The Elusive Green Box

Twelve cents! Why bother?

Twelve cents.

Not want sound ungrateful. But. Some Rx questions arise.

#1: 2013 Bigfoot insurance not cover syringes/needle tips from pharmacy. Must use durable medical equipment supplier. But unable figure out how use durable medical equipment supplier. And since these items not expensive, and only need one time for have on hand in case pump failure, fill Rx at pharmacy.

Today notice BCBSRI chip in twelve cents for syringes. Foolhardy ask why. But why? And thank you.

#2: Bigfoot family insurance plan super-high deductible, amount of deductible loaded on to HSA Visa card for use pay every medical thing until meet deductible. (Pretty neat!) It only February. Close, but not yet meet deductible. So expect pay full cost every Rx, every appointment, etc. So very puzzling why Glucagon (2 sets, $290) come w. copay instead of pay whole thing? And why copay so high? ($60! Last time was $5.)

Yes it is. No it isn't. Yes it is. Maybe it isn't. Maybe it is. We'll get back to you.

Yes it is. No it isn’t. Yes it is. Maybe it isn’t. Maybe it is. We’ll get back to you.

#3: Ketone items arrive with note, “This medication is not covered by your insurance.” Pee strips + blood strips alike. Why this change? Bigfoot call BCBSRI ask why no more cover ketone tools. On hold forever. BSBCRI say CVS wrong, ketone blood strips are covered; pee strips not covered because OTC. CVS say BCBSRI told them blood ketone strips also no covered. BCBSRI then say, “things are denying incorrectly.” (Clever use passive voice!) Then ask, “How many kinds of Lantus does your son use?” and “Do you care if it’s the NovaMax Plus Ketone or the NovaMax Gluc?” and “I bet they’ll put an override on this in research.” These statements not inspire confidence. Then BCBSRI say no claims on Bigfoot file, impossible Bigfoot Spouse pick up items today. And yet. Here these items right before Bigfoot eyes.

Photo1-6

$2.50 a strip and worth it. (But I’d rather pay zero.)

My Funny Valentines: Blue Cross, Catamaran, Target, CVS, Animas, Dexcom, and Thou

Happy valentine. For love letter to self decide finally untangle Rx situation.

Catamaran

Part of problem: thought mail order would make easier. And Catamaran = Blue Cross Blue Shield Rhode Island mail order pharmacy provider. Sparkly new BCBSRI feature for 2013!

When I see these numbers, my first reaction is a thrilling shiver WE ARE SO LUCKY! But for today, while I have a bad cold and am spending all day talking to dumb pharmacies, I realized: it's not lucky to have diabetes. Just dawned on me.

When I see these kinds of money numbers, I get a shiver of thrill: WE ARE SO LUCKY! Today, maybe because I have a bad cold and am spending all day talking to dumb pharmacies, it dawned on me: this whole scene might be more bad luck than good.

One fun Catamaran feature = when on hold for long time, phone system eventually connect holder to other holder. Usually it confused elderly. Sometimes Bigfoot able answer other holder question, usually not. (Oh dear. Well would you happen to know if Catamaran accepts personal checks?)

Other fun Catamaran is agree fill 7 Rx’s, send two.

Other fun is Humalog arrive in giant styrofoam cooler, perfect for frat party.

Call Catamaran ask status 5 missing Rx’s, eventually get final answer:

  • One not available until March 6th (Verio IQ test strips)
  • Two not covered by insurance “because they are available over the counter” (Ketostix, NovaMax Plus Ketone test strips)
  • One Rx lost (Lantus Solostar)
  • Final one not available (Glucagon Emergency Kit)

Not seem right. Ketone stuff always covered before; also seem irrelevant if available OTC; Verio IQ test strips OTC too, no? But very apparent not worth attempt sort out with Catamaran. Blue Cross Blue Shield tell Bigfoot Catamaran wrong; everything covered. Anyway. Decide go back to previous pharmacy:

Target

Target Pharmacy feelings maybe hurt because fill Bubs’s Rx’s always huge hassle for staff. Have to go to refrigerator. SIGH! Have to look in oversized bin. HNNNNNH. Then after finally acclimate huge, confusing Rx order, Bigfoot switch everything Catamaran. PFFFFFFFT.

