Wednesday, 23 April 2014

Pharmac and Insulin Pump Funding concerns

I'm worried about the funding for my insulin pump, or more specifically the pump consumables. As far as I am aware, an application for funding was sent off in July/August last year. The application listed the last three of my HBA1cs, the lowest of which was 73 in the new units, or 8.8%. I received 9 months of funding for pump consumables in August and started the pump in October.

In the middle of last month (March) I had an appointment with my CDE. My A1c was 64 - or 8% in the old units. It was actually the lowest it had been in my 8 years with my current District Health Board. I haven't always been so intensive with my management. It was interesting to look back on those results, there was a couple of results that were so cringe worthy that I didn't want to see but for the most part my control has stayed in the 70s for the past 8 years. I hadn't realised that so seeing that 64 was even more of a win. What's more, is that I knew I could do better than this. In February the average on my meter was about 12.5 mmol/l, I had a couple of unfortunate experiences where my site or tubing pulled out so I woke up in the 20s with ketones. I was also using teflon cannulas with my Animas Vibe pump and found that on the 2 or 3rd day I would sky rocket in my BSLs and it would take so much insulin to bring them back down. When I switched to metal cannulas, the results were amazing. The March Average on my meter was 8.5 mmol/l - which would equate to about a 53 HbA1c. So at that meeting, my CDE was a bit puzzled at what she could do to bring down the 64 lower, based on a few days worth of records that indicated I was running pretty good averages. I explained that I'd changed cannulas and was certain that the month of February would be artificially putting my Hba1c higher than it was. She was happy with this, I was happy and I left feeling positive and overwhelmingly happy at the pump. We organised I would get an A1c test done in yjr beginning of May and that my CDE would put through the application for continued funding in Mid May.

And now we come to the month of April. The average on my meter is 11.1 mmol/l - which would equate to an Hba1c of 70 or 8 %. To qualify for continued funding I need to show a 10 mmol/l drop to a 63 I was on track for this in March but now? I'm scared. I'm been trying to figure out the reasons for the increased Bsls - I had been extremely busy at work, I had a family bereavement, I thought I might be getting a bladder infection...many things which could contribute. Freaking stress. So I'm scared I'm not going to qualify for funding.

So my plan of attack is:
- Increased exercise
- Recording BSLs and sending them to my CDE
- Healthier eating

It looks easy when I put it like that. I think it's been working though, I tweaked my Insulin Sensitivity factor a couple of days ago and I am noticing lower morning BSLs. I feel a lot better writing this all out and there is another thing that could be helpful to me. I received funding in August last year but didn't actual start on an insulin pump until October, so in theory I haven't actually had 9 months of treatment on a pump. My CDE has said that will be enough to get an extension, so I imagine that's the next step.

It's nerve wracking thinking about all of this and it has been on my mind a lot. Writing it down has been cathartic for me. If there is any one else having trouble with continuing their pump funding I would love to hear from you.

S x