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Frustrating pharmacy visit - watch your pens!

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Aye, the title was created by the DNA - The National Dyslexia Association
 
Rosiecarmel said:
My DSN explained it slightly different. She said 1 unit of Toujeo is 1 unit of lantus but a lot more concentrated. It's why I couldn't inject 26u lantus as it wouldn't be the same as Toujeo. It's the same strength but more concentrated so it's less liquid. One drop of lantus is three times bigger than one drop of Toujeo. It took me a while to get my head round it and maybe I don't actually get it all ha ha
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I don't understand a word of it. o_O
 
khskel said:
I ended up with 3 Novo pen echos when I asked for a half unit pen. The only problem was convincing the Dr that I need insulin to go in them.
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Yep that was my problem too, got the pen alright because the consultant did the prescription, took from the 27th march till last Thursday to get the insulin to go in it, and then, yep just one cartridge at once. It's a constant battle.

My GP Couldn't understand why I'd need two pens, he suggested removing the rapid cartridge and replacing it with the basal when needed. Now that wouldn't lead to bonny French farce would it!
 
KookyCat said:
My GP Couldn't understand why I'd need two pens, he suggested removing the rapid cartridge and replacing it with the basal when needed. Now that wouldn't lead to bonny French farce would it!
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I would have suggested he try putting a plastic bag over his head and only taking it off when he wants to breathe... 🙄 I understand the need to save money in the NHS, but that shouldn't blind them to the logic of needing more than one pen, and being prescribed more than one cartridge! 😱
 
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Northerner said:
I would have suggested he try putting a plastic bag over his head and only taking it off when he wants to breathe... 🙄 I understand the need to save money in the NHS, but that shouldn't blind them to the logic of needing more than one pen, and being prescribed more than one cartridge! 😱
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Logic? What is this thing of which you speak good man? That has no place in this debacle. It's because Tresiba is expensive, twice the price of Lantus you know, I know because that's the only sentence they ever utter to me. Yes says I but I take half the amount of Tresiba so actually it costs the same as the Lantus so no change in price, no they say it's double the price, yes say I per unit, but I take less Tresiba so per day the price of me is the same....no they say it's double the price. Get some maths lessons say I, because you're doing my nut in 😱. Funny though, they're quite prepared to pay the price of testing me multiple times for the same thing when they get a tick in the CQC box, and very keen to prescribe statins and blood pressure medication when I don't need either, anyone would think there's something init for them 😉
 
DeusXM said:
You can imagine my frustration when, after handing in my script at the pharmacy, the chemist said "We can't give you this because it's discontinued. It's now been replaced with the Novopen 5."

"Ok, well obviously I want one of those then."

"I can't give you one of those."

"Why not?"

"Because this prescription is for a Novopen 4, not a Novopen 5."

"Yes, I get that. But if the 4 has been continued and replaced with the 5, then surely the obvious thing to do is give me the 5?"

"No, you'll need to speak to your GP and get another prescription."

"And bearing in mind this is for injecting insulin and I die without insulin, do you not think that maybe that might add something of an unnecessary and slightly fatal delay for the sake of there being a wrong number?"

"Your GP should have known not to write a script for the 4. You'll just have to come back with another prescription."

So I've now filed another prescription and had to fill in manually the option for a 5 since the system doesn't seem to have it on it. Let's see if I get this issued, eh? On the plus side, at least this validates my extravagant approach of having more than one pen. Imagine what would have happened if I was trying to replace the only pen I had?
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Sometime it just makes you want to . . . . . . . . Such irresponsible "jobs worth" behaviour that I would suggest you make sure the pharmacy and the GP are made aware of in writing. We seem to live in a place where we're made to feel guilty about the amount of money we're costing the NHS and this is the sort of stupidity that we have to deal with.

Obviously part of the problem is that the computer system wasn't aware that the "mark 4" was no longer availalble, how could it be? Somebody has to tell it. Perhaps your letter to the GP should ask what they intend doing to make sure that there computer is up to date.
 
I'll be honest, I'm less bothered by the pharmacy as I can understand the need to cross-reference everything accurately to ensure they get reimbursed (although a little common sense wouldn't go amiss). I'm more worried that the Novopen 5 doesn't show up on the GP's list of medications and this isn't the first time I've been prescribed something that's discontinued. You'd think the database would be regularly updated. I'm wondering if I'm going to be told that either the NHS doesn't fund the 5, or that the GP will claim it doesn't exist, or that they'll refuse to prescribe it on the grounds I've apparently just had a pen from them.
 
