Doc Visit

[JediSurfer]

Well I have just wasted another half hour of my life talking to a doctor. Went to get signed back to work and change my insulin pen type.

What a waste of time. He told me to seek the advice of a diabetic specialist nurse. So now I am stuck at home for another 2 weeks and not a happy person at all.

He also said that using an insulin pen which only has increments of 2 unit. should not be a problem for me and that its my understanding of insulin treatment which is at fault. And refused to give me insulins in vials with syringes. He made me fee like all this is my fault.

I just wanna go back to work and feel truly fed up.

[gettingby]

Sorry to hear that Rich ! :(
That stinks !!!!!!! :mad:

[notme]

Hey Rich...... know what time it is????


Time to find a new doctor. Sorry about your trouble.

[Scratch]

Stupid doctor. Ask him if a working pancreas can only dose in 2 unit increments.

[Scratch]

Stupid doctor. Ask him if a working pancreas can only dose in 2 unit increments.
If he answers yes, then his understanding of how the human body works is flawed. If that is so, then he is either a twit or a stubborn git and not a doctor worth seeing. If England's NHS has a way for you to lodge a complaint, I'd suggest doing so.

If he answers no, then ask him to consider again if he should write you a script for a pen that will dose in finer increments so you can more successfully emulate the human endocrine system.

[JediSurfer]

I sorta said that too him in not so many words and then he reccomended I see a D nurse. Idiot.

Think I'm gonna find me a different doctors surgery.

[JediSurfer]

Did have some good news this afternoon . Spoke to one of the managers at work whom had talked with the GM about me going back part-time and he said it wouldn't be a problem. Yay.
Every cloud.....

[lisa821]

Let's all form a posse. Any time some idiot who claims to be a doctor says something like what this person said to you, we will all meet up and go over there and kick his a**.

That includes insurance companies, too. :evil:

[2high]

Let's all form a posse. Any time some idiot who claims to be a doctor says something like what this person said to you, we will all meet up and go over there and kick his a**.

That includes insurance companies, too. :evil:

Lisa.. I bow before you and kiss your feet

[JediSurfer]

Lisa, you are our posse leader.

[lisa821]

2691

Need I say more...

[HollyB]

Do you need an RX to buy insulin pens? I mean to get them covered yes, but if you can just go to a pharmacy, cough up the money and buy what you want, then if you don't get anywhere with your doc/nurse that might be the way to go.

Two-unit increments would be WAY too much for Aaron. I'm still wishing we could program an insulin to carb ratio of 1 to 5.5 as 5 is too much for breakfast and 6 too little...

[JediSurfer]

I think I will have to wait til my annual rewiew at the hospital next month. The pharmacist was very helpful and looked the SoloStar pens up for me but couldn't find it on the computer. She told me that if I get anymore info they will change the prescription for me with the docs office.


Lisa that pic is awesome.

[Gary_W]

Sorry to hear you've had problems like this.

A good GP is one who knows his limits. You cannot possibly know about every single bit of the body to the extent that is required to refuse 1 unit insulin pens with a comment like that. I personally wish that my 1 unit pen would do half units, as (if I'm running a bg of 9.0) I would like to be able to whack in the exact amount to get me to a 5.0 rather than have to settle for either a 6 or a 4.

If you have similar ratios to me (and a lot of other folks) then 2 u will drop you around 4.0 (around 76 US speak). This is why I went away from Apidra in the disposable pens as if I checked my BG and was a 7.9 then there is absolutely nothing I could do about it in insulin terms without risking hypo. That is unacceptable. As 7.5 consistantly puts you above the recommended level you should run at, he is risking your long term health just so as he can talk out of his rear end. See how he likes being an 8 and unable to treat it safely.... Unbelievable.

I'm fortunate with my GP; he is very human and freely admits that I know more about the subject than he does. As such, if I ask him for anything with a brief explanation of why I need to do it that way he just does it. He sees the bigger picture and realises that he rarely sees me for anything else due to the fact that his progressive ideas help me to keep myself out of his office!

Changing doctors takes time, but is needed long-term for you. Your current guy is acting like the village idiot on national cider-drinking day. My short term solution would be to contact the local hospital directly and get them to fax your GP the clearance to go with the 1 u pen. Write the letter out for the hospital so they just have to sign it. The less hassle they have, the more likely they are to do it for you in a timely manner.

Good luck

Gary

[JediSurfer]

Cheers Gary you are like the tree of knowledge

[JJM335]

He also said that using an insulin pen which only has increments of 2 unit. should not be a problem for me and that its my understanding of insulin treatment which is at fault. And refused to give me insulins in vials with syringes. He made me fee like all this is my fault.
.

What a complete eejit!!

