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  1. #1
    Registered User piratekitty's Avatar
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    Default Getting medicine refilled on the trail?

    I was recently diagnosed with MS, and will be taking a daily medication during my thru. The only issue with the meds is if I miss a day, I have to take the next dose under doctor supervision (8 hours in the urgent care, woo). I can also only be issued a 30 day supply at a time (hurray for controlled substances).

    In your collective opinion, what would be the easiest way to get the meds while I'm on the trail?

  2. #2
    Registered User Engine's Avatar
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    I would think you are gong to have to get your physician to send the Rx to pharmacies along the way. Since you cannot miss any doses, I would plan on pharmacies which would give you at least a 1 week window on the 30 days. I know it's not legal to mail Rx meds to a private individual, only a pharmacy or licensed physician.

    I understand the aggravation on this, I had thyroid surgery for a cancerous lesion a few years ago and I'm trying to figure out how to get my meds on the trail. However, since it's not a controlled substance, I can probably get a script for 180 days from my Doc.
    “He is richest who is content with the least, for content is the wealth of nature.” –Socrates

  3. #3

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    How common are the meds? By that I mean, the pharmacies all work together and quite well. I was in a very small mountain town in PA. My back went out and I had NOT packed the two meds. My wife walked down the block to the mom&pop pharmacy and explained the issue. They took down information and said "have a seat". they called our pharmacy back here in Texas and within 10 minutes, had the two RX's "transferred" to them! Within 30 minutes, she was walking out with like a weeks supply of each. These are COMMON meds however so any pharmacy will have them.
    Also, can you get like 90 days supply? Mail order them? See what the refill policy is for those.
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  4. #4
    Registered User piratekitty's Avatar
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    1) it's a new-ish, name-brand-only immunosuppressant drug (Gilenya) that is distributed out of Novartis' pharmacy to mine (can only get it from the manufacturer, in other words)
    2) I just got turned down for a 90-day supply by my insurance, as there is a max number that can be issued at once. However, since I'm changing insurance providers in January, I'll have to check with the new one.
    3) I know that I can contact Novartis for an emergency 14-day supply that they'll overnight to me, so I have a bit of wiggle room (but not much, as it's an emergency supply)

  5. #5

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    Do you have a sams club or costco. They are the cheapest places i know to pay for scripts. You do not need a member ship to use the pharmacy. Maybe you could afford to pay out of pocket to get a 90 day supply.

    Also if your doctor sees a reason to increase your dosage or change how you take it most insurance will cover it.

    My mom was taking 40mg omeprazole once daily. She lost her pulls. Her dr "coincidentally" decided she should take 20mg every 12 hours. The next month he put it back to normal.

  6. #6
    Registered User Maydog's Avatar
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    I'd look at national chains like Rite-Aid, Kroger, CVS, etc. Look for towns along the trail where you will/should be in the given timeframe to see what pharmacies are there, then stick with one chain as much as possible. You can increase your chances by calling ahead a couple of weeks to make sure they have a) the Rx transfer from the previous pharmacy, and b) the meds in stock. This is going to take some homework on your part.

    Alternately, if you have someone that can ship your meds to you, then check with your home pharmacy to find out the requirements for having that person to be authorized to pick up your meds. Then they can pick them up for you and have them sent to you.
    "I haven't been everywhere, but it's on my list." - S. Sontag

  7. #7

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    All good suggestions above, however given the seriousness of this issue, I would recommend discussing this with your doctor during your "maintenance" appointment and how they can help. Certainly they've had other patients who move around a lot for business, go to sea, or other vocations that removes them from the "normal" environment of medical maintenance care.

    Additionally, your primary pharmacy may be able to help in staging Rx packages for you to pick up given the need to stay on meds.

    Good luck!

  8. #8
    Registered User TylerJ76's Avatar
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    Quote Originally Posted by Traveler View Post
    All good suggestions above, however given the seriousness of this issue, I would recommend discussing this with your doctor during your "maintenance" appointment and how they can help. Certainly they've had other patients who move around a lot for business, go to sea, or other vocations that removes them from the "normal" environment of medical maintenance care.

    Additionally, your primary pharmacy may be able to help in staging Rx packages for you to pick up given the need to stay on meds.

    Good luck!
    Agree with all of this.

    I would be talking to your doctor(s) to see if they can help work something out.

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    Invite your pharmacist to hike with you.

    That would make for an awesome book afterward, too...
    Hiking is the best teacher, it grades on a curve.
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  10. #10

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    Quote Originally Posted by Greenlight View Post
    Invite your pharmacist to hike with you.

    That would make for an awesome book afterward, too...
    a real "fear and loathing" event...I'd buy that for a dollar!

  11. #11
    Registered User Venchka's Avatar
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    I read a trip report on the Great Divide Mountain Bike Route by a man from Austin, TX who required a regular injections of a medicine. The medicine required refrigeration.
    The gentleman and his doctor tried to explain the situation of getting the medication in towns and using it in the middle of nowhere. The drug company was totally inflexible and oblivious to his situation.
    He was able to complete the route with the help of folks along the route who would meet him with the medicine.
    I suggest you locate every pharmacy along the trail. Make a list. Check it twice. Leave copies with friends, your doctor, your pharmacy at home and of course in your pack. Try to stay ahead of your refills when you have cell coverage. Be prepared to log a zero or two waiting for the medicine to arrive at a pharmacy.
    I have one required daily prescription. I am able to get 90 day refills. Thank goodness.
    All the best to you!
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    In the shadows AfterParty's Avatar
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    Just go to a pharmacy and call you Dr and have them fax or call your RX to where you are and wait about an hour. If you have insurance communicate to them and your dr your plans and see what they suggest. This seems like the easiet way. This is what I would do anyways. But I'm just a random dude on the internet trust your health care to the pros.
    Hiking the AT is “pointless.” What life is not “pointless”? Is it not pointless to work paycheck to paycheck just to conform?.....I want to make my life less ordinary. AWOL

