Last spring, my wife ended up in the hospital with a rip roaring manic episode, so this year, we were on high alert. A couple weeks ago, she noticed herself having trouble sleeping, one of our first early warning signs, so she did the right thing and called her doctor. She requested a prescription for temazepam (Restoril), but he said he didn’t like to prescribe it because patients tended to develop a dependency. Instead, he called in a prescription for Ambien CR – an extended release form of Ambien.
Anthem, my wife’s insurance company, refused to cover the cost of Ambien CR. Apparently, this stuff’s like gold; $150 for a month’s prescription. That’s five bucks a night to sleep. She could file an appeal, fill the prescription out of pocket, and hope that insurance would cover it… yeah, right.
For several days, the doctor did battle with the insurance company, while my wife self-medicated to get some sleep. Melatonin was her remedy of choice, complemented with a few Benadryl every so often, which would help with her seasonal allergies as well. She continued to get more manic – talking more, louder, and faster; gesturing more; racing thoughts and difficulty concentrating while continuing to work; becoming more and more irritable and argumentative.
Unable to convince the insurance company (which was playing the role of God Almighty with my wife’s life), the doctor prescribed Lunesta as a second choice. My wife took it for a few days and reported that it had the same effect on her as Ambien (non CR) did when she had taken it in the past – she would sleep fine for four to five hours and then wake up WIRED! It was not helping. It was making things worse.
She needed something that worked and she needed it soon. Her friend from Japan was scheduled to arrive for a week-long visit, and my wife needed to be able to gain control over the mania. Sleep was key. Sleep is always key.
This brings us to yesterday. My wife called her doctor’s office, and the receptionist agreed to fit her in for a 3:30 appointment. My wife’s friend from Japan was flying into Indianapolis the same day. Her flight was due to arrive at 9:45 pm. We live about an hour from Indianapolis, and since my wife’s doctor’s office is just south of Indy, we figured we could do the doctor and the airport in one trip.
After some discussion, the doctor agreed to provide my wife with a month’s prescription of temazepam. Instead of taking the written prescription and having it filled, she asked the doctor to call it into her pharmacy back home. We would have our son pick up the prescription before the pharmacy closed, and it would be waiting for us when we returned from the airport.
After the doctor’s appointment, we headed to downtown Indianapolis, where my wife did some light shopping and we went to a movie to kill some time. After the movie (about 7:30), my wife checked her cell phone. She had one message from her sister in Phoenix explaining that my wife’s friend’s flight was cancelled. She would now be arriving in Indianapolis at 1:30 am.
Instead of waiting around another six hours we decided to head home. My wife could take a temazepam and start getting some much needed sleep, and I could return later to pick up our guest at the airport.
We arrived home at about 8:40 pm. On the counter were two prescriptions. When my wife opened them, she was in utter disbelief; neither of the medications were the one she desperately needed. She called the pharmacy as I put on my shoes to fly out the door before the pharmacy closed at 9 pm. She signaled me to wait. The pharmacy had no record of a prescription for temazepam and was closing in 8 minutes! UN-bleeping-believable!
With insufficient time to resolve the snafu, we decided to give up and try again tomorrow. My wife took one of my Buspars to help with anxiety and a Lunesta to sleep and we headed to bed. I got a couple hours sleep and headed to the airport.
Next day…
My wife calls the doctor’s office and asks about the prescription. The doctor’s assistant assures her that they did, in fact, call in the prescription. My wife calls the pharmacy and learns that the prescription had been on their answering machine. It’s been filled and is now ready to be picked up. UN-bleeping-believable!
I’m so sorry this happened to you. It sucks that not only do we have to deal with our disease throwing us curveballs, we have to fight with our insurance companies, pharmacies, and so on to get what we need.
best of luck. why can’t the meds just WORK, dammit??? i had just been musing over the same thing on my own new bpd blog. www. sethwindsor.blogspot.com
anyway, all the best. hopefully you’ll get some decent sleep. i’m beginning to hate the hours from 11pm-6am. you?
You may want to try the old remedy, camomile tea. Not instead of medication, but as an adjunct.
If you use it, put two table spoon of the flowers in a cup of boiling water. yes, it is yuch. For me it always worked and helped me sleep whenever I had trouble sleeping. It is considered a very safe herb.
I feel your pain. My mother-in-law has bi-polar and is currently staying with us for 30 day. One day down and already tension and arguments, sure you understand. We’ve been dealing with this for almost 15 years now but it doesn’t get any easier. Would love to swap advice/stories as sometimes we feel so helpless. Have you found the doctors are in th dark with this disease?
My heart is pounding. I thought I was alone with this sleeping HELL. Nobody gets it if you don’t live it you can’t explain it. The tossing turning at this point does it really matter how addictive the sleeping meds are within reason? I actually have not been on many “sleeping pills” more mood stabilizers.I tried to switch same story with Dr’s.I’m at the worst point ever I rarley will even try to go to sleep because I know the outcome.I don’t sleep no matter what stage of bipolar I’m in. I worry as you about insurance co. will they pay?will I sleep? will I be up,down? I feel your pain so so much.It’s a cycle that won’t end. I will go anywhere no matter how far to sleep or learn how help please boston ma
We all know insurance companies could care less about anyone. Maybe we should all stop fighting this disease and go with the flow. Our minds take us places for a reason. Just because you might not understand bipolar logic does not mean it does not exist.
