Thank you! Still time to Give HOPE through Research!

FundaCureHuge thank you to everyone who have already donated to the Cystinosis Research Foundation to help Give HOPE through Research!

It means so much to me! I realize that it was during a weekday and that not everyone who wanted to attend was able. Therefore, there is still time to donate! Go here to: DONATE

If you also were interested in hearing other cystinosis patient’s stories please watch the youtube video below of Tina’s story.

If you were quite interested in what I was going to say in my little speech you can check that out right bellow!

599457_111877858954314_119659440_nMy name is Mika Covington; I’m 23 years old and hope to live 23 years more. I was diagnosed with cystinosis around age 10 months old. Cystinosis is a rare “orphan” disease that causes that amino acid cystine to accumulate in the cells. As the cystine accumulates in the cells, it slowly damages organs including the kidneys, liver, thyroid, eyes, muscles and brain. An orphan disease is a disease that has not been “adopted” by the pharmaceutical industry because it provides little financial incentive for the private sector to make and market new medications to treat or prevent it. Almost 7,000 rare or “orphan” diseases in the United States collectively affect nearly 30 million people. In the case of cystinosis, only 2,000 in the world are affected.

Cystinosis has been a struggle. It has been a challenge for me and those who are about me. Yes, I maybe a so-called survivor; however I’m living with it every day. When I was a kid, I was always seen as different. Every day, I went to the nurse’s office to take medications. Many days, I had bad breath and body order from the Cystagon, and I felt sick to my stomach that usually ended in me vomiting. Elementary and middle school were especially difficult for me because of this. Not to forget all of the doctor appointments and hospitalizations I had to go to which caused me to frequently miss school. Growing up with cystinosis is difficult and quite the journey.

Cystinosis has been difficult on my family, too. I cannot even comprehend how heartbreaking it must have been for them to get the news that cystinosis is an incurable disease. Then, to see me go through all of the hospital visits, side effects from the medications, and just daily life with cystinosis. However, I am proud because I am one of the only cystinosis patients to make it to 19 years old before needing a kidney transplant.

In 2010, my senior year in high school, I turned 19 and lost my health insurance. This happened because in Nebraska, you are an adult at age 19 and you must re-apply for Medicaid. I did just that and I was denied. I was told that I was not eligible for coverage for having a pre-existing condition (the cystinosis). I tried applying four times with the same results each time. With no avenue to appeal their decision, I decided to focus on graduating high school and going to college until my scheduled trip to the National Institutes of Health that fall. I went most of that year without any of my medications. this resulted in me going into end stage renal or kidney failure and it probably cut a few years off my life. I went from needing a kidney transplant in 2-4 years to needing one in six months to one year. If I would have had health insurance, I might have been able to wait until after college to get a kidney transplant.

International Day Against Homophobia and Transphobia Rally
International Day Against Homophobia and Transphobia Rally

When I graduated from high school, I knew I wanted to contribute to society in any way possible and work to create the change I seek. However, because of having cystinosis and going on dialysis, it forced me to stop working. To stay busy, I volunteer on issue and political campaigns, such as fighting for Full LGBT Equality, voting rights, and health care for all. I am passionate about these because I look forward to a future where everyone has the right to vote, has full and equal human rights, and access to high quality health care. For me, these causes are important because I know first-hand how not having access to health care can cause a chronic disease to get worse like my disease did.

I was on dialysis for almost three years. I began dialysis in May of 2011, when I was a patient at the University of Nebraska Medical Center (UNMC) being evaluated for kidney transplant. I first was on hemodialysis, a form of dialysis that is performed with a catheter placed in the chest that is used as an access to cycle large amounts of blood into a machine that cleans the blood and returns it to the body. Fortunately, I was only on this form of dialysis for nine months, until I switched to peritoneal dialysis.

I started peritoneal dialysis in March of 2012, because I was denied getting a kidney transplant at UNMC from my living donor and would need to be on dialysis much longer, in addition to hemodialysis not working out for me. I had many complications with hemodialysis and cystinosis. For example, cystinosis patients are not your typical kidney failure patients because we still need access to water and potassium. This is why our specialists recommend having the kidney transplant as soon as possible. Most health care professionals are not fully educated on cystinosis. Therefore, cystinosis patients like me must take it upon us to help educate our health care professionals.

