New update...

[Keezheekoni]

Thanks everyone, for your support in my other thread. :)

I went to see the ANRP yesterday. She basically told me that my best case scenario (after having a "team meeting" about me on Tuesday night) was that I'd get my pump sometime in the last week of October. That is, IF I comply with their conditions.

Condition 1: I check my bg hourly during the weekdays and every other hour on the weekends until my next appointment (on Sept. 12).

Condition 2: I keep my A1c below 7 at my next check (sometime in Oct.). The A1c they did on Tuesday was 6.9 (hey now, I'm impressed with myself...my last one done in June was 10.7!)

Condition 3: I meet with the dietitian again (Oct. 4th) and until then follow a pretty strict diet... (which I basically told her was near impossible, but that I'd try)

So, looking at those conditions, I almost think that I'm not going to get on it, since like I said condition 3 might be impossible...unless I want to start making three different sets of dinner for my family. I don't think so!

I've been doing condition 1 since Tuesday... condition 2, well if I keep giving myself the 12 injections a day, I guess that'll will be easy.

I'm still so frustrated. She told me that I was welcome to go to any other endo in the area and just get a pump from one of them, but that she didn't advise that since they are "the best" in the area... Yeah, okay... except my primary doc won't send me anywhere else. I told her that and she said, "All right! I love your doctor!" Grrr...

So, there's the update. I'm pissed, I'm in pain... I also can't have my surgery until the end of September, so I get to remain in pain, on percocet, for another 5 weeks!

[gettingby]

Wow Rikki. I'm sorry to hear that. It all just truly bites !!!!!!!!!!!!!!!!!!
I'm sorry that they want you to jump through all those hoops.

[JediSkipdogg]

I think your doc and their team is a bunch of idiots. There is truely no need for the hourly tests. That proves nothing about dedication and is not required on pumping at all. As for the condition two, that is actually one of the easiest ways to get rejected by insurance on a pump. Some insurance companies won't give a pump to a person with an A1C above 7. As for condition 3, why??????? I eat what I want on the pump, on MDI I stuck with smaller meals and was actually about 20 lbs underweight. Now I happen to be 20 lbs overweight, but that's another story, lol.

I still recommend a new doc if that is possible in any small way.

[Dewey]

What he said! I can't believe they're trying to pull all this on you, Rikki. I PMed you with that doc's name in Seattle. He's definitely worth checking into, and has a very vast knowledge base. He's also extremely compassionate. If a patient asks him for help, or anything (within reason, lol), he does what he can to get them what's needed & help ensure that they're healthy & happy.

I for one, don't like your current doc or health care team at all. As Jedi said, their conditions are the opposite (with the exception of testing & logging more) of what's usually required to get a pump. The doctor & cronie nurse I had (that I spoke about in the other thread) wanted to "fudge" my A1C to make it look even worse than it was, just so insurance would cover it. I also agree (with Jedi) that testing more doesn't prove anything in regards to dedication. Just what are they trying to do to you!? It's almost like they're trying to make you get under better control with MDIs so that they Don't have to put you on pump therapy....either that, or they have no da** clue what the heck they're doing...

And, lastly.....October!? After ALL the hoops You've jumped through, you deserve it far sooner than that!!! :mad:

[duck]

Wow, how did I miss that they wanted you to do hourly tests until mid September??? When my team made me do that, it was for ONE week.

[poodlebone]

Rikki,

Your doctors are pissing me off!! Since your primary care doctor will only send you to that one clinic, you should first dump your PCP and find a new one who will allow YOU to choose the endo/clinic that you'd like to go to. I forget if you already have a pump picked out, but if you do maybe you can call the pump company and ask them for an endo/clinic in your area.

It really sounds like they're on some power trip. Asking you to test every hour for a month is insane. Do you get enough strips to do that from your insurance?

[Keezheekoni]

Thanks everyone.

Dewey, I'm going to call the endo that you referred me to. The problem is that most of them seem to want a referral from my primary. If I quit my primary, it's school season, so *all* of the primary docs (adult and child) are booked until mid-late September anyway...so if he required the referral, it'll probably take me the month to see a new primary, on top of waiting to get an appointment with him... Which would be around the end of October anyway. I will call them tomorrow and see, though. Maybe if I plead my case enough, they'll take mercy on me. Did he seem like the type who would prescribe one to a new patient, or want to establish a "relationship" first?

Jedi, my insurance required *nothing* but the doctor saying that I need one. This is because in WA, we have an awesome mandate that *all* diabetes supplies, meds, DMI, etc. be covered. My insurance went a step further with this and if you have the diagnosis of T1 or T2, then they will cover it, no questions asked. On their website, it actually says that someone with an A1c of over 8 is considered a good candidate for a pump since they are "out of control". I'm starting to wonder if I'd be denied with anything below 8! LOL

Duck, yeah, hourly! I'm really perturbed about this. It's pissing me off. Their rationale for this? Oh, that's to see how the Humalog actually works in my system... You know, for that since they are "the premiere" hospital to go to in 3 states, why can't they put me on a CGMS for a week or two? Wouldn't that give them better results, especially if I do fingersticks on my "normal" schedule to confirm the CGMS results? Apparently they won't do that though...

