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Quitting smoking, presciption medications, and health insurance
meatflower
Registered User regular
Registered User regular
Thread #2 of the day in H/A. What? I've got problems.
So I've been smoking for like 3 years now, not proud of it, and I want to do something about it. I don't smoke that much, maybe three packs a week. I've never been a pack a day person, frankly I don't see how anyone with a job has the time to get in 20 cigarettes a day.
Most people will probably laugh at this, but I don't think I'm so much addicted to the nicotine. I mean I am, but I don't think nicotine replacement therapy (ie Nicorette gum, the patch, etc) would help me quit. Reason being is that I don't reach for the smokes because I'm having a craving, but to deal with stress. At work and I just dealt with a difficult customer? Smoke a cig. Studying in the library at school for 8 hours? Smoke some cigs. General drama in my life? Smoke a cig. The physical act of smoking makes me relax, it's probably the deep breathing and the fact that I get to go outside and have some quiet time.
I'm gonna try to go see a doctor today and ask for a prescription for Zyban (aka Wellbutrin). I've talked to some people at work who have used it and said it helped them quit because they just didn't care about not smoking. This sounds right up my alley, as (hopefully) when I have those stressfull situations I won't feel like immediatley going for the cigarettes. I've never gone into a doctors office with the intention of getting a prescription, so I don't really know how to go about it. I assume I just say, "Hey, I'm trying to quit smoking. I've talked to some people who have taken it and I think Zyban might be a good choice for me". Is that about it?
My other concern is that if I did get a prescription I'd be paying for it with the health insurance my mom gets from work. As I'm under 21, I'm still covered as a dependent. I don't get the bill, or whatever it is, I don't know if there even is one. I have BlueShield PPO. Reason I'm concerned is that my parents don't know I smoke. This isn't because I'm underage or anything, it's just that it's an ugly topic in our family for reasons I'm not gonna get into and I'd rather not tell them I'm a dirty smoker when I'm hoping to not be one in the coming months. Does anyone know if prescriptions show up on some kind of bill or documentation from a health insurance company? If so I can just pay for it with cash, I just want to know.
Also, has anyone used Zyban? How did it work out for you?
So I've been smoking for like 3 years now, not proud of it, and I want to do something about it. I don't smoke that much, maybe three packs a week. I've never been a pack a day person, frankly I don't see how anyone with a job has the time to get in 20 cigarettes a day.
Most people will probably laugh at this, but I don't think I'm so much addicted to the nicotine. I mean I am, but I don't think nicotine replacement therapy (ie Nicorette gum, the patch, etc) would help me quit. Reason being is that I don't reach for the smokes because I'm having a craving, but to deal with stress. At work and I just dealt with a difficult customer? Smoke a cig. Studying in the library at school for 8 hours? Smoke some cigs. General drama in my life? Smoke a cig. The physical act of smoking makes me relax, it's probably the deep breathing and the fact that I get to go outside and have some quiet time.
I'm gonna try to go see a doctor today and ask for a prescription for Zyban (aka Wellbutrin). I've talked to some people at work who have used it and said it helped them quit because they just didn't care about not smoking. This sounds right up my alley, as (hopefully) when I have those stressfull situations I won't feel like immediatley going for the cigarettes. I've never gone into a doctors office with the intention of getting a prescription, so I don't really know how to go about it. I assume I just say, "Hey, I'm trying to quit smoking. I've talked to some people who have taken it and I think Zyban might be a good choice for me". Is that about it?
My other concern is that if I did get a prescription I'd be paying for it with the health insurance my mom gets from work. As I'm under 21, I'm still covered as a dependent. I don't get the bill, or whatever it is, I don't know if there even is one. I have BlueShield PPO. Reason I'm concerned is that my parents don't know I smoke. This isn't because I'm underage or anything, it's just that it's an ugly topic in our family for reasons I'm not gonna get into and I'd rather not tell them I'm a dirty smoker when I'm hoping to not be one in the coming months. Does anyone know if prescriptions show up on some kind of bill or documentation from a health insurance company? If so I can just pay for it with cash, I just want to know.
Also, has anyone used Zyban? How did it work out for you?
meatflower on
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There will be a record of the prescription with your parents' insurance. However, in my experience that's not something that's going to be seen/noticed by them unless they're talking to the insurance company and it comes up somehow. You'll pay for the prescription when you pick it up, the rest will be covered by the insurance, so they shouldn't be getting a bill or anything like that. Then again I might just be too hands off about my own insurance, so I could be wrong.
Also, I wouldn't underestimate the chemical effects of nicotine. Sure, you just smoke for the act of it. Most of the smokers I know say similar things. And when they stop smoking they get messed up because they don't have that regular flow of nicotine into their system. The nicotine is part of how cigarettes are helping you deal with stress, it's not just the breathing and act of it. Even if you start the Zyban, you'd likely be doing yourself a favor by picking up some gum or patches or whatnot, at least as a 'just in case' measure.
