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.

Strip Hog

Tiny golden appetizer forks.

Recent switch VerioIQ meter. When pick up snazzy golden strips, find 300 in bag, not 400 as anticpate. That odd. Ask CVS pharmacy technician why change, technician answer with professional tone, These strips are used for testing the blood sugar up to 8 times a day. As if frequency of test relate to color scheme on box. Bigfoot hate when get this technician. Always manage smug + dumb combination, even if Bigfoot purchase bandage, Cashew Lover’s Mix, or probiotic supplement.

Call Coro Center ask why change, also write email explain why need at least 400, it not Bigfoot attempt open small business test strip cantina in garage.  Also, insurance already pay 400/month. Why Coro center downsize Bubs strip allocation?

CDE call back. Heard from Other CDE Dr. Doughnut say “That’s too much testing.” But this CDE read Bigfoot email explain why so many. Agree with Bigfoot not too much testing. Generously add, “You didn’t even include needing to re-test him after he’s low!” (Good point! This statement make Bigfoot feel understood.)

CDE: I’m glad I spoke to you. I’m going to print out your email and present it to Dr. Doughnut. I mean, especially if your insurance was paying for 400 before, there’s really no reason for it to change just because you changed meters

BIGFOOT: Well, you know, Dr. Doughnut might think this much testing is too much of a burden on the child

THIS CDE: You’re right. She might think that

BIGFOOT: But with his school schedule, and recess happening way before lunch, and needing to test before he eats, and before he rides his bike to and from school by himself…anyway, you already agree with me so I won’t go on and on about it but really I don’t see what we can cut out, and even if our insurance wouldn’t cover more strips, we’d still want to buy more and be able to use our HSA account to pay for them, and we can’t use our HSA unless we have a prescription. I’m sorry, I won’t keep talking about it. I know you know what I mean

THIS CDE: Yeah, you’re right. I’ll talk to Dr. Doughnut in the morning and call you tomorrow to let you know what she says

Bigfoot sad request result in endocrinologist slap Bigfoot for try too hard. Violin music, poor Bigfoot. Hope story end w/ more test strip in Rx, not Bigfoot come to term w. own insanity.

I have been adding this up over and over and over again. 15 is normal for us. Fifteen! And still with such rickety control. We really need to learn to use the Dexcom. This whole thing is stupid.

Schooled

Desperate times call for reading Old Cricket marginalia.

Pump practice week require saline bolus. Saline bolus make Bubs cry: it hurts like a bee sting! Bigfoot raised by wolves; wolves train Bigfoot first course action when feel bad/sad/pain is decide bad/sad/pain imaginary; overcome problem by read book/Cricket magazine.

Faces hidden to protect these sweeties from overexposure. Pump hidden by laser gun.

However, after five bee venom bolus, Bigfoot Google “saline in pump hurts;” learn this not only real but also common. DOC recommend let saline drip into paper towel during practice week, in order not psychologically retard child pump progress/cause child hate pump.

Bigfoot not hate pump anymore. Nice pump: excellent calculator. Pump drip insulin all day, not need remember Lantus. Pump give very precise bolus. Bigfoot ashamed complain so much pump not have touch screen/moan about wish Steve Jobs Type 1 before die cancer. Bigfoot know complain/moan no good except for community service, make enlightened person feel good about self.

Lately Bigfoot provide other community service: advice repository. Bubs need exercise: check. Bubs need Omega-3 fish oil supplement: check. Dr. Weil say Bubs need cinnamon: check. Thank you these astute tips.

 

Someone owe someone else $82.70

and after the hospital, Target for Lego sets. And after Target, CVS for drugs.

Blue Cross Blue Shield Rhode Island call Bigfoot today. Say need apologize. Tell Bigfoot overpay on deductible, maybe pay Providence Pediatrics $82.70 twice. Very complicated book keeping information relayed by telephone, Bigfoot not able to process—while on phone, Bubs looking up with eager eyes, miming play PSP game—also Bigfoot slicing apple, also kind of uninterested this topic.

Try to end conversation. Say, “Wow, well, thanks for telling me. I guess if I owe anyone money they’ll bill me.” Representative correct Bigfoot. It that maybe Bigfoot family pay twice. Representative notice much activity on account around August 9th, can Bigfoot remember why go pediatrician after hours that day?