 554643_454772334563780_354924217_aEven with the additional education sometimes, mistakes are made. While I was on hemodialysis, it caused me to continuously become dehydrated, have hypotension (low blood pressure) and tachycardia (fast heart rate). In addition, I had other complications like the catheter itself falling out of my chest and a couple of times where there were infections. By the end of the period of me being on hemodialysis, I had seven hemodialysis catheters placed in my upper right chest. I can show those afterwards. 

Peritoneal dialysis is performed using a catheter placed in your abdomen that cycles a dextrose mixture fluid into your peritoneal cavity that uses the wall of the cavity as a natural dialyzer that cleans your blood. Peritoneal dialysis was much better for me because I was able to better control how much fluid I take off my body and my health care was more in my own control. It also was done at home. This way I did not have to go to a dialysis center. It gave me more of my life back. I was on peritoneal dialysis until May 30, 2013, when I received the Gift of Life from my living donor. I had the kidney transplant at the wonderful University of Iowa Hospitals and Clinics (UIHC), in Iowa City. At UIHC, I received excellent care and compassionate treatment. I personally feel they are the best in the Midwest. 

Today, I am living with a new kidney, which I named Serenity after the ship on FireFly a scifi show, and doing wonderfully in aspects of my kidney health. The transplant team at UIHC was impressed with how well my body accepted the kidney and recovered from surgery. My creatinine level, which determines how well the kidney is doing, is 0.9. This number is awesome! You don’t always see transplant patients do this well at this point post-surgery! Even my incisions are healed so well you can hardly see them. I can show those to you afterwards too! I am now down to only having blood draws once every other month to check my levels and only need to visit UIHC once a year. 

Currently, I am not employed because even though my kidney issue is resolved for the moment. I still have cystinosis; remember it affects my entire body. Because of cystinosis, I have Fanconi Syndrome, where I constantly must fight the loss of water, important minerals, salts, and nutrients. I have issues with my eyes being extremely sensitive to sunlight and light in general. I also have some issues with my heart and frequent headaches. This all leads to a lot of stress and still feeling sick. 

I must point out, I don’t only have cystinosis. I have nephropathic or infantile cystinosis. There are three forms of cystinosis: nephropathic (infantile), late-onset (intermediate), and ocular (adult). The most common and severe form is nephropathic cystinosis. Patients with nephropathic cystinosis appear normal at birth. However, before one year of age have excessive thirst and urination, and failure to thrive. They are smaller than others are their age and often tend to be in the lowest percentile or even off the pediatric growth chart. There may be delays with walking and bearing weight. With late-onset cystinosis, kidney symptoms typically become apparent during adolescent years. With ocular cystinosis, cystine crystals are present in the eyes but kidney function remains normal. 

Fortunately, we have the drug cysteamine to slow the progression of cystinosis by removing the cystine from the cells. There are two forms of cysteamine Cystagon and Procysbi. The FDA approved Cystagon for the treatment of cystinosis in 1994. Cystagon must be taken every six hours, every day. I was on Cystagon during the trial and had been taking it for nearly 21 years of my life. It caused me to feel sick almost every day. 

Last year, the FDA approved Procysbi, a delayed-release capsule for the treatment of only nephropathic cystinosis in adults and children 6 years and older. I was lucky enough to start Procysbi about four months ago and I have nearly no side effects from the new form. There is only one medication to treat the corneal cystine crystal accumulation in patients with cystinosis, Cystaran. Cystaran must be used every hour while awake in order to remove the cystine crystals from the cornea. Patients who begin cysteamine treatment early enough, and are compliant in taking cysteamine as prescribed, generally delay the need for kidney transplantation for several years. 

250px-NIH_Clinical_Research_Center_aerialWe must find a cure. Thus, I am participating in a long-term clinical research study at the National Institutes of Health (NIH) in Bethesda, Maryland. In the study, I see Dr. William Gahl, one of the leading researchers in the world on cystinosis. Dr. Gahl’s study was one of the first studies of it’s kind on cystinosis. I currently see him for the specialized study of the progression of the disease in my body and to aid his research in the long-term effects of the disease, which I hope will assist in finding a cure. I began seeing Dr. Gahl when I was a baby, shortly after I was diagnosed with cystinosis. I spent several weeks at a time there. Basically, I grew up there from 1992 to 1996.

In addition, I have participated in several other studies, including at the University of California at San Diego Medical Center, where they studied the neurological and psychological effects of cystinosis. I was also a participant in the study at the NIH, which proved to the FDA that the eye drops work to reduce the cystine crystals on the corneas. 

