This is a story about everything I went through the past four weeks in order to get what I’ve dubbed Liquid Life, or that tiny glass bottle with the shiny red cap that contains Humalog insulin.
About 4 weeks ago, I noticed I was opening my fourth to last bottle of Humalog. At this point, I routinely called the mail-order pharmacy that my insurance company requires I use.
“Can I refill my prescription for humalog vials?” I have to specify the vials because the pens are still on my account and won’t expire until July, since I only started pumping in November.
“Hmm, you mean the prescription for ten bottles of humalog for three months?”
“I think I asked her to change it to twelve.”
“Well, the most updated version we have says ten bottles for three months. Would you like me to refill that prescription?”
“Sure, I’ll just call and have her update it again.”
So, I was told the 10 bottles of Humalog would be shipped to me the following Tuesday and that should they receive and updated prescription from my Doctor, they would go ahead and send me the two extra bottles as soon as they had time to fill it. This was all fine and dandy. The next Tuesday came. No insulin. I didn’t notice until I was opening the second to last bottle.
I never got my insulin.
So I called them again. They told me that my insurance company had rejected the prescription because it was too early to refill it. I thought, really?
“Well, when can I refill it?”
So I called them that Tuesday, which was a week ago today. They went ahead and filled the prescription. When I told the nice lady who answered that I only had one bottle left, she said that due to the insurance mess she could, one time, ship it to me overnight with no extra charge.
“Are there ten or twelve bottles on the prescription?”
“Ten bottles, Ma’am.” (I hate it when they call me ma’am. How old am I anyway?)
“Okay, I asked my doctor to refill it but I guess she didn’t get the message.”
So fully expecting to receive my insulin within the next two days, I went ahead and called my Doctor’s office. I left two messages, one asking for an increase in my humalog prescription (again), and one asking about beginning Symilin again. The Medical Assistant I spoke with informed me that Dr. M was out of the office that week and would return the following Monday. Was that too late, or did I need the script sooner?
I assumed that waiting would be fine, because I was supposed to get ten bottles the next day.
So Wednesday came. And Thursday. And Friday. And on Friday night, when I went to refill my cartridge, I noticed that the bottle was getting low. Too low for another 200 u refill. Crap. First day of the weekend, and I had no insulin.
So that refill lasted me until Sunday night. At which point, I called the mail-order pharmacy again. I didn’t remember if they had service on weekends. They did. The kind man who answered explained to me that when you have a pending, automatic refill order and you place an order on top of it, the auto refill order is the order that gets filled. He said that my auto refill was supposed to ship out on Friday.
Basically, he was telling me that because I had an order due to ship out on Friday, the order I had placed when I had one bottle left on Tuesday was kicked out of the system.
So essentially, because I signed up for auto refill, I couldn’t get my insulin when I needed it, regardless of the fact that my insurance was finally covering the refill.
Can I get a big “What The BEEP?”
What he did do was he placed an override on my account which allowed me to pick up one bottle from the regular pharmacy at no extra charge. Of course, this means that I would need a prescription from my doctor to be sent to the pharmacy.
So, at 8:30 in the morning, with 25 units left, I called the doctor’s office.
Apparently it was 8:25. Their line still said “closed.”
I went to class at 8:3o and called immediately afterward.
I told the Medical Assistant who answered that this was urgent. That I was going to run out of insulin before tomorrow morning. That I needed this script as soon as possible.
I called the pharmacy at 1:30. They hadn’t received it. Called the doctor’s office again. The problem with having the MA’s take the calls (they used to have a receptionist to leave messages with, but fired her) is that they have to do other things. Like take every patient to their room and get their vitals. Among other duties, of course. So the phone rang. And rang. And rang. For about five minutes it rang. I hung up. I waited ten minutes. I called back. Finally, after a good ten to twelve rings, someone answered.
“Hi, I called earlier about a prescription and –
“What’s your name.” I put a period because that’s how her voice sounded. Short. Flat. Like she was annoyed with me for calling her.
“It’s Sarah Blacksher but – ”
“Date of birth.” No question. Just an order. I was flabbergasted. I almost couldn’t speak.
I told her my birthday. She typed on her computer. I couldn’t say anything else. I was too angry.
“All this needs is Dr. M’s signature.”
“Okay, when will she be doing that? Can you mark it as urgent? I really need this today. I have less than 20 units left.”
“I’ll do what I can do but she has a lot of messages today.”
“I know but this is very urgent. Can you get her to sign it as soon as possible please? I need it, like, now.”
“She’s with P-A-T-I-E-N-T-S.” As if I don’t know that they see patients in their office.
“I understand that but I need this as soon as possible.”
“Ma’am, she will get to it when she can.” Again with the ma’am.
At this point I regret what I said. I regret being rude to this woman even though she was rude to me. I was very upset, my blood sugar was running close to 200 because I was afraid to correct, and I was starving because I had not had any food since my eggs at nine thirty that morning.
“Well, I hope that she doesn’t have to come see me in the hospital with keyotnes because I ran out of insulin then.” And I hung up.
I regret that statement because I know if it had been me on the other line I would have been furious. I would have put that patient’s note on the bottom of the file. I would have done that, I say, if I didn’t have diabetes. Because if I had diabetes (and she should have known, she had my chart in front of her saying I used an insulin pump and she worked in an endocrinologist’s office – she should have known) I would have known that insulin is a matter of life and death to a person with type 1 diabetes.
But Dr. M never got my note because at 6 o’clock that evening the pharmacy still did not have my prescription.
I finally, using the emergency line on the doctor’s office’s automated after hours answering service, got a hold of my doctor. She called me back and I frantically explained the situation to her, and she sent my prescription on over. I have never been more upset with the string of events that left me with thirteen units of insulin left to my name. The insurance company. The pharmacy. The doctor’s office staff. Everything happened in a manner that caused me to not receive my insulin on time.
I don’t know that I did anything wrong. I truly believe that this time, it was not my fault. I wasn’t losing sensors or neglecting to order infusion sets on time. I did everything right.
My life was in other people’s hands, and the other people nearly failed me.