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another test strip question (does everyone have a limit)
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rebrascora
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Yes, I think that would be a very good idea.
I can imagine that must be quite a daunting prospect for you with all the difficulty you have had in getting enough test strips, so go armed with all the evidence you need to support your case. Tell them that you don't enjoy pricking your fingers but that you need to test so much to keep yourself safe and be confident of your levels to go out and live your life and work etc. It may be that because you have been prescribed Libre they think you should be using less test strips so maybe they don't realize that you are not using the Libre at the moment.
I can imagine that must be quite a daunting prospect for you with all the difficulty you have had in getting enough test strips, so go armed with all the evidence you need to support your case. Tell them that you don't enjoy pricking your fingers but that you need to test so much to keep yourself safe and be confident of your levels to go out and live your life and work etc. It may be that because you have been prescribed Libre they think you should be using less test strips so maybe they don't realize that you are not using the Libre at the moment.
No it's not that that's not even on the list anyone plus it's different doctors I changed hoping it would reslove the issue but my team in the hospital arnt supported of. They even changed me to a cheaper meter which o don't get on with as well so it a way it might be even cheaper. But baislcly they do know I'm not using the libre.
My old GPS told me once I should only be testing 4 times day(this was I was persiced the libre and not long after digoused) and I said what about at work when on my feet alot should I not be testing more and they say more. They also expected 100 needles to last 2 months(I still don't know how they managed to work that one out)
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Hello @rayray119 ,
Delighted for you that you have been asked to book an appointment with the clinical pharmacist. This could be your opportunity to get the test meter and strips business properly sorted out. But to achieve that preparation will be essential and I know from this and other threads that you are both willing and able to do that preparation.
I presume you don't yet have a date for this appointment. When you book it ask for the name of the person you will be meeting for this review and precisely what their role is in the Practice; always helps to know someone's name in advance and where they sit in the practice. I was phoned by someone from my surgery and it transpired it was a pleasant but extremely young and inexperienced individual and I quickly realised this person was not in a position to decide anything about my needs; forewarned was forearmed! When you know the date let us know and perhaps we can help you with your preparation.
Meanwhile, start your prep by making a written list of all, the prescription items you have concerns about, both repeat prescriptions and "one-offs".
Definitely take a copy of the NICE guideline NG17. Having that with you will make it clear to the pharmacist that you understand what you can ask for. This does not and should not be confrontational (which I know is something you don't want to be). It is simply "businesslike", appropriate for such a meeting. Take a pen and notebook with you so you can make record of anything relevant.
Now regarding meters and strips: the important thing is to argue (politely of course) your concern about having the appropriate meter for your needs. Only when that is agreed should you get sucked into the 2nd point about how many test strips you need. If you don't get the right meter you could well end up needing many, many more test strips. Remember the pharmacist may be an expert in their world of dispensing medicines, but won't necessarily understand the difficulties of testing and how wasteful this can be with the wrong meter nor how dangerous it can be fumbling around with the wrong meter when hypo, outdoors and in the cold, and unable to get a quick clean result.
They might see it as "you know you're low so just take some glucose" rather than understanding the need to test; understand how low; take the right amount of glucose; wait; test again; and possibly more glucose; and so on. Be prepared to politely and patiently explain that sometimes hypo recovery is quick and straightforward, sometimes frighteningly slow.
Anway: opportunity has knocked - now you need to take advantage of it.
Delighted for you that you have been asked to book an appointment with the clinical pharmacist. This could be your opportunity to get the test meter and strips business properly sorted out. But to achieve that preparation will be essential and I know from this and other threads that you are both willing and able to do that preparation.
I presume you don't yet have a date for this appointment. When you book it ask for the name of the person you will be meeting for this review and precisely what their role is in the Practice; always helps to know someone's name in advance and where they sit in the practice. I was phoned by someone from my surgery and it transpired it was a pleasant but extremely young and inexperienced individual and I quickly realised this person was not in a position to decide anything about my needs; forewarned was forearmed! When you know the date let us know and perhaps we can help you with your preparation.
