a hard pill to swallow

There sure are a lot of pills you have to swallow when you have a chronic disease – both literal and figurative. But what do you do when dysphagia is part of your disease? Dysphagia is the medical term for difficulty swallowing, the greek dys meaning “bad or disordered” and phago meaning “eat”. Dysphagia ia a terribly common symptom of all types of myositis. Here is a link to a great article about dysphagia on Nature.com, click here.

You know that Marine’s slogan “Improvise, Adapt, and Overcome”? with chronic illness that is exactly what you have to do. When Mo’s myositis-induced dysphagia made taking his oral medication nearly impossible we had to come up with some solutions. First and foremost we sought treatment options from our gastroenterologist. Mo started seeing a Speech Pathologist where he was given Vital Stim treatments (we’ll talk more about that treatment later, if you want to check it out now, click here). We also used that “time-tested-labrador-retriever-approved” method of medicating pets where you crush meds into powder form to mix them into pudding-consistency foods (ALWAYS check with your doctor or pharmacist before crushing pills as some cannot be crushed or may become toxic). For information about pill crushing, click here.

Then we found this beauty. 

This is a simple pill cutter, and probably the best $5 we spent during Mo’s problems with dysphagia and after! You simply put your pill in the V guide and when you lower the lid an affixed razor breaks the pill evenly in half. You can tilt the cutter to move the two halves into the lower compartment to cut more pills (we would do batches of each type of pill for a week, then portion them into dated poly bags). Pill cutters can be bought at just about any pharmacy, Walgreens, Rite Aid, Walmart, Target, grocery stores, online, etc. They are extremely inexpensive ($5-ish) and even ended up SAVING us money – here’s how.

Mo responded great to his Rituximab infusions, and as his blood levels began to normalize we talked extensively with our rheumatologist about tapering off some of his meds like prednisone and imuran. Getting down to the minimal dosage your body can maintain at should be a goal for all your medications! Finding that perfect balance is a tricky thing, but having a pill cutter will make it easier and can really save you money! Again, note that not all pills are intended for cutting. Coated pills are time-released and should not be cut.

Rather than get prescriptions for new dosages (and paying the extra copays each time), we strategized and requested our doctor continue to write Mo’s 10mg. With our insurance plan, Cigna, it is cheaper for us to get a 90 day supply than three 30 day supplies. After we received that 90 day prescription, our doc wrote a lower 5mg prescription of the same meds. Now we had 90 days of 10mg, and 90 days of 5mg. We could split the 10mg into 5mg, and the 5mg into 2.5mg (so now we had 180 5mg, and 180 2.5mg). Doing it that way we could lower his dosage from 10 mg to 7.5mg to 5mg to 2.5mg to none and we essentially paid 2 copays instead of 4. We did this for months as Mo tracked his mgs and physical responses to find out what dosage was the best for him (Mo being a software engineer, plenty of spreadsheets were created to track all of this, yay for Excel!). If Mo needed to stay at 7.5mg or 5mg longer, we fulfilled both prescriptions. Once at 2.5mg we only would fulfill the 5mg prescription (cutting pills into quarters wasn’t so great).

Hope this trick works out for you, too! Once you get a pill cutter you will wonder why you didn’t sooner. Guaranteed.

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