Today call, try ever so polite voice ask if can fill what Catamaran missing: (Ketostix, NovaMax…etc.) Can hear AYFKM? sauce all over voice. Yes, Target remember Bigfoot. yes, can fill everything except NovaMax Plus Ketone Test Strips. Reason: not available any pharmacy anywhere, possibly not even exist. Try ever so polite voice thank you, Bigfoot see if possible CVS obtain.

CVS

Then call CVS. Bigfoot leave CVS months ago (for Target) when annoying technician make break out in hives. Guess who answer phone! Yes, I remember Bubs. Yes, we can fill those. (So far, so good.) But because of the power outage (Bigfoot think see where this edifying soliloquy headed but bite tongue because know fastest way through technician’s edifying soliloquies = silent listen) during the blizzard, we were unable to maintain some of our inventory due to the temperature sensitive nature of some insulins, it is simply not safe to use them if they haven’t been—-

Foolish Bigfoot attempt interrupt: Oh, I hear ya! We had to throw away some of our insulin too!

Technician continue if the insulin is not kept within the correct temperature range, it wouldn’t be responsible of us to fill your son’s insulin prescription, as the efficacy might not be standard, and—-

Attempt interrupt again that’s okay! I’m not in a hurry!

So the soonest I could possibly get this ready for you would be tomorrow, but you should always have a safe, temperature-controlled back up supply on hand, because many diabetics need insulin regularly, in fact sometimes several times a day, in varying doses…

OhmygodIhatedealingwiththisguysomuch

Of all complex customer service dealings, can say #1 valentine = Animas. Very helpful. Even billing department personnel quite charming. Not sarcasm.

IMG_6194

This makes me happy. I think I am starting to understand.

Two Disconcerts, No Photo Available

Disconcert #1 (long one)

Yesterday Bigfoot math volunteer Bubs’s class. Notice Bubs read library book while teacher give math instructions, then continue read when divide into groups.

Friend call “Hey B, how about you, me, and P?” Bubs not reply, although this premium favorite friend group. “Bubs?” Bubs blink at friend say Nah, I’m leaving. I have low blood sugar.

Teacher hear, ask classmate escort Bubs nurse’s office, meanwhile math volunteer job begin: help children plan 8-person Thanksgiving feast for as close to $175 as possible using Shaw’s sale flyer.

Bubs not come back, not come back, Bigfoot think must be low, must be recover on nurse fainting couch. Then Bubs come back. Sit on floor near group. Group already chose turkey, 99cents/pound. Already calculate cost. Already choose beverage: it Mountain Dew. Ten bottles, $10. Now time for choose vegetables. Boys discuss merits canned vs. fresh. Bubs move away. Sit alone, criss-cross applesauce on cold floor, chin on palm of hand/elbow on knee. Pale.

BIGFOOT: Hi! What’s going on?

BUBS: I’m not going to tell you

BIGFOOT: Why did you leave your group?

BUBS: (Scowls, moves away)

BIGFOOT: Should I leave you alone? I feel like something’s wrong (<–insightful)

Then awesome teacher approach, explain Hey Bubs, your group needs you! Come on, buddy. That  type friendly man chat. It work. Then teacher explain quietly Bigfoot it turns out he was angry that he had to wait so long to test his blood sugar, because someone else was in the nurse’s office, getting their I think it was a GI tube? changed, so it took a long time. But his number was fine. Anyway, it turns out he was just angry that they chose the drinks without him. Guess he’s not so into Mountain Dew.

Meanwhile, Bubs move away. Sit alone again, scowl Bigfoot, mumble something.

BIGFOOT: What did you say?

BUBS: I said I’m DEPRESSED because you did not put anything. Edible. In. My. Lunchbox. So I’m not going to eat ANYTHING for the rest of the day

BIGFOOT: Well, you’re in luck. Because I’m here today. And there’s still time before lunch. So you can tell me what you’d like and I will go get it*

BUBS: I don’t want ANYTHING. Everything you make is always disgusting

BIGFOOT: (having seen this extremely negative rage personality before, makes an unbelievable offer) How about if I go to McDonald’s, and get chicken nuggets and an icy Diet Coke, and drop them off for you in the office?

