I need someone's experienced opinion please

[kellyt]

Okay, this morning at 6 a.m. when my alarm went off I rolled over and emptied the first little box on my medications holder for my a.m. meds.  I take 3 Prograf, 4 Cellcept and 1 Pepcid.   I popped them in my mouth, drank some water and went back to sleep.

Just a while ago I open my 2nd little box to take my 9 a.m. meds and there is my Valcyte and my 1 mg tablet of Prednisone, accompanied by 1 Cellcept.   I don't know if somehow one of my 6 a.m. capsules was accidentally placed in the 2nd box when I filled the medication holder or an extra one was accidentally dropped in the 2nd box when I filled the medication holder.

My question is, do I assume I didn't take 4 capsules at 6 a.m. and take this one now, or do I assume it's an extra capsule and not take it?

Any thoughts?    Of course, this happens on a Sunday when there's no one to call but the service and they're ridiculous with questions such as this.

 

[Wenchie58]

Dang Kelly....don't you hate that?  I've had the same type issue.  I don't take cellcept...so I don't know a thing about it, but if you don't want to make that call and try to get an answer from them I'd opt for one "less" than a dose than one "more" than a dose.  It's a tough call, I can only offer my 

I only take one batch (17 pills) am and one batch (9 pills) pm and I still get that dorked up once in awhile.  Usually have a brilliant thought right AFTER I swallow em.  Damn, did I swallow 3 blue ones or only 2?  lol  Good luck!

[okarol]

My question is, do I assume I didn't take 4 capsules at 6 a.m. and take this one now, or do I assume it's an extra capsule and not take it?

If I was pretty sure that I filled the daily dose accurately most of the time, then I would go with assuming it's an extra capsule and not take it.
But that's what I would tell Jenna if she had the same problem, because she is pretty good about filling her box routinely.

[kellyt]

Same here, and the night before when I place the holder next to my bed I usually open the morning box and just give it a good looking at because I don't even turn on a light when I take them in the a.m.  I pour them into my hand and I make sure I can see all of the pills individually and then I take them.  But now I'm second guessing myself.  Did I do those two things that I always do?

I may call the service just to be sure.

Thanks so much, both of you.

[willieandwinnie]

Kelly, don't take it. We went through something very similar with Len and I called transplant coordinator to find out. She said don't take it and go back to normal schedule in the morning even if it was a missed dose. You'll be fine.  

[kellyt]

I just got off the phone with the service and luckily it was my post coordinator/nurse on-call.  She said not to take it.   I feel better now.

[pelagia]

Stephen completely missed a dose of prograf about a month ago (by six hours) and they wanted him to take it right away and then still take the next dose about 6 hours later.  Go figure!

[okarol]

As I recall the advice Jenna was given about missing an entire dose was: If remembered within 6 hours, take the missed dose as soon as possible. If it is past 6 hours, skip the missed dose and resume regular schedule. Do not take two doses at one time.

[kellyt]

That's good information.  I was told just in general that if I miss a dose you have to "make it up", but I didn't know exactly what that meant.  She said if it happened to call the clinic and it would be discussed/explained then.   But one thing I do remember her saying was "If you drop your pill box the Prograf and the Cellcept are the two medications you want to go under the refrigerator to get.  They are that important."  I don't want to mess around with these two.  So, I'm glad I posted and I'm glad I called the service.

The nights before lab I take my Prograf and Cellcept at 8:30 p.m. instead of the normal 6 p.m., so if I take it late (and I have by 1/2 an hour - didn't hear my alarm and had lost track of time) I don't stress.  I've never been told the "six hour" rule so to speak, but that is darn good information.

I think I've come up with a pretty good routine. When I leave the house, no matter how long I'm going to be gone I always put my daily pill box in my purse because I'm terrified of getting caught up somewhere and not getting home before 6 p.m.  San Antonio is going through massive road construction and if you get stuck on the hwy with lane closures it could literally put you back hours!

Thanks for the responses.  Willie, you must have posted just minutes before me and I didn't see your post until now.  Thanks so much!

[okarol]

Since we live in earthquake country I always worry that Jenna could get stranded away from home for days with no meds (it would have to be a huge event, unlikely, but we should always be prepared.) So in her purse are 2 small pill bottles, one with prograf, one with cellcept. For emergencies only.

[kellyt]

That's why we love you, Okarol.  You give excellent advice, as well as handy and possibly life saving tips.         

[KT0930]

I'm glad you got your question answered and that you had done it correctly, Kelly. I have also heard the 6 hour rule from two different transplant teams, so I'd say it's a pretty good rule of thumb.

BTW, you look GREAT!!

[kellyt]

Thank you, KT, but this photo is from 2006!!!   I look horrible!  ha ha   I've finally hit 10 mg of Prednisone, but so far no change in face or weight.  I've only been at 10 mg for two weeks and I haven't been walking because my feet have been bothering me really bad (heels).

On the up side, I feel great!   

[okarol]

That's why we love you, Okarol.  You give excellent advice, as well as handy and possibly life saving tips.