Good going! Yes, maybe stay where you are so your body can get used to it, rather than increasing dose. After three days at one level, you’ll have established that contract with your body that it needs, and it will tell you then what to do.
Glad to hear that things are going reasonably well! NPH really is a beast to get good fasting #s with. I never did, though I have to admit that that was a time in my life when I wasn’t trying very hard. I hope that your experiment will be successful enough to get you a Rx for a better basal!
a doctor may recommend insulin
injections.
The word may is very bad.
I was left on avandia for a whole year when it had no effect. I had to threathen the doctor before I was allowed insulin.
If you'd like to know more about how health insurance companies influence the cost of medications, procedures, etc, I'd suggest reading some of the blog entries from NPRs award-winning programming, Planet Money. Particularly read this one, and pay attention to the comment made by RandyP:
In the podcast you ask how the doctors came up with the $1200 charge for ear tubes, especially in light of the fact that this particular insurance company only paid $400. Most practices will look at how much each insurance company with whom they deal will pay for any given procedure, and add some percentage (we used to use about 5%) to the maximum amount paid by that company.
For example, if Blue Cross (say) would pay $1000 for a particular procedure and everybody else paid $500, we would set our charge at $1050. It wouldn't make sense to charge less than $1000 because we would collect less that what was possible from any Blue Cross patients .
When you hear doctors saying they only receive x cents on the dollar, this is where x comes from. If an insurer pays $500 for something that we bill for $1050, then we are collecting 50 cents on the dollar. However, I've always thought that was misleading. We could bill $10,000 for the procedure and then we could claim that we are losing even more money on the dollar, but that is just playing with the numbers.Monday, October 05, 2009 11:32:53 PM
I know Anthony ..." may " is leaving it wide open .
The patient " may" go somewhere else ...I had to ,several times in my 28 years ...
Dear Nel
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I know Anthony ..." may " is leaving it wide open .
The patient " may" go somewhere else ...I had to ,several times in my 28 years ...
The word "may" is worst than wide open it gives the feel that insulin is a last resort treatment when for many diabetes it should be the first line of defense.
I went to 1 GP and 3 Endos and they all refused insulin where was I supposed to go ?
Anthony ...maybe too late for you now about this particular topic , but I would have written a letter to the Alberta Medical Association with a copy to GP /Endo ...they need to " hear" from their patients !
I am blessed , that my present Team listens .
Now this would be pointless and then I did not know that much about diabetes I was counting on their expertise. It is now that reading all the horror stories I have realized that Doctors behave in what they perceive to be their best interest not necessarily their patients best interest. BSC has also been left out to dry, what p--ses me off that it is 12 years later and not much has changed.
I may have threatened them with legal action. Yes you are blessed.
Wait a second. I am not really out here flapping in the wind all alone. I have chosen to take control of a basic medical decision, but I am not opting out. With the exception of firing my last endo (and I am looking for a new one), I still have all my medical team and continue to see them. While I will decline to involve them in my three month venture starting insulin, I'll continue to involve them and seek their advice. And I will return to involving them in my treatment, including insulin, once I have removed the reasons for denying me insulin.
I am just dissappointed in my doctors and the system.
I am sorry if I gave the impression that you have opted out of the medical system. I meant more to say that they failed you in the issue of insulin as they did me. I still go to my endo last visit was useless but you never know he may have a good idea in the future,
I know, but I would not want someone reading this thread thinking that I have just opted out of the medical system and everyone was cheering me on.
I am not one to delete my management of Diabetes and never will be. After the death of my Mother and Sister from Diabetes complications I am in there trying to get answers. Perhaps your availabity of Diabetes providers is more available then where I live. Yes, you are right in saying there are many out there but, are they interested in my case or just the copay. I have been a Registered Nurse for 49 years and am aware of treatment Diabetics receive. I have done my part on that two way street and many medical professionals remain on a one way street. Many doctors and Endos just can not handle a person that knows as much about their health as they do.