Today, I am here raising funds to help find that cure for my terrible disease. The money raised here will go directly to the Cystinosis Research Foundation (CRF). CRF is a non-profit 501(c)3 organization that was started by the amazing Stack family in 2003, after Natalie Stack their daughter, made a wish on the eve of her twelfth birthday, “to have my disease go away forever.” CRF today supports bench and clinical research that is focused on developing improved treatments and a cure for cystinosis. 

CRF has funded every bench and clinical research study that lead to Procysbi, allowing cystinosis patients like me to take the drug every 12 hours instead of every 6 hours, which greatly improves our quality of life. They established the CRF Cystinosis Gene Therapy Consortium, whose mission is to bring stem cell therapy to clinical trial. The CRF is currently funding investigators in eleven countries. Some of the areas of focus include stem cell and gene therapy, effects of cystinosis on neurological function and cognitive development, causes of muscle-wasting and potential therapies, etc. 

Finding a cure may save my life, as well as others with cystinosis including my sister Mary, or even persons with other diseases. Knowledge discovered by studying one “orphan” disease often leads to advancements in other diseases. 

Can I count on you to join me?

Go here to donate online: Fund a Cure 4 Cystinosis 

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Help Fund a Cure for Mika’s Disease

599457_111877858954314_119659440_nMy name is Mika Covington and I live with Cystinosis. I am 23 years old and hope to live 23 more.  I was born with Cystinosis and diagnosed around age 10 months. Cystinosis is a rare metabolic disease that causes cells to crystallize causing early cell death. This happens because the amino acid cysteine accumulates in the cells, but has no transporter out. Cystinosis slowly destroys the organs in the body including the kidneys, liver, eyes, muscles, and brain. Cystinosis is a progressive disease. As I age, the disease affects my body further, inflicting damage to multiple organ systems. The medications I take only slow the progression of the disease but there is no cure. I have already been through the kidney failure, next up is thyroid insufficiency, calcifications on my brain, muscle wasting, and swallowing difficulties.

Cystinosis has always been a struggle for me and my friends, and my family. It of course continues to be a struggle. It has caused a lot of trauma not only to me but also to those who care about me. I cannot even comprehend how difficult it was for my family to get the news of my disease and how it will eventually take my life if we do not find a cure.

Post-Op Kidney Transplant
Post-Op Kidney Transplant

A year ago, I had a living donor kidney transplant at the University of Iowa Hospitals and Clinics (UIHC). At UIHC, I received excellent care and treatment. I personally feel they are the best in the Midwest. I was on dialysis for almost three years. I began dialysis in May of 2011, when I was a patient at the University of Nebraska Medical Center (UNMC). I first, was on hemodialysis, a form of dialysis that is usually performed with a catheter placed in the chest used as an access to cycle large amounts of blood into a machine that cleans the blood and returns it to the body. If you are on hemodialysis for a long-term period, a surgeon will create a port in your arm or leg called a fistula. However, I was only on this form of dialysis for nine month, until I switched to peritoneal dialysis.

IV meds post-op transplant. Not many compared to most transplant patients.
IV meds post-op transplant. Not many compared to most transplant patients.

I started peritoneal dialysis in March of 2012, because I was denied a kidney transplant at UNMC. Peritoneal dialysis is performed using a catheter placed in your abdomen that cycles a dextrose fluid into your peritoneal cavity that uses the wall of the cavity as a natural dialyzer that cleans your blood. I was on peritoneal dialysis until May of 2013, when I received the kidney.

Today, I am living with a new kidney and doing wonderfully in aspects of my renal (kidney) health. The transplant team at the UIHC was impressed with how well my body accepted the kidney and recovered from surgery. My creatinine level, which determines how well the kidney is doing, is 0.9. This number is awesome. You do not always see transplant patients do that well after transplant. My incisions are completely healed. I am down to only having blood draws once a month and only needing to visit UIHC once a year.

Me in Pre-op with Diane and family
Me in Pre-op with Diane and family

In 2010, my senior year in High School, I turned 19 and lost my health insurance. This happened because in Nebraska, you are an adult at age 19 and you must re-apply for Medicaid. I did just that and was denied. I was told that I was not eligible for coverage for having a pre-existing condition. I tried applying four times with the same results each time. However, I was still in High School, therefore I stopped trying and instead focused on graduating High School. I went most of that year without any of my medications. It is a fact that because of this, it cut a couple of years off my life and made me go into renal failure more quickly. I went from needing a kidney transplant in 3 – 5 years to needing one in six months to a year. If I would have had health insurance, coverage I would have been able to wait until after college to get a kidney transplant.