Pffffft. $82.70 nothing! How BCBSRI afford spend time track down information this amount when hospital bill probably a 5 digit-er. Bigfoot never become CFO. American Express bill show August 9th charges Boston Museum of Science, then later Rhode Island Hospital Au Bon Pain. Bigfoot remember everything. Go Science Museum, get diabetes. Pediatrician, ER, Hasbro hospital Au Bon Pain. Red velvet cupcake for Bubs, then vegetable soup for Bigfoot, then another vegetable soup for Bigfoot. Bigfoot even remember scratchy area on soup spoon, small cut on tongue.

Bubs feel a low in school this morning. Bigfoot happy Bubs notice. He tell teacher “I feel shaky.” Teacher call nurse. Nurse enter classroom. Number 60. Nurse telephone Bigfoot when it over. Later Bigfoot remember idiot move: Bubs pour entire glass of milk on oatmeal today. Swamp it. After eat oats, milk remain in bowl. Bigfoot subtract carbs for left-behind milk but not sharp enough think: there’s maple syrup in that milk, you’d better subtract for that too.

Every parent child with diabetes wish could have diabetes in place of child. This especially so Bigfoot case not just because Bigfoot so so kind but also because Bigfoot total food control freak, probably excellent diabetes patient. Also look at swish belt hold insulin pump. Bigfoot like one in center photo, large polka dot. Maybe get for iPod.  Now look how sad same product for boy. There no way make accessory for boy look good. It impossible. (Sorry fan of Pixar Cars.) Bubs not have pump yet anyway. Hope not have to resort fanny pack.

Hurricane zucchini bread

Famous librarian place all three Graham Roumieu book on Bigfoot front porch! Now have something good to read when not have pharmacist on telephone.

Spend day in Irene waves at 2nd beach with different librarian friend, this one work right beside beach at St. George’s school. This librarian have boys same age Bubs and Jack, they all attend East Side Nursery School in era when Munroe Dairy milk delivery replace 100% apple juice as snack accompaniment. Current matriculator at this school find difficult believe juice ever offered as legitimate beverage. Maybe one day pendulum swing in favor or Tang, Mountain Dew, or VitaminWater Zero. Bigfoot not have crystal ball. However, Bigfoot pretty sure cow milk trigger Type 1 diabetes, base this on one evening internet research plus fact Bubs love drink milk plus such high incidence of Type 1 diabetes in Finland, where Bigfoot assume guzzle milk for ski sport endurance, high blood pressure, rosy cheek, withered up pancreas.

At beach Bigfoot have idea spur of moment invite two little librarian offspring friends for sleep over. Rinse off sand, table for six: three coffee milk, two diet coke, one red punch, one hamburger on toast, one cheeseburger with ketchup, one hamburger patty with no bun and one pickle, two wieners all the way, one large platter french fries. It utterly disgusting. Happiest customer boy who select naked patty and red punch.

What happen? Maybe some Homestar Runner. Maybe some video game. Now it quarter past eleven PM. Bigfoot and Bigfoot spouse make other spur of moment decision: bake six chocolate zucchini bread. It eleven-sixteen PM. 57 minutes to go on oven timer. Four boy wandering around looking woozy, not want go bed. Household lead by worried, fake-jolly Bigfoot not so good place for visiting children—they probably be bitchy when go home tomorrow. Bigfoot sorry. No givebacks. Eleven thirty-four.

Pretty sure brush teeth. Now Bigfoot spouse reading hilarious Mr. Gum story out loud, everyone laugh when main character Polly use “Low-fat yogurt!” as expletive. Tee hee hee hee hee. Hope visitor boys really think is funny, not peer-pressure to laugh, not feel homesick. Hope they not harass Bigfoot in middle of night.

Throughout day, Bubs mention, “Isn’t it about time to check my blood sugar again?” He very self assured with test kit now, but still often assess size of blood bead as adequate when it too flat or too small, result in ErR5 message. That why Bigfoot so happy CVS encourage BCBSRI pay for 400 strips/month instead 300 strips/month. Bigfoot not mean to be gauche.

Hurricane Irene coming. No banana in Shaw’s supermarket. Also no Diet Coke, and only one Lime Diet Coke—now that gone too. Still available: Coke Zero, Coke Zero Cherry, Coke Zero Vanilla, Caffeine Free Diet Coke. Three addict stand together in Soda-Diet Soda-Water aisle gaze at shelf where plain Diet Coke belong. It not appear. Move to other department. No need panic, many cases remain Poland Spring Water, Thomas’s English Muffin, Olivia’s Organic Baby Collards.

