FMGetting Prescriptions Filled Overseas

I've become a grumpy morning person of late. Not that I ever was a happy morning person. After all, the first thing I do when I wake up is drink coffee and browse the headlines. The headlines will make anyone grumpy. Then, there was the whole getting ready for the day and slipping into a fatalistic swamp of my own imagining in which I know I will either become overwhelmed by or fail at anything that I attempt that day.Usually, that passes once I get moving. Not so much these days.

Right now, I blame two things for this grumpiness. The first is simply chemical. I'm having my usual difficulties in getting a prescription filled in a new place. Depression is really one of the stupidest disorders out there. Not that you are stupid if you have it, but the whole disorder itself -- well, if I believed in a god, I would think he was a petty creature for coming up with such a thing. You are sad and hate yourself for no reason whatsoever.

I will digress here also to explicate on migraines, too. Normally, physical pain is supposed to indicate that something is seriously wrong with your body. "Ouch!" you say, "my foot hurts! What could be wrong? Oh, I broke my toe! Get to the doctor, quickly!" With a migraine, you collapse in agony, restraining yourself from banging your head against a brick wall because that just might provide some form of relief from this excruciating assault on your very brain. Yet, nothing is actually wrong. Nothing is broken, nothing is dented, no little beasties have invaded your body. You have just entered a world in which pain is the norm.

In fact, I recently heard of someone who got a furious headache and ran to the emergency room to find that he was in the middle of a stroke. I wondered how he would know that the pain was bad enough for the e.r. If I were in such pain, I'd just think "shit, another migraine. Another four days I will lose. Please shoot me. Right here on the left side of my head." That's probably how I will die.

Depression is similar, but the pain is psychological. You are just sad, then grumpy, then sad, then hate yourself. Plus, if you grew up in family and a world that was as sympathetic as mine to any sort of pain, you also have these little gremlins running around in your head saying, "Why don't you just get over it? You just WANT to be miserable! You are a weak and useless person! You are doing this to hurt ME! You are a cruel and selfish person!" You start to wonder if those gremlins are right because, after all, what do you have to be so sad about, really? I mean, aside from the fact that you are a weak, useless, cruel, and selfish person who is also lazy and will amount to nothing.

One of the problems in having depression is that you do get overwhelmed by the simplest of tasks. Seriously, you end up sounding like Eeyore, thinking "what's the point? Why bother? It's all going to end up for shit anyway." Except, I don't think Eeyore ever said "shit." At least, she (I decided Eeyore was a "she" because there were not many other girls in Pooh, because my mom was always calling me Eeyore, and because Eeyore wore a pink ribbon.) didn't in the expurgated versions for children.

You become so overwhelmed by the simplest of tasks that any obstacle, no matter how slight, will become an insurmountable obstruction/ Thus, I always hate hate hate hate hate having to deal with prescription refills when I am away from my usual home because there are always all sorts of stupid obstacles that have their own logic and purpose, but just become such a terrible hassle to overcome, especially if you end up in a spiral in which you have absolutely no will to overcome them.

See how stupid depression is? You are in psychological pain, and the lethargy that the depression causes keeps you from doing what you have to do to get relief from that pain.

So, my grumpy mood here is that getting my happy pills has become a major annoyance. Maybe "major" is overstating the case. "Annoyance" is not.

Here I am, in Dublin, running out on my three months' supply of happy pills. Why only three months? Because the damn insurance company wouldn't let me have more on a co-pay. Fine. They have happy pills in Ireland, don't they? Yes, they do. So, I go to the chemist. The chemist says that you have to have a prescription. Well, I have a prescription -- with lots of refills to get me to May. Here is the printout from my pharmacy in the U.S. showing those refills. Here is my quickly emptying bottle showing that I have refills. Here are all of the numbers and names and amounts and whatever the hell you need to just get me the goddamn happy pills. No, that won't work. They need a prescription from an Irish doctor. Go make an appointment with an Irish doctor who will give you a prescription that an Irish pharmacy will fill.

Ah, jeez! In the U.S., they want to "monitor" you. Now, I'm very dubious about this "monitoring" because they want to see you just often enough to be annoying, but not often enough to really determine if the pills are working. Sure, they go down a check list every time, but half of the time I have had to tell my own damn doctor what and how much I am taking, and they are the ones with the chart in their hand. "Is this a test?" I wonder, when that happens. My analyst -- god, I miss her -- is the one who actually monitored my mental health. The psychiatrist just checked the boxes and gave me access to the pills every six weeks or so. I think of the psychiatrist as my "dealer" and the analyst as the mental health professional.

