How Much Patience Must A Patient Have?

This is not a tongue-twister.  It is a temporal lobe twister. 

Recently, I entered an endocrinological perfect storm. The experience left me wondering whether it is time for me to raise my medical expectations. 

When I moved to Florida from California, I had to find a new endocrinologist to manage my diabetes and thyroid issues.  I looked for a doctor close to my new home but found only one.  The online reviews for this doctor were not stellar, to say the least.  In fact, he sounded downright mean… or, at least, curt.  For reasons I am not going to bother to explain here, I have a hard time going to see doctors in the best of circumstances. I was certainly not anxious to see the endocrinologist whose reviews made him sound like the medical version of Simon Legree.  I widened my search and ended up selecting a doctor in Orlando, which is about 40 miles from where I live.  I know that is a bit far to travel but the doctor’s name was Dr. Steady (not his real name, but a synonym of it).  For anyone who has diabetes, the quest to keep blood sugar levels stable is the holy grail.  How could I not select someone called Dr. Steady?  

Dr. Steady also had excellent reviews.  My visits to the office for the past five years have been efficient, relatively painless experiences. Dr. Steady always concluded a visit by telling me I was too healthy to be there.  I only go a few times a year, so the commute was not that big a deal. In fact, it was kind of pleasant taking a trip to the “big city” every few months.  I felt very sophisticated and precious.  

Fast forward to a few weeks ago.  I realized I was running out of my blood sugar stabilization medication.  Now, in my world, I would always have at least 30 days’ worth of drugs on hand so as not to worry about running short.  However, insurance companies tend not to think that way.  They only let me get a new supply when I am down to 10 days or less of the old prescription.  I think they figure I could die in the interim and they would have wasted the money paying for medication that I would never take.  Still, 10 days really should be long enough to get a prescription refilled. 

I called the pharmacy to order the refill and they indicated they would need to contact the doctor to get an authorization for the prescription renewal.  I had an appointment scheduled, but not until a few weeks after I would run out of pills.  I waited two days, then called the pharmacy.  They told me that they had not heard from the doctor’s office.  I called the doctor’s office, who told me that they had submitted the authorization.  They said they would send it again.  The next morning, I called the pharmacy again and they said that they had not heard from the doctor’s office but would resubmit the request.  The next day, I called the pharmacy again.  Again, they told me they had not heard from the doctor’s office.  I called the doctor’s office.  At that point, I was completely out of medication.  The doctor’s office swore to me that they were submitting the authorization while I was on the phone.  

Apparently, the problem stemmed from the fact that the doctor’s electronic prescription service only works within Orlando.  Since I was needing the prescription authorized in my town, which is apparently in an international zip code as far as the doctor’s office is concerned, the electronic system did not work.  Never mind that the doctor’s office has been handling my prescriptions for over five years.  For some reason, despite my numerous, increasingly more desperate pleas for drugs, someone just kept pushing the computer button.  What is the definition of insanity?  Doing the same thing over and over again and expecting different results?  I do not like to cast aspersions, but I think an insane person must have been trying to authorize my prescription.  

Six days into this process of medical musical chairs, I completely ran out of medication.  I was going cold turkey.  Although my blood sugar levels were certainly higher than they normally are, I was able to keep them reasonable by exercise and consuming only about 1100 calories a day.  This was not a mood-enhancing system, I assure you.  I also felt like crap all the time.  I felt exhausted, headache-y, and weak.  I had this strange sensation that there were two incredible forces pushing from both within and outside my body, in conflict with one another.  I felt like I was going to spontaneously crumble, as if hit by The Invisible Ray (for those of you who have not seen this old Karloff/Lugosi movie, you might want to check it out.) I am surprised I remained conscious.  The only hopeful sign was that I was able to keep my blood sugar level beneath a dangerous range.  As the days crept by, one broken promise after another, I did almost surrender.  It really seemed a lot easier to die than to continue the fight for Janumet. 

At one point a couple of years ago, Dr. Steady suggested the possibility that I might be able to go off the medication because I was doing so well.  I was excited because Janumet is expensive.  When he made no mention of going off the medication at my next visit, I asked him about it. He explained that he had thought better of the idea because I was doing so well on it.  He said that, if I went off the medication and my blood sugar got out of whack, it would be much harder to get it back in whack.  At the time, I was disappointed.  Now, I see the wisdom of that decision.  I think we have all learned now that going off the medication is not a good option for me. 

Finally, on Monday (ten days after I originally called in the prescription) afternoon, I confirmed with the pharmacy that they received the authorization.  They told me they would fill it the next day.  On Tuesday, I called and found out that the pharmacy had none of the drug I needed, so they had to order it.  I could expect the prescription to be ready around eleven on Wednesday. 

On Wednesday morning, my blood sugar elevated into the danger zone.  I was able to work it down with exercise and famine, but it was concerning.  I did not hear from the pharmacy on Wednesday, so I went in to see them at around 3.  At that point, my next stop was going to be the emergency room.  I was back in the “safe” zone on the blood sugar, but I still felt horrible and I was no longer able to keep hope alive.

You guessed it. The drug did not arrive in the pharmacy’s order.  The pharmacy tech, to her credit, knew desperation when she saw it.  She got on the phone and found me a 30-day supply at another pharmacy about 15 miles down the road.  I got back in the car and headed to the other pharmacy, fully expecting there to be yet another problem.  Happily, they did sell me my drugs and I downed one immediately.  I am still re-whacking my blood sugar levels several days later, but all evidence seems to point to recovery with no lasting consequences.

No lasting consequences to me, that is.  For the endocrinologist, not so much.  You remember that local endocrinologist that sounded mean in his reviews?  It turns out that a friend of mine has been seeing him for several months and really likes him.  I decided to fire the Orlando doctor and risk possible curtness.

I called his office to make an appointment yesterday.  The office is closed all week.  Heavy sigh.  I am in the medical twilight zone. 

Just to quell any alarm this blog may generate, please know that I wrote in a few weeks ago.  I am now safely back on my drugs and managing my blood sugar well. 

As we age, health concerns seem to loom much larger than they did in our younger years.  What tips and tricks do you employ to keep as healthy as possible in your “more than ready for prime time” years?  Please share your perspective by leaving a comment.  In the alternative, you can email me at terriretirement@gmail.com

Have a healthy day!

Terri/Dorry

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