After letting that little diabetic rant stew for a few days (Oh, the uppity folk who pitched a bitch-fest came from here. Notice how almost ALL of them are on insulin and proudly display their insulin pumps and a1c score. Now notice how the people I was bitching about probably think an insulin pump is where soda comes from at taco-bell and the a1c is a new brand of steak sauce. Enough about that, draw your own conclusions) its time for me to talk about one of my favorite topics of all time. Something I see almost nothing of on a daily basis, and something that ties into my diabetic rant.
Patients need to start taking an active role in their own care of whatever they have.
Foreign concept isn’t it? Amazing how many people I see on a daily basis not only do not care that they have HTN, DM, etc that can possibly kill them, but as long as someone else is footing the bill, they do things that make the condition worse!
For those who work retail; how many grossly overweight type-2 diabetics come to pick up their meds, and as your clerk is checking them out, the plop about 5 candy bars on the counter and begin unwrapping and eating NOT one but TWO! (2!). Now add on a few grossly fat 10 year olds on top of that and have them plop their candy on the counter as well. Hm, is that silence I hear from the diabetic whiners (or are you going to stand up and defend the type-2 450-lb fatty eating that Baby Ruth as shes signing for $200 worth of taxpayer-paid Avandia)? Is that the collective sighs from the retail folk out there because im absolutely fucking right? Now how many of you actually say something? I usually make a comment of “You know those have a ton of sugar in them”. I’m usually met with a laugh and an “I know”. Temper, meet roof. Let me dispense to her a gun so she can just take herself out NOW and save us the billions of dollars of hospital visits, medication costs, and crotch-fruit checks. That right there has me pissed off at the world, not the uber-compliant diabetic who is always on time and breaks a bottle of Humalog once every other year (and wants to pay out of pocket when I’m insisting that I’ll get an insurance override for them). It makes me happy when patients come to me and brag about their a1c, it makes me angry when patients brag how high they got their glucose machine to read as they eat candy and drink pepsi.
I’m sure the diabetes police will whine about something related to this (because they ALL see this sort of stuff 9 hours a day 5 days a week for a living). Diabetics can obviously do no wrong, and heaven forbid I bitch about them eating fucking candy-bars in the store. Maybe they should just stick the test strips in a jar of Karo Syrup, since testing that and their blood has the same result; and in both cases the patient is able to do the same thing, just watch the meter explode.
Thats one example, another one is actually taking responsibility and planning ahead for your medication refills. If you are leaving for Mexico and are going to run out early, you do NOT come into my store the morning that you are leaving and want 10 Rx’s refilled RIGHTNOW. Then get all huffy and pissed off when I say that the insurance company is going have to be called and if they want to pay cash we can work something else. The icing on the cake is when they say “Well i’ll just have to cancel my trip because of you”. Wait a sec, back the truck up.
You know when you received your medications last. Now I know math is hard, but if you take 1 pill twice a day, and you have 60 pills, 60/2 = 30day supply (unless its vicodin, then 60/2 = 4.5days and an escalade payment). So right there you know if you are going to be out during your trip or not. Now unless you just found out and planned this trip RIGHTNOW, you had a few days to call me and get this shit-storm sorted out. Yet here you are, screaming at me and blaming me for canceling your vacation (which how welfare patients can afford to always go on so many “vacations” boggles my mind) over something that was YOUR responsibility. Lets bitch at Cadillac because your escalade ran out of gas because you thought it was someone else’s job to check the gauge. I just don’t get how people can bitch and blame /ME/ over something that is 100% preventable for THEM just by taking 2 seconds and a quick phone call. Just because I have a computer that has all of your medication in it does NOT mean that it knows when you are leaving on vacation. I don’t check every morning to see what refills are due for the thousands upon thousands of patients that I see every month.
As my boss likes to say “A lack of planning on your part does not constitute an emergency on my part”. I’m not going to drop everything that I’m doing just because you’re an idiot.
My final point drives pharmacists up the walls from CA to NYC. We need to be kept in the loop when your doctor changes directions. Its a little known fact that doctors and pharmacists only talk when the doctor either whines that something expensive isn’t covered, or he thinks we fucked up. Thats all. When the doctor tells you to take 2 furosemide a day, and we have a record of only 1 a day, and you come in 15 days early and want more, it really puts us and you in a bind. You see, your insurance company (along with us) thinks that because the label on your bottle says “one tablet a day”, it means you are taking “one tablet a day” not “one tablet twice a day” like your doctor told you and nobody else. Medication changes aren’t a fucking secret. Take some responsibility for your medication and call me and say “Hey! Doctor said for me to take Rx# 2349234 twice daily now!”. I’ll confirm this, and get you more when you run out. Case closed. Coming to me on a FRIDAY night 5 min before closing when EVERYONE has gone home to tell me that you’re out of digoxin because doctor told you to take 2 a day last week really pisses me off. Amazing how many times a day I bitch at people who do this and they STILL think that medication changes are some sort of secret and that I’ll never find out about them.
I’m not going to get into doctors telling patients who can barely wipe their asses about medication changes. Talk about a whole messed up clusterfuck of misunderstanding. Thats for another time though.