Pills

I have begun to envy my grandmother, who set out her day’s worth of pills—3 or 4 perhaps—in an antique crystal saltcellar about the size of a large thimble. At the end of the day, if the saltcellar was empty, then she knew she’d remembered to take all of her pills. In contrast, I take more than a dozen pills a day and they’re scattered across the day.

When I graduated from just taking pills straight from the bottle, I bought a weeklong container with a separate cell for each day. That has now become a double row of daily cells, one a.m., the other p.m. Let’s see. Each a.m. cell holds a thyroid pill, two blood pressure meds, and an over-the-counter antihistamine. The p.m. cells contain another blood pressure pill, a statin, a low-dose aspirin, and a B-complex vitamin pill.

For years—since my 30s—I got by with one blood pressure med. A couple of years ago I needed another, at least part of the time. And now that I’m taking Sutent for targeted cancer therapy, it tends to raise my blood pressure and so a third med has been added, a simple diuretic that I discontinue taking during my “rest” week. My BP readings are nothing if not erratic, but somehow with a bit of pill juggling they’re still relatively manageable.

Blood tests in April when I was diagnosed also revealed that I was slightly anemic and so I began taking a prescription iron supplement. It’s supposed to be taken two hours after a meal and one hour before a meal, which argues for midmorning. I wash it down with Emergen-C, which I’ve nicknamed “Fizzy Lifting Drink” (a la Willy Wonka) because it fizzes slightly. The drink supplies 1,000 mg. of vitamin C and an assortment of minerals. The vitamin C helps the body take in the iron.

And then there’s Sutent, the daily capsule to be taken for two weeks, followed by a week off, and then repeat. Sutent, manufactured by Pfizer, is the targeted therapy drug for my renal cancer. Pfizer’s assistance program supplied a special pill case with cells for four weeks, a full cycle of the drug. I load each cell with a Sutent capsule and an Ondansetron tablet. The Ondansetron is taken half an hour before the Sutent to ward off nausea, a common Sutent side effect. It can be taken once every eight hours but I never have taken more than the single tablet half an hour before I take the Sutent capsule. I have wondered whether I actually need to take the Ondansetron at all because I’ve never been nauseated by the Sutent, but as yet I haven’t braved going without it. Could be that I haven’t been nauseated because I take the Ondansetron, and one dose is sufficient. Who knows?

Morning pills before breakfast; iron and vitamin C midmorning; Ondansetron and Sutent, usually at 6:00 and 6:30 p.m. respectively; evening pills just before bedtime. It’s a routine. The various containers help keep it organized, but what any routine boils down to is habit. While I would not characterize this routine as particularly convenient, like any habit one gets used to it. And all of the times are somewhat flexible. For example, if we’re going out in the evening, I can take the Ondansetron/Sutent sequence ahead of time or after we get home. In a pinch, I can even bring the pills along in a pocket pillbox and take them over dinner in a restaurant.

Pills are a modern medical miracle. When I consider the good I derive from the various meds, it’s easier to reconcile the inconvenience.