Healthcare event in Council Bluffs, Iowa.
Healthcare event in Council Bluffs, Iowa.

Since I graduated from High School, I have wished to contribute to society in any way possible and work to create the change I seek. However, because of having Cystinosis and going on dialysis forced me to stop working. To stay busy I volunteered on issue and political campaigns such as fighting for Full LGBT Equality, voting rights, and health care for all. I am passionate about these because I look forward to a future where everyone has the right to vote, has full and equal human rights, and access to high quality health care. For me, these causes are important because I know first-hand how not having access to health care can cause chronic diseases to get worse like my disease did.

International Day Against Homophobia and Transphobia Rally
International Day Against Homophobia and Transphobia Rally

I am currently not employed because even though my kidney issue is resolved for the moment. I still have Cystinosis. Remember it affects my entire body. Because of Cystinosis, I have Fanconi Syndrome, where molecules that should be reabsorbed into the blood stream are instead eliminated in the urine. This leads to the loss of important minerals, salts, fluids, and many nutrients. I also have issues with my eyes being extremely sensitive to sunlight and light in general. I have some issues with my heart and starting to have some neurological issues and frequent headaches. This all leads to a lot of stress and feeling sick. Not to forget, during my time on dialysis, I gained a lot of weight, which in of itself is causing problems.

National Institutes of Health (NIH)
National Institutes of Health (NIH)

I am participating in long-term clinical research study at the National Institutes of Health (NIH) in Bethesda, Maryland. I see Dr. William Gahl, one of the leading researchers in the world on Cystinosis. Dr. Gahl’s study was one of the first studies of its kind on Cystinosis. I currently see him for specialized study of the progression of Cystinosis in my body and to aid his research into the long-term effects of the disease. I first saw Dr. Gahl in 1992 shortly after I was diagnosed with Cystinosis. Since then I have participated in several studies elsewhere including at the University of California at San Diego Medical Center (UCSDMC) where they studied the psychological and neurological effects of Cystinosis.

There has been a lot of progress in treatment and management of Cystinosis. For instance, I take Procysbi instead of Cystagon. When I took Cystagon, I had to take 13 capsules four times a day and the medication made me sick. With Procysbi, I only take five capsules two times a day with nearly no side effects. There has also been progress made in studies using stem cells, which could cure Cystinosis. Therefore, there really is hope.

I am raising funds to help find that cure for my terrible disease. I hope you all will join me in this effort. Finding a cure not only will save my life but will save my little sister’s life and many more. Can I count on you all to join me?

You can donate by visiting www.gofundme.com/9ibcmo or click here: Fund a Cure

*Funds will go directly to the Cystinosis Research Foundation (501(c)3 non-profit) that has no paid staff and sending all funds to cystinosis research. 

Mika’s Cystinosis

SAMSUNGAt age ten months, I became very ill and was rushed into the emergency room (ER). The doctors diagnosed me with dehydration and failure to thrive. In the following months, I went through many tests including bone marrow taken from my hip. The doctors concluded from these tests that I had Nephropathic Cystinosis. This was a very scary moment for my family, they had no idea what Cystinosis was.

Dr. Gahl at NIH
Dr. Gahl at NIH

I owe my life to Dr. William Gahl from the National Institutes of Health (NIH). I began seeing him in 1992. Dr. Gahl shortly before meeting me he discovered that Cystagon and some other medications are successful in treating Cystinosis. I started the Cystagon treatment in 1992, during my first visit to the NIH. It is because of his research and those medication that I am still living. The first group of doctors, I saw at the University of Nebraska Medical Center were useless, they told my parents that they did not believe I would live to be six years old because they didn’t wish to go out of their way to really figure out what was wrong with me. Nevertheless, they were right, if I would not have started the Cystagon I would have died.

Cystinosis has become part of my life. Cystinosis had done many great things for me. I look at Cystinosis as some sort of tool. I have been able to educate myself on many things that most people do not understand because of this illness. I understand most if not all of what many of my medications do and how they work. I understand what Cystinosis does and what Cystinosis is; I know the many different functions of the body especially the kidneys and what levels should be. I am able to travel to many different places. For instance, I go to the NIH once every other year, which is located in Bethesda, Maryland just outside of Washington, D.C. It has given me the opportunity to travel to California where I took part in a psychology study in San Diego. Cystinosis has also made me become more mature then many people my age and thus, I look at the world much differently.