Meanwhile, start your prep by making a written list of all, the prescription items you have concerns about, both repeat prescriptions and "one-offs".
Definitely take a copy of the NICE guideline NG17. Having that with you will make it clear to the pharmacist that you understand what you can ask for. This does not and should not be confrontational (which I know is something you don't want to be). It is simply "businesslike", appropriate for such a meeting. Take a pen and notebook with you so you can make record of anything relevant.
Now regarding meters and strips: the important thing is to argue (politely of course) your concern about having the appropriate meter for your needs. Only when that is agreed should you get sucked into the 2nd point about how many test strips you need. If you don't get the right meter you could well end up needing many, many more test strips. Remember the pharmacist may be an expert in their world of dispensing medicines, but won't necessarily understand the difficulties of testing and how wasteful this can be with the wrong meter nor how dangerous it can be fumbling around with the wrong meter when hypo, outdoors and in the cold, and unable to get a quick clean result.
They might see it as "you know you're low so just take some glucose" rather than understanding the need to test; understand how low; take the right amount of glucose; wait; test again; and possibly more glucose; and so on. Be prepared to politely and patiently explain that sometimes hypo recovery is quick and straightforward, sometimes frighteningly slow.
Anway: opportunity has knocked - now you need to take advantage of it.
That's part of the problem because I can't put a number on it because of my job and other things. My life style really doesn't suit a set number being put on it. And I actually haven't gone low on a shift since starting backproperlly while once when I got home. But that's only because I've been keeping an eye on things and stacking when I did.
However they some instances where I don't know I'm low(doesn't happen all the time). I think my 3.1(I think I was a bit tired anyway though). before tea my have actually been fluss reading because of a few issues (the stepid wavesense jazz meter it's not even cold now). I ended up treeting it like I was afterwards I was 10.4
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Well, now I'm pretty confused @rayray119, because your reply or comments on my contribution to your posting today at 1.04pm about booking an appointment with 'a clinical pharmacist' don't make much sense to me. So please bear with me while I query what you've just said:
I'm not sure you have understood any of the points that I was suggesting to help you have a successful meeting with the pharmacist from your GP's surgery. I read back to 7 Feb 22, #41, in case there were some clues in the discussions over the last 8 weeks - alas not.
Please help me to understand, so that I might be able to help you .....
What can't you put a number on?
What has "keeping an eye on it and stacking" have to do with preparation for your appointment with the Pharmacist?
Where does your 3.1 BG fit into this? It feels to me that you are in a completely different topic.
I really don't understand what point you are making here with these last 2 sentences. Do they have any relevance to today's post?
I'm not sure you have understood any of the points that I was suggesting to help you have a successful meeting with the pharmacist from your GP's surgery. I read back to 7 Feb 22, #41, in case there were some clues in the discussions over the last 8 weeks - alas not.
Please help me to understand, so that I might be able to help you .....
Sorry perhaps I did shift topics a bit but I guess I was more agreeing to that I could use as pont to why I test offen I can actually put out to that keeping an eye on things on shift and deciding to eat has prevented me from going low on shift I was kind of ageing with you about things but sound like I was argugwing you I guess sorry.
rebrascora
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Perhaps I can shed some light on this.....
1. She can't put a number on how many test strips she needs because it varies so much.
2. Keeping a close eye on her levels by testing more at work and snacking (stacking is a typo I believe) prevents her from having hypos which is why she has had so few hypos at work... ie testing lots (and therefore using more test strips) has prevented hypos at work.
3. The 3.1 was a test result before tea/supper (I believe) some weeks back where she didn't feel hypo and became worried that she was losing hypo awareness.... another reason to test more.
4. Following on from No.3 she is now wondering if the meter was giving a false reading and she wasn't really hypo because after treatment her levels went up to 10.4 .... She has a lack of confidence in that meter now because of the issues with the cold and error codes.