1. your doctor’s office can hook you up with the pharmaceutical company to give you, as sort ‘financial assistance’ free medications of the pills that run $5 apiece. Drug companies have to report a certain amount of ‘charity’, as it were, in their books. The doctors, to whom the drug reps call on, have no trouble getting this done for patients; they do it routinely.
2. I really like Valerian Root, a $5/bottle herbal relaxant that is good for taking the edge off. I didn’t say for sleep–it’s nowhere near strong enough. I meant it’s the key pill I keep at home, work, and in the car. I get stressed out from lack of sleep, I’ve gone manic a time or two, and Valerian nips the ‘angry at self’ energy in the bud, replacing it with a functional calm.
Speaking of sleep difficulties, (and I know this isn’t something that is just a by-product of hypo-mania, because a lot of women in their mid-years suffer from insomnia also)…
in what form do you use Valerian Root? Just a capsule? I have heard it is one of the ones to be “careful” with…due to possible interactions or over-sedation (although, that seems almost laughable at this point in my cycling).
I like the comment about just go with the flow…maybe we are all denying ourselves the lessons to be learned from bipolar. It seems most of my scariest moments have been on meds. that have been to “calm” me down.
I will definitely try the chamomile tea although I hate the flavor, that’s hardly the point, is it? I always say, I’ll try anything once, within reason.
My mother’s mother had problems with sleep and mom said that when she couldn’t sleep, she complained that she was sure she was dying. I know philosophically speaking, that we are all dying…but I get the same exact feeling, and I do get scared. This is so draining, I really feel like the not sleeping is certainly speeding up the process!
Good luck to everyone.
Hello there:
I’m so sorry to hear about the run around you were given with the prescriptions and the pharmacy! I’ve been reading up on your last couple posts and couldn’t find the exact right place to post this response, so I just went with the most recent post. I was curious as to whether you or your wife had any opinions on the recovery movement hitting the mental health field, especially in relation to treatment for bipolar disorder? It’s a bit off-subject, but I thought perhaps it might interest you enough to get a good conversation going.
Have you encountered a recovery-based treatment vs. a non-recovery-based treatment plan? I would very much like to hear what you feel the difference is, or if you haven’t had the chance to compare, perhaps just a comment as to what you feel about the movement in general.
If you are not overly familiar with the movement, there are a few pretty informative articles about it at:
1) What is Mental Health Recovery
2) Mental Health Recovery Model
If you wouldn’t mind, if you have the time to respond I would very much love to quote you in my blog about the recovery movement, the Mental Health Recovery Blog. I will of course reference back to you in the posting but if you are not comfortable with being quoted then I’d love to just hear your take here! I would very much value your opinion considering I am trying to get inputs from all sides of the mental healthcare field (practitioners, consumers, advocates, family members, etc.) in order to get a meaningful dialogue going as to what the mental health recovery movement really means.
I look forward to talking with you more in the future if this sparks your interest!
All the best,
Lex
MHCD Research and Evaluations
Feel for you guys. My illness has been acting up bad enough for me to start having some really scary thoughts. Hope you don’t go there too.
Yours,
Bill
Meds and Medicaid, county insurance is great, they pay for all my appointments for my disease(bipolar) but they dont pay for the medications, and the doctors they cover dont do prior authorizations. so i run around in circles, trying to speak with the insurance companies and trying to make the doctors talk to them and the pharmacies talk to all of them. handling 4 doctors and a slew of insurance company mid-level associates and pharmacists who’s hands are tied really sucks. especially when i know how easy it is to do a prior auth. they dont even have to write down the diagnosis all they have to do is fax my charted in-take diagnosis. one week of all my meds is over $200. so i have been begging my insurance company for week supplies for the past 4 weeks and now i have to run around to get HAND SIGNED auth’s from the dr’s because they must all use the same fax machine(no one received the multiple faxes.)
Joe,
Thank you for posting this article and sharing your experience! People like you who are coming forward helps to make this easier on folks who may be dealing with something similar, but don’t know exactly what it is yet.
Social Security is getting more sympathetic to certain mental health conditions. I know they are considering adding schizophrenia to the compassionate allowance list.
When I was having a manic attack I took the strongest Ambien CR every 6 hours for a couple of days and did not sleep at all. Nothing works in that state of mind. Now I’m on Seroquel and I sleep very well.
My late father was bi-polar- but back in those days (1950’s & 60’s) it was not even a recognized as mental health disorder. He had a ‘beautiful mind.” Although he was indeed brilliant, he could not hold a job. My mother endured abuse -physical and emotional and there was no hope or help. As a child, after hearing the midnight to 4 am rants and screams, followed by my mother’s tearful pleas for naught-I remember having 2 ongoing fantasies; one fantasy had to do with the accidental death of the monster/father wherein he added rat poison to his coffee instead of sugar; the other fantasy had to do with my being adopted by a stable and healthy family. Manic depression or bi-polar disorder is a destroyer of lives and relationships. It’s hard to decide who deserves pity and compassion; the sick person or those of us who have to interact with them.
same thing happened to me…fucking walgreens (supposedly a pharmacy)…now i go exclusively to wal mart, believe it or not, ’cause they’ve never fucked up like that….