Pill Packing — Mood and Clothes

Okay, so clothes are settled. Now for the most anxiety-inducing part of packing: pill packing. It’s a rather elaborate process for me when I’m going to be out of the country for two months or more, but I think I’ve finally got the hang of it. That said, the stakes are high and there are a lot of moving parts, so it always stresses me out.

Step One: Figure out how much medication you need. I like to start from whatever day it is, and just count how many days until I’m home from the trip. This way I account for all the meds I need leading up to the trip, plus whatever I’ll need to bring with me. Since I started the counting process on October 5th, I counted up 63 days from October 5th until I get home on December 6th. Then I like to add on a buffer period in case a volcano erupts and I’m stranded in Europe for a couple of weeks longer. So I added 14 days to my tally, bringing the total up to 77 days. Now, some pills I take twice a day, so those ones went up to 154. And fish oil I take 4 of per day, so I need 308 of those. Now that I’ve got the numbers worked out, I can move on to step two.

Step Two: Get your refills in order. Once I have my numbers squared away on how much of each drug I need, I get in touch with my doctor and have him call in enough refills to cover me.

Step Three: Get your hands on the meds. There are several ways to go about this. First, I try to time my prescription pick-up date so I get a 3-month supply soon before I leave (this happened to work out for me for the majority of my prescriptions). If the timing’s not quite right, I switch to 30 day supplies until the pick-up right before the trip when I get a 90-day supply. Another way I go about it is I get a “vacation override” from my insurance company so they let me pick up more than 30 days’ worth (I had to do this for one of my meds that wasn’t timed right for a 90-day pick-up). My final approach is to have my doctor over-prescribe. This was necessary for me for my anti-anxiety medication. You just can’t get more than 30 days’ worth of a controlled substance in my state, so even a vacation override wasn’t going to help. In this case, my doctor agreed to prescribe double the dose which, in combination with the extra I had socked away, worked out just fine to get me through the trip.

Step Four: Count ‘em up. I like to spread out my stash on a large, flat surface (the dining room table is best for me). I rip open all the little pharmacy bags and arrange the bottles according to medication, including with them whatever current bottles I have going. Then I make a written list of each drug and jot down my count as I go. For example, if I have an open bottle of 17 pills for the first drug, I write that down next to the name of the drug. Then I dump out the next bottle of the same drug and count that (call me crazy for recounting what the pharmacist already counted, but I just like to be sure there’s no mistake). If I have sealed factory bottles of pills, I trust the number on the label. I write down how many are in every bottle, so let’s say it’s 17+60+180 which adds up to 257. Next, I separate the number of pills I need for the trip and the time leading up to it, plus the buffer, so 154 in this case (2 pills a day). I set aside the rest to leave at home, usually in one of the bottles, but sometimes I have to use little ziplock bags with sticky labels saying what drug and dose it is. I repeat this process for every single drug and vitamin that I need, setting aside all the extra for safe keeping at home. That way, if something disastrous happens to my travel supply, I can always fly home and have meds to return to. This may all seem excessive, but I’m just extremely aware of the gravity of my illness and the importance of taking my meds. And I realize how complicated it is to get psychiatric medication when you’re in a foreign country. It’s not like traveling domestically, where you can just have a prescription called in to a pharmacy wherever you are. There are often entirely different medications and certainly different laws on prescribing them depending on the country.

Step Five: Leave all the pills and vitamins in their original bottles, never combining them to save space. This is in case anyone in airport security questions my possession of so many prescriptions. I make sure they all have my name on them and contain no more than the pill count on the label. Having my meds confiscated would force me to return home to my backup supply, so I like to be overly cautious in carrying them. I always, always carry them in my “personal item”- the bag that goes under the seat in front of you- so I never lose sight of them. I don’t even want to risk putting them in the overhead bin, should someone steal them or take my bag my mistake. I’m less protective of my vitamins, and since they’re so bulky, I’ll even put them in my checked baggage. I don’t know if I’d be able to replace them on my trip if they got lost, but I’m not dependent on them for my mood stability- they’re just supplemental.

Step Six: Dole out a week’s worth of pills into daily pill cases. I like to do this the night before I leave, so I don’t have to delve into my larger stash until I’ve reached my destination, even if there are travel delays. I actually have 3 pill cases- morning, afternoon, and night- plus a little pouch for emergencies (anxiety medication, ibuprofen, etc.). I keep these in my personal item, too, for easy access during travel.

So there you have it: my self-devised, step-by-step guide to traveling abroad with a bucketload of psychiatric medication. I really think it’s worth being meticulous and methodical in preparing my prescriptions. Jet lag and red-eye flights are difficult enough to cope with without going through withdrawal or developing symptoms. This whole pill-packing process can be daunting, but it’s so worth doing in order to avoid any major medical issues on the trip.