Hopefully I interpreted that correctly @rayray119 . Sometimes it can be quite difficult to understand what you are trying to say unless you closely follow all your posts/threads, as you do sometimes jump about a bit and of course the text is quite jumbled, so it makes comprehending it difficult and very easy to misunderstand. I wonder if miscommunication is at the heart of the problems you are having both with prescriptions and your team supporting you better.
I think it is important to mention how the cold often means that it takes 2 test strips to get a reading because the first one is wasted with an error, so that in itself can almost double your usage.
Does your My Sugr app tell you how many tests you do in a day/week/ month so that you can get a rough idea of your average usage of test strips. I think they will be very reluctant to allow you an unlimited supply, so you need to have an idea of how many you need and if you are logging all your tests on My Sugr it should be able to show you if that is about 250 a month or 300 etc.
As regards needles, that should be easy enough to explain. 5 injections minimum a day is at least 150 a month but with corrections then say 200 a month should be reasonable.
The only thing that was wrong about your InterNations was was number 3 was tonight.
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All fine @rayray119 . But this does illustrate to me how important it will be for you to stay focussed on the main issues.
I think it is essential that you first agree with the Surgery which meters (plural) you will be using. Then, only then, sort out how many test strips.
So first: are you now clear what meter will be best for you, with your work commitments? I know you've done lots of research. If you are clear then you need to make sure they agree that is the meter that they will support, including replacing if necessary and, of course the strips. If you are not clear you will need to explain that you are currently using a certain meter, but it's still not wholly suitable for your work needs. Then see where that bit of the discussion goes. You are entitled to BG test equipment suitable for your purposes. You can not have an unsuitable Meter forced upon you. That would be wilful discrimination and illegal.
You will always need 2 meters, in case one breaks or gets lost. I'm pretty sure you already have more than one, but will you have 2 that use the same strips or will you need 2 sorts of strips? That is a discussion that needs to be had, ie agreeing what the 2nd meter will be.
Then the question of how many strips. The reality is that none of us know how many strips we need per day, but alas only insulin dependent diabetics will ever understand that! On a really lousy day, with or without Libre, I can end up finger pricking more than a dozen times and still be unsure about what is happening. Today, with Libre I receive 200 test strips (or more accurately 4 x 50 test cassettes) every 28 days and I only just keep ahead; my reserve is very small. So that works out at 7 per day. But I have written agreement (emails) from my GP that if my allocation is not enough I can ask for extra. Because I have that assurance in writing, I'm comfortable about my re-supply situation.
If I did not have Libre I would expect to test 10 x daily. You, considering your work circumstances, might well want to insist that you need more, simply because your tests will fail more frequently than mine. [I have the Accu-Chek Mobile, which is ideal for me and I only need to test indoors in "good" circumstances]. For you, perhaps 12 daily, maybe more. If my "allowance" was just 70 per week, I would insist that I have a full 30 days reserve as well. If someone were to try and reduce that I would point out that I don't want to finger prick, but it is essential as part of controlling my DM. I am given insulin in large quantities and considered capable enough to not kill myself with that, so I expect to be trusted with a good reserve of test strips!
Hope this helps you think through what you need.
That's what mean the average will change depending how many shifts I do a week what level of activity is how many what number. I can put an average number on a non working day but because my job has abbousttly no routine both in terms of how active it as and how offen it happens this is and how long shifts are and traveling makes even longer days. This is why I it's not really possible to put a rough s number on it. Its different to explain the exact nuture of my job over the internet.
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Thanks @rebrascora. I roughly got there, but was more concerned that none of it seemed to connect with the pharmacist meeting. Hopefully my very recent post adds more value to that aspect.
I agree that an unlimited supply of test strips is unlikely. But an agreed commitment to a 4-weekly quantity, with a decent buffer as reserve; along with recognition by the Surgery that testing frequency is truly difficult to pin down in the real world. 4-weekly for me, since my Surgery work in 13 x 4-week periods and that's probably best to assume for rayray119, rather than hassle over dealing across 12 unequal months!