Poodlebone, yes my insurance covers any number of strips as long as I make my $20 copay for them. I got my script upped to 500/month and it's just costing me the $20. If I didn't have prescription coverage, I think I'd have to file bankruptcy just to take care of my diabetes... ugh!

It also bothers me that I told them that the whole major reason I wanted to go onto a pump was because I wanted more flexibility in my life. I have 5 kids and on top of that "job", I volunteer A TON. I'm pretty much always out of the house and it's really inconvenient to be asked by a school principal or heck, one day by our Governor, to go out to lunch...and have to tell them, "Oh! I'd love to, but I don't have my insulin with me since I didn't think I'd be eating out today..." Who the **** is going to tell the Governor that you're declining their ever-so-wonderful lunch invitation?!? (I'm heavily involved in PTA legislative advocacy.) You'd think that maybe they'd be preparing me for what life will be like with the pump, not the other way around! I already know what a PITA it is to do MDI, with my lifestyle. I don't need HOURLY reminders, lemme tell ya!

[gettingby]

My CDE at my PCP's office told me today that she would allow me to choose whichever endo my insurance allows to go see. She mentioned the practice that I went to before (didn't care for the endo I saw) and said that if I wanted to go back there, she would write on the referral that I want to see the other one. She also mentioned one that is about an hour away that is female. She's covered by my insurance too.
The only problem I had with my talk with my CDE today is that she seems to be "gently" pushing one pump company in particular because she has knowledge and experience with their pumps so I may get info from them.
It's terrible the way your PCP's office is treating you. :mad:

[Infosec]

Rikki - That is crazy! Sorry to hear that they are asking you to do all that. I hope you are able to get with a better endo soon that is covered by your insurance!

[Shotokan]

In your situation, I would change my PCP. If you stay with this PCP, you will be forced to work with this idiot endo for who knows how long. And you still don't know what they would require of you if they do finally allow you to pump, but I'll bet that won't be pretty either. For me, it would be worth a little delay (even a few months) to hook up with a more supportive PCP--one who will refer you to the endo of your choice. After all, it's probably the rest of your life that you'll be dealing with some doctor or another for diabetes. It might as well be one that you like.

BTW, do you have to download your meter to show the hourly BG readings, or do you record them manually? If it's manual (and you continue with this nutcase of an endo), you could alternate between writing down real BG readings and fake BG readings (for the fake reading just use the average of the two adjacent real readings and add or subtract a little "error").

[Cyborg]

Sorry to hear about your continuted frustration. I suggest you somehow manage to deal with them and get the pump. It will be so nice to tell them to kiss yer arse afterwards... :reddy:

[Keezheekoni]

Shotokan, they download my meter at every visit. So, I can't "fudge" any test at all. It's not so bad checking every hour, however I just feel so "tied down" by it. I want the more freedom that a pump provides, and it seems to me that they want to see how willing I am to follow their program and make sure that I'm a good little 2 year-old before they give it to me...LOL

Cyborg, that's pretty much what I'm feeling right now! If I can't find someone who will see me before 2.5 months from now, then I will get the pump from them and then go somewhere else... :)

[Dewey]

Thanks everyone.

Dewey, I'm going to call the endo that you referred me to. The problem is that most of them seem to want a referral from my primary. If I quit my primary, it's school season, so *all* of the primary docs (adult and child) are booked until mid-late September anyway...so if he required the referral, it'll probably take me the month to see a new primary, on top of waiting to get an appointment with him... Which would be around the end of October anyway. I will call them tomorrow and see, though. Maybe if I plead my case enough, they'll take mercy on me. Did he seem like the type who would prescribe one to a new patient, or want to establish a "relationship" first?
Well, let's put it this way....I lived in Seattle for 3 months (from June 22nd of 05 to Sept. 23rd, 05) and in that time, went to an internist (across the way from the endo). Within a few days, I had an appt. with the endo. I think the only referral I got was from the internist (who couldn't help as it wasn't his specialty), but I got in right away. Though he may want to establish a little of a relationship, he's extremely knowledgeable about pump therapy & it took me maybe a week before he changed my insulin (he only wanted to see what I'd done thus far, in terms of blood sugars & such). It's worth a try, and you've nothing to lose by speaking with him. He's very nice, and if I lived there, he'd be the only one I'd see. :thumbsup:

For those who don't know what we're talking about, the Dr. I referred Rikki to is in Seattle, and is specialized in the following:

Diabetes
Insulin Pump Therapy
Insulin Resistance Syndrome
Hypoglycemia
PCOS
Hirsutism (abnormal hair growth)
Obesity
High Blood Pressure
High Cholesterol and Triglycerides
Graves' Disease
Goiter
Thyroid Hormone Replacement
Thyroid Cancer
Pituitary Disorders
Pituitary Tumors (medical)
Adrenal Disorders
Testosterone Insufficiency
Hormone Replacement Therapy
GID Hormone Replacement
Menstruation Disorders
Gynecomastia
Parathyroid Disorders
Osteoporosis
Paget's Disease

He has quite a bit of credentials & background knowledge, and above & beyond all, is a caring person.