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Thursday, March 17, 2011

"Please, sir, I want some more."

The past day has been a whirlwind for me with my endo and getting a new test strips prescription.  It actually all started on Sunday when I went by the pharmacy to pick up a new refill for all things diabetes:  insulin, syringes, strips, and glucagon.  The cashier hands me my bag o' diabetes and I double check the strips amount because a lack in communication has occurred before.  I peek in the bag and notice that I'm short 50 strips.  I asked the pharmacist why I only had 150 strips when my prescription was written for 200x/month.  Turns out my endo wrote in parentheses after 200x, "test 5x/day".  So my insurance company interpreted that to mean only 150x/month. 

I figured this was a simple glitch on my endo's part.  So I called his office first thing on Monday morning to ask the Rx to be rewritten.  I leave a message on the nurse's voicemail, "Hello, this is Holly, birthday eleven twenty-nine nineteen eighty-four, pharmacy is 'such-and-such' Pharmacy on 'blankity-blank' road, and I need Dr. Special (not his real name, but he has a 'special' sense of humor) to rewrite my prescription for strips from 5x/day to 6x/day.  Thank you!"  Well, the little voicemail message said to allow 48 hours for prescription requests.  So I (not-so) patiently waited until Wednesday afternoon to call my pharmacy to see if the prescription had been changed.  "Yeah, I don't see anything from your doctor," the pharmacist said.  So I braced myself for calling my endo's office . . . again.

This time I refused to be sent to a mailbox, so I optioned for the receptionist to get a live person.  "Hi, this is Holly, I'm a patient of Dr. Special, and I called on Monday to have him change my prescription for strips from 5x/day to 6x/day and that hasn't been done yet?" I inquired as if asking, "And why hasn't this been done yet?"  I get put on hold for a few minutes and the receptionist comes back and says . . .

"Well, his nurse said that 5x/day should be enough since you're wearing a monitor and only need to test 3x/day."  

I stumbled for words before I finally said, "Uhhh yeah, that's not going to work for me.  I want to have 6x/day."  Nevermind the fact that CGMs are not meant to replace finger stick tests, what made me mad is that I told my endo at my last appointment that I wanted 200/month and he didn't even blink!  I really didn't appreciate that he was changing my prescription without talking to me first.  Well the little receptionist said, "We'll need to talk to the doctor about this.  We'll call you back."  Yeah, OK.  This was about 2 PM yesterday, and I never heard back. 

I was steaming after that phone call!  Forget about lowering my blood pressure!  Every vein in my body was pulsing with rage, frustration, and sadness.  Three times a day?!  Sometimes I test that many times before breakfast!  I mean I love Constance and all, but she is not accurate enough for me to rely on her 100% of the time.  The fact that my endo would suggest this meant to me that he is ignorant of the purpose of CGMs and was abusing their purpose.  However, this information was being relayed 2nd-hand through his nurse and receptionist.  I could only HOPE this was a huge error in communication.  

I called again today after lunch (giving them plenty of time to call me back) to see if I was about to make the decision to change endocrinologists.  I get the receptionist on the phone and she said, "Yes, a new prescription for test strips was sent to your pharmacy for 6x/day, 200x/month."  "OK, thank you."  So I have my strips, for now.  But I hope at my next appointment in June that my endo doesn't allude to me needing to test less because I wear a CGM.  It's an extra tool, not a replacement.  It would be like trying to use a screwdriver as a hammer, it just doesn't work the same way.  But I should trust my endo to know that! 

As much as this infuriates me, the last thing I want to do is change endocrinologists.  The next closest options for me are another office 45 minutes away or a university hospital 2 hours away!  I know my endo is not the best endo I could possibly have, but he's honestly all I've got.  And I really don't want to go through the process of changing doctors at this time in my life (see also:  planning for pregnancy).  But right now I feel like Oliver in the orphanage asking for more gruel.  I feel like I'm being punished and put through the mill for wanting to take better care of myself than what 3x/day would result. 

"Yeah, I'm gonna need to see a copy of your insurance card first.  Mmmmkay?"

7 comments:

  1. This just happened to me! It wasn't for test strips, it was for insulin. My normal prescription is for 9 vials/ 3 months. My endo's physician's assistant decided to recalculate my need and changed my prescription to 4 vials!!! He only calculated the need for bolus and forgot to include the basals.... very embarrassing for the endo doctor!!!

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  2. You hit the nail on the head. CGM does not mean less testing. In fact, I test more with my CGM than I do without it, which results in tighter BG control. Don't be afraid to drive further to get what you need. I had an endo 95 miles away from home for years, and it was the right decision, because I'm still here. I look forward to hearing what Dr. Special says at your next appointment!

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  3. My testing went down....barely. From 12 times a day to around 6-8. You still have to double check every action taken w/ a finger stick. Says so in the manual for mini med cgm. See if dex has that. And then show it to the doc. :)

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  4. You're right about CGMS not replacing fingersticks; in fact you need to calibrate those with fingersticks. But aside from that, the quantity is only marginally different & you doc really has no financial impact either way, so why limit the quantity by specifying a number of times/day?

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  5. I'm glad I'm not the only CGM user who sometimes tests 3x before breakfast!!! When I was first diagnosed, I was only allowed 100 strips/mo per my quack-ass primary. Who told once said, in response to a plea for more strips because I was exercising almost daily, "You should only test before you take insulin, do you take insulin before you exercise, you shouldn't, so you don't need to test then and don't need more strips." I responded with "Can you refer me to an endocrinologist??" At least that was a primary who espoused such drivel. If it was an endo...eek!

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  6. i had a similar issue last time i ordered some test strips - well sort of...

    i put in my prescription for 10 boxes of 50, only when i went to pick them up there were only 3! why i ask? well, the doctor has changed your prescription down to 3 boxes at a time....!?! does he know how many times i check my bg?

    so, i think a stern-ish word is in order to my GP (although given i'm in the uk, and it's on the nhs, it's a little different...)

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  7. read your post and have to tell you that some receptionists and nurses get off on making it difficult for people - I have encountered this. do not play into the game going on in that office; document all communication then periodically email it to the endo

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DISCLAIMER: I am not a doctor, nurse, certified diabetes educator (CDE) or any medical professional of any kind. (But I did stay at a Holiday Inn Express!) Therefore, please do not use any of my postings as medical fact. I am simply a blogger expressing my highs and lows (pun intended) with diabetes. For changes in your medication, exercise regiment, or diet please consult a qualified physician.

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My name is Holly and I live in north Alabama with my hubby, two cats, and a dog.