BUBS: I TOLD you. I don’t. Want. Anything. Especially NOT FROM YOU

BIGFOOT: How about EATS?

BUBS: No!

BIGFOOT: How about Five Guys?

BUBS: Nice job on wasting your life trying to name restaurants. You don’t even know any good restaurants

etc.

After math volunteer job end (Bigfoot recommend each group $4.99 clementines, Buy One Get One Free Boursin cheese, avoid pre-made Shaw’s pie. Very help), nurse call Bigfoot telephone. Hello, Bigfoot? It’s not an emergency. Before recess he was 79. When he came at 9:30 he was 252, no ketones. When he left math because he felt low, he was 119, and then just a little bit later he was 79 so I knew he was dropping so I got him to eat part of a Luna bar…

All pieces fall into place. Bubs read instead pay attention because BG mid-plummet. Does right thing: visit nurse. But # is normal. So return same dismal situation. Sit in math, more plummet. Feel worse and worse. Probably feel something along line of “I asked for help because I feel like shit and they told me I was fine.” Disconcert because: not sure how could be different, but this very sad.

Disconcert #2 (short one)

Pick up Rx refill @pharmacy. This trip Rx special. Because for 1st time in forever, pick up syringe refill. Because travel Thanksgiving. Because back up for pump is Lantus pen/pen needles + Humalog (non-pen) + syringes. Co-pay for syringes: $25.72. That weird amount for copay. Thought would be $5. Call Blue Cross. Very helpful. Say Bigfoot responsible entire cost syringes because name brand. Ask is there a generic brand I could get instead? Answer no but: you can get them at no cost from a durable goods supplier. Say what? Blue Cross Rep start rattle off names durable good suppliers.

Disconcert because: Bigfoot consider mail-order diabetes supplies territory of Actual Diabetes Persons. Such as: people meet at Friends for Life (experts), old people, Type 2s, people who can’t drive/no legs/blind, Wilfred Brimley. Today mark day Bigfoot cross over into Actual Diabetes Person.

*Defensive N.B.: Bigfoot not usually so coddle, but Cognitive Behavior Diabetes Therapist teach Bigfoot how bend away conflict this manner when child so insanely unreasonable.

Birthday

March 13th dinner at Sushi Express: I tried to give out Lego minifigures for dessert instead of birthday cake. Not recommended.

Bubs nine now. Happy Lego. Sushi Express dinner. Avocado maki. Miso soup. Green tea ice cream tempura, “9″ candle, Chinese Sushi Express owner sing happy birthday song. Happy.

Today Wednesday; no school. Bubs attend huge birthday party brother/sister twin friends. Bigfoot sit in sunshine, deck, host and hostess so nice, bring water/pizza/chocolate pretzel/plenty cheez doodle. Bigfoot work little bit. Mostly worry. Carb(how much?)-injection(guess)-running around(low?)-cake (high?)-2nd injection(mistake?)

Never mind a functioning pancreas, you get a CREEL!

When this get better? Know from read, answer is never. Never get better. Always hard. Sick of. Sick of hear self complain. That why seek always better diabetes app, better wicker creel, better breakfast, better better better. Never better.

BC=Before Cheeto, Before Cake

Bigfoot know many nice person, cut Bigfoot lot of slack. Today so sunny. Perfect day for party. Host, hostess make Bigfoot feel at home, not dork with medical supply hovering in creepy fashion. Before diabetes, Bigfoot probably characterize adult stay at party with needle bag Big Creepy Helicopter Loser. Bigfoot lucky most people not mean like Bigfoot.

I had a mouth full of Cheetos while telling Bubs he had to wait to eat Cheetos.

Tomorrow Bubs’s last normal day for while. Friday skip school for Coro Center/Animas pump lesson #1. Shudder. Bigfoot learn insert tiny tube under skin. Hope not barf. Know pump good. Trust pump improve health, improve life. Know lucky insurance provide pump. But dread learn how use. Not even use remote control Bose radio–climb up kitchen stool, reach top refrigerator, use regular on/off button instead.

Whoop

Kemal, what are your thoughts on the Pertussis vaccine?

