Stigma Alert: Anti-Kobach Web Site

My friend Dan over at Gone Mild linked over to my blog with the entry "Courageous Mental Health Blogging." He says that even supporters (like himself) "tend to lurk in silence because it's not a topic we're accustomed to being honest about." That describes part of the reason stigma about mental health issues exist. I understand Dan's feelings and I have been there myself.

NAMI (The National Alliance for the Mentally Ill) has a great network of Stigma Busters. Stigma Busters watch for images that portray mental illness in a particularly offensive and outmoded way. I have a site to recommend.

Krazy Kris Kobach showed up as a Google Ad on Gmail the other week. The site is a blog which seeks to negatively attack Republican Kansas Secretary of State candidate Kris Kobach. Sometimes politics is a full contact support. And Kobach is clearly an intelligent candidate who can more than defend himself.

My issue with the blog is the photoshopped image of Kobach in a straitjacket. This is a classic stigmatizing image for people with mental illness and the site should remove it immediately.

I would like to email the creators of the site, but they are anonymous and a check of the domain whois shows they have used a service to hide their identity. I don't know Kansas campaign law (or should I say kampaign law to keep with their kute use of the letter k?) but I wonder if they should have a disclosure (paid for) statement on the page.

I'm not a voter in Kansas and if I was, I probably wouldn't be a supporter of Kobach. I also recognize that by putting this blog entry up, more people will go the page. Still, the image, if not the entire site should come down.

The image is not funny. It is offensive in the extreme and critics of Kobach can do better.

Coming Out of the Mental Health Closet

In the spring of 2007, I found myself checked into Research Pyschiatric Hospital. The same hospital that I had received my initial diagnosis of bipolar some 11 years before. There were a number of interesting encounters that week, but one of them was with a young mother who had been suicidal after the birth of her child. The mother happened to be a member of the LDS Church and I noticed that I was the only person in the entire wing who had any clergy visiting them. When talking with this LDS woman, I asked her why she had not asked for the bishop or one of the other elders to come visit her and she responded, "Some things are best handled within the family."

There was a lot of wisdom in this woman's response. For many, hiding mental illness is the best option for ones career and interactions with friends and family. Yet I have also come to believe that the shame and stigma of mental illness then also contributes to further depressions and new cycles of shame and stigma.  Mental illness is a huge killer in our nation. Twice as many people in Missouri die of suicidie than die of homicides. Yet why isn't there an outrage and a demand for better access to mental health services? Because too often those that suffer, suffer and then die alone.

Andrew Sullivan is one of my favorite bloggers. When I realized that this gay man who happens to be HIV+ can be honest about his status, perhaps so can I.  It is perhaps one of the reasons why I have found myself spending Sunday evenings at Stonewall Ministry. A ministry of the Community of Christ that is open and inclusive for gay, lesbians, bisexual and transgender individuals and their advocates. One of my lesbian friends said that I would find that hanging out with a bunch of "queers" would toughen me up a bit. Perhaps she was right.

I hope so, because as a part of me coming out of the mental health closet, I have received many positive comments and appreciations. (Especially from those who struggle with mental illness as well.) But I also have encountered some anonymous haters. 

Here in Missouri we have had one of the first cyber-bullying cases in the nation, when Megan Meier completed suicide after a classmate's mother sent her threatening messages.  Well, I'm not a 16-year-old, and I can handle the haters, especially because it feels like it takes little or no courage to attack a person with an anonymous comment.  I'm glad to be out of the mental health closet.

30 Day Drug Journey, Day 21: The Seroquel is here, The Seroquel is here

So, my package of Drugs arrived from AstraZeneca. I'm almost out of samples too, so this is great. I now have 90 tablets of the Seroquel. I am staring right now at the pills that have a retail value of $806, and I can't tell you how secure that makes me feel.

The meds were shipped directly to my doctor's office and I stopped at the store on the way home. I had my digital camera out and I decided to simply cover my digital camera in the car, but I carried the drugs into the store with me. Yes, I was far more worried about having my drugs stolen (very unlikely, right?) than my digital camera (more likely, but I did lock the doors).