250px-NIH_Clinical_Research_Center_aerialNonetheless, there are many negative aspects of living with Cystinosis, such as I have been to so many hospitals that I have lost count of them. The hands of so many medical professionals have touched me, which has led to me trying to tell them what to do, when they draw blood and start IVs. I have had so many different scans and X-rays that now, I have been exposed to more radiation then an average Iowan. I also take many different medication, which have many different side effects. Some of those side effects including vomiting, diarrhea, headaches, and bad breathe. Thus, the medications are another negative aspect of Cystinosis. But, I guess the most negative aspect of living with Cystinosis is that it will eventually kill me. 

Today, living with Cystinosis is much easier because I finally after 3 years of waiting and the first transplant center refusing to do the transplant after scheduling it twice in the same year, I got my kidney transplant. I am doing much better and continue to improve. I owe that to the University of  Iowa Hospitals and Clinics and Dr. Reed who did my kidney transplant. Oh and I guess Jon the donor. But, he didn’t have a huge roll in it, he only had to lay on a table and give up his kidney. Thanks Jon!

The following are graphs of my blood levels post kidney transplant. 

Creatininelevels

Potassiumlevels

Hemoglobinlevels

BUNlevels

WBClevels

PlateletCountlevels

 

Six Month Post Kidney Transplant UPDATE

Me in Pre-op with Diane and family
Me in Pre-op with Diane and family

Yesterday, December 4, 2013, I went to the University of Iowa Hospitals and Clinics (UIHC) for my six month post kidney transplant check up. Kidney-wise, I am doing great!

The following are my most recent labs:

  • Sirolimus level – 11.7
  • BUN – 8
  • Creatinine – 0.9
  • Potassium – 3.7
  • Hemoglobin – 13.9
  • WBC – 5.2
  • Platelet Count – 233
  • CO2 – 25

These lab results indicate that I am doing great.

US-News-rankings-2013My UIHC transplant team has decided that I can stop taking sulfamethoxazole-trimethoprim (Bactrim) which I use to take every Monday, Wednesday, and Friday. Bactrim is an anti-bacterial drug. In addition, the UIHC transplant team decided that I do not need to have labs every week. Thus, I will have labs once every two weeks until February when I start having labs once a month. This means that I get to have much more freedom. I can travel and stay away from home for longer periods of time and now I have less medications to take. Finally, my next visit to UIHC will be in June of next year at my one year anniversary of the kidney transplant or as I like to call it kidney adoption day.

970200_581143018593377_1471588441_nMy new medication list only includes these:

  • Cysteamine Bitartrate: 50mg cap, 11 caps 4x daily
  • Levocarnitine: 100mg/ml solution, 2ml 4x dayily
  • Mycophenolate Mofetil: 500mg tab, 1 tab 2x daily
  • Cysteamine HCI BAC: Eye solution 1 drop each eye every hour while awake
  • Sirolimus: 1mg tab, 4 tabs 1x daily
  • Prednisone: 5mg tab 1 tab 1x daily
  • Sodium & Potassium Phosphates: 250mg tab 1 tab 2x daily
  • Docustate: 100mg cap 1 cap 3x daily as needed
  • Sennosides: 8.6mg tab 1 tab 2x daily as needed
  • Sertraline: 50mg tab 1 tab 1x daily
  • Ondansetron: 4mg tab 1 tab every 8 hours as needed
  • Acetaminophen: 325mg tab 2 tabs every 6 hours as needed
  • Sumatriptan: 100mg tab 1 tab as needed

Nevertheless, I also ended up getting very sick yesterday with acute nausea, vomiting, and diarrhea, blood pressure 147/103 with a pulse of 109 and temperature of 98.9. Thus, I went to the emergency room (ER) at Alegent Mercy Hospital in Council Bluffs, Iowa. At the ER they started IV fluids and gave me zofran. They then performed serveral tests including urinalysis & culture, CBC with differential, comprehensive metabolic panel, fecal hemoccult, abdomen complete 2v, culture stool, fecal WBC, and giardia/cyrpto screen. The medial team there diagnosed me with a gastrointestinal infection and put me on the following medications ciprofloxacin 500mg tablet and prochlorperazine 10mg tablet. This is in addition, to the acute sinusitis I was diagnosed with on Tuesday which my primary care physician prescribed me cefdinir 300mg capsule.

Overall, I am doing pretty well for a post kidney transplant cystinotic (cystinosis) patient of 22 years old. My kidney function is awesome and I am gaining back all of my strength. The kidney is saving my life. My current vitals include temperature 97.6, blood pressure 126/86, pulse 102, and wight 102.8. thus, I am doing good. But, my friend Paige is not. 