All over Rhode Island, first day of school already cancel for hurricane.

Kwikpen at America’s Douchiest Colleges

Juniper

Bubs need smaller dose insulin now. Ratio one unit : forty carb. This mean Bigfoot need use one unit dose some of time, but Kwikpen release only unenthusiastic dribble drop, not genuine unit. For two-unit dose, Kwikpen spray with gusto. For one unit it say, “meh. I’ll give you a little droplet, I guess.”

Bigfoot ask endocrinology nurse this seem correct? She say she never try Kwikpen only one unit, “I’ll get my Kwikpen out right now and see.” Bigfoot hear rummage-rummage sound, then, “OK, I’m priming it with two units, yep, and there’s a nice spray for two units. OK, and yup. For one unit I do get a definite spray, but a much shorter spray of course, and then a droplet. Your pen may be defective.”

Bigfoot huge fan of Patagonia return policy, also L.L. Bean, so ask, “Do you think I can take it back to CVS for a new one?” Nurse say, “Sure. They’ll alert the manufacturer that there may be a problem with that lot.” Bigfoot call CVS. They say come to store, pick up new case Kwikpen (5-pack) right now. Bigfoot feel pretty sure new pen also not work but that may only be craptastic mood, not rational thought.

CVS pharmacy staff very kind for diabetic family. No one CVS ever show concern when Bigfoot present mundane ailment such as psoriasis, dandruff, yeast infection, depression, conjunctivitis, anxiety, seasonal allergy, sinus infection, louse infestation, migraine. Not ailment of Bigfoot self, of course. Bigfoot never have problem—it amazing. Young man pharmacist trainee even help Bigfoot find blood glucose meter replacement battery. Here is hint: it reside in battery department. Official diabetes medicine snake icon on package.

Many part of day quite fine. Bubs and Jack swim with friends indoor and then outdoor at YMCA, fun ladyfriend by side listen Bigfoot rattle off long list of problem and anxiety, not give advice, just agree it suck.

Later in day visit Juniper on Thayer Street for addictive tangy frozen yogurt top with assorted fruits microdiced by family of Korean perfectionists. If not enjoy fresh microdice of fruits, may choose Fruity Pebbles cereal. Juniper yogurt contain many carb, so no need try make Kwikpen deliver one unit. That a relief.

Entire conversation with endocrinology nurse take place in Urban Outfitters books section. Bubs’s open blood glucose chart block other patron access to America’s Douchiest Colleges. Bigfoot not notice Bucknell University listed, it probably not rigorous enough land in glossy humor book, but Bigfoot get caught in reverie of water polo team members wear woven leather belts with long, dangly excess belt hang along fly of Bermuda short—Bigfoot not 100% sure but Bermuda douche short circa 1993 probably even have pleat. This look remain popular in current era among some Sowams School parent, it kind of thrill rub shoulders with genuine, guileless douche in gymnasium-cafeteria. Almost same as come across Renaissance Faire Lord or Lady in Shaw’s.

Too Myopic for Bigfoot

When I see coverage of the famine in Somalia, I just think: whoa, better not go there with Briggs. I picture being in the Cormac McCarthy The Road and how many syringes I’d need to carry, and then that it wouldn’t matter if I filled my entire survival wagon with medicine and needles, it wouldn’t be enough, and anyway people would steal the syringes to make me into a better-tasting ham.

Briggs is still doing fine, if you overlook the dinnertime “No thanks, I’m hungry but I think I’ll just lie here until I die” thing on the living room rug. (He ate farfalle and Nate’s vegan meatballs and broccoli, and lived.) Everyone except target-audience Briggs guzzled a green smoothie which was so sweet with pineapple juice and bananas any kale benefit was surely cancelled out but he did eat the broccoli without comment, as if it were the most normal thing in the world.

Insurance papers are staring to come in the mail, retelling the story of the past week point five. They seem to indicate that we owe no one money, but they make it seem possible that none of this is covered. Everything says THIS IS NOT A BILL. Nothing says DON’T WORRY YOU DO NOT OWE ANYONE MONEY. A smart insurance company would stamp those words in corporate red-magenta ink whenever applicable.