I assume under the recently passed health care plan, these drugs will not be free from the manufacturer anymore, but the company will be getting some portion of the $800 retail cost, which is probably why the drug companies supported Obama's plan. I do care about the big picture, but right now, I'm just happy to have a 90 day supply of Seroquel.

30 Day Drug Journey, Day 17: $12 is $12 Bucks

So, I am currently off the Stavzor and have moved over to the Divalproex. As I have mentioned before, the drugs are very similar and I feel better than I have felt in a long time. A friend of mine commented on how productive and stable I currently seem. The best mood stabilizers allows one to more smoothly navigate the highs and lows that one with manic-depression (or bipolar) experience.

So, I found an extra 3 pills of the Stavzor, with a retail value of about $12. It would be 1 days dose of pills. I shouldn't switch back and forth between meds. I probably will never be on the Stavzor again unless I have great insurance, but I'm having a hard time throwing out the leftover pills. I kind of feel like someone who has lived through the great depression and is very reluctant to throw out anything, because they have lived through lean years. Maybe I have lived through a great depression: a great manic depression. Today that feels very much in the past.

30 Day Drug Journey, Day 15: Gotta Love the Drug Companies

And no, I'm not being ironic about loving the drug companies. Because most of the major drug manufactures have assistance programs for low to moderate income individuals who have no insurance. I have already been enrolled into the the AZ&Me™ Prescription Savings Program. They are the ones that make Seroquel, which is a great drug. According to their page, "If you are an individual making $30,000 or less or a family of four making $60,000 or less you may qualify."

Why do drug companies do this? One could guess:

• Genuine Concern for those that can't afford their medicine.
• To receive a needed PR boost in the public's mind.
• By providing free or low cost drugs to the neediest in our country, they soften the push for real health care reform.
  

Honestly, I am willing to give them the benefit of the doubt, since I am benefiting from their program. So, since I was already enrolled in their program, I had to mail my new script to their processing center in St. Louis. According to their phone system, they have the script and should have it processed in 7 - 10 days. I knew I qualified for this program when I started this blogging, but until I have the drugs here, I'll still be a little worried.

I have to fill out another form to receive assistance with the Wellbutrin and that requires the most recent tax return, so that hopefully will be finished today or tomorrow. Plus, where Stavzor didn't have a corporate program, the makers of Depakote (Divalproex) do, so I'll explore that option too.

Day Drug Journey, Day 15: Shop Hy-Vee

Today, I was going to go to my psychiatrist and see if he would substitute the Stavzor for Valporic Acid (apparently they are very similar). The script that he had written though was for Divalproex, the generic version of Depakote. At Walgreens, they could not use the Valporic Acid as an approved substitution without a new script and my doctor wanted to talk with me before that happened. (Are people still with me?)

To continue to comparison shop I took the Divalproex script to CVS and they quoted me the price of something like $250 for a 30 day supply, the same as Walgreens. Yeah, that wasn't going to work. And then I went over to Hy-Vee and they said the cash price for the Divalproex for someone without insurance is $42.31. Yes that is right over $200 difference.

I considered shopping around some more, but there is snow on the roads today and I need to finish my taxes and lots of other things. While I hope these blog entries are helpful to people, I have to live my life and I can't do everything I might like to do if I was an investigative reporter on this topic. And honestly once you see that you are saving over $200, don't you think you are pretty far ahead?

30 Day Drug Journey, Day 2: Acid, Valproic Acid

I found a coupon that I had thought was lost for 2 free weeks of pharmacist Stavzor. I had tried to use it when I was in Michigan around the holidays, but they did not carry Stavzor in stock. It is a newer drug and actually both Walgreens and CVS that I visited didn't have it.