Can you contact your Diabetes Clinic and have them e-mail or FAX over to your GP asking them to issue you a prescription for the SoloStar Pens? This is what I have done in the past when I have changed a prescription.

[soso]

Rich
what typr of insulin do you use? I have 2 pens here that work for novorapid (not sure what that is called in UK.....one is a junior and works in half units and the other in 1 unit increments.. I could send them to you and you would prolly get them middle of next week... PM me your address if you think they might work... (I can get them free anytime at any pharmacy)
ss

[JediSurfer]

Thanks for the kind offer soso. But I use Apidra and Lantus insulins and the novo pen wouldnt be compatable.

I have phone the diabetes clinic at the hospital today and left a message explaining the situation. So hopefully someone will get back in touch with me soon.

Also searching for a local GP whom has some experience of diabetes. I will not be returning to that office again. Had nothing but trouble with that place since I moved to this area.

JJM335,

Do you use the SoloStar pens?

If anyone in the UK uses SoloStar pens could you pm me the product code which I can then take to my pharmacist who will get the docs to change my prescription for me.

Or if you could let me know where you got the pens from.

Thanks

Rich

[JediSurfer]

Just got a phone call from the hospital. YAY

The lady I spoke with was absolutely outraged by my GPs comments and given me some info to pass on to him.

She also gave me the product codes for the SoloStar pen for Lantus. But I had to telephone Sonofi for the Apidra product code.YAY
I should have the prescription tomorrow.

[shabbie6247]

rich i feel so farkin annoyed for you with that stupid doctor!!! get yourself to another surgery pronto mate!

im so mad i want to kick his ice-hole!!!

gggrrrr!!!:mad: :mad: :mad:

[SueM]

New medicines / SPC changes / Prescription productsNet price: 5 x Apidra SoloStar prefilled pens, £25; 5 x Lantus Solostar prefilled pens, £42. Legal category: POM. Back to Top ...
New medicines / SPC changes / Prescription products (http://www.pjonline.com/Editorial/20070922/products/p323products.html) - 12k -

Found this on google. No wonder your gp doesnt want to prescribe the pens. At that price you could bankrupt the NHS :eek:

[JJM335]

Rich:

Yes I use a SoloStar Pen for Apidra and Cartridges and an Autopen 24 1-20 for Lantus. I have to pick up a new prescription for Lantus and Test discs tomorrow. I can ask for the product code if you like. I live in the wilds so I get my stuff directly from the local health centre. I know they order it from one of the big pharmaceutical wholesalers, but I can't remember the name.

Maybe if you Google up Sonofi Aventis, you can get a contact number. I'm sure if you give them a ring they will give you the product number. I had a similar problem getting test discs for my Breeze 2. The Bayer helpline gave me the info.

Joel

BTW, I try to make it a point of principle not to let my GP get involved in my diabetes care. They now get extra ££££ for running their own Diabetes clinics and signing up their patients. A number of GP surgeries have been applying pressure on their patients to switch from a specialist clinic. However I understand that the view from the Department of Health is that these GP clinics are not suitable for T1's.

[JJM335]

Rich,

Just read your last post. Good luck with the Apidra. BTW, don't expect the magic bullet. My numbers are better than with NovoSLOW but I still tend to spike. I know some people don't appear to go above about 7.5 PP, but I can't do it, not even with Apidra.

Joel

[JediSurfer]

New medicines / SPC changes / Prescription productsNet price: 5 x Apidra SoloStar prefilled pens, £25; 5 x Lantus Solostar prefilled pens, £42. Legal category: POM. Back to Top ...
New medicines / SPC changes / Prescription products (http://www.pjonline.com/Editorial/20070922/products/p323products.html) - 12k -

Found this on google. No wonder your gp doesnt want to prescribe the pens. At that price you could bankrupt the NHS :eek:

Sue, the DSN I just spoke with told me to tell the GP that the pre-filled are £5 cheaper per box than the cartridges. So I am infact saving him money every year. Thanks for the info.

Joel,

I think the GP is trying to pressure me into going to his diabetes clinic and this could be the cause of my recent problems. They also get a bonus every year if HbAC1 is on target. Just doesnt make sense.

I was also told that the choice of device is legally my choice and the doc cannot refuse me my choice of.

Seem to have it sorted. See how it goes tomorrow. Might bypass the GP and go straight to the pharmacist.

[JJM335]

Sue, the DSN I just spoke with told me to tell the GP that the pre-filled are £5 cheaper per box than the cartridges. So I am infact saving him money every year. Thanks for the info.
.

Yes, and why is the Apidra so much cheaper than the Lantus. The cost of production can't be any different, and I don't imagine the recoup on R&D is either. Surely it couldn't have anything to do with the fact that Lantus is the ONLY true 24 h long-acting (ho-ho) on the marketand is the World's No.1 selling insulin, whereas Apridra has to compete with NovoRapid and Humalog? Surely not??