  13. #13
    Registered User Venchka's Avatar
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    Quote Originally Posted by AfterParty View Post
    Just go to a pharmacy and call you Dr and have them fax or call your RX to where you are and wait about an hour. If you have insurance communicate to them and your dr your plans and see what they suggest. This seems like the easiet way. This is what I would do anyways. But I'm just a random dude on the internet trust your health care to the pros.
    A perfect plan...
    Unless. It's Friday afternoon. The pharmacy doesn't have the medicine. The medicine won't arrive until Monday.
    Been there. Done that.
    Wayne


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  14. #14
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    My doctor prescribes me meds at double dose so I can split the pill, so a 30 day supply would last 60 days. I know not all meds can be split, but it's an option for some meds.

  15. #15
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    Quote Originally Posted by piratekitty View Post
    1) it's a new-ish, name-brand-only immunosuppressant drug (Gilenya) that is distributed out of Novartis' pharmacy to mine (can only get it from the manufacturer, in other words)
    2) I just got turned down for a 90-day supply by my insurance, as there is a max number that can be issued at once. However, since I'm changing insurance providers in January, I'll have to check with the new one.
    3) I know that I can contact Novartis for an emergency 14-day supply that they'll overnight to me, so I have a bit of wiggle room (but not much, as it's an emergency supply)
    1. It is not "newish", it is 6 years post-FDA approval.
    2. It is NOT a controlled substance. Any prescribing limitations are imposed by the manufacturer, in conjunction with the prescribing physician. Theoretically, you could have a recurring prescription good for up to one year.
    3. The difficulty with this drug is not with the manufacturer. Its with the drug's side effects. I'm sure your doctor has gone over the side effects with you. They are common(what drug do you know causes diarrhea in over 12 percent of its users? Other than Milk of Magnesia or ExLax...And I mean real diarrhea, something you won't want on the trail) and potentially life threatening. Things from a brain infection to severe modifications to your heart's electrical performance to dizziness and, most disturbingly, the incredible frequency of blurred vision/loss of spatial awareness. The side effects alone are enough to keep me worried for 2200 miles. The other thing....its for relapsing MS. Which is a pretty harsh disease to begin with. Have you a plan for when your MS goes out of remission on the trail and relapses, or is the drug your Plan A?

    You can be hours or days away from rescue on the trail. Sudden dizziness, blurred vision and loss of balance can be fatal on the trail. You get this from MS AND/OR the drug! How are you going to get your liver enzymes monitored on the hike? Have you discussed the use of this drug and extended periods of intense physical exertion? This drug is a heart function interferer, the absolute LAST thing you want to introduce to intense periods of intense physical exertion, I would think....
    Also, it is a powerful immune-suppressant. You are going to need to purify your water like its a religion, avoid bathing in non-treated water, maintain a high level of daily hygiene, etc...your risk for influenza on this drug is greatly increased as well.

    I admire your courage and respect your desire. I just don't want you getting hurt or worsening an already bad situation. Please try to get clear answers to whether your disease, this drug, and lengthy periods of intense physical exertion in less than sanitary daily conditions are a healthy mix. Your disease alone, unless you are convinced will remain in remission and not relapse during the hike, is a clear impediment to completion and a potential real danger to your safety. But, you probably already knew that....

    Be safe. Be well. Bob Barker made it with MS and crutches, so it can be done...

  16. #16
    T-Rx T-Rx's Avatar
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    If they are not "controlled drugs" or "schedule drugs" they can be transferred from pharmacy to pharmacy as you make your way up the trail. It's a little more work for the pharmacist but most are glad to do it to help the patient.

  17. #17
    Registered User dudeijuststarted's Avatar
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    Your guidebook should show you trail towns, I'd compile a list of pharmacies in your network along the way (shouldn't take too long,) and then take the plan to your doctor. I'm sure he/she would take an interest in what you're doing and be better able to respond to your needs when they arise.

    I have seen someone with a very strict prescription schedule lose their meds, and it was not pretty, so consider stashing one or two doses in a separate and sealed container somewhere else in your pack (or on your person) in case you lose your meds. The AT is more town-accessible than other long-distance trails, but make no mistake it can still be life-threatening work getting to a trailhead in an emergency, and hitches cannot be depended on.

    A responsible thru hike is a successful thru hike. Start by coordinating with your medical provider(s,) and good luck!

  18. #18
    T-Rx T-Rx's Avatar
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    Also, if it is scheduled or controlled drugs consider having your physician write multiple prescriptions but put "do not fill before" dates on each prescription. Then you can take these Rx's along with you and have them filled as you need them. Also carry the physicians contact information with you as the Pharmacist will most likely need to contact the physician to verify the authenticity of the Rx's.

  19. #19
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    Opiates require an in=person physician visit for every script and no script is good for longer than a 30 day supply. Your Doctor won't risk the loss of his DEA license by post-dating opiate scripts.

  20. #20
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    You also cannot fill an opiate script while you still have pills left to use. For example, if you have a 30 day 4x/day dose, for 120 pills every 30 days, and you get caught with 121 pills in your possession, guess who's committing a felony?

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