Ranting about the system

#1

So, my transmitter for the dexcom g6 ran out of batteries yesterday. I remembered talking to Walgreen’s speciality pharmacy about a month ago about the new one, but failed to follow up because things have been crazy busy recently. I called them again today. The first woman I talked to was useless, and kept thinking I was talking about the receiver, which I dont even have because I only use my phone. Then, the call was dropped. I called again and the second woman actually understood what the hell I was talking about, but said they had sent paperwork to my doctor and never heard back, so call him.

I call my endocrinologist office and they say they sent information to tandem a while ago. I say, no, not tandem, Walgreen’s speciality pharmacy. They insist they got something from tandem. Okay, about the new insulin pump (which I’ve been trying to get since the warranty ran out on my medtronic on April 22nd) or about the dexcom g6? Confusion, followed by saying it was about the new insulin pump and they will contact Walgreens about the dexcom g6 as soon as possible. Okay, I now know the delay on the insulin pump isn’t on my doctors side, but that’s not urgent. The dexcom is fairly urgent because hormones have been making my blood sugars swing like crazy and I’ve already gone 18 hours without it. I’ve now been waiting several hours, but have not got a phone call back from Walgreen’s to confirm that they got the doctors orders. Its Thursday, so I dont want to wait until after the weekend to sort this or I will be a whole week without the cgm.

Thank God, every finger stick I’ve done so far has come out nearly perfect (including the one at 4 am just to be safe), but I have no idea how long my luck will last because the hormones are making things even less predictable than normal. I’m trying my best not to freak out, but I’m a combination of worried and incensed. And then theres the part that’s blaming myself for forgetting to check up on these things before they became an issue. Its been a trying experience to say the least.

Anyway, that was my rant. I’m just crossing my fingers now that it gets fixed as soon as possible.

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#2

I completely agree with your rant. We in the US live with a convoluted and needlessly complicated system of health care coverage and financing. The system is designed and implemented by insurance companies, pharmacy benefit managers, employer benefit departments, and public payers like Medicare and Medicaid.

The patient and his/her interests are deliberately left out of this process yet we are the only player in this scheme who suffer when it breaks down. In fact, delays in this system benefit payers.

I have little patience for this complicated process. I remain focused on the only thing that matters to me: keeping my supply shelves stocked to the extent that I maintain at least a 30-day buffer, if not more, of supplies and medications needed.

I’m able to develop a safety surplus of essential medical supplies with these tactics:

  • I have my doctor order me to change my infusion sets every 48 hours so that each 90-day order produces a surplus over my actual usage.

  • I request that my doctor order more insulin for me than I actually use so that I always have a surplus of this life-essential medicine in my refrigerator. Remember that pump priming and infusion set replacements all incur a certain amount of insulin “wastage.”

  • I do much the same for test strips.

  • I ask my doctor to order that I replace my continuous glucose sensor every 7 days. I usually get 14 days from a sensor and that keeps a comfortable surplus on my shelf.

I do not sell any of this stuff on the grey market. When my surplus supply starts to get too large, I simply omit an order or two and my over-supply then shrinks.

In an ideal world, we would all get the medicine and supplies we need in a dependable and timely manner. Since this is just not the case, I have no trouble doing what I need to do to keep comfortable access to my essential medications. None of the other players in this system are worried about my supply; they’re concerned with getting paid or otherwise administering their institutional missions.

Building up a surplus supply relieves you of the emotional burden that running out entails. No one should have to live that close to the cliff. If you only play by their rules, you will forever live on the cusp of chaos and suffer the emotional burden associated with that situation.

I realize that you are pregnant. That heightens all the natural concerns any of us have about keep the diabetes meds/supplies flowing. I wish you well with this, @BeckyZ. I wouldn’t be shy about employing some of the tactics I’ve listed.

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#3

I ran into a similar problem in March when Dexcom was unable to send my transmitter order on time. I used the Spike app to reset it and I’m still using. See the first link

The app is only available for iOS. There were recent issues obtaining the spike app due to a dispute with Apple, but the second post has an update on how to get it.

#4

I also hope you get it resolved quickly. It’s stressful to be without a CGM for most of us that have come to rely on it.

#5

I definitely have a surplus of pump supplies and insulin by using the tactics you have suggested and I have 1 extra sensor because 2 times the sensor came off after 5 days and I contacted dexcom and got new sensors, and pretended I didn’t when the pharmacy called. But the pharmacy is militant about only sending me 3 sensors a month because dexcom says the sensor should last ten days. Any more than that and they say I have to contact dexcom. And they only send 1 transmitter at a time every 3 months. In fact, the 1st woman I talked to today misunderstood everything and said any transmitter that had a problem before 3 months I had to contact dexcom about because they would not be flexible on how many they send out. Apparently, interrupting treatment is preferable to them just sending 1 extra transmitter out. Its baloney in my opinion, but clearly my opinion counts for very little.

#6

Update: I just called the pharmacy and of course, they said, “oh, the refill JUST came in.” So, they’re shipping it out today, and it should be here tomorrow morning, so I will have only been without for less than 36 hours, luck permitting. I’m going to keep my fingers crossed because I’m in a feud with the FedEx delivery driver at the moment, but I’m cautiously optimistic.

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#7

The transmitter has a warranty from dexcom, starts based on ship date. So if under warranty, it is correct to call dexcom for replacement.

#8

So, unless there’s a problem with a transmitter before the end of the 3 months, is there any way to get a backup?

#9

I believe the warranty is 6 months from purchase date or 3 months from activation.

#10

Here is the warranty info from G6 user guide.

F.2 Dexcom Transmitter Limited Warranty
What’s Covered and for How Long?
Dexcom, Inc. (“Dexcom”) provides a limited warrantyto the original purchaser (“you” or “Purchaser”) that the
Dexcom G6 transmitter (the “transmitter”) is free from defects in material and workmanship under normal use
(“Limited Warranty”) for the period commencing on the date of first use by the original purchaser (the “Date of
First Use”) and expiring three (3) months thereafter; provided, that, the Date of First use occurs within five (5)
months of the date of shipment (or disbursement) of the transmitter to you (“Warranty Period”).
Note: If you received this transmitter as a replacement for an in-warranty transmitter, the Limited Warranty for
the replacement transmitter shall continue for the remaining Warranty Period on the original transmitter, but
the replacement is not subject to any other warranty.

G6 user guide with warranty info

Technical Support

Product troubleshooting or replacement inquiries

1-844-607-8398

Available 24 hours a day;

7 days a week

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#11

This will depend on your insurance and how you purchase.
Some can order a 6 month supply, so they get 2 transmitters. But each transmitter usually can last up to 112 days, when it is designed to shutdown. Some use other apps (xdrip, Spike), on smartphone to get additional days and features not in standard dexcom. So transmitter works until the battery is too weak.

If you can order every 90 days, many places allow order to be placed a few days before day 90, so that you get it by day 90.

#12

Mentioned upthread but worth repeating: the open-source Dexcom apps xDrip (Android) and Spike (IOS) can save you a lot of angst around transmitter end-of-life, which as we all know is an artificial limit programmed-in by Dexcom and not actually the end of battery charge. Some people prefer them over the actual Dexcom apps and use them continuously, but I mainly use mine to bridge the gap when I’ve still got a perfectly good sensor in when the transmitter “dies,” or to maintain access when there’s some delay in getting a new transmitter.

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