couple of medications, but then they’ll be left scratching their heads. You can’t walk into appointments just hoping that the doctor will come up with a great idea for you – you need to have an agenda for every appointment. I understand that when you feel like crap, the last thing you want to do is research things on your own. However, once you find that first drug that makes you feel a little better, that will be just enough to help you looking for more.

Doctors often don’t understand the medications they prescribe

Doctors have a short list of medications they try people on, the drugs that are pushed on them the hardest. For example, go see a rheumatologist for your joint pain, and they will throw Neurontin and Lyrica at you. Look around your doctor’s office: You might notice that every piece of stationery has a drug name on it. The drugs you see advertised on TV are also the ones being pushed on doctors. They are not prescribing unique drugs for your unique problems, they are prescribing the most common heavily-advertised drugs that vaguely treat┬ásymptoms similar to yours. The dose of each medication is very important as well, which doctors do not always understand. 10mg might not do anything, but suddenly relief comes at 30mg. Often they will try you on the introductory dose and then move on. For many medications, the starting dose will be completely ineffective, especially for those suffering from particularly debilitating illnesses.

Educate yourself

The internet is a great resource, so take advantage of it! When looking up drug information online, don’t just look at the “WebMD” type of sites. These will tell you the “official” information provided by the drug companies themselves but don’t tell the whole story and won’t tell you what to expect. Look up sites where users discuss their personal experiences. There may be effects, side-effects, concerns, and warnings that you won’t see on WebMD. I used to think drug experience sites like drugs.com and erowid.com were just full of junkies trying to get high… no, often these people are sick and desperately trying to feel better – just like you and me.

 

You need to take an active role in your health care. Putting the effort in can be the hardest thing to do when you aren’t feeling well, but it’s something you need to do.