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[IP] Convincing Blue Shield...
As my profile said, I'm looking into pumps and working on
convincing my insurance company (Blue Shield of California) to
They rejected the humalog pen just last week, telling me that it
wasn't a "medical necessity" and that they cover syringes. Well,
the only time I got a syringe prescription (March), they rejected it
and I had to pay full price. So either someone's confused, lying,
incompetent.... or they've changed policies recently.
The MiniMed packet my endo gave me has a form to fill out where
they'll take the info, and contact my insurance for me and try to
convince them to get coverage for me.
I'm wondering if I should include a note explaining a few things
about myself--hopefully to give them more fodder.
For example, I bought a GentleJet (from Avanta) out of pocket for
$500 because I was simply far too needlephobic to do injections. I
tried injections for 4 days (9 injections in all) and began waking up
truly suicidal. I didn't want to get out of bed. I didn't want to even
wake up. I started imagining ways of "getting it over with" very
quickly and realized that I had the tools I needed right there in the
The logical part of me was very alarmed at those thoughts... So I
stopped all injections and started looking for alternatives. I found
GentleJet (needle-less injection using high powered spray) and
Autoject 2 (which is a lancet type device that plunges the syringe
for you at the push of a button and you don't have to see the needle
The GentleJet hurts like hell if you do it even slightly wrong. But
that's less important to me than the needle is. That's how
needlephobic I am. I have little problem with mild pain itself And I
have my teeth drilled without Novacaine--just to avoid the needles.
There is nothing rational about this phobia and it doesn't respond to
logic of any kind. It's more a like Beast that takes over and has
total Rule. I tried to contact Behavioral Health, but they didn't even
return my call for more than a week, so I figured they wouldn't be
much help in the short run if they were that overloaded and
Recently, my Jet was clogged and I had to switch quickly to the
Autoject/syringes.... and I can't re-adapt a previously-adapted vial
so I can't use the Jet again until I refill my insulin prescription. It's
working ok, except that I'm finding myself "forgetting" to inject.
I wanted to try the Pen to see if I'd made *any* improvements in my
needlephobia, but since they rejected it, I can't find that out.. And I
still can't even tolerate the thought of injecting without the Autoject.
Although I can now look at a needle and draw up the dose without
going into panic symptoms.
There's a couple of other things that might make them change their
minds: I'm actively working on getting pregnant and I'm 38 y/o
(never had kids, finally in a marriage where I WANT kids).
And I frequently forget that I'm even supposed to inject anything.
Moreso now that I'm using the Autoject w/syringes. Such as this
morning, where it took me 4 hours to remember that I'm supposed
to inject insulin several times a day. (Must be a form of denial or
avoidance or something. I can't quite pin it down).
Also, I've changed careers recently. I used to be a completely
sedentary database programmer. Now I run a small janitorial
company with my husband and have frequently had hypos while
alone in buildings that I'm cleaning or inspecting. Scared the
dickens out of me the first time. I refused to work at all for several
weeks. The exercise is good for me, but the being alone part isn't
and we just can't have me accompanied all the time. Our profit
margin is very very slim and we can't afford to double up.
My endo says that I"m also very insulin-sensitive (probably cuz I'm
still underweight) and take such small amounts that it would be far
easier to have tight control on the miniscule amounts capable with
The biggest impediment to convincing them is my A1C: 6.7%,
down from 12.1% at diagnosis last year.
Can you think of anything else I can use as ammunition and do
you think that any of the above has a strong enough case convince
I really want at least the *chance* to try this. The idea of inserting
a cannula (such as that soft short one for thin people on the
MiniMed page) every 2-3 days, as opposed to several times a day,
is really attractive to me. Especially now that I'm stuck with
needles again several times a day (MDI -- which is the only way I
can hope to avoid hypos in those buildings).
Any ideas would be very very very very gratefully received!
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