More luck: a woman in town befriended me for a mysterious reason about maybe a year ago, acting on a feeling that we have something in common. It turns out her daughter is one year older than Briggs and diabetic. We got together yesterday. She is wonderful–the kind of person who says humans probably shouldn’t drink the milk of other mammals except for in coffee.

She pulled prize after prize out of a shopping bag: a travel-sized sharps container (actually a box of EIGHT travel-sized sharps containers. “I don’t need these!” she said, then demonstrated the sharps-clipper that allows her to separate the needle bits from the bulky plastic bits of syringes); CVS-brand cherry glucose gel to revive a passed-out child (“It came in a three-pack! It tastes gross”); a spare finger pricker set (“Every time you go to a doctor, they give you another one of these. You might as well keep an extra one in your car”). And more riches.

She said she now thinks Type 1 diabetes is the reason she was mysteriously drawn to me. At the end of our meeting I found out her husband is a dog whisperer. Maybe this miracle person will teach me to be a diabetes mother (“we are their pancreas–we inject insulin”) and the husband will work some woo-woo on Butter.

Bigfoot forget medicine

Bigfoot family go Brewster for day, see Bigfoot sister family, Bigfoot parents, and crowning jewel Brewster, The Cook Shop.

Bigfoot purchase tea cup fit in car, it have matte jade green finish, it double-wall ceramic, it not have cumbersome handle, it not have silicone lid, it perfect for Bigfoot on go when no want silicone flavor tea. Bigfoot find giant refill Mrs. Meyers Lemon Verbena hand soap. Also mayonnaise spreader design in Sweden. Bigfoot plan use spread peanut butter or goat cheese with dry rind/gloppy center. Pay for all with gift certificate. Free kitchen item reliably bring Bigfoot invincible luck feeling. Bigfoot tired from diabetes week but heart overflow with joy at sight of merchandise.

Bad side Bigfoot not think need bring Bubs’s night time diabetes medicine and syringe. Also forget Sagamore traffic bad on Saturday. Grammy always warn Bigfoot, “That’s changeover day! All of the tourists leaving their rental houses stay for the day if it’s good beach weather and the traffic will be terrible at night!” It only true 7% of time in Bigfoot experience. Worry like tsunami hit Bigfoot and Bigfoot spouse at 6PM: what if trap on bridge when time for injection and no have medicine? Decide need page doctor on call.

Bigfoot and Bigfoot spouse not pimps, not know how work pager. Coro Center nurse explain pager yesterday but Bigfoot not absorb lesson. Yesterday Bigfoot pretty sure not have emergency, it not seem pertinent. Emergency maybe for other family, Bigfoot family have enough excitement for week. Now Bigfoot know how work pager. It simple enough for idiot. Secret is resist thought, push Bigfoot phone number on keypad, and wish.

This happen Paine’s Creek beach. Bubs and brother and cousin have fun attempt boogie board at low tide. It futile! On call doctor have screaming baby in background, she patiently go over blood sugar numbers with Bigfoot. She not rush Bigfoot no matter how much baby scream. It calmest Bigfoot ever feel in presence of screaming baby. She tell Bigfoot Bubs’s numbers sound OK. She call Lantus prescription to Brewster pharmacy.

Brewster CVS not in Brewster, it Harwich. It think Brewster better address; value social climb over geographical accuracy. Bigfoot spouse find CVS and get medicine. Blue Cross Blue Shield want Bigfoot spouse pay $150 for extra medicine. CVS pharmacist think that not right. He call Blue Cross Blue Shield to finagle “vacation exception” and save Bigfoot money. That nice enough Bigfoot not mind CVS fake address. Bigfoot understand desire impress customer. Bigfoot get married in Harwich at place describe self in Chatham; when stranger assume Bigfoot get married at Chatham Bars Inn, Bigfoot not mind misconception.

Bubs eat swordfish, corn, watermelon, and sand torte for dinner. It impossible to know precise carbs for cake. Creepy Calorie King assign 50 carbs to 3.5 ounce slice pound cake, Bigfoot go with that number but know deep in heart this sand torte no ordinary pound cake. Maybe tomorrow Bubs eat only food in package, cheese, and diet jello.

Bigfoot say other thing

Bigfoot sure this not right placement Pinterest button

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