Update on Abdominal Agonies

The stomache pain has faded but isn't gone.
I saw the endo last week, and he did some bloodwork (electrolytes, white blood cells, etc), although I don't know the results. He gave me two bottles of Nexium40 samples, which should help if acid is the problem, but they don't seem to have made any difference thus far.
I had a gallbladder ultrasound this morning, where a student of some kind (with supervision) took pictures of my gallbladder, liver, and pancreas. I asked if the pacreas looks normal in diabetics, and the supervisor said yes. I wonder if I can get a copy of the picture of my pancreas. That would be cool. The doctor won't have my results from the ultrasound all that soon, and I won't have the results any sooner than he will, so I'm guessing that I'll have no more news on that topic for a few more days.

Abdominal Agonies

I've been in abdominal pain of various levels of severity since Thursday evening, and it is now Wednesday morning. The pain has woken me up every night, I've spent over an hour each day (and more than six hours on some days) in the kind of agony that shuts out everything else, the rest of the time being in pain but not so bad that I can't walk or shelve or dress a loom or go to a museum.
I have not thrown up (though some weird gobs came up to my throat). The pain itself has sent my blood sugar up, as much as 300 points in under an hour. The abdominal pain doesn't seem to be caused by food, although eating sometimes makes it a little bit worse- but not eating doesn't help, I haven't thrown up, and it's been six days so I don't think it's the food.

This morning, after waking up in pain and spending an hour rolling, pacing, thrashing, rocking, etc, I asked my mother whether she thought I should see one of my usual doctors or a regular internist or a gastroenterologist, and she suggested my endocrinologist, so in four minutes, when his office opens, I intend to make an appointment for this morning, tommorow evening, or Friday. I've packed in case the visit results in a hospitalization (my mother the MD thinks it may be a gallbladder stone, and I keep wondering about appendicitis). I decided not to take the Lantus with me, but I labeled it in the fridge so that my parents will be able to locate it if I need them to.

General Updates

I stuffed myself for two weeks and my weight still didn't go up..... grrr! It was one pound down from the last reading, three weeks ago. Maybe I really gained like half of a pound, but wasn't as hydrated or something, I don't know. It's kind of discouraging. I'm never hungry after the first hundred calories, and what am I supposed to do, eat twenty snacks per day? It's so tough to stuff myself and then not see any results. We are halving the testosterone dose again, which had better not further the weight loss.

The medtronic representative called and said that my insurance, Blue Cross Blue Shield of Illinois, has issued a statement saying that on April 1, they will come out with their decision about CGMS coverage, and that it will be up on their website at that time. It had better be a good decision, that's all I have to say.

A Word About My Shipment, and Those Pictures I Promised

I talked to Prime Mail again this morning. They said they don't stock multiclix devices because they're OTC and insurance doesn't pay. I was like, But ketostix are OTC and you stock them (although insurance did not, in fact, pay). I'm going to go to a pharmacy and see if I can buy a multiclix lancing device. I've been using the softclix and it just hurts too much.
I got a box with some of my supplies yesterday and another box today. Here are pictures.


This was the first of the two boxes, and came on Wednesday. My mother opened it while I was at school, and put the Novolog in the fridge. Here's the size of the box. I took the two boxes of syringes out so you can see them. They're two boxes of 100 syringes each, with half unit markings.



This came in the second shipment. I got one box of Lantus opticlix cartridges. I squished out my name on the prescription label. Hopefully that makes this private enough.



This is what it looked like inside of the box. I was surprised to see the screw type plastic at the bottom of the cartridges. I haven't used them yet.




P.S. 12 to 15 units is actually a very generous description of how much Lantus I use these days. I haven't used 12 units in one day in over a month. However, for most of 2008, I averaged over 20 units of Lantus per day. In May I used almost 40 units per day. However, since lowering my testosterone dose in August, my doses haven't exceeded 15 units, and since lowering them again in late January, I've rarely taken 10 units. It's kind of neat how that works. I took 8.5 units of Lantus (in a new syringe) yesterday and 8 (in an old syringe) today.
Oddly enough, I averaged 29.5 units of Novolog per day in December and 22 in February, meaning that I take more than twice as much Novolog as I do Lantus.
I weigh about 46 kg, btw., and back in August I weighed 54 kg.