Yesterday at Pediatric Anxiety Clinic, therapist ask Bubs, “So, how was your weekend? Did you do anything fun?”

BUBS: I played Just Dance on XBox Kinect while my mom was drunk with her friends

BFOOT: I was not drunk. (Say to Bubs, but for benefit therapist)

THERAPIST: (Nods encouragingly.) I’ve always wanted to play that game!

BUBS: Mom was so drunk with her friends

BFOOT: Come on, I was not drunk. (Was I drunk?) You know that’s not true

THERAPIST: Let’s move on

Therapist already notice Bigfoot obsessive cuticle problem. Also, probably think Bigfoot have overly large handbag with too many item inside, it challenge find calendarphone when time for schedule more Pediatric Anxiety Clinic appointment. Psychologist probably learn in graduate school big handbag mean something about vagina anxiety, or womb issue. Carry big handbag compensate not have more children? This why so Bigfoot become so emotionally invest in dog? Now therapist make note Bigfoot alcohol abuse parent too.

Try hard remember: it not all about Bigfoot self.

Now calendar page flip to 2012, Bigfoot learning price tag on all medical treatments. 45 minutes anxiety therapy: $350. Office not have floor-ceiling bookshelf or Tekke carpet or even fresh coat paint. Everything cost big heap of money, still not enough Ikea/Pottery Barn level sophistication. Bigfoot make extra sure spouse not late work—set lunch container out in obvious place, that often what cause delay.

Meanwhile, town have outbreak of plague, also go by name pertussis, cute nickname Whooping Cough. Town offer free vaccine, all citizen may attend, bring insurance card. Bigfoot poke around, try determine children need vaccine booster stay safe this germ. Jack sit at desk cluster with Patient Zero. Patient Zero cough on Jack daily. (“Not contagious any more.”) Bigfoot know Jack hardy but worry if bring home germ for Bubs. Call pediatrician. Put on hold. Come back on phone, sound exasperated. Say will have to call back. Inform Bigfoot this third person in row call ask what do.

Pediatrician office call back.

BFOOT: Hi there

PO: Bigfoot? This is the pediatrician’s office. Your children aren’t yet ten, so they’re all set.

BFOOT: Jack is ten

PO: Yes, ahhhh, Jack is ten

BFOOT: So…should he…

PO: Yes. He can get the vaccine at school (click!)

This pediatrician office worker tire so easily persons call advice, maybe in hot discussion latest Downton Abbey. Bigfoot finish season one, episode two, Kemal Pamuk death episode. Very engrossing.

got more cheddar than some super sized nachos

It's expensive to keep our ducklings alive

Something happen 2012: Bigfoot family see price diabetes first time. When diabetes adventure begin August 2011, Bigfoot family already meet $3000 insurance deductible; everything label with price tag $0.00. Hospital: $0.00. Medicine: $0.00. Equipment: $0.00. Yesterday, after read Six Until Me, Bigfoot learn this not very close approximation actual cost.

Drugstore dot com list 5-catridge pack Humalog: $628.28 – save 18% ($136.74). Bigfoot obtain 5-pack each month. Lantus: $125/bottle. Holy crap. Bigfoot currently have $3000 insulin in fridge. That legal? And test strips: $120/100 strips. Fucking ass hats! Also have Animas insulin pump in basement ($7000.) Dexcom CGM on way tomorrow ($2000?)

Please watch this movie

One part brain, feel lucky. Other part, feel sure insurance system brink collapse. (When Bigfoot run insurance company, light cigar; sign initiative giant Mont Blanc pen: DUMP THE TYPE ONE DIABETICS ASAP.) And third part brain, feel disgusting hog resources.

Watch Life for a Child movie. Spoiler alert: Rural Nepalese diabetic child test blood sugar once every few months, travel six hours on foot/bus, faint on way, father scoop water buffalo dung bare hand earn money live close enough hospital keep child alive, keep vial insulin in twist-tie baggie in hole in floor fill with water—no fridge. Rural Nepalese cuisine look good though: rice + curry.