Image from Help Find Paige a Kidney Facebook Page.
Image from Help Find Paige a Kidney Facebook Page.

Paige Orlinski needs a kidney to survive, she is only 12 years old. If you are willing to be tested to see if you are a match for Paige, please contact the transplant team at Egleston in Atlanta, Georgia by calling (404) 785-1405 and ask for Debbie. Tell them you wish to donate your kidney to Paige Orlinski. For more information on Paige and kidney donation please visit my post on Paige, “Save Paige’s Life and Get Tested.”

 

Medical and Life Update

SAMSUNGToday, my lab results came in from the Alegent Creighton Clinic on West Broadway where I see a new physician who is just amazing! The results are just awesome! I am doing very well for a post-kidney transplant Cystinosis patient.

Medically, I am doing good. I gained weight so I am working on loosing that. I keep having headaches but mostly I am doing good. Although, as a Cystinosis patient I must watch my Thyroid and other systems since the Cystinosis affects the entire body. I am doing more walking again. I was additionally more depressed so I think that effected my weight a bit too.

My life update, I just went to my grandmother’s today, and I plan to stay here for a couple days. I plan to help her out with some house work and just visiting with her since most of the family don’t spend any time with her. I am going on a break from most of my political organizing for the rest of the year. I am doing this because I am trying to financially (I live on Disability) save more of my money instead of spending it out travel expenses for the LB380 (Second Parent Adoption) campaign. In addition, I need to spend more time focusing on myself. I need to figure a lot of stuff out and work with my medical insurance to cover the new form of Cystagon and get my insurance to pay for the eye drops that were just approved by the FDA. I need to prepare for the next chapter of my life. The next chapter of my life, should include going back to college. I need to finish my degree in Psychology and Political Science so I can get a job at the University of Iowa Hospitals and Clinics and hopefully work in the transplant department. My goal is to move to Iowa City and go to the University of Iowa for my masters degree in Psychology and Political Science. I also hope to help out on political campaigns while in Iowa City.

US-News-rankings-2013Here are those results:

  • WBC (White Blood Cell): 6.7
  • RBC (Red Blood Cell): 4.98
  • Hemoglobin: 13.9
  • Hematocrit: 43.3
  • Platelet Count: 219
  • Neutrophils: 72
  • Lymphs%: 18
  • Monocytes%: 7
  • Eosinophils%: 3
  • Basophils%: 1
  • TSH: 1.560
  • Glucose: 92
  • BUN: 8
  • Creatinine: 1.0
  • Sodium: 138
  • Potassium: 4.1
  • Chloride: 103
  • Calcium: 9.5
  • Protein: 7.9
  • Albumin: 4.3
  • Alkaline Phosphatase: 111

Clarification: All those results are great.

Now, here is all the medications I am on including Vitamins and Sinus spray:

  1. 970200_581143018593377_1471588441_nCystagon (LTD DIST) 50 mg cap. 11 caps 4x daily
  2. Mycophenolate 500 mg tab. 1 tab 2x daily
  3. Rapamune 1 mg tab. 4 tabs 1x daily
  4. Prednisone 5 mg tab. 1 tab 1x daily
  5. Phospha 250 Neutral tab. 1 tab 2x daily
  6. Levocarnitine 10% oral solution. 2 ml 4x daily
  7. Cysteaminine Ey Drops. 1 drop each eye every hour while awake
  8. Sulfamethoxale – TMP SS tab. 1 tab every monday, wednesday, friday
  9. Ondansetron HCL 4 mg tab. 1 tab every 8 hours as needed
  10. Sertraline HCL 50 mg tab. 1 tab 1x daily
  11. Sumatriptan SUCC 100 mg tab. 1 tab as needed
  12. Clindamycin 300 mg cap. 4 caps 1 hour before dental appointment
  13. Docusate Sodium 100 mg tab. 1 tab 3x daily as needed
  14. Sennosides 8.6 mg tab. 1 tab 2x daily as needed
  15. Vitamin D 2000iu ta. 1 tab 1x daily
  16. Magnesium 500 mg tab. 1 tab 2x daily
  17. MutiVites Vitamin Gummies. 2 gummies 1x daily
  18. Acetaminophen 325 mg tab. 2 tabs every 6 hours as needed
  19. ProAir HFA 90 mcg inhaler. 2 puffs every 6 hours as needed
  20. Oxymetazoline HCI 0.05% Mist. 2 sprays each nostril every 12 hours as needed