So I went to the pharmacy…I picked up insulin pens and mini pen needles…I parked in the parking lot to verify what I got…they filled Novolog pens…not Humalog pens. The endo nurse had confirmed Humalog pens before she called it in…but I guess she called it in wrong. I went right back to the pharmacy window and returned the Novolog pens (I’m not touching that stuff for a very long time after my shower drops on it). She said, “no problem, I’ll take care of it.” She came back after 10 minutes with four vials of Humalog. I said, “That’s awesome…but I need Humalog pens.” She went off and checked with the pharmacist. Pharmacist said they’d need a new prescription saying Humalog pen. Pharmacy tech assured me she erased my Humalog vials prescription in the system so no one makes that mistake again. I had to explain…no no no, I need vials, just not right now. Please un-erase that.
I called my endo’s answering service. It was like a Family Guy routine that went too long. I couldn’t get past them to leave a message. Policy is no messages about medications after hours. I explained that insulin is more of a hormone than a medication and that’s a terrible policy for people who will die without it…but policy’s are policy! I kind of kept it going for a while to see what the guy would say since I was clearly taking him off-script.
Looks like I’ll be back to voicemail hell and telephone games on Monday.
Why can’t it just be easy? It is incredible how bureaucracy gets in the way of common sense. Like why does your doctor need to OK the use of pens versus vials of humalog? It is the same insulin.
Here was my last pharmacy experience, which was very different from what you went through. My wife stopped by the pharmacy to pick-up 3 boxes of insulin penfills for me. Pharmacists says - "Your husband’s prescription expired a while ago (my fault completely) and the insurance company needs an up to date prescription to provide drug coverage. You will have to pay out of pocket if you want it now. Or… I can give you one box of penfills as an emergency fill which insurance will pay for and then get your husband to ask his doctor to fax a new prescription to us and we will get the other two boxes.
See what a great idea - you get enough insulin in the short term to buy enough time to get a hold of the doctor to sort things out.
Don’t want to declare any sweeping victories too soon…but post-dinner and post-snack BGs tonight are far more recognizable after taking a solid bolus via syringe. I feel a huge exhale that I haven’t felt in four years of pumping.
I’ll obviously keep you posted since I’m pretty much on here way too much.
And if I do this pump = basal Humalog and syringes = bolus Humalog, that will put a kink in @Sam’s philosophical question of which is which when there is no separate basal insulin. Clearly the basal Humalog is the stuff coming from the pump.
That philosophical question is tricky enough on mdi with a real basal… then a lot of people just start calling one unit basal and one administered at exactly the same time “bolus” and it’s just based on how your mind considers it (as per the current model). it’s no wonder it just doesn’t work like it’s supposed to
Any suggestions on where to buy BD Ultra-Fine 6mm (or shorter, if they exist) insulin syringes? Amazon only has the 8mm length which is too long for me.
Yeah, these are just conceptions we’ve created based on the current insulins/treatments that exist. I’m sure in 10-20 years basal/bolus will be archaic terminology.
It’s based on the functioning non-diabetic pancreas.
A working pancreas gives insulin every few minutes, even when the person is not eating. It increases the amount released when a person’s BG rises from meals or hormones.
So the non-diabetic pancreas continually releases insulin at a fairly consistent interval, but the only thing that changes is the amount. That’s the idea behind basal and bolus.
So how do I know if I’m truly giving a subcutaneous shot vs an IM shot? My legs are my injection areas of choice (stomach bleeds too much)…and two of my my four shots on my legs have bled a bit underneath the skin. But I was just used to that on MDI before…
Anyway…I know the whole “pinch an inch” demonstration…but how do you really know if you are pinching an inch of muscle vs fat? My legs and my everything else are lean.
Tighten your muscle as hard as you can, and then pinch it. The soft part you can pinch easily is the fat layer. The hard part underneath is the muscle.
You should be able to feel the difference.
For example - when your muscle is relaxed, maybe you can pinch 3 inches, but when you tighten it, you can only pinch 1/2 an inch. That will tell you exactly how deep you can go.
Maybe that’s why I had a rockin’ A1C on MDI…most of my shots were accidentally IM!! (or not - who the heck knows…)
So I just injected 7 units for dinner. Got a lump under the skin. I do remember that happened with injections (and heck, pumping now) frequently. Did you experience that? They go away after it’s absorbed…but it’s weird. Anything to worry about?
My Dexcom shows really blunted swings when it’s anywhere other than my back. My current reports show a Standard Deviation of 36 but I have to imagine that’s in part due to the less accurate/timely numbers I see from my abdomen and legs.
Should I worry about wearing out my back skin if I continually move my Dexcom around in the same area if the skin can tolerate the adhesive? I’ve not had adhesive issues on my back and it IS most accurate there…so other than needing to share my back with my pods…any concerns? Since it’s not causing trauma like insulin delivery does with the pods, I’m kind of inclined to rock my back sites for Dexcom and not worry about it.
Rather than Tribal Knowledge, I’ll offer a rumor. The insertion of a needle doesn’t cause significant scarring, it’s the repeated dosing of insulin into the same spot. So, unlike infusion sites, CGM sites don’t need to be rotated extensively. I wouldn’t worry about always wearing the Dex on the back. (I’d avoid putting the needle into the exact same spot each time, but the needle damage doesn’t extend over a large area.) That’s my rumor.
Clearly the basal Humalog is the stuff coming from the pump. 
