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Comment by kstrauser | Hacker News Reader

Regarding #1: my insurance pays for 100% of my meds. It seems like the extended release versions are the hardest to get covered, but people who can get by with the plain old all-at-one formulations may have a much easier time with that. Also, insurance doesn't pay for my doctor directly, but their website has a place for me to submit out of network claims. I do that with my doctor's receipts and insurance cuts me a reimbursement check for a large portion of the bill.

It's a pain in the neck in the sense that getting all the insurance stuff straight is extra hard when you're in need of being treated for ADHD in the first place. It does give me something to hyperfocus on every couple of months.

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My insurance also covers my meds but there's still a million things that end up getting in the way of me actually getting it. I won't get into the details but things like working memory with appointments, booking the right appointments, getting vitals, the med shortage and navigating calling different pharmacies, and much more. I have a lot of horror stories (that are mainly my fault and due to my ADHD) and similar stories from our members/community.

It's great that you've got it largely down though!

Personally, I like to know that I have a foundation (and a person) to fall back on when all the med stuff doesn't pan out the way I want it to (which is unfortunately frequently), and a big part of the value of coaching & body doubling too is community and not going through this alone.

I hear ya. It's a cruel situation. I've likened it to building an asthma clinic on top of a mountain: if I could jump through all these hoops, I probably wouldn't need the help in the first place.

I absolutely, 100%, completely agree that the medicine is only a small part of it. I have a hundred little rituals and coping mechanisms that had let me manage my life without it. Small examples:

- Appointments go straight to my calendar the instant I schedule something. If something's not on my calendar, it doesn't exist. I make liberal use of early reminders, too.

- I'm not a GTD purist, but I track it pretty closely. When I say I'll do something, I put it in my inbox. Same as with my calendar: if a to-do isn't in my to-do app, it's not getting to-done. There's nothing I've committed to that isn't in one of those 2 places.

There are plenty of others that I've been doing so long that they're unconscious habit.

These are the things that work for me. If the things you talk about work for you, and other people are willing to pay you to help get them on track, excellent!

Extended release was hard with some, but I had one insurer that would only pay for 1 pill per day, so I had to use ER with them.

I have heard ahem that you could get 30 pills that were each an entire day's dose, cut them in half, and take them as 60 separate doses. For example, you and the doc think you should take 10mg in the morning and 10mg at lunch, so get a prescription for 30 20mg pills and buy a pill chopper.

Purely rumor, I'm sure.

That would work if the pharmacy reliably provided tablets rather than capsules.

When I was tapering off a capsule med, I used to pull the two halves of the capsule apart, pour out a bit of the powder, and plug the halves back together. Not amazingly accurate I admit. But it shows that it's not impossible to disassemble and manipulate at least some kinds of capsule, tedious though it is to do.

Last time I tried that, I had to vacuum the stuff from the floor. Turns out some CR capsules are filled with a lot of tiny little frictionless spherical pellets instead of powder.

Probably "Extended Release". The ingredient is coated with a range of thicknesses, so that different ones become bioavailable after different lengths of time in the gut. That is actually what my "powder" was

I had a way to avoid spilling them, but it's too long ago and I don't remember what it was.

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