Bigfoot have idea for Blue Cross Blue Shield Rhode Island: offer $5000 diabetes supply Nepalese baby if Bubs forgo insulin pump. BCBSRI keep $2000 savings for cigars/Mont Blanc pens, Bigfoot not need learn insert tube Bubs’s abdomen, Nepalese baby test blood sugar 5,000 times over course 4 year when Bubs eligible insulin pump again.

Low Blood Sugar vs. Sportsmanship

Not 61, not 52, not even 74: 124. Just a bad mood.

Bubs flop out on floor halfway through fencing tournament. Bigfoot impress self: stay calm, cool, enter emergency mode. Low blood sugar! Test. Bubs get 124. Damn.

Bigfoot fondest wish blame bad sportsmanship on blood sugar, but it not possible this day. Fencing teacher encourage Bubs finish tournament, feel “sense of accomplishment!” Reluctantly agree.

Small people fencing fun to watch, only because when score, see cute little gauntlet fist pump and hear “yessss” through spooky hornet mask. At end, Bubs win green “Sportsmanship” ribbon. Bigfoot have hard time not laugh when Bubs cry, “I didn’t even win eighth place!” Tears streaming down red, red face.

In car, test blood sugar again: 71. That low, but not low enough explain away ferociously pissed off mood. I HATE FENCING! and YOU HATE ME, THAT’S WHY YOU MADE ME COME! and FENCING IS SO STUPID!

Bigfoot ineffectually say over and over, “No, it’ll be OK. You know I love you. Come on, it’ll be OK. Oh, honey. You know that’s not true” in allegedly soothing voice, try channel Ma Ingalls. Half Pint freak out sometimes too.

Meanwhile, Bigfoot complete 2011 insurance medical supply hoarding cycle. Most impressive: lancet tally—1,122. Probably last three years, since Bigfoot, Bigfoot spouse, and Bubs never remember advance barrel until lancet too dull penetrate calloused fingertip.

Stocked

(BLEEEP) in Bed

Bigfoot try so hard not mention new terrible thing. Not mention this other parent diabetic child, not even mention this to other parent diabetic child live in Bigfoot own home. Why make catchy rhyme, so terrible thing? Whole thing BS: …found dead in the morning in an undisturbed bed after having been observed in apparently good health the day before. No cause of death can be established. This is the typical situation of the “dead in bed” syndrome, a very tragic outcome which leaves the family with many unanswered questions: Why, when, how, could it have been avoided?

Now we REALLY need one of those hypoglycemia sniffing dogs.

On plus side, it rare: a number of young people with type 1 diabetes have been found dead in the morning without previous symptoms of illness, hyper- or hypoglycemia. The number of deaths of this kind per 10,000 patient years has been estimated to 2-6. For a population of 100,000 persons with diabetes, this represents 20-60 deaths per year.

Semi-plus side, seem mostly UK endocrinologist study it. Maybe Bigfoot forget about it soon.

Father and son at the statehouse, enjoying Lincoln Chaffee's holiday tree.

Meanwhile, three good event. 1: Bigfoot and Bigfoot spouse go on first date since August 9th (dream babysitter have 10 year old diabetic daughter.) 2: Bubs finally meet legendary Dream Teen: supercool boy, varsity hockey, diabetic since age 8, know how babysit. 3: Bubs and Bigfoot begin use FrogLog or LogFrog app, keep track blood sugar, carbs, insulin, activity. Frog create satisfying graph. Person at company agree add fencing icon to exercise section. Nice. Bonus good event: Christmas lights everywhere.

And one neutral event: Shane at Animas wrestling Blue Cross Blue Shield get money for Ping pump. Bigfoot never consider what happen Blue Cross Blue Shield say no. Why have think it over so many days?

The Pump. The Pump. The Pump.

A disturbing story about whacking a young duck

Today see Coro Center Diabetes Nurse Educator. Love this nurse. See nurse around town. Cute curly hair, very short. This nurse stop to pee in Bigfoot area Shaw’s supermarket (bathroom) when on long distance run. This nice nurse show three insulin pump samples.

#1: 1950′s-thick Kotex, egg shaped/size of duck egg. Remote control in Walmart blue with Oldsmobile dashboard texture

#2: not waterproof, cool transparent design

#3: waterproof, look like iPod if created in late 90′s (jellybean iMac era)

Bubs choose #3. That not true. Bigfoot and Bigfoot spouse choose #3, Bubs stick Kotex egg over belly button, it fall off.  Then play Doodlejump on phone. Meanwhile, as if need pretend consider options, Bigfoot spouse stick Kotex egg on arm, say, “Well, this doesn’t hurt at all.”

