Personal Post. The Pillminder Death Spiral. 10/21/2026 (Patreon)

No game, geek, or game industry content here. Just a personal post. If you want to see these, join this Patreon as at least a free member. This stuff isn't going on social media anymore, it's going here. Eventually, I'll make an index.

Before I was diagnosed with cancer, I took 3 pills a day. One blood pressure pill, one antidepressant, one multivitamin. That was it. That took care of everything as well as it could be taken care of.

Now? Now I take 34 pills, every day.

Three are different kinds of antidepressants. Two are for blood clotting. Two are for blood pressure. Two are for kidney function. Fifteen are for electrolytes. Three are to remove symptoms I suffer while sleeping. One is for muscle cramps, and anxiety, and maybe helps with pain. Three are to tamp down side effects from some of the other pills. Plus a multivitamin, plus an extra specific vitamin, plus a dietary supplement.

Some days I take more. I still have prescriptions for nausea and dizziness. Some days I need all the acetaminophen I can get, since I am not allowed any other painkiller. Some days the pain is so bad I take a forbidden NSAID, despite the risk to my kidney, liver, and (thanks to my LAP-Band) stomach and esophagus. Also, I have some injections I need, none of which are related to weight or diabetes. I'm not diabetic, and my insurance doesn't cover any weight loss effort, of any kind, ever. No insurance ever has, over the past 15 years of me seeing what my options are. But I have hormone issues, on top of everything else, and that requires injections.

It's all a huge pain in the ass. I have to get my prescriptions from two different pharmacies, and they come from four different doctors. Thank god my GP is so good, because she checks me for interactions. We never add more than one thing at a time, so we can make sure we know what is causing a problem when we add one new thing. I get bloodwork every month to make sure it's all still working as intended, and nothing new is breaking down. If a problem persists or worsens, we adjust.

Now, keeping track of 34-38 pill daily, plus injections, would be a bit much for me in the best of conditions. With my brain fog and mental fatigue, it's almost impossible. I use pill minders and tracking programs and an RX diary to try to make absolutely sure I never miss a single pill. And I try very, very hard.

And sometimes, I fail.

It seems stupid, I know. Sometimes it's an issue of having to time some of these with meals, and some without. Sometimes it's an energy issue, where I collapse into torpor 8 hours earlier than expected and sleep through scheduled pill times. And, sometimes, my depression simply gets out of control and I am too apathetic to give a shit.

The big problems with this are twofold. First, some of my pills are dangerous to crash off of. It can cause psychological and physiological damage. One of them specifically notes that just stopping it can lead to heart attack, stroke, and death. Second, when I miss an entire schedule of pills, my brain turns to complete mush. And when my brain is mush not only is it hard to keep on my pill schedule when I want to, it's sometimes hard to want to.

Not to mention when my health insurance or pharmacy screw with me and I can't GET my needed medications. Some I just buy out-of-pocket and eat the higher cost. Some I now manage to have a 90-day cushion on, because sometimes it's not in stock. And sometimes a pharmacy in Arizona takes over all my prescriptions without warning and says I have to travel 1,000 miles across 4 states to go get them. (Okay, that one only happened once, and it was years ago, but it STILL ticks me off!)

Anything from massive confusion to complete enervation, to near delirium, to total apathy, all the way to suicidal ideation, can hit me with little warning, and leave me unable to make rational decisions about my own health care. My wife and housemate work to help me with this. My doctor has literally called my family to check up on me. And each time some system or safeguard fails, we build an additional failsafe to make sure THAT problem doesn't beat us again.

Even so, 2-3 times a year, I either become unreliable with my dosages, or fall off entirely. It's dangerous. It's embarrassing. And it is hard as fuck to get back on schedule.

It's the Pillminder Death Spiral. If I wobble a tiny bit, there's a good chance I am going to crash, and have to spend time and effort to pick up the pieces... of myself.