For needles 250 is probably fine, providing rayray has a full box of 100 in reserve.
rebrascora
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Ah, OK. Sorry about that, I was thinking about the time you got a hypo reading a few weeks back as your premeal reading and didn't feel it.....
Just so you know, it happens to me occasionally (and I would imagine most other people) and doesn't mean I have lost my hypo awareness but just that perhaps it was falling really slowly and sneaked up on me and I didn't pick up on it at that particular moment due to whatever I was doing or as you say, maybe a bit tired. Being out in the cold can make it harder to detect them as well sometimes. Usually I can feel it at low 4s, mostly high 3s but just occasionally I will be down to low 3s or the very odd high 2s... although that is usually a Libre reading which will actually be a low 3. The time to worry is when you are more regularly not sensing them, rather than just an odd occasion or you have dropped so low that you need assistance to treat them.
Remember it is important to retest if the reading doesn't match how you feel.... and yes of course that also uses extra test strips.... it is a bit of a vicious circle isn't it!
I purchased extra test strips because I wasn't getting enough on prescription for the testing I wanted to do but we shouldn't have to do that and I could afford it. I now average approx 30 scans a day to manage my levels well and give me confidence. There is no way I could finger prick that frequently of course, so sometimes you have to think, "Is it necessary?"
Yeah I was doing that at first. But had the stupid wavesense jazz meter be stubtom for bit why I decided to switch to my the one that's easier to keep warm until I had that apoitment.
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OK, I do understand that. Honestly. But, if you had 6 full work days in one week and most involved travelling, you must know what your typical test strip usage would be. Calculate that and use that as your start point, per week. Then if you accumulate too many, ie your reserve is too big, you can always choose to not order replacement strips every once in a while.
Look at this from the Surgery perspective. They have to bid to the CCG for a financial allowance for prescriptions for the full year. To do that they need to know what the patient requirement will be. That means estimating for every patient (they will have a process for doing that) and adding a percentage for unknown (new diagnoses). There is a lot of guess work in this, yet because they've been doing this for decades they will have a system that broadly works and each year they will also have a review process. But they can't just dream up requirements out of thin air; they need a start point - hence the review with you.
I still think I'm explaing probably but as I said I can't explain it probably over the internet. I think to understand it people would have see me do it I can the miuem number I do on s non working day is. Apparently they is a consultant on team who is type 1 diabetic who I haven't met but someone did say I would start seeing a different consultant so perhaps it could be her and possibly might be able to explain how it works to doctors. I do know of other people that don't have a due that if I didn't have a cannot vreorder until date. I would only order them when I had a box or two left.
Well it will also depend how early the pick up is. For an example a my in a couple of weeks I have shift which is 7am(it may change)pick up I probabably get 5am I probably want to test to where I am then but I probablly won't eat until the way up. That's just an example.
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You have ducked my simple question @rayray119.
How many test strips would you need in a full busy week with early starts?
With that answer you have a 'worst case' weekly requirement.
No-one needs to see you doing it. Its your statement of what you require. Let others challenge that, if they must, but it remains your worst case requirement. Any challenges will ultimately flounder, since the challengers aren't getting up at 5am and managing a day travelling in work provided transport to an outdoor work environment, etc, etc. Yet during all of this you are managing insulin dependency, 24 hours per day! The alternatives are either you ending up in hospital, because you lost all control; or you not working and becoming a much greater burden needing a great deal more State assistance.
Sorry that I complicated things but my job really doesn't have an aswer to the "simple question" it may sound simple(not a cristeriming at all just trying to explain what some might seem simple) but it really isn't in my case. However as I said I do now of others that don't have due that. I have managed to get around the issues so far by ordering however the next alot however Manny I got left when they due(someoneo once gave me a few boxes when I was being refused more) but I actually wouldn't do this if I could sure I was goin to be able to get somemore if I got towards the low end.
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