You're going to have to tell them if you want to use the insurance. It sucks, but at least you'll be closer to quitting.
Oh, and I understand the need for smoking over the need for nicotine. The lozenges help because you're still doing something: Your still taking something when you get stressed out, and you're doing it orally. My suggestion would be to keep the lozenges away from where you work, so you can walk over and get them. That'll help give you the "getting away for a moment" element of smoking.
If you drink, ease up on the booze/beer; it's much easier to unthinkingly light up again if you're drunk.
Gum's good, or hard candy, or carrot/celery sticks, or even a pen, something to do with your mouth.
That's why I liked the lozenges. They last about 15 minutes, and the nicotine delivery is much faster and stronger than the patch.
Any truth to that or were the people I talked to taking the nasty ones?
I'd continue on your current course: go see a doctor, talk to him about Zyban.
However, also try to develop some better stress management techniques. A therapist would be good for that. Do a Google search for the psychologist referral hotline in your state, and call them asking for a therapist with experience in smoking cessation.
Not usually, no. But it can happen. If there's an issue with the insurance and they have to back-bill you for prescriptions you picked up on the plan, the bill will show the names of the medications. That's a relatively rare occurrence but it's happened to me before.
But they'll be generic names: bupropion, not Zyban. You might be able to convince your parents that you were taking Wellbutrin for depression. I dunno if that's any better.
But frankly, your prescriptions show that you know smoking is a bad habit and that you're trying to quit. Anybody who has a problem with you trying to make a positive change in your life needs to go suck a chode.
Ask the doc for sample packs first.
the "no true scotch man" fallacy.
Yeah, don't let that worry stop you. You may get shit for smoking, but you can argue that you're wanting to make your life better by not doing it.
Oh I know. Just the conversation leading up to it or explaining it would basically be how I've been a closet smoker for the past three years and committing a lie of omission. I guess I don't have to tell them it's been three years. Still, the word uncomfortable comes to mind.
I just checked BlueShield's formulary (prescriptions they cover) for employer groups (since the insurance is from the school district my mother is employed by), and they list Bupropion and Zyban. This leads me to believe that it wouldn't show up in the example case you give.
These are amazing. I use them occasionally, and they helped for a while. I found them to be pretty hard on my lungs though - more so than the actual smoking. If you want to faux light up in the movies, in the club, or after dinner though, they are pretty good for that; they don't hurt nobody but you.
I hear Champex (Chantix sp?) is the drug of choice, tailor made for nictotine addiction - it actually binds to the receptors for nicotine, and give you a small buzz so a) smoking does nothing, and b) the cravings are lessened by a whole lot. I know quite a few people who have dropped the habit for good using this one. Zyban/Wellbutrin is actually an anti-depressant with anti-smoking as a side effect, it can also be habit forming, and expensive without medical coverage.
Things to stay away from: the patch. YMMV, but I was a light smoker (6-7 a day) before I used the patch and it buzzed me so hard for so long when I quit the patch, I suddenly sprang up to half a deck.
I dunno, I love nicotine, it does all the things I want it to. I love pretty much everything about it, cept the smell of smoke to non-smokers, and the damage it can do to others. So weirdly enough I dose on 'replacements' as secondhand friendly options, with no real eye towards quitting entirely. If I ever get serious though, it would be Champex all the way.
A big part of why I'm trying to quit (besides you know...CANCER) is that I've lost a lot of weight over the last year or so and the only way I can lose more at this point is to start exercising. Problem with that? I fucking run out of breath like nobody's business when I start doing any kind of heavy cardio.
I quit cold turkey on Sunday, and after a few days of jittery nerves and short tempers, I feel fine. I had one last night and found it kind of disgusting (and not at all satisfying). I still think about 'em all the time, but they don't have the same hold on me that they did a week ago.
So you don't need prescription anti-smoking aids in order to quit. If I can do it, you can do it.
My secret? Vegetariansim. Not out of ethical reasons, or anything like that, but because once you start replacing your meat protein sources with vegetable ones it cuts out a shit ton of calories and fat. I also started avoiding junkfood pretty well, and eat a freakishly balanced diet. You almost have to if you're not eating meat and want to get the amount of protein your supposed to. But I digress...
I'm not too concerned about the weight gain and I'm hoping the exercise I will be taking up will counteract any that I do encounter.
I'd be VERY careful about that prescription. You are not going to get that prescription without telling the doctor you smoke. That WILL go on a record of some kind. Your insurance company may see it; they may not. If they find out you've been smoking, it will be similar to getting a DUI on your car insurance if you ever wnt to get life insurance (or in many cases medical insurance). Consider if you REALLY need prescription drugs to get through this. I am NOT going to advocate lying about your smoking habits to insurance companies in accordance with board policies. Just bear in mind that if you put smoking down on record, and then tell companies you've never smoked, you will be in a shitton of trouble compared to someone who never has smoking on record yet mysteriously shows up with emphysema. If you've smoked, ever, it doesn't matter if you've been clean for 25 years...you will probably still find yourself paying inflated rates.
