I made an appointment with a different doctor using the link @kmichel posted. The doctor shares his office with another doctor who could conduct the spirometry test, and so it only took one appointment to get everything approved!
Spirometry came back normal. My doctor told me he had one other patient on Afrezza, but she was a type 2. He told me that he was concerned by how new the product was and that itās a foreign drug in your lungs. He said he was very willing to prescribe it, but he wanted me to know what the risks were. He was much more knowledgeable about the drug than my last doctor, and he basically went over everything we did in this thread: Afrezza.
He put in a 90-day mail order prescription for 540 cartridges (half 4 units and half 8 units). He was honest and said that he was just guessing at how much to prescribe. I really have no idea how much Iāll use, but I have plenty of Humalog as back-up. I need the 90-day prescription because it only costs me $80 whereas a 30 day prescription would cost $270 (the ridiculousness of insurance). He said itās probably way too much, but we can always adjust the next 90 days if it is. Canāt wait to get it
The spirometry test was in this bizarre glass box-like thing. I think they can do more in-depth tests in that thing too. I honestly wasnāt very good at timing everything right. It was a much more complicated contraption than the little ball ones.
Iām very pleased I switched endocrinologists, and heās only 5 blocks from my apartment! His staff was so pleasant and easy to schedule things with. Honestly, such a better experience overall.
Too much of any medication is never a bad thingā¦ thatās how you build a stockpile, and then afterward just fill it as neededā¦ donāt ever tel a doc to reduce your quantity!
Half 4s and half 8s seems like a reasonable place to startā¦ youāll have to experiment around with it to learn to time it right, thatās far more important than wirh liquidā¦ timing is everything, your cgm will make it pretty easy
Yeah, but I have all this leftover pump supplies because I always stock-piled. Now I have nothing to do with itā¦ it just sits in my closet until it expires. Complete waste!
Youāre right though, nice to stockpile a bit, but Iāll probably adjust the prescription if it ends up being WAY more than I need.
As @Sam said - it is all about timing. I find it effective for me if I dose 15 minutes after eating. Others do it as they eat, many do a follow up after 30 minutes. I highly suggest not dosing any earlier than just before you eat. Some experimentation is needed.
And do not be shocked if you need more units than your injected insulin-carb ratios. Find that right dose for an āaverageā for you. There is no insulin-carb ratio for Afrezza. And hang in there - your cough will go away quickly, as you learn to adjust how hard you inhale, the tilt of the inhaler, etc.
I do find that 3 boxes (what you are getting) last me more than 3 months, and I tend to eat high carb.
Congratulations! I have been using Afrezza a lot lately - itās so nice to not have to prebolus or carefully count carbs. I am trying to get my prescription changed from just 4s to 4s and 8s (not sure why it wasnāt originally prescribed that way, as my doctor said she was going to prescribe the combo). Itās really great to have both. It is also nice to still have your RAI, too - I still use it for breakfast (which is generally lower carb/heavier fat, which I find Novolog is better for), and for things Iād already nailed the dosage on - donāt feel the need to do new experiments if Iāve already got a decent plan.
This is what I do with my Novolog (and will do when I get a decent stash of Afrezza stocked up).
Many other Cigna plans will likely not cover Afrezza. My planās benefit design has been customized to fit criteria defined by my employer. Afrezza is not listed on the formulary of my plan, but there is still a benefit for non-formulary brand name drugs.
Also welcome to the site! You can introduce yourself on the welcome thread if you want.