So, I put the order in for 2 weeks and it should be in on Monday or Tuesday. But the great thing is that the that I spoke with said that bipolar illness is kind of a speciality of his. He told me about a number of family members that have the diagnosis. I won't put his name down, or even what Walgreens I went to, but I am so impressed with Walgreens right now. Honestly I have never had a better encounter with a pharmacist. Never! So I am happy to plug Walgreens all day.

He confirmed what I thought was true about some alternatives to the Stavzor. The active ingredient is valporic acid, which does come in a generic. If I switched to the generic (with my doctor's approval, of course) it would only cost $42.36/month, or $119.08 for a three month supply. That figures out to be $39.70 a month, if you buy ahead. Now you need a Walgreen's Discount Card to get this and there is a yearly fee of $10 - $20.

Still, I was very concerned that I might have to find a different drug from the Stavzor. Still, what does the consumer get for paying $300 more a month for Stavzor, than for generic valporic acid? Stavzor is timed released which helps keep a constant stream of the meds in one's system. You don't need to take it as often, so that is a helpful benefit. And Stavzor is a pretty, easy to swallow coating.

Is it hard to swallow that those benefits (which aren't insignificant) should cost $300 more a month? Right now, I'm just not sure.

Sample Drugs from the Doctor!

I should also say that my psychiatrist has been great about giving me samples. I left today with 40 tablets of the Stavzor, almost half of month. I guess the retail value of $159. He also gave me 8 tablets of the Seroquel (retail value: $100). The Seroquel is actually a little higher dose than I normally take, but it seems the doctor thinks that is fine. He is a private doctor and I paid $70 for the office call, pretty good for psychiatrists.

While the samples might help for a bit, obviously sustainability is of a key concern too. Seroquel has a good manufacturer's program (I'll write more about it later). Stavzor does not seem to and I need to do more research on this. This is a relatively new drug for me, so I'm still learning about it. One option might be that the most expensive meds have to be taken out of my "drug cocktail." Yet there is a lot that is working well for me right now in all of this.

Total Retail Price of Meds:	$780.89
Value of Discount Card	52.00
Sample Prescriptions	259.00
Still Needed for the Month:	469.89

So, we are coming close to the end of Day 1 of my quest and we still have a long way to go before this will work!

30 Days -- Paying for Medication

I recently watched the movie SuperSize me. In it,Morgan Spurlock, decides to eat nothing but McDonalds for 30 days. It was a great concept and a very entertaining film. Spurlock went later on to a TV series called 30 Days were one is faced with a change of some kinds for 30 days (living on minimum wage for 30 days, or an evangelical Christan living in San Fransisco with a gay roommate. The show is worth checking out.

Well, I'm going to start to work on my own 30 day challenge. How can I afford the perscription medication that I need for the next 30 days? I just returned from my psychiatrist today with a 4 fresh scripts for drug cocktail we are using to treat my bipolar disorder. And I am one of the 30 million Americans who are uninsured.

So I started today at a local Walgreens in Independence and just got the cash price. Here is where we start:

	Perscription	Cash Price
	Stavzor 250 mg -- 90 Tablets	357.89
	Seroquel XR 200 mg -- 30	268.52
	Wellbutrin XL 150 MG -- 30 (Generic subsisuted)	139.99
	Ativan .5 mg -- 30	14.49
	Total:	$780.89

Now, I don't have an extra $780.89. I do have some resources and ideas about how to make this affordable and I plan on blogging about this process.

So, first a couple of early methods to bring the cost down. I have a Walgreens Prescription Card and a Together Rx Access Card, though the associate said the card would only save me $2. I also have a card from Stavzor to take off $50. So with those savings, that brings me down to: $728.89.

The mental health safety net in our country has been hit hard in the past couple of years, especially here in Missouri. I hope that my experience in the area can be helpful to others especially as our lawmakers continue to try to pass some type of comprehensive health care reform.

I should also point out that I currently do have adequate meds and am not in crisis, so I have the mental and emotional resources to deal with the challenge. Your thoughts and comments are welcome!

Instead of Mental health think of Mental Wellness

Think Mental Wellness instead of Mental health. A better term.