DeusXM said:
I'll be honest, I'm less bothered by the pharmacy as I can understand the need to cross-reference everything accurately to ensure they get reimbursed (although a little common sense wouldn't go amiss). I'm more worried that the Novopen 5 doesn't show up on the GP's list of medications and this isn't the first time I've been prescribed something that's discontinued. You'd think the database would be regularly updated. I'm wondering if I'm going to be told that either the NHS doesn't fund the 5, or that the GP will claim it doesn't exist, or that they'll refuse to prescribe it on the grounds I've apparently just had a pen from them.
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This was the root of my problem. The half unit pen didn't show up on my GPs database ( and several discontinued ones did, the nurse showed me the screen) so the nurse tried to enter it manually, but then someone else at the surgery obviously overrode it and put me down for a whole unit pen off the list. And did it again when the pharmacist queried it. I assume part of the problem is that I'm one of the few Type 1s the surgery deals with. Most will get their pens issued at the hospital which is where I got my first ones from.
 
I wonder if they get their updates a bit like we used to get PAF (Post Office Address Files) where I used to work - you had to manually install/update it when they issued a new one, but if you didn't do it then you might not be able to find some addresses. When I worked at one place I couldn't actually find my own address because their file was so out of date 😱 Mind you, all this was a few years ago, it ought to be available real-time nowadays.
 
That happened to me with the Toujeo. In the end my GP had to hand write the prescription due to Toujeo not being on their system at all. They had to ring the hospital initially to get proof I was on it.
 
I thought it excessive we were given the in use pens (different colours for different insulins) and 2 spares for each so 6 pens total! Now I can see why
 
Isn't it amazing that a GP (who you would assume had a reasonable amount of intelligence LOL) wouldn't understand how the piston in an insulin (or other drug, eg Epi-) pen works? Surely during his training, or even later, he'd be aware of ordinary syringe drivers in hospital use?

Hardly new technology, is it !
 
I think that is a little unfair on GPs, TW. It's not exactly a common condition, and things are moving at such a pace in insulin delivery that it's hard to keep up. That said, the two pen problem is hardly rocket science. I find the same problem with the even rarer chronic pancreatitis, not so much in prescribing, but in regular monitoring. I think I may be the only case on the island (population around 3,000).
 
Well I'm obviously not sure when you hung up your hat that said 'GP' on it - but these days I believe in order to retain their GP status, they do have to complete ongoing education, on a compulsory basis. If they don't they can't keep practicing.

Maybe GPs suffer from the same assumptions that we do? Having been diabetic for over 30 years, medics assume your knowledge is up to date. Usually - it isn't! It's nowhere near.

It is interesting - every trainee my pharmacist gets if I happen to collect a prescription or nip to ask him or the counter staff anything while they are there - he regularly asks me if I've got a minute to demonstrate my pump! Off we go into the consulting room, LOL. They've all been girls so far - most of them in traditional dress appropriate to their job ie faces fully showing, etc. They're always very shy - but I always show them wherever I have my cannula, how can you explain properly when they've not even seen an unattached cannula, since they aren't found in ordinary pharmacies. I also tell them if there's anything they think of after, that they'd like to ask - to ask Bal (the pharmacist) to ring me and I'll always try and help.

Not one GP ever asks anything - I find that odd !

I am currently wondering what reaction I'll get from the hospital dermatologist I'll be seeing soon, when I show her the particular seborrheic keratosis that are causing me the problems that I've been referred to see about - one lot are right under several bits of my bra and the others are, ahem, adjacent to my perineum - and that's the absolutely only bit of me, that even my close naturist friends only ever happen see purely accidentally! The ones on the rest of me hardly ever cause a problem, except I'm really not sure whether to try and avoid them with cannulas - I mean they bleed like stink when they cut em out, don't they?
 
I think it's possible to by a pack of 10 insulin syringes over the counter if the pharmacist knows you are diabetic. When I last did this ( as a back up when I was on a pump and using vials so needing emergency devliary device in event of pump problem)- a pack of 10 was less then £2.
Also ypsomed did free trial packs of their little tiny syringes which could store a pre drawn up dose
Hence I always keep a few syringes in event of pen failure- should be reasonable easy to draw up insulin from cartridge or even disposable pen.
However I know this is not ideal and common sense should prevail for someone who is known to depend on insulin


I'm considering asking to change my basal to Lantus instead of Toujeo

I'd be careful unless you need less basal at certain times of day as many people find- and even the manufacturers now seem to acknowlege that lantus sometimes fades before the 24 hours is up.
However lantus might be a better option if your basal requirements change regularly e.g. according to shifts - as it's action is less prolonged effects of changing dose maybe less delayed
 
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