A protocol and a schedule are different objects. The protocol is clinical (compound, dose, frequency, duration) and it is set with your healthcare professional. The schedule is logistical: where those doses actually land in a week that also contains work, travel, and Tuesdays.
People usually blame themselves when a schedule falls apart. More often the schedule was built in a way that was never going to survive.
Anchor to events, not to clock times
A 7:00am reminder competes with everything else at 7:00am and loses on the mornings that are unusual, which are exactly the mornings a reminder is needed. An anchor to an existing fixture typically holds up better, because the fixture is already load-bearing in the day.
- Alongside something that already happens without prompting: a morning coffee, brushing teeth, the same point in an evening routine.
- At a location rather than a time, where the fridge or the bathroom cabinet is the cue.
- On a day-of-week anchor for less frequent protocols, where "Sunday" is more memorable than "every 7 days".
Design for the awkward weeks
A schedule that only works on a standard week is not really a schedule. The weeks worth designing for are the ones that break the pattern:
| Situation | What tends to break | What tends to help |
|---|---|---|
| Travel | Time zones, storage, the routine anchor | A day-relative rather than clock-relative anchor; a plan for the vial |
| A change in work pattern | The fixture the dose was attached to | Re-anchoring deliberately rather than hoping |
| Illness | Everything | A protocol conversation, not a schedule adjustment |
| A vial running out | Continuity | Knowing the remaining count in advance, not on the day |
Know how much is left before it matters
Running out unexpectedly is one of the more common causes of an interrupted protocol, and it is entirely avoidable arithmetic. Vial strength divided by dose gives the number of doses; subtract what has been logged. A 5 mg vial against a 250 mcg dose holds 20, so a twice-weekly protocol has ten weeks in it, and the reorder point is knowable from day one rather than from the day the vial goes light.
Log at the moment, not at the end of the day
Retrospective logging degrades quickly. Within a few hours the detail is approximate; by the next day it is reconstruction. The value of a log is that it is a record rather than a recollection, and that property survives only if the entry happens at the point of the event.
This is a small thing that compounds. A log that is accurate is something that can be shown to a healthcare professional and reasoned about. A log that is roughly right is a set of impressions with dates attached.
Missed doses
What to do about a missed dose is a protocol question, and the answer differs by compound and by protocol. It belongs with your healthcare professional, ideally answered in advance rather than at 11pm on the night it happens.
What is a scheduling question is the record: noting that it was missed, and when. A gap in a log that is documented is information. A gap that is undocumented is indistinguishable from a logging lapse, and neither you nor your healthcare professional can tell them apart later.
What a workable schedule looks like
- 1Write the protocol down as given
Compound, dose, frequency, duration, review date, as set by your healthcare professional, in their terms.
- 2Pre-calculate the draw once
Vial strength, diluent volume, and the resulting unit figure. Done once at reconstitution, this never needs repeating for the life of the vial.
- 3Pick an anchor per dose
An existing fixture, not a clock time. One that exists on weekends too.
- 4Set the reminder to the anchor
The reminder is a backstop for the anchor, not a replacement for it.
- 5Log at the moment
Dose, date, time. Anything else is optional; these three are not.
- 6Know the reorder point
Doses per vial minus doses logged, checked before it is urgent.
