Wednesday, August 27, 2008

New Insulin and Non-Swimming Phones

The trouble with "starting" a blog at a set point in time (what, a little over a week ago?!) is that one sometimes feels compelled to share Prior History when a particular rant is posted.

And on the off-chance that I do have some followers "lurking" (As near as I can tell, I have none!), well, some posts might seem a bit weird - given the lack of context.

Ahhh well - such is the case with Today's Story. And today's story is actually a Copy/Paste of an email to an ePal - who *does* know at least some of the "history."

In any event - on the REMOTE chance that maybe there are some "interested lurkers" out there - I'll go ahead and post a bit of "history!"

I am diabetic.

This was diagnosed in late-December of 2007 (between Christmas and New Years - Party on, right?!). And it really is a "recent event" given that I was experiencing Extreme Challenges with losing weight - and that compelled me to buy a Blood Glucose Meter in July 2007 (Primarily b/c my grandmother was- and mom is diabetic - and I figured I was running a pretty "high risk"). My readings, at that time, were "normal."

I also have a LOOOOOONNNNNGGGG history of A) Not getting sick and/or B) On the rare occasion that I *did* get sick, it was generally something REALLY serious, rare and EXTREMELY bizarre.

I don't waste my time with "Garden Variety Illnesses" - Ohhh Nooo! And my Diabetes has proven to be no exception. I am *EXTREMELY* insulin-resistant (this was recently confirmed by an Assistant Professor at Stanford's Endocrinology Clinic). Okay, I'm probably not THE most IR (Insulin Resistant) Diabetic in the world, but I'm definitely "up there."

And I've experienced many, many, many "challenges" with pharmacies AND insurance companies - trying to obtain the appropriate levels of medication.

I'll leave it at that, for now - lest I launch myself into a diatribe...

Well, as of my last Stanford Appt, I was taking roughly 300 units of insulin per day - three different types. I was actually seeing some significant improvement in my BG (Blood Glucose) levels, but there were some caveats: 1) When taking NPH (which has a 6 hr "Activity Curve"), I was having to wake up at 3:30am to take add'l insulin and 2) One of insulin's properties (the ONE property that seems to be working EXTREMELY well - for me, anyway!) is it's ability to convert damn-near-anything into STORED FAT! And the more fat you're carrying, the more insulin-resistant you become. Then you need MORE insulin, which stores MORE fat, which requires MORE insulin... Do you see where I'm going with this?

So, recently, the Stanford Endocrinologist has decided it's time to take a different approach. We're stopping the NPH (6 hrs) and Levemir (24 hours - Basal Insulin) and switching over to Humulin R U500 - which is FIVE TIMES the potency of "regular" insulin (So instead of taking 15-20 injections/day, maybe I can drop back to maybe 6-7!).

I'm still on Novolog (1.5 hrs - Bolus / Mealtime insulin) - I dose that "to my BG numbers" (rather than "covering meals" - which is normal. "Normal" diabetics figure out how many carbohydrates they'll consume, and dose enough insulin to "cover" the BG rise for x number of carbohydrates. I don't eat carbohydrates [okay, very "minimal" carbs], so that doesn't work for me).

See? It gets long-winded when I have to add "background info!"

Okay, that said, let's turn to Today's Story!

* * * * *
"Big Switch is Tomorrow!"

Once again, I had a simply Grand Time with the Pharmacy - trying to get my insulin prescription filled!

To be fair, this is the U500 stuff (5x as strong) and I'm sure that's not a "normal" request. And since I have to jump thru hoops for "normal" insulin refills, I wasn't the least bit surprised about experiencing delays with filling the new stuff.

What *does* kill me though, is the fact that when there are problems, they don't bother to communicate that. Or if they do, it's really "vague." In this case, I got an automated voicemail saying my Rx wouldn't be ready. I called to inquire. The first issue was that they had to order it. OK.

Then I got another automated yaya call saying my prescription *was* ready. Now, I filled a whole bunch of stuff at once (have to get in the "last" of my refills before Roger's old insurance runs out). So I go and pick it up. Three BIG bags of drugs (Gawd - have I mentioned, lately, how much I *LOVE* getting old?!! Jeeee-zus!)

Anyway, I get home and open all the packages. I got everything except the Humulin. "Lovely!"

Now this is, like, 10:30 at night, and I gotta call the pharmacy (open 24 hours, thankfully) to find out what's going on... Well, they had been trying to reach the doctor b/c they thought the prescription was wrong - and something about the syringes for U500 being different (Yes, I know that), and "We don't carry them and can't order them."

Well, doc had already explained all that to me and she'd already converted the U500 dose in such a way that I *could* use regular syringes (knowing that the "other kind" of syringes were next-to-impossible to get). So I repeated that story to the pharmacist and assured him it was correct. And "Can I please come pick-up my insulin?"

