August 13, 2013

A Problem for a Friend of One of Our Group

Problems can happen when you least expect them. Barry was having a friend from his previous town on a visit with Ben and himself. They had discussed and talked about diabetes, but nothing had been discussed in specifics. Then the second day, Barry did ask his friend what his last A1c had been. His friend said he did not know as the doctor had not told him. Barry said the only comment he could remember was something to the effect of watch what he was eating as it was creeping back up.

This caused Barry to ask what his blood glucose reading had been that morning. He got a puzzled look and a question about what was a blood glucose reading. Barry patiently took out his testing supplies and showed his friend. His friend did not know anything about what he was seeing. Barry asked if he could do one test as it was about time for the noon meal. His friend said okay, so Barry pulled out the lancet, inserted a new one, put the device back together, and armed it. His friend hesitated and said you aren't sticking me with that.

At that point, Ben took his out and asked Barry's friend to watch him. Ben pricked the side of his thumb, set the lancet device down, and reached for the meter he had previously inserted a test strip in, as it was now ready to receive the blood. After the blood was wicked into the test strip, the meter took about five seconds to give a reading of 96 mg/dl. Ben recorded the reading, with a tissue, wiped the excess blood from his thumb, used the tissue to pull the test strip out of the meter, and discarded both in a wastebasket.

Barry's friend asked why he had used the side of his thumb and not the tip or sole. Ben explained that the side had less nerves and he had little or no pain on the side and that he could use the tip or sole of his thumb or any finger as he had pain insensitive fingers at his age. Ben said that yes, he occasionally hit a nerve and could have a little pain, but in general he was not concerned. Barry's friend said that the doctor he went to, the nurse always used the tip of a finger and it always hurt, but if there was less pain on the side, he would give it a try.

Barry said he put a strip in his meter and adjusted the lancet device to the lowest setting. His friend held out his hand and Barry said he rested the device on his small finger and pressed the release. When Barry lifted the lancet device, he said his friend was still expecting a sting. There was sufficient blood with a small squeeze so he inserted the test strip to wick the blood and when the meter reading showed it was 298 mg/dl. Ben asked if he had taken his medications to which he stated not until the noon meal. Barry asked if he could see the medication and his friend hauled out the container. The directions said one at the noon meal and one at the evening meal. It was for one of the sulfonylureas and the dose was small.

After the noon meal, Barry called Tim who was not available. Then he called Allen who was also out of town but would be home shortly. Allen told Barry to call the local doctor and ask him the questions. Barry was hesitant, so Allen said he would call after he had talked with them. When Allen arrived about 2:30, he was given the information and Allen asked them to call Barry's friend's insurance company to find out which meters and test strips were on the approved list.

Then Allen called the local doctor and asked if he could do an A1c test and go over the medications Barry's friend was taking. The doctor could see him that afternoon, but did not have the A1c kit as the order had not arrived that day. That was when Allen called me. I told Allen where I was and that I would call back when I could get off the interstate which I did. That was when I started to hear of the problems. I suggested that they start calling the pharmacies starting with the pharmacy near the clinic at the hospital and ask for the Bayer A1c kit. Then if they did not have any to go to another pharmacy until they found one. Then I remembered and suggested he call the diabetes clinic first to see where to find one. Allen said he was grateful I knew where to start and said he would wait until I called to tell me where to go first.

When I got near the diabetes clinic, I called Allen and he said the clinic could sell me one and to go there first. Then I would need to go to the pharmacy to get a meter and two containers of test strips for which Allen gave me the name. I made the stop at the clinic and I asked if they could sell me a meter and if I needed a prescription for the test strips. I briefly explained the situation and was given the meter and a prescription for two containers of test strips. I paid for the A1c kit and went to the pharmacy to get the test strips and headed for home and Ben and Barry's residence.

At that time it was time to take Barry's friend to the doctor, so Allen, Barry, and his friend left with everything while Ben and I talked and waited. When they returned, Barry said the two of them would go to the pharmacy and get his new prescription filled and then he would pay me. Allen said the doctor had received permission for the charges to his insurance and for his prescriptions. Allen also stated that the doctor agreed that he should start on insulin and that was the prescriptions plus metformin. The doctor had also stated he knew an endocrinologist near him and would be calling him to set up an appointment as soon as possible.

When Barry and his friend returned, his friend said this is quite a community you have here. Barry said he hoped so as we had saved his hide. Barry's friend asked how we came together as he did not know of anything like this where he lived. Allen stated that most probably wanted to keep it a secret and therefore very few even talked about diabetes. Barry had to agree and said this was a unique group and he was happy to be part of it. At that point Barry's friend, thanked me and paid me saying that the delay was so he could get the extra cash when he used his debit card.

Barry asked how I knew where to find things so fast and I said it is just knowing who to ask. I explained that the meter had not cost him anything as my clinic had supplied that because of the people using it. I said knowing what his insurance covered also was a great help. Allen said that was good and he asked Barry's friend if he could remember this for the future is it became necessary. The answer was yes, and that he had learned a lot in about five hours and he would be working on reinforcing his memory. I said that with Ben and Barry he could learn quite a bit.

Tim arrived then and was introduced. Allen and I made our exit and received profuse thank you's for our part and it was agreed that those of us that could, should get together on Saturday to cover the events. Barry said he and Ben would send out emails about the events and lessons learned. Allen said he would add another if necessary.

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