Hi Ellen. Great news, indeed! I sent you an email...
Hi Lots,
So sorry that this is being so complicated and difficult at a time when you have other serious health issues to deal with!
It's hard to have to deal with such complex bureaucracy when you are feeling bad! I'm sure that you are doing the absolute best you can to deal with this mess!
Wishing you improvements in health and that the process of getting good, knowledgeable and helpful healthcare improves for you very, very soon!
Best, best wishes,
marty
Marty, Thank you very much. It has been quite shocking when the most pain I am dealing with is the getting the MRI and worrying about the pain. It was all I could do to keep my head straight in the office. I know I was the last appointment of the day and she was talking about the advanced directive and everything. I ended up getting my blood tests, ordering the MRI in DC, doing my whole history and then the prescriptions. I think I burned her out. When she got home she probably read the record and pulled up the fact that I was service connected for Type 1 hence the prescription. Now I am looking at the vial and it is Novolog 70 30 mix and I am trying to figure out how to take it. I take 30 Lantus, 25 in the morning and 5 at night with 5 Novolog units per meal. I am going to have to look Online to see how that shot will translate. Just one shot a day in the morning. I am confused. Does anyone take this by injection? I have some Lantus that I took this morning and some of the Novolog pen left. I will get the prescription and write it here and am asking for help with figuring out how much to use. I think it will be quite different than what I am used to taking.
Oh my this is very confusing. She must have taken my A1C and it must have been higher. I think she gave me a much higher dose but I can't really see why. When I am not sick it is 6.1. I wish I know what she was calculating from. Anyway, I am looking at the vial and she sent five vials of a different kind I have never used, of Novolog Human. I hope I get this right.
It has a prescription on it to do one injection every morning and one every evening of 50 units. That is Novolog 70/30 mix. What I am hoping is that she figured what I was taking before and then translated it into what the new kind of insulin injection will be.
I am sorry this is getting so confusing for me. I have done MDI with pretty much the same dose for years of the same insulin. I am not eating like I used to and I have lost a lot of weight due to surgery. I am actually afraid to take 100 units of anything especially at night. I do not understand this new insulin. Has anyone taken Novolog 70/30 before? I have some extra syringes. I have to try this tomorrow morning so that it doesn't conflict with the Lantus and Novolog I took this morning. Yikes. I am confused. Time to research insulin. This seems totally unscientific. Were is bsc? I need him.
I think an advance directive is document that spells out how you wish to be treated should you be unable to express your wishes. I just went through that with my aunt who had one that she did not want to be resuscitated. A power of attorney gives someone the ability to speak on your behalf. What I discovered was that it was really important that you not only have these documents but you also need to make sure that you file them with places like the VA otherwise they mean nothing.
It is great that you got the Lantus.
Unfortunately the Novolog mix will likely be a nightmare. It consists of 70% NPH and 30% Novolog. The NPH is an intermediate insulin and normally when taken three times a day it acts kinda like a basal. If you try to get 5 units of novolog for a meal that would require an injection of 16.5 units of mix which would give you 5 units of Novolog and 11.5 units of NPH. That is far too much NPH, if you did that for three meals a day that would much more basal than you currently take.
I actually think you would be better off just not using it and going to Walmart and getting Regular insulin (it is $25/vial). You can just use the same 5 units you have always use just take the dose 30-45 minutes before eating.
Actually, I have a vial of R in my fridge, it is unopened, but expired. It is probably fine, you can have it if you want.
Hi Brian, I got this new insulin in the mail from the mail order but it is Novolog 70/30. Do you know anything about this mix?
I wrote some basic stuff above. I'll send you a private message if you want to talk in more detail.
I was surprise that the prescription on the vials said. Take 50 units in the morning and 50 in the evening. Holy cow. If I did that I would not make it through until Monday. I have enough Novolog and Lantus to last until Monday and needle tips. I think I will not touch the 30/70. I knew that something was wrong when it said do not take without eating within 15 minutes. Then the night would have been a nightmare with 50 units of the stuff. I feel like I am in an episode of the Twilight Zone.
Dear Lots,
This all sounds really overwhelming! Do you have someone to go with you to the doctor on Monday to be another set of ears and to make sure the doc is doing what you need?
I wish I could help, but I'm too far away!
Will be thinking of you and sending good wishes that the rest of the weekend goes as well as possible and that the doctor on Monday is attentive, sensible, and give you what you need!
Best wishes,
marty
Its so sad when our docs treat us this way. What did he say you should do in the meantime?
Actually I did look this up. You are not supposed to do MDI with Regular Insulin. The peak is too long. I did not realize that the 29th was nine days away. I know that they would never have fast acting insulin like Novolog, never need to invent if regular worked. This is what they give me in the hospital and it always peaks after the meal even if you wait 45 minutes. I don't think that the 30/70 is any better of an idea either. Why expired insulin, though I do appreciate your offer. I am insured and I can't get a doctor to write a prescription for the medication that keeps me alive. Taking a hundred units of the 30/70 would have killed me. I don't think I am wrong. I at least get that. This is way to stressful of a situation to ignore or gloss over.
Thanks for the reminder, Brian, about how important it is to make sure that you doctor, your local hospital, and the person you are designating, all have copies of this.
Dear Lots,
You've probably already thought of this.
It sounds like the NP did, after all, order the insulin for you when she read through your records, later. If so, you might be able to call her on Monday and explain that the 70/30 won't work for you, and might mean that you end up in the emergency room. Maybe she will be willing to order something else that will work for you until the 29th.
Wishing you a good day and a good solution to this challenge,
marty
It's also possible that the 70/30 Novolog Mix is a dispensing error by the pharmacy or they clicked the wrong thing when the nurse practitioner ordered the insulin. The whole thing doesn't make sense.
I would definitely call Monday if you have enough Novolog and Lantus to get through the weekend and if not there's always someone on call. They are the ones who messed up the prescription and if you have to use the 70/30 Mix over the next few days it's not going to be unreasonable to call the on call physician before using it and get some clarification.
Wow, no , if you use the mix don't use 50 units. I don't know how much you'd need so you PROBABLY shouldn't use it. I know someone on another diabetes forum that currently uses the mix (and is a type 1, they're trying to get on the regular sort of mdi but this is all they have) and uses 12 units twice a day. A much less scary amount? You don't use regular mdi with the mix you just use the mixes like twice a day it seems? I would still not use it though when that dose is too high, does this lady still think you're a type 2? :(
What is really bad about the whole thing is that I am terrified they think I am going to take this forever. They sent five vials of the stuff with three refills. Enough to last for a long time. I am afraid they are not going to listen to me. They might say this is all they have. She acted like she didn't know what a type one was. I am have a service connected disability of 50% for Type 1. I have several other serious health conditions. If I run out of Lantus and Novolog all I will have is the 30/70 Novolog mix. If I follow the prescription there is no doubt it would put me into hypoglycemia for the whole 24 hour period. If I buy Humalog it might work during the day very badly but what about the night. It stops working in six hours. I am going to call the pharmacy but I am scared they will not understand. If this is prescribed by a doctor maybe they will say it is all they give.
I never saw the doctor who prescribed it. There is someone's name on the vial for prescriber. I never saw him. Just the NP.
It sounds like the NP probably got a doc to write the script and he did not know what to do with a T1, so wrote like he would for a T2. Would definitely call back and insists on scripts for your correct medications and appropriate dosing.
Even if you have to camp on the door step.