Lantus formats

11 days ago, I mailed in a prescription for Lantus penfils. Yesterday I got an automated phone call that there'd been a problem with my order but that it would ship in a couple of days. Today my mother conveyed a message from my endocrinologist; the pharmacy called him to ask if I wanted the Solostar or Opticlix. I'm supposed to call him and tell him. Of course, I want the Opticlix because that's just plain insulin cartriges; the Solostar is an actual disposable insulin pen. I mean, I could draw the insulin from that too; but it doses in full units only, requires more force than I want, and isn't known to be accurate.
I am sooooo impatient for my supplies to come!

Waiting for the Shipment

I am waiting for the new supplies. Anxiously. It was time to use a new thing of Lantus last week but I was hoping to start on the new penfills (I'm not switching to a pen, it's just that I hate wasting the stuff), so I waited. But I changed Lantus vials today. It was really time for that.
I'm no longer upset about the 6.9 A1c because I've figured out that the higher hemoglobin level probably caused the rise. It's okay. If it was just a tad higher, insurance might care because I'd be "uncontrolled" but for insurance purposes, the difference between the 6.4 I expected and the 6.9 I got doesn't exist. And I know perfectly well what my blood sugar average is without an A1c to tell me. I am somewhat concerned about the high hemoglobin level now that I've read more about it, but I'll be sure to talk about it at my next appointment in another two and a half weeks. Maybe I'll have a fructosamine drawn while I'm at it.

When my supplies come (from Prime Mail Pharmaceuticals, btw), I'm sure I'll take pictures and post them. In the meantime, here are some of my thoughts.

Tip: Always get your endo to write prescriptions for more than you need. Your needs may increase between now and when you next get scrips, it might take the pharmacy too long to fill your order- whatever. More is better. This is particularly true for the insured.

Tip: For drugs other than narcotics and anabolic steroids and stuff like that, prescriptions are generally good for twelve months. The doctor can check a little box that says you get to refill and he can either write in a number of refills or check unlimitted refills (I get unlimitted refills on glucagon and limitted on the rest of my stuff).

It's possible that it's your insurance's fault if you have to resend prescriptions every 6 months.

Tip: Prescriptions will be kept on record by most mail in pharmacies and walgreens, so you'll only need them once, but you can get your doctor to write two versions if you think you'll switch pharmacies.

Tip: Get the NDC or a very exact description on the prescription itself if you use a mail in pharmacy; otherwise you may get something that wasn't exactly what you want. For example, a couple of years ago I got a prescription for pen needles. I wanted BD 5mm pen needles, which are preferred by my insurance; the mail in company sent me 6mm novofine needles, which are not preferred by my insurance and are longer besides.
Also, have the doctor check that no substitutions are allowed!

Tip: If you use a mail in pharmacy, avoid ordering in December. The mail is way too slow.

Tip: Complain to the pharmacies if you need to. They replace stuff.

Tip: If you use a mail in pharmacy and they send you insulin, you'll never need to buy an ice pack again. Save the ice thingies.

Tip: The labels that are on your boxes of prescription items have details that the pharmacy will want next time, and they also count as prescriptions for police and airline security purposes. Don't lose those labels! If the pharmacy prints your name wrong on them, get them to give you new labels. Walgreens gives me labels than say "John" instead of "Jonah" most of the time, then put on a new label with my actual name after I complain.

No Way, Jose!

My A1c was 6.6 back in October and I thought I was doing better and that it would be down in the lower 6s. Instead it came in at 6.9. That's diabetes, I guess. But really, no fuckin fair. The lab uses slighly higher than normal normals, so this would be a 6.8 of 6.7 in a usual lab, but the doctor switched labs back in September, so it is an increase in A1c, whatever the normals.

Also, my hemoglobin levels came in high. This is the first time that that has happened and I don't know why and I don't like it, but I am not making a fuss about it. I will discuss it with the nurse practitioner I'm seeing about testosterone levels in two weeks, and maybe we'll drop my dose further. I am now on 45% of my starting dose. Also my testosterone levels, which we had intended to measure at their trough, came in towards the upper end of the normal male range. My endo thinks that this may be why my hemoglobin levels were high, but I'm not so sure. My testosterone levels were much higher in the spring and the summer (cuz my dose was more than twice as high), and my hemoglobin levels were normal then.