"Yes, give me an hour to complete the prescription."

So I head back at quarter-to-midnight and pick it up b/c I *don't* want to wait 'til the "next shift" starts and run the risk of going through all of this AGAIN!

Yes, I understand the pharmacist's concern. And yes, it was a valid one (And yes, I do appreciate the concern!). But it *did* have a valid explanation as well - one that I would have gladly shared, given the opportunity.

(And please don't tell me I should have explained this to the Pharmacy-Tech - at the time I dropped off the prescription! "BTDT" Anything "Outside the Box" is completely lost on them, and any attempt at "proactively addressing potential issues" is beyond their comprehension - I'm sorry to say!)

(Gawd help me! I'm turning into an Old Fuddy-Duddy, but I "remember the days" when pharmacies were small, privately-owned stores and the pharmacist actually KNEW you... Of course, I also remember when gasoline was $0.45/gallon and you could pull up to the pump and say "Fillerup with Ethyl" and 6 people would rush out to fill the tank, clean ALL the windows and check the tire pressure and ALL the fluids under the hood! Yes, kiddies, it's TRUE!!!) (And I SWEAR it wasn't THAT long ago, was it?!!)

Oops - I digress!

I think the thing that irks me (aside from the fact that eight-times-out-of-ten I go through SOME kinda B.S. trying to get insulin!!!), is the fact that they don't bother to SPEAK TO ME.

If one gets a "Your prescriptions are ready for pick-up" message, one might NATURALLY assume that that means "The prescriptions are ready for pick-up!"

I know... I know... I'm being unreasonable again!

Anyway - b/c of the timing of everything, and Roger going out of town, and the doc putting the fear of [insert deity-of-choice here] into me over possible hypoglycemic reactions. Annnnnd the general anxiety over making the switch ("I know I'm gonna feel like sh*t"), it kinda pushed off my "implementation schedule."

Sooooo... Roger's coming home tonight. My last shots of Levemir (24 hours) and NPH (6 hours) were @ 9:20, last night. I'm going "Cold Turkey" tonight, and I'll start the new regimen tomorrow morning...

It doesn't help much that my BG has been "All over the board" for the last day or two. Sunday we had neighbors over for a BBQ and I "ate like a normal person" (including - GASP! - 3 bites of carrot cake!) And yesterday the boss took us out for Ice Cream. I'd downloaded the Nutritional Info from the store's website before we left and I chose the "lowest carb" flavor I could find - and it wasn't very low-carb!!!

But it could be worse, I s'pose...Actually, overall, I'm doing pretty "okay" - just feeling sluggish and verrrrrry apprehensive about the insulin switch. I'm expecting it to suck, short-term. But long-term I believe it will be worth it...

And yes, there's the "End of Summer Malaise" that always kicks-in this time of year. I need to get out here and take some pictures of the yard while everything is still "thriving" (Definitely got the Jungle Vibe Kickin'!)

Actually, I think this week really is summer's "Last Hurrah" here. Temps were in the upper 90's today ("It's a DRY heat!") and I managed to knock-off work @ 3:00pm and swim a few laps in the pool. So that helped my attitude immensely!

Up until the point that I dropped my cell-phone in the pool!!!! I wish it had been one of those "Slow-Motion" events ('cuz then maybe I could've dove-in and saved it!). Ohhhh no! RAZRs sink *very* quickly! And naturally it was at the deep end of the pool!!!

Funny part was, I was talking to my Joysey Colleague/Friend at the time. We keep each other company when we perform mundane chores (in this case, I was cleaning the crap out of the skimmer basket of the pool). All she heard was "OHH-SH" then the phone went dead!

I have since retrieved it and, at the Verizon CSR's suggestion, I've put the phone and battery in separate ziploc baggies full of rice. "Maybe that will dry it out and maybe it will work. I see that you didn't sign up for the $4.95/mo Replacement Insurance on your phone..."

Actually, the Verizon Girl was quite helpful and nice. I mean, I'm the idiot who had the phone in a case that's notorious for spinning upside-down and spitting the phone out - WHILE I was crouched at the deep-end of the pool. How dumb was THAT?!

Well, worst-case scenario, I extend my contract and they offer me an "Upgrade" phone for $20.00 ("B-B-But! What about my Jimmy Buffett RINGTONES?!!")

(Or worse, my Jimmy Buffett Concert Pics!!! Those're on the phone - excuse me WERE - on the phone, as well)

(Yeah, I've got screwed-up priorities, I know! ;-)


Anyhooooo... Wish me luck with 'The Big Switch' tomorrow!

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