Also, I'd be surprised if you got through the doctor's appt and the prescription without your parents eventually finding out.
Oh and what Than said...I just posted in a similar topic thread on this a couple days ago about someone who blew up in weight after quitting and gave themselves diabetes. Extreme example of someone way older than you, but still relevant: it happens ALL the time. If you ned substitution, use caffeine not food.
PSN: TheScrublet
I'm a legal adult here, and they're not going to ask too many questions about me seeing a doctor in and of itself. I haven't had a physical in years for one. Also, I told them I was going to see a doctor this week for the lone reason that I haven't seen one in a long long time and it's probably a good idea.
And of course I'm going to tell the doctor I smoke. As far as the life insurance goes, that's really not of a concern to me right now.
As far as employers go, I have ethical reasons against working for any company that places restrictions on its employees private lives. If a company isn't going to hire me because I quit smoking years ago, then I don't want to work for them. Plain and simple.
At this point I think I'll just be paying for the prescription myself, if I do get one. They only prescribe you a 3 month supply of Zyban anyway, after that you're on your own. How much can that cost?
If you pay cash for everything, insurance companies will never see it unless you specifically release your records to them.
meatflower: I don't know how much it will cost you, it depends on the pharmacy. But there is a generic available.
the "no true scotch man" fallacy.
Confidentiality doesn't apply when your insurance company is involved.
Because they're paying for your health, being on their plan gives them the right to see your medical records.
the "no true scotch man" fallacy.
The small print for the drug lists a few side effects. One of them was 'slight depression', and in extreme cases 'suicidal thoughts'. Now, I am a well balanced guy... never been on drugs to control my moods or depression or anything like that, and I'm generally happy. I'd tried patches many times and was always tempted back to smoking, so the theory behind Zyban really appealed to me. I started taking it while still smoking... after 2 weeks you stop smoking and up the dosage of Zyban to 2 a day. 3 days into not smoking... I was feeling good! Didn't want to smoke, was having minimal withdrawal... all was well.
I come home from a fairly standard day at work, sit down at my computer, and for a while I am fine. Then, all of a sudden, its like something has swept over me. From feeling fine, I suddenly become really emotional. I feel very lonely, and generally depressed. I start to cry for no reason, pacing my room wondering what the hell is wrong with me, at the same time having this horrible feeling of being all alone and sad. In the end I had to call my mum, who was at work, 3 hours away (I no longer live at home), and her supervisor had to call her off her till to talk to me. I had been crying for 2 whole hours at this point, and could barely talk to my mum, I was that hysterical.
In the end, she had to come over and take care of me for a few days. The crying went away after 3 hours, but I was left with an emptiness and this general feeling of being depressed. That took a couple of days to go away. Needless to say, I stopped the Zyban and started smoking again. My doctor advised me not to go on it again.
Now, this sort of side effect is probably not hugely common, but hell, it knocked me for six. So be aware of it. There is another form of treatment I'm aware of, but not sure what its called. That one makes you feel increasingly nauseus as you smoke, making you hate the taste, etc, so that after a couple of weeks you just associate smoking with feeling sick and quit. Might be worth looking into.
I am now on my 5th attempt (in 3 years) of quitting by using patches. I have tried a few more times to quit in other ways, including Zyban, gum, inhalators, etc. While I tended to go back to smoking within a couple of weeks with patches, I have found that it was more down to my lack of willpower. This time, I am over 4 weeks through the NRT program, and have no intentions of stopping now. I don't want to smoke at all, am feeling the benefits, and liking the extra money. I think it is true that it can take a few attempts before you finally actually quit. You just need to be strong, man up, and have the will to decline offers of cigs, avoid places you know there'll be smokers as much as possible for the first few weeks, and just stick with it.
*Thanks Thanatos!
Beyond the life insurance thing though does this really matter? As I stated before, I have no plans on working for a fascist employer at any point in my life. There are plenty of non-fascist companies out there to work for.
I'm not going to be on this health insurance plan a year from now anyway because I'll be beyond the age of coverage.
It matters most if you ever want to go into business for yourself or freelance and you need to get individual health insurance.
If you get on an employer's health insurance, it doesn't matter, because group plans give you the same rates regardless of health history. Some professional guilds - like if you were a screenwriter and a member of the screenwriter's guild - provide group health insurance, too.