My only beef with the dispo pens are that they must have a bigger Carbon footprint compared to reusable pens and cartridges. Oh well, if Yorkshire is under water again next summer they will know who to blame.

Joel

[JediSurfer]

hehehehe. I'm OK 794 foot on the top of a hill where I live. lol

I only use the disposables because of my active lifestyle. Been out camping many times before and the cartridges have broken inside the refillable pen and the glass broke the mechanism in the pen. So all in all the pre-filled are a far better option for me and I haven't had any breakages with them so far.

[Gary_W]

Glad you're getting sorted.

I'd potentially like to try the SoloStar pens, purely due to the fact that the optipens are pretty horrible...

Regarding GP's and the 'specialist clinics'. I was under my GP's surgery's specialist clinic until the start of the year. I believe a lot of this is due to the fact that a lot of the hospital clinics are failing the waiting list targets and get hammered for it. If they manage to offload patients into primary care, they have more chance of hitting their waiting list target. Even now, I don't have an appointment; the waiting list at the hospital in reality is 9 months, but what they do is give you an appointment 8 weeks before you are due to go. If you make that appointment or refuse it, they have met their target. Crafty isn't it. Massaging of figures like this happens on a daily basis. The hospitals don't really want type 1's going into these but many seem to think that the more type 2's they can get rid of the better.

Joel - I still spike with Apidra as well, but the spike tends to be a lot smaller and a lot shorter. Certain silly foods will still put me in double figures but not for long. I don't always hit the 7.5 or below, but more often than not I do. I feel well and am enjoying life, so that'll do. If it didn't do what it did for me I'd be straight back on the Novorapid as the pens are a lot better and it stings less. I hope it works out for you.

Gary

[JJM335]

Gary,

Sorry to hear that you have problems getting an appointment at a specialist clinic. My Diabetes Clinic is in its own dedicated building and my routine visits are scheduled nominally every 6 months and I get given an appointment for the next one at the end of the visit. On the few occasions when I have had to cancel near the time of the visit, I have got an alternative within a few weeks. I guess I am just lucky.

I agree that the GP clinics are no doubt designed to offload the T2's. I can't see that that is a good thing at all. T2's often have more problems with complications because unlike T1's they are not faced with "adjust or bust" and can get away with less than ideal control for years.

I've now been using Apidra for 2 weeks. It's not the magic bullet (sadly, fantasies of a breakfast consisting of 4 pains-au-chocolat and a 1/2 litre of orange juice followed by a spike to 7.5 have not been realized). However, like you said, the spikes are much shorter lived than with NovoCRAPid (e.g. 10 at 90 mins can be down to 7 by 45 mins later).

More importantly, my I:C ratios are 25% better, and although I have still had a few hypos, these have mostly been the result of jumping in too quickly with a correction bolus (1 U can kill you), or following prolonged exercise. What doesn't happen with Apidra are the regular 2.5's at late morning or late afternoon that I got from the tail of the Novocrapid. I don't think it starts working that much more quickly, but it builds up quickly and goes away by 3.5-4 h.

I was a bit sniffy about the Solostar pens in an earlier post. However, though they feel pretty cheap and nasty, they actually work fine as long as I change the needles after 3 or 4 shots.

Joel

[JediSurfer]

Spoken with the pharmacist and he couldn't find the SoloStar pens. So he immediately called his supplier to find out about new pens. The suppler is waiting for the new pen to come into stock and will ship some out as soon as it arrives and my pharmacist will pass a couple of box onto me as soon as he gets them.

I will then have to take these boxes to my GP so they can write the prescription out until they data base is updated.

Its just amazes me that the pharmacist is of far more use to me than the doctors have ever been. I now know not to bother with the GP when new products or insulins are available. My first call will be the pharmacist or the diabetes clinic.


Phew... after this week I feel like I work for the NHS. lol

[JJM335]

Spoken with the pharmacist and he couldn't find the SoloStar pens.

Now why does that not surprise me???? I only got the Apidra Solostar pens because they were sent by mistake instead of the Lantus Solostar (I then persuaded my Diabetes Clinic to let me try them on the grounds that they would otherwise have had to be thrown out).

Doncha just LUV the NHS! I've moaned previously because my local GP practice will only write me a prescription for 1 months supply (I'm waiting for a cure for T1 by the beginning of December!). Apparently it's the RULES. Since they are a "dispensing practice" I have to take time off work to pick up my stuff during their opening hours. They had a meeting about changing this "rule" but have decided not to, and also that there can be no exceptions!! They have generously decided to send me my prescriptions in the mail, so I can take them into the Chemists next to where I work.

Right, I'm off home for the weekend, have a good one.

Joel