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[IP] Insurance Frustrations



------- Forwarded Message Follows -------
From: Kimberly <"email @ redacted"@postoffice.att.net>
This may be a little long, but I wanted to explain the whole thing.  
I have been diabetic for almost 18 years now.  I have never been 
under very good control and I now have some minor complications as a 
result. After fighting this disease for 14 years a doctor finally 
decided to trust me when I explained what was going on, and why I 
couldn't seem to get under control.  (Most doctors previously seemed 
to think that I was telling them what they wanted to hear and that if 
I really was trying that hard I would have a far better HBA1C 
results.  Blame the patient.) After carefully watching my BG's, this 
doctor told me that I had a "sensitivity" to the long acting insulin 
that I was on, and reccommended that I get an insulin pump.  He said 
that my response to U was "Unpredictable at best".  This was a noted 
research Dr. at the Barbara Davis Center for Childhood Diabetes in 
Denver, CO.  Several other doctors at this facility concurred with 
the conclusion.  My insurance (Kaiser) did not agree and therefore 
refused to refer me to this clinic any longer.  They claimed that I 
was old enough to see their doctors now.  "Their" doctors, however 
see primarily type II's, and do not stay up to date with the latest 
developments.  I tried the Kaiser doctors suggestions with very poor 
results and generally ended up self medicating in order to achieve 
any semblance of control.  I went through each of the Kaiser 
endocrinologists in turn and after each of them had on at least one 
occasion made a statement to me in direct conflict with recent 
research findings I moved on to the next endo.  I finally managed to 
obtain an old 504 pump and I paid for all of the supplies and put 
myself on an insulin pump with wonderful results!!!  My A1C was the 
closest it had been in many years to normal.  Unfortunately, the pump 
began to malfunction after about 5 months of use and I had to go back 
on traditional therapy.  After a break from the U, my diabetes seemed 
OK, for several months, but went into a slow decline thereafter.  
Recently my BG's have ranged from 30-over 500 often making violent 
swings several times a day.  I went back to a Kaiser endocronologist 
recently and he suggested that maybe the reaction was between the 
regular and the U and suggested that I try Humalog instead.  This was 
a big mistake!!! I had to boost the amount of U that I was giving and 
it made the problems even worse. After convulsing one morning after I 
went to bed at 230 (I gave no additional insulin for fear of a hypo, 
and it had been several hours since food, insulin, or exercise) I 
knew that I couldn't do it any longer (I had already lost my job for 
having called in sick and/or having to take off too much time running 
to the hospital for emergency treatment).  I located a barely used 
507 insulin pump and purchased it myself.  Now mind you, I'm not 
compulsive, I have a very high IQ, intimately understand all of the 
technicalities of this disease and I can probabaly explain the 
clinical effects of insulin better than many doctors.  I wasn't doing 
ANYTHING "wrong".  My body just does not seem to respond to the U 
predictably and it had gotten to the point where my reaction could 
probably best be described as violent and probably allergic.  I had 
tried switching to semi-lente, but after a short while I developed 
similar reactions to semi-lente.  Because of the variation in my 
insulin needs, NPH and R just wouldn't cut it.  Now I am on an 
insulin pump (1 week, 3 days.) I have had to adjust my own needs, but 
I haven't tested above 180 since I started and I've only had 2 mild 
hypos (miscalculated a bolus).  I've been narrowing in on excellent 
control and I feel soooo much better.  My problem is this, the 
endocrinologist from Kaiser refused to prescribe Humalog for me as it 
costs $3 a vial more than ultra-lente.  Essentially after a brief 
conversation, I was told by this moron that he would no longer treat 
my diabetes as he did not feel qualified to work with the pump.  He 
told me that there wasn't a Kaiser doctor qualified to help me, and 
then refused to give me a referral to an outside doctor since he had 
not prescribed the pump.  My regular physician wants to  send me to 
the endocronologist, and the endo doesn't want to talk to me!!!  I 
can't even get a prescription for Humalog for petes sake!!!  Prior to 
going on the pump I for no reason would test at "HI" once or twice a 
day, and also suffered from unpredictable lows (below 35) usually 
about once a day.  These wild swings were making me violently ill, 
and had also brought on depression.  Now I am narrowing in on 
excellent control (BG average is now 115, YEAH!!!) but I'm so pissed 
off at the doctor that I'm considering a lawsuit.  If I felt that he 
was competent I might try to talk further to him, but my sister saw 
him as well and he gave her a sample of humalog.  He told her to use 
it 1 for 1 instead of her regular with no further explanation.  She 
began spiraling out of control.  When I realized what was going on I 
had to explain to her how long regular acts, and how regular adds 
onto the ultralente's basal rate.  I explained that she needed to 
take less of the humalog and more of the ultralente and helped her 
adjust her insulin rates.  I don't think that a doctor should be 
handing out a product that he does not fully understand, and I think 
that my sister should have received a full explanation of the effect 
that this new insulin would have.  I guess I'll have to pay for my 
own insulin as well now.  I don't mind having to take care of myself 
as I seem to know a lot more about my condition than the doctors do, 
but a competent physician to talk to would sure make me feel better.  
I guess I'll have to buy ALL of my medical needs, even the insulin, 
as my insurance won't cover a dime.  My sister would like to try a 
pump, but given my experience she's very hesitant.  Isn't this breech 
of contract???  Is there anything that I can do??  I'm forced to stay 
under my fathers insurance until I can get a new job, wait the 90 
typical days, and go through the 6 month pre-exsisting clause on most 
insurances.  I think that since my father is paying premiums to keep 
me on his insurance the insurance should at least make an effort to 
take care of my medical needs.

Frustrated,
email @ redacted

email @ redacted