Now, I do understand that the psychiatrists have their own problems with the state of mental health care in the U.S. They have to be the dealers and they have to see you so often but not much more or the insurance company won't cover you; and the cost of running their practice means they have to stack patients' appointments on top of one another with no time for reviewing charts or anything else in between. My understanding of their situation, however, does nothing for me, who must look out for myself. All I can do is not be mean to them when I get frustrated.

Anyway, back to my prescription woes. So, I must go to a doctor in Ireland. If the Irish system works like the U.S. system, then who knows how long I will have to wait until I can see that doctor. Then, I have to convince the doctor that I do, in fact, have depression, and that I don't just need to "get over it." (Yes, I had a doctor tell me that once, despite a deep medical chart on the subject, and I wasn't even seeing him for the depression, he just offered that bit of advice up when I went to see him about a migraine -- which he also openly doubted that I had -- which is also why I refuse to see old, white, male doctors -- call me sexist, but I won't). Every new doctor has to be certain that I'm not just a drug seeker -- as if happy pills will do anything for you if you don't need them -- and I end up feeling like a drug seeker in the process. Then, I have to convince that doctor that I need the prescription until May. Then, I run the risk of having him "monitor" me, meaning more appointments. Then, I have no idea how American insurance will fit with the system here --and, well, now you have a glimpse into my fatalistic thought process and the reason that I am willing to run the risk of a few months of a dark depression so as to not have to deal with this until I return to the U.S., find a new doctor who will, seeing as I will be in an existential funk by then, not make me run a gauntlet of proving that I am depressed and then trying whatever "new and improved, better than" free samples that the pharmaceutical rep has dropped on them. (Yes, all of this has happened in the past.) All of which I understand but -- damn! -- my body and my brain become entirely demoralized by having to cover the same damn territory that they have covered however many times I have had to change doctors in the past twenty years of treatment.

I tell ya, I had less trouble back when I was a grad student with no insurance and could just go over to the health center; but, then, a university health center does take mental illness much more seriously than most institutions outside of a mental health facility because -- well, sometimes college is like a mental health facility.

"Fuck this noise," I thought, when the second pharmacist said I had to go to the doctor and the above scenario ran through my head. "I'll just get my American pharmacy to send me my damn pills."

They don't do that overseas, unless you are a G.I.  Now, I had to maneuver around this new wrinkle. I could order my prescriptions, have them sent to someone in the U.S. who could then send them to me. I'm actually at an advantage on this one because the Gentleman Caller's kids -- who are adults -- are visiting next week for the holidays. I am having the prescription sent to one of his kids and they will bring them over here for me. Yes, we've turned his children into drug mules.

But, of course, ordering online can't be so easy can it? I'm using my usual, chain pharmacy, which has all of my prescription and insurance information in their system. Except they don't. They have the prescription part -- thank god! -- but they now want the insurance information. The prescription insurance is different from the medical insurance, but I usually don't have to think about that because of the whole computerized records thing. So, I don't have the prescription card with me. Ah, jeez. Now I have to pay full price and make a claim later on the drug, except they won't tell me the full price because -- get this -- they have to check with the insurance company first on what the insurance company will cover.

Meanwhile, the happy pills have run out. Now, had I started this whole process say, two months ago, I would not have run out. I didn't know that there would be this problem two months ago, so I didn't deal with it then. Now, I'm running on empty. Back when I took the Big P -- god, I miss it! -- the drugs took a bit to work into your system, but they also took a while to work out, so I would have some wiggle room here. This generation, however, goes in and out much more quickly, so I'm blaming it for my grumpiness. Better the grumpiness than a full-blown funk. I can recover from a grump better than a funk.

So, my happy pills will be here in a week -- I'm hoping! There is always the possibility that they won't get to the Gentleman Caller's kid on time (3-6 days for delivery was the fastest they had, and the child lives in a major city); but we will hand that one over to Scarlett and think about it tomorrow.

I know I bitch and moan about this, and that everyone should have these sorts of problems. I wonder about people who have life threatening illnesses, who can't go for a week or so without medication without risking something horrible, who can't afford doctor, prescription, or insurance. I wonder about people who have to advocate for their elderly charges or children. What horror stories do they encounter. Do the people who have created this behemoth of a system have any awareness that health care, which should be as easy to acquire as groceries, is such a pain in the ass in the best of circumstances?

Meanwhile, I just want my damn happy pills because I hate being grumpy.

By the way, Hyperbole and a Half once more says it all, this time in regard to depression.