Napalm Riot

I started writing a blog yesterday, about something I read in #devart, but I never got around to finishing it. I don't want to combine it with what's currently on my mind, so it'll have to wait.

I'm usually loathe to discuss some of my medical issues, but I'm rather upset at the moment and I need to vent a bit.

I'm fully aware that I have a really good deal regarding health care and health insurance. I'm on my dad's health plan and he's an employee of Kaiser Permanente. This means I never pay more than $5 for medications, and I take three daily and another three when needed. Four are medications I take because of the migraines and severe headaches I get, one is birth control and one is for depression/SAD.

Where I'm getting somewhat screwed is that the medication I take daily, as a way to prevent migraines, is also an anti-depressant, nortriptyline. I'm just about certain that it does affect the effectiveness of the Wellbutrin, despite it being just about the lowest dose you can take (25mg). But the nortriptyline works and it doesn't make me physically ill and non-functional if I miss a dose (I tried a beta-blocker prior to nortriptyline and that's what happened if I missed a dose or took it too late in the day), though I can experience withdrawal symptoms from missing just one dose.

Kaiser provides a service to refill medications online - and ship it to you, for nothing extra. Awesome, right? When it works properly, anyway. It does work properly, when I just have it send medications to whatever is my default address at the time (home or, usually, school).

The problem is a huge bug in the way their shipping system works. I can see how it might be by design, but they don't tell you that and that's what makes it a bug, a problem.

I'm in South Carolina right now, I have been since mid-June and I will be until the end of July. My nortriptyline ran out on Monday night, I took the last capsule I had (if it had been a tablet, I probably would have cut it in half, to try to reduce the possibility/severity of withdrawal symptoms). I ordered a refill in late June and put in Dave's address. My mom called me on Monday, during the day. My medication had been sent to my school and then they forwarded it home.

This is the second time it's happened (well, probably more like third or fourth, but the medication has still arrived in time other times so I didn't care). I let the first time go because it was during school, I was stressed, I could have put in my home address. I let it go as user error. I do know, however, that my home address was set as my default address at the time. My school address is currently set as my default address. Their system completely disregards the entered address if it's not the default address or you use the option to make that address your new default address.

Okay. It could be a security feature. But, anyone could pick up my medications from the Kaiser Richmond Pharmacy as long as they know my medical record number. My parents have picked up my medications countless times for me. I'm over 18. Legally, they should not be able to do that; they are not on record as authorized to pick up my medications. Legally, Kaiser Pharmacies are supposed to request ID and only give the medication to person associated with that medical record number (or someone authorized to pick up medications). As a minor, only my dad should have been able to pick up my medications. I'm on his medical plan, so it would make sense that he could pick them up (especially since a lot of minors don't have a legal ID; I didn't have a legal ID between 15 and 18 and I only had a legal ID between 10 and 15 because I had a US passport). My mom picked up medications for me when I was a minor and she shouldn't have been able to do so; she hasn't been on my dad's medical plan since they got divorced, when I was like 6.

Now let's think about another situation. Someone gains access to my online Kaiser account. If they've gained access to that account, they'd likely have to know me decently well. I also don't hide away my medications, so it wouldn't be terribly hard to get a prescription number. All they need to do to ensure that they get my medication instead of me is click that "set to default" check box for the address and then change it back when they're done. They only way I'd find out is because they now have an automated call to let people know their medication has been shipped, but they could change the contact phone number, too.

Let's say I had always previously had my medications shipped to a default address and had never changed that address. I go away for six weeks to an area that probably doesn't know what the hell Kaiser is. I order a refill and put in the address where I'm staying, but don't mark it as my new default address. Why would I? I'm only here for six weeks, but I need my medication and ordering it online is a hell of a lot easier than requesting a script from my physician (or psychiatrist in the case of the Wellbutrin), getting that script to, say, a Walgreens - or hell, WalMart, picking up that medication at a local store, paying for it out of pocket, and then going through the hassle of getting Kaiser to reimburse me when I get home. My medication gets sent to my default address instead and there's no-one there to send it on to me. What if that medication had been my Wellbutrin and I'd been having a rough time? What if Dave had to have me hospitalized? Or what if Dave has been at work and I'd done something stupid?

I don't see the above as an impossible situation. I take brand-name Wellbutrin, because it works well and it ensures that I always get bupropion instead of the generic budeprion, which I found out doesn't work for me the hard way (right before finals too!). Kaiser doesn't like when their doctors prescribe brand-name drugs. It's expensive. I'm also taking a high dose (300mg). So Kaiser makes sure that if I reorder that prescription online and have it shipped to me, that it will arrive the day after I run out - so that there is absolutely no overlap in the prescriptions. If it had been my Wellbutrin that got shipped to the wrong place this time... going cold-turkey off of Wellbutrin is not fun.

I'm sorry for the length of this. Congrats if you actually read the whole thing. I'm going to finish washing the dishes in the sink while I wait for Dave, he should be home soon.