Tuesday, May 14, 2019

Do you use an insulin pump? Then check your prescriptions...

Not that long ago you would have probably had an MP3 player of some sort, a phone, a GPS for the car (one of those that you fixed to the windscreen), a camera, books of paper maps and maybe something like a palm pilot that worked when you were in WiFi.

Now you, probably, just have a phone that does it all. All your eggs (insert plant based alternative for this metaphor to work) are in one basket.

I found myself in this position on Friday evening.

My OmniPod needed changing something I did very efficiently (it takes me so little time to do this now). Within a minute of completing the POD change the PDM displayed an error screen advising me that the POD was not working and should be removed. I removed it as instructed but then found the PDM screen to be frozen. None of the buttons worked and it wasn’t going into auto-shut off as it normally would. I called the technical support line and spoke to a chap that helped me through the reset function. After a few attempts where the reset was not working the decision was taken to supply me a new PDM. In view of the weekend this would be provided to me by Tuesday.

The tech support guy asked me if I had backup kit that I could use to which I confidently answered yes.

I was only partially right! I have insulin pens that I carry all the time just in case. However what I had not realised was that the Levemir I use was out of date by 6 months, something I only realised after I had injected it, it didn’t do anything bad to me, in fact I don’t think it did anything at all as when I woke in the morning my sugars were at 17mmol – unheard of for me even when I was struggling with overnight sugars. The NovoRapid by comparison was in date but by a matter of days. This was now Friday night close to 10pm – how would I get prescriptions updated in time?

I called NHS 111 and felt like a total fraud as this was not an emergency or something medical this was a lack of preparedness on my part.

I explained the situation and was advised that a Levemir prescription would be available for me at a specific pharmacy for the morning and that I should contact them first thing. The Pharmacy opened at 8:30 and I was at the door when they did. They had no record of my prescription at all and suggested that it might have gone to my normal pharmacy that I use for this. They opened at 9am. I waited int ha car and called them as soon as they opened. They had nothing either. I went back to the 111 service and they promised to chase it up within an hour and get back to me.

An hour passed and I called them, they had no record of my call so we went through the process again. This did yield a result with the out of hours doctor calling me and saying that a prescription would be at the original pharmacy within the hour. I went back to them on the hour and there was nothing that had come through. They were now close to their closing time so issued me an emergency prescription using a paper based facility that they had. I had my Levemir that was in date!

The other issue was that I use my PDM to test my blood sugars too. With this not working I needed to find a spare meter. I had one with a nearly full barrel of test strips. Over the weekend I was fine on insulin pens and using my Accu-Chek Aviva Expert. However I then realised that I did not have any spare test strips.

All of which takes me back to the first point. Technology is great when it’s working but with increasing reliance and seeming reliability comes complacency. I have used an OmniPod for a couple of years and bar the occasional pod failure have not had any issues. The PDM failing is more serious than that. Not only is it my insulin delivery method it’s my blood testing method too. Without doubt the two most important technological dependencies that I have. 

My health and well being depends on it.

The lesson has been well and truly learned. I have now got (or have on order) prescriptions for insulin pens for Levemir and NovoRapid, I will check the expiry dates of these and add them to my diary so I know when they expire and do not get caught out again. Similarly I will have a couple boxes of test strips for my backup monitor and if they have an expiry I will do the same. It took a lot of chasing around and calling on resources that are over stretched to try and sort this on a Saturday morning, something that was wholly avoidable had I been prepared.

The issue isn’t that the PDM malfunctioned or that NHS 111 couldn’t get a prescription through its that I never thought about it. I thought I was prepared with spares for what I needed but as I have not really needed them I wasn’t.

If you are an insulin pump user you need to do this (assuming like me you haven’t already);
  1. Check your backup kit – do you have pens/needles/test strips and insulin
  2. Check the expiry date on the insulin and either order replacements (making sure to throw away the old stuff) or add the dates to your calendar/diary so you don’t miss it
  3. Make sure you have back up test strips and that your meter works (and that you have batteries for it) 
Technology is remarkable these days, things do not often just fail. This leads to complacency which is exactly where I found myself. In a jam because of that. Hopefully, if you’ve made it this far into the post, you can avoid this!

Massive shout out and thanks to the people at MyOmniPod support, Spa Pharmacy and NHS 111.