Busy Week, But Still On Track

[T-Plus 19 Days.]

I can't believe it's been nearly a week since I last posted! What a week it's been, too; between work, starting another semester of grad school, and adulting the crap out of my day to day chores and stuff, I haven't had a lot of time to post. I have been keeping up with my adherence thoough. Check it out:

Keepin' on track.

Bam! Okay, so the "monthly" adherence bit is a little misleading, since I started PrEP on January 12th, but still, even with a super busy week, I've managed to keep on track with my daily dose every single day so far. Being this busy has made me pretty thankful for that emergency pill bottle I put together, though! I refilled it twice this week; four out of the last five days I've taken my Truvada away away from home, whether at class, at work, or out with a friend. In class, I talked to my professor in advance, and just let her know that I had a medication I have to take at 7pm each day. She was totally fine with it, and I was able to take my pill in class on a break she offered right around dosing time (you can see it there on Thursday, in the picture above). So, pretty proud of myself for keeping on schedule. 

The funny thing is, getting myself organized around taking my PrEP every day has helped my adherence to my Lisinopril (a blood pressure medication) tremendously. Maybe it's just that the app is making me more aware of my dosing times, but I think there's more to it than that; I think that the motivation I've had to get and stay on PrEP has encouraged me to be more engaged with my health overall. It's a good feeling. So is having a consistent, guaranteed appointment for HIV/STI testing and labs - I've always been a fan of knowing about my health... and TERRIBLE at scheduling... so having something mandatory and predictable is fantastic.

Hey, and my side effects are just about completely gone! I gotta say, it was kinda crummy those first couple weeks, building up protection but not feeling good enough to, um, use  that protection. Look, I know what you're thinking, I can hear the "Truvada whore" comments starting to bubble up, but I'm being honest here; I want to get laid. Um, duh. Not crazy, run-to-the-bathhouse and f*ck ten guys kinda laid, but something. And it sucks not feeling like it. But two weeks worth of feeling a little off is nothing compared to the alternative. So, I'm not complaining.

Cheers, friends.

Day Twelve - Protection Up, Side Effects Down

[T-Plus 12 Days.]

Twelve days in now, which means I'm getting close to half way through my first month on PrEP. I've taken my doses on time (well, within about 45 minutes of my alarm) every night so far, and at this point I should be very, very protected from infection; for the most part, things have gone smoothly, but the nausea I was experiencing at first lasted a bit longer than I expected, and I've gone for about a week with some mild indigestion. Not fun, but not debilitating at all, and my appetite has been fine. On the upside, it's been getting better daily, and my doctor explained that most side effects pass within a month.

In terms of adherence, I've been digging into the MediSafe app I've been using a little more. There are several handy features that I've found beyond the ones I described in my previous post; you can see a lot of those features in play in the picture below:

MediSafe adherence app.

There are a few things going on here. The app tracks my medications in a virtual "Pill Box" each day. If I click on a medication, I see a box like the one pictured above, displaying the next scheduled dose of the medication that day, dosing instructions/preferences, the number of remaining pills (which I've set in the Profile portion of the app), and when I have my refill reminder set (in about two weeks as of this posting). The app also lets me enter my prescription numbers, which is handy when I get texts from my pharmacy for automatic refills, since that's the only identifier I gen in them.

I haven't had to use a pill from my emergency stash yet, but I expect I will soon; I'm taking an evening graduate course each week this spring, and it generally runs past my dosing time. I could wait until I get home afterwards, but I'd rather stay as consistent about my timing as possible, so my plan is to speak with the professor and ask permission to step out for a moment each night. I don't need to tell her what specifically I'm taking, but I can explain that it's an important, time-sensitive medication. Schools in the United States are generally expected to make minor accommodations for health and wellness, so this should be adequate. If you're a student as well, don't be afraid to ask for permission to go take your PrEP when it's time! It only takes a moment, and by speaking with your professors, you should have no trouble keeping your dosing schedule punctual and consistent.

Cheers, folks!

Day Six - Achieving Protection

[T-Plus 6 Days.]

Took my sixth pill last night, which means today is the sixth full day of Truvada (PrEP) in my system. This means that sometime between today and tomorrow, I should reach the peak level of Truvada in my system, and thus peak protection from HIV infection (current research suggests it takes about 5-7 days for the body to build up enough of the meds to provide maximum protection). So, um, woohoo! 

This is why keeping up my adherence is such a big deal though. I know I said it repeatedly in my last post, but I don't think I can emphasize enough how important it is to take my PrEP every single day. Because a level of the meds persists in my system for a while, I can miss a dose here and there and still be well-protected, especially once I've been taking it for a while. This is a good reminder that I don't have to freak out if I forget a dose from time to time, but it's not an excuse to be bad about my dosing! It's really easy to get "too busy" or whatever, but if I'm missing too much, then I'm not protected.

So I've taken up a couple of habits to try to keep my adherence up:

First off, I downloaded an app that helps me track my meds and my adherence. The one I opted for is called MediSafe, but there are loads of others (perhaps sometime soon I'll start assembling a list of other apps in the Resources tab).

Pictured below, MediSafe allows folks to do a number of things that help stay adherent. When you first open it, it asks for a list of your medications, as well as their dosing instructions. You can edit this list whenever you want, and it also lets you add medications you take "as-needed", such as aspirin or antacids. After that, you have your daily "pill box", which displays all of each day's medications, quartered off by time of day that they're supposed to be taken. Each medication that you take on a regular basis comes with a reminder, and those reminders can be customized; I personally love the Star Wars-themed "medtone". Over the course of time, MediSafe tracks your adherence, and it can generate reports in a couple formats (including Excel spreadsheets) that you can export and email to, say, your doctor.

MediSafe adherence tracking report.

The second thing I did was to make an emergency to-go bottle of my most important medications, so that I always have some doses with me - there's always the chance that I'll spend the night at somebody's place... or maybe work really late or something. I used a small pill bottle from an old prescription, and taped my own label over it with a list of the medications in there and their colors (I suppose that's a little bit obsessive, but I want to be sure that the pills aren't mistaken for something else if it's ever found by, say, airport security or something). You can see a picture of it below.

  

My emergency to-go medication bottle.

So that's it for now. I've been spot-on with adherence for the past week, and hopefully I'll stay that way. I had a couple of rough patches in the mornings on Friday and Saturday (I got pretty nauseous both mornings, but both days it went away within a few hours, and since then it's been getting easier each morning). I'll check in again soon. If you're reading this, please feel free to post comments and questions - I'd love to answer what I can!

Cheers, friends!