Ruddy GP !

[trophywench]

Having been on a pump for 10+ years I always had one Flexpen of Levemir and one of Novorapid on my repeat prescription list, but at some time because I hadn't ordered them for ages, they dropped off. Now, one having expired in June 2021 I thought it was high time I replaced them, hence added a note to my order last Friday, to request one of each. It has never bothered me using them straight out of the fridge when I've had a cannula site fail and BG has shot up, and I haven't had a pump failure since my very first pump and was gobsmacked how long the replacement took to get here by Royal Mail parcel post - best part of a week! - when people with Medtronics said they were couriered next day. The cold insulin has always worked perfectly OK - last time I needed this was over last Xmas and there was still half tat insulin and all the Levemir in the pen though meanwhile they've been out of the house fridge and into the Moho one multiple times and vice versa. I have two half-boxes of so far unused pen needles, both well past their use by dates - don't know how that happened to have two half used boxes, but currently they still work as per normal so I haven't worried about them.

Just been to pick up scrip - one Lev Flexpen and 2 vials of Novorapid, which I didn't order and don't need - pharmacist said Well keep them in your fridge and I replied that I would if I had space so she said she'd just stick em back in theirs - then we both had to go into the GP surgery to try and get it sorted - she landed up walking around the reception counter and typing the note to the doctor on the receptionist's keyboard herself, cos she understood my problem precisely. I will just have to be more vigilant when things drop off !

Now a question - the Levemir one, the pharmacy label on the too small outer box they put the new pen in before bagging it, which is now in our recycling bin and the pen in our house fridge, actually said 'Discard the pen 6 weeks after first use'. OK I can probably remember do that 6wks after whenever I need to use it first, BUT does that apply equally to ALL insulins? - bearing in mind my very sporadic use of the Novorapid one with only a couple of mins outside the fridge each jab?

 

[Kaylz]

Yes they all have a message of how long they have before needing discarded after opening, my novorapid is 28 days but Tresiba is 8 weeks xx

 

[trophywench]

Thank you for that.

Yes - and the Novo which I now have does indeed say 'after 4 weeks' BUT ! like I said, it hasn't actually been left OUT of the fridge when using it like this, and I did wonder over Xmas whether its potency would have diminished, which indeed it still may have done to some slight degree but when your meter says your BG was eg 28 for starters so you have 7u to start and is then later eg15, so you then have a bit more to counter that last bit which works OK, do I really need to start panicking when I used it 4 weeks, 4 months or 4 years ago? Or just try and routinely replace em, used or not, after 12 months? - cos I would have to remember independently there being no prescription dates on the pens themselves?

Other thing is - and I will discuss ALL of this at clinic in Sept - when I did my knee a few years ago I had high ketones (and needed 3 x the amount of insulin until things got better) so the hosp I was in (NHS but different Hosp Trust) supplied me with an Abbot Freestyle meter complete with ketone strips. Since then I haven't bothered to test even when my BG has been 28 due to a failed cannula - of course I had ketones, who wouldn't? and I always know anyway cos I feel nauseous - so I had more fast acting insulin pdq and drank as much water as I could, for as long as until the BG got back down again. I did initially try to get strips for it added to my repeat but they said they needed the card out of the box it came in, to add them and there isn't a card in the box, so I haven't bothered since.

Am I just too blase?

Pete knows to test my BG if he finds me on the floor before/whilst dialling 999 of course - but can't now administer a rescue jab if the answer is LO or ---, cos that's another thing that's dropped off and outdated unused, so hence dumped. That bothers him - though again not a thing I think about cos when I was last 'out of it' was approaching 20 years ago and hasn't happened since as I have had so much better control since then than ever before.

Opinions?

 

[Kaylz]

I'd get ketone strips added, they will be wanting the PIP code which is 323-7773, some require that for them to allow them to be added but others don't, I can't say on the "rescue jab" as I've never been supplied with one xx

 

[mark king]

Hello @trophywench. Jenny I've recently had things disappear off my list if not used again in 3 months. They have reinstated it all now but only after I went in and remonstrated with the pharmacist making it very clear that I had previously set up my medicines after fully discussing all with the Doctor. They replied that they had just had new notifications about reducing repeat medicines nationwide and had gone shot-gun happy about it. I've asked to be kept informed before any medicine changes are made for me and put my request in writing.

Just to be clear in your comments above about "rescue jabs" you're talking about both end of the scale but the rescue treatment is very different if HY it's insulin to bring you down if LO it's a a gluco boost pen but that fell out of my list due to lack of reorders. I have replaced it with a pack of 3 gluco-gel tubes which you squeeze into/onto the gums
After chatting with my wife I decided she should do the following.
If HY put me on my side and call 999 and cross fingers - keep checking sensor every 15 mins.
If LO squeeze up to 3 tubes Gluco-gel into my mouth/ gums - check sensor again after 15 mins. call 999 for instructions.

Maybe now would be a great time to review our methods to find which is the best practice.

 

[trophywench]

I have once been so hypo I literally could not move a muscle, could not even see although I think (don't know) my eyes mat still have been open. In any event thereafter the person who found me and spoke to 999 said they'd asked her if I wore a denture if so to remove it if she could and I couldn't hear the question but heard the answer when she said Aaah - I don't think so - whereas really she though I might (which was correct) but could see my mouth was clamped VERY firmly shut and didn't fancy trying in case I viciously and unknowingly crushed her fingers! Hilarious in retrospect - but how the heck would a person do it IF the hypo-er's mouth was THAT clamped? No idea whether she'd have managed or not. I do know I'm eternally grateful to the paramedic who talked to me throughout, introducing himself, saying he was going to test my BG at which point I remember thinking Thank God for that, and relaxing whilst he put the glucose drip up. Took a good while for the ambulance to arrive as there was a multiple pile up on the motorway with the air ambulance and God knows what, during the evening rush hour that evening - just my luck.!

But anyway - I'll discuss it with my clinic - wonder if they'll let Pete in with me now, he's the poor bugger who'll have to help me, all things being equal, so will need to know what he's sposed to do now instead of That Jab.