Twice a Day

Every day I have at least two moments when I long to be carefree and untethered by responsibilities. Most days, of course, have a thousand little obligations, responsibilities, deadlines, or other duties scattered around, but there’s a depressing inevitability about at least two of them that always grinds me down just a little bit, no matter how content I’m feeling otherwise.

Every morning, I worry about breakfast. I don’t particularly like breakfast, and would prefer to just eat whenever I first get hungry on any given day, but I have to eat at least a bowl of cereal or a couple of pieces of toast by 11:00 at the very, very latest so that I have a full stomach before I take my morning medicine. I have to take two pills every morning, and I usually throw in a multivitamin just to be on the safe side. One of those pills is really easy on my system, but one will give me a crampy, acid stomach for the rest of the day if I haven’t eaten anything first. For a while I took that one pill at night instead, but bed-time was usually too long after dinner, and I eventually develop a minor ulcer and an ongoing case of indigestion that just wouldn’t quit. Switching to a morning schedule pretty much cleared up those troubles, so I stick with it.

Every night, I take a second dose of the other pill, the easier one. That one doesn’t really affect my stomach very much, but I need to try and take it about twelve hours after the morning one, just to spread out the dosage as evenly as possible. I’m lucky that today’s drugs give you some wiggle room with the timing, but I still need to do my duty within a certain window of opportunity.

If I can’t get any breakfast, or I forget to take my medicines at the right time, or if I’m away from home and I’ve forgotten to bring my pills with me, it’s better if I skip a dose altogether than start taking my medicine erratically. I’ve never asked how often I could miss a dose before I have reason to worry, because I’m better off worrying every day, just to be safe.

So every day, at least twice a day, I worry how long I can keep this up. All things considered, I’m pretty lucky that such a relatively easy regimen has kept me in such good shape these past six (well, it’s almost six — WOW, it’s almost six) years, and I have no idea when or if I’ll need to switch to something else. Every three months or so I have at least six vials of blood drawn for some tests, and a week or so after that I go for a check-up so my doctor and I can make sure everything is still ship-shape.

If my test results start showing a pattern of changes for the worse, I’ll need to switch medicines until some other combination gets things back on track. My doctor in the UK isn’t used to seeing patients take the combination I’ve been on for the last five years or so, so he’s been pressuring me a bit to switch to something he’s more familiar with. I trust my doctor in New York, though, who has gotten me this far with a minimum of fuss, and he and I both think that if the current treatment has been so successful for me for so long, it doesn’t make much sense to monkey with it. Once you’ve used any one antiviral medicine for a while, you can’t ever go back to it (so I’m told), so I feel a certain pressure to keep as many options open for as long as possible.

So I get up and forage for food every day, whether I want to or not, so I can take my morning pills without any discomfort. Every night I take my evening pill as promptly as I can, to, so I can maintain a regular barrage of medication into my system that will keep my unwelcome tenants from getting used to the regimen and finding new ways to cause trouble.

Every time I take my medicine, I give a passing though to how lucky I am, all things considered. I responded to treatment quickly, and have actually been healthier than ever before in my life once things settled down. I live in a prosperous western society with easy access to the medicines that keep me going. In the UK I’m even luckier, because I don’t pay a thing for my medicines, while in the US I was paying over 850 bucks a month in insurance premiums and copayments to support my habit. Even those prices were a bargain: the retail value of the pills I take is somewhere in the vicinity of 2,000 dollars a month.

So at least twice a day I think about how my situation is a drain on someone else’s resources, since I’m getting such a good deal (financially speaking). At least twice a day I think about how the clock keeps ticking inside me, wondering when I’ll have to give up the security of a comfortable, predictable treatment plan. At least twice a day I try to think if there’s any likelihood of me needing to have my medicine with me in the next twelve hours, instead of leaving it on the shelf in my room where I always know where to find it. At least twice a day I wish I could just forget about it, and then I remember that there was at least one time when I forgot about vigilance and then ended up in this whole mess in the first place. So at least twice a day I feel a little sorry for myself, and then think it’s my own fault anyway so I should stop whining about it and just count my blessings. Then I sip some water, swallow, and get on with my day.

And that’s at least twice, but usually other things will come up in the course of a day that makes me think about the same things. Granted, I spend a lot more time thinking about comic books and typography and people I love and other things that make me happy, but at least twice a day I wish things were a little easier.