But if you try to strike out on your own, be self-employed, and get your own plan, insurance companies will scrutinize your medical records and find any reason to either deny you or jack your premiums up, including being an ex-smoker. But to get your old records, they'll go through your old insurance companies. If no insurance company has ever been involved with your care, that care is effectively 'invisible' to the insurance industry unless you yourself agree to release those records to them. Of course, they might ask, "Have you ever smoked?" in which case it's your choice to answer that question honestly or not - but if you answer 'no' when the truth is 'yes,' well there's a word for that and it rhymes with "endurance clod."
the "no true scotch man" fallacy.
Some people can do it without help. Some people can't. Our bodies and the nature of our addictions are all different. If the guy says he needs help, he needs help.
The lozenges aren't amazing candy by any means, but you get used to them pretty quickly. The toughest part is that they can dry out your throat. Of course, all you need is a drink of water to fix that. But the first couple can be kind of harsh. It also won't affect your breathing or anything like that.
The appointment is in an hour, I'm still going....I just don't know what I'm going to say.
Shit, man. Sorry. You asked about the insurance risks and I answered.
Go anyway. Your health right now is immeasurably more important than the risk of having to pay a extra money for health insurance at some undefined hypothetical date in the future.
the "no true scotch man" fallacy.
No I know. That wasn't directed at anyone in the way of malice or anything. I know you're just telling me reality and I appreciate that.
Maybe I'll just ask what they suggest, and it probably isn't going to be prescriptions and maybe just maybe I can get them not to make a formal record of it.
edit: It looks like I can buy a months worth from Canada for $38.00, which isn't ridiculous at all. In the rare event that the doc thinks Zyban is the best choice and prescribes it to me, I'm just going to buy it that way.
Let me be clear though...in general doctors keep dictations. This is for their own records as you come in multiple times for the same issue, and also as part of their backup against malpractice lawsuits. If you go in there and talk about smoking, it's probably gonna be kept somewhere.
PSN: TheScrublet
To Makershot, more power to you brother! I just don't have the willpower.
But hey that's just my opinion and this isn't D&D.
the "no true scotch man" fallacy.
Unfortunately, the sad reality is that only 2% of those who attempt to quit cold turkey remain smoke free a year out. I'm pulling that from memory, it may have been 18 months or 6 months or whatever. But the 2% is right. That's how the tobacco companies stay in business.
Also, I am leaving for the doctors office now. I will report back here with what happens after I get back from work tonight.
Yeah, and for the fact that each person's physiology and emotions react very differently from each other, it's very bad advice. I mean, if it were the case, no one would get depressed because that's just not normal.
If you've tried and failed cold-turkey, or with over the counter, you may need to try again with prescription. I do commend you for trying the other routes, though, it's a noble cause.
Have you considered a buddy system? Finding someone who's also quitting and wants to work together will be undoubtedly better than going solo. Just like working out and dieting. The power of working together can accomplish even some of the hardest things, and there's nothing like a little moral support when you're feeling down about it, or if you can't restrain yourself.
This is all I was saying. Had I known the prior attempts, I wouldn't have even made the comment.
I think this is what they actually do in the real groups for this sort of thing. I would strongly recommend this. And while I definitely don't think you should drop friends because they smoke, I would avoid putting yourself in situations the first month that could easily lead to regression. Namely, getting drunk together. I'll be very impressed if you are able to withstand the urge to smoke if you're drunk and everyone else goes out for a smoke break.
Here's that other thread: http://forums.penny-arcade.com/showthread.php?t=59697
I knew a similar focus had also been covered recently somewhere.
PSN: TheScrublet
http://www.penny-arcade.com/comic/2008/5/30/
I am now on Zyban.
The doctor was really nice, and very easy to talk to. She basically felt there were two viable choices given my prior history, Zyban or Chantix. I wasn't too crazy about the main side effect of Chantix...the sometimes frighteningly realistic dreams. Ended up going with Zyban since I thought it would mellow me out some and help me deal with the stress that was a trigger for my smoking. She apparently agreed as that's the one she ended up prescribing.
When it came to the topic of the health insurance, my parents, and privacy concerns she was amazingly down to earth. She called the pharmacy downstairs and basically explained my situation and tried to find out how they could get it to not show up. The answer was to prescribe the generic version. The doctor also had the same health insurance carrier as me (I guess that's a good sign), and said whenever she picks up prescriptions for her son she never gets anything in the mail about them.
My quit date is one week from today, June 12. Also, I will be going back in a month to check in and get my regular physical I've been lacking all these years.
I know this isn't a band-aid solution, and it's not a short road I'm about to embark on, but I feel pretty good about it already and the drugs haven't even kicked in :P
Edit: Also, interestingly enough, she was pretty vehemently anti-NRT. Basically, she said that when you quit nicotine it's best to avoid replacing it with anything if you can...especially more nicotine.
Later he told me the shoes were talking to him in some other language. Anyway, while the dreams were very vivid, neither had any really disturbing dreams or anything that messed with their heads.