Walk in my shoes and live where I live and then tell me where these concerned professionals are located.
One of my friends moved to New Zealand recently and observed that there were a lot less plans/ structures/ organizations in the office in which he is working than they had when he worked here? He is still getting used to it but a lot of my encounters with doctors, both for diabetes related stuff and other items, it seems almost like there’s a ‘script’ behind the conversations? I think that many in the field are excellent people in that there conversations are interesting but I don’t seem to get all that much from them? Even when I’m sick, I explain the symptoms but what I’m really saying is ‘write me a script for antibiotics, I’ve had this cold for 2 weeks…’ rather than ‘what can you do for me doc?’. Since, for example, during cold and flu season, the docs are bombed w/ people needing meds like that, they don’t have time to read all 20 pages of my log and discuss my BG with me and all that other stuff. I can say anything I want but the bottom line is that it’s my schtick and I am the one pretty much in charge of it? Once they give me the RX’s, of course?
Thanks for the update! It sounds like you have tracked down the culprit! My experience w/ N was very similar to Tom T's. I agree with Jan, I always wait a few days after I change something to see if it works. Come to think of it, I was not very organized w/ R/N and thought little of blasting away with another 5 units here and there as when I felt like it?
I can tell you that they are NOT located in Pennsylvania!
Some of you have asked privately how I am doing, so I’ll provide a quick update. It has now been 2.5 weeks and I’ve been going slowly. I actually don’t think I have quite reached a basal dose which brings my fasting levels under control. I started with the initial guideline of 0.4 IUs/kg/day for total daily dose and have moved up from there. I have started to bolus for dinner using an I:C of 5 and that seems to work out reasonably well. I have had only two mild lows, both from the use of R. The first when my dinner was badly delayed after taking my insulin and the second when I ended up not being able to eat the food that I had predicted (my eyes were bigger than my stomach). Both were in the 70s, by some definition, not lows.
During the first week of insulin, my fasting blood sugars actually rose 20-30 mg/dl. I have no explanation. I had started with a three injection regime, but have switched to two shots a day. Until I actually observe some lowering action on my fasting blood sugars that reliably brings my blood sugar below 100 mg/dl at some point during the day it makes little sense to worry about finer tuning.
Since I’ve been injecting for more than 2 years with Byetta and then Victoza, the injection part was a non-issue. I gained 2-3 lbs within a couple days, but no real change in weight since then. The biggest adjustment is needing to carry my “stuff” 24/7. Where before, I could go somewhere without my my “stuff,” now I have to keep it with me. I am still adjusting and may need to get a “man bag,” but I am resisting.
Thanks to everyone for their support.
So what does your doc make of this, or are you going to suprise them with your experiment? It sounds like you are really doing it properly, with a careful approach and lots of detail. I think that appointment would be an amazing YouTube video!
I’ll return to my doctor at 3 months and get my standard tests. I always give my doctor a list of my current medications and supplements and I will now list insulin. At that time, I’ll also ask for a referral to my diabetes center for insulin class. And then I’ll ask for Lantus and Humalog. I still need to find a new endo, I had to fire my last one, I lost confidence in him.
= one set of raised eyebrows? heh heh heh. If you maintain thatlevel of record keeping the endo will certainly be pwned! That’s a long time to wait thought. It would also be interesting, for sporting purposes, to hang on to your receipts and enter the lists with your insurer to get them to reimburse you for the medications the doctor will retroactively agree you needed?
You have to understand, I was paying $250/month out of pocket for the 2 medications that did not work. I stopped those 2 medications and started the NPH/R regime, which should save me at least $150/month. I’m saving serious buckos.
I fired my endo cause I felt pwned. It was bad enough he would only give five minutes and I had to resort to short written lists to put in front of him, but it turned out he had accepted $250,000 in gratuities from pharma companies over the last year.