NURSE: you know, there’s no needle in that one

BFOOT SPOUSE: ah, I see. So it can’t just atmospherically secrete insulin through my pores

NURSE: no.

Actually look more like Zune or Rio.

#3 name Animas One Touch Ping. Ping, like ping pong. (Bigfoot favorite sport.) Ping like storybook duck, pretty sure duck Ping receive corporal punishment (lead pipe?) when tardy arrival Yangtzee River. So Bigfoot fill out paperwork, fax to Animas tomorrow. Bigfoot also fill out paperwork Dexcom continuous glucose monitor. Although Nurse say Dr. Doughnut believe CGM a useless device, Bigfoot wish get one while insurance pay 100% cost.

End of meeting, Bigfoot ask, “Are there any other expensive gadgets I should request before our insurance changes?” Not say out loud, but stall while rack brain for idea more thing ask have.

Remember 1980s SNL skit The Pump? Bigfoot remember jingle, “the pump(…)the pump(…)the pump(…)” but not remember premise. Now see it about lung cancer and syphilis. Eddie Murphy play smoking doctor hold spray bottle anti-cancer treatment. It not funny, but jingle run through head all week.

So Savvy

It happen: Bigfoot guess correct insulin dose heretofore unknown Whole Foods Bakery Banana Chocolate Chip muffin. It true. 2.5 units at 1:20 (this mean Bigfoot guess 50g carbs.) Check blood sugar two hours later, it 108. This closest thing win lottery Bigfoot experience in life. (Tie with time win $780 in 50-50 raffle.)

Boy, is he savvy!

Yesterday Dream Nurse absent from school. 18-year-old Dream Nurse daughter return USA from semester in Australia. Dream Nurse warn Bigfoot two weeks advance this happen on November 28th.

Monday, November 28 morning, Sub Nurse call Bigfoot. Sub Nurse unusual speech pattern, overuse word “savvy.” As if just learn word savvy, love it, want use it over and over. “Mrs. Bigfoot? I just wanted to call to introduce myself? Bubs came down to see me and, you know? Boy, is he savvy.” Then invite Bigfoot come in office, demonstrate how test blood sugar. In person, Sub Nurse explain, “I have seven diabetic kids at my school in Portsmouth, and they’re all on pumps! But I can tell, your son is savvy! Boy, is he savvy! He was ready to show me how alllll the equipment works by himself, but I told him we’d better have Mom here with us for the first time.” Then, in voice like Broadway musical aside, “He is so savvy.”

Pick up time, more savvy-savvy-savvy. Nurse offer Cliff Notes version life story: turn out nursing second career for Sub Nurse. Have “rich background in Rhode Island schools,” as administrator and guidance counselor. Bigfoot say, “Wow! That’s really cool.” But think, you are frightening me. Then Sub Nurse ask, “When will Bubs be on the pump?” As if plan not return our school until that time arrive.

It a huge relief Dream Nurse back on scene today. Bigfoot really enjoy Dream Nurse daily email with blood sugar numbers and play-by-play commentary: Bubs had only 16g carbs for lunch (the crackers, the roast turkey, and some of the nuts), but gave him a whole unit since he was veering a little more toward the high side. That not actual quote, but it true she specify roast turkey—as if in deference Bigfoot prowess cook turkey not purchase Sara Lee Honey Turkey in resealable tub—and describe nuances dosing decisions.

Bigfoot tell Dream Nurse, “Sub Nurse was a real character! (I mean that in a nice way.)” But it not true, Bigfoot mean it in bad way.

Next week, whole family have appointment see Coro Center nurse Terri for pump class. Bubs not allowed use pump until February, but Dr. Doughnut allow Bubs get pump sooner, avoid hazard of potentially large 2012 insurance co-pay. Now that luxe insurance chapter of life coming to close, Bigfoot relish opportunity get free items.

Bigfoot say other thing

Bigfoot sure this not right placement Pinterest button

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