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Supplies, Supplies, Supplies

Eric Lagergren

October 1, 2009

OK, all Gomer Pyle references in my title aside — or, for those of you who know it better from the end of Pink Floyd’s song “Nobody Home” from The Wall, all Pink Floyd/Gomer Pyle references aside — I have some musing to do on my durable medical equipment.

I’m a person with Type 1 diabetes. I’m insulin dependent. And I use an insulin pump. When it comes to health insurance, I am one of the “haves.” I have great insurance coverage. I have an employer-paid plan that covers 100% of all of my diabetes-related health-care costs when it comes to prescription medicine and diabetes supplies (doctor visits require a $15 co-pay).

And I have supplies-eyes that are bigger than my needs. See, I’m human, so I want and need. During my first year or so with diabetes, I knew I wanted — and needed — to get a handle on my self-management and maintain my blood glucose as close as possible to 120 mg/dl to bring my HbA1c down. Therefore I wanted to test my blood glucose about ten times per day, and my endocrinologist prescribed that many test strips.

I also knew, once I received my insulin pump, that I wanted to change my infusion sets and cartridges on time every time, and they told me I needed to use the alcohol wipes and skin-prep wipes and site dressings. So I did so. Religiously.

My diabetes medical supply provider automatically sends me a new box (or boxes) of supplies roughly every 40 days, so I didn’t have any worries. Everything was pretty much at my house when I needed it.

These days, however, I’m a seasoned diabetes veteran. My average for testing-per-day has dropped to about six or seven blood glucose checks. For the insulin pump and its accoutrement, I’m able to stretch things out more than I used to. I will fill up the insulin reservoir with enough insulin to get me through four — maybe five — days, rather than the every-three like it was recommended I do. I will push an infusion set for four or five days, too (I don’t think I’ve gone much longer than that); and I do this in part because, yeah, I’m sometimes lazy and the site changes are a pain, but also because I’ve yet to have any infection from leaving sites on longer. I haven’t experienced any problems from stretching the supplies’ duration. (And if you want to speculate about manufacturers’ recommendations for frequency of materials change and how much of it is for health safety and how much of it is for more use and more profit, feel free.)

Sometimes I use the skin-prep wipes when I change the infusion set. Sometimes I don’t. I use the surgical dressing, however, by cutting it into a larger circle than my infusion set and then cutting a little circle within that, then pasting that over my infusion site to keep it more firmly affixed to my body. Yet for both of these products, I use less than ten each per month. But how many come in a box each time they send me new products? Fifty. Each.

And lancets? Don’t get me started. Lancets, lancets, lancets. They’re everywhere. And because I don’t even use the type of lancets they now send me — instead I use, and love, my Accu-Chek Multiclix, for which I have 90 boxes on hand — I’m accumulating thousands of lancet needles I’ve no need for. (Oh, and if you wonder why I’m getting lancets I don’t need? Long story. Told them not to send. They still send. And it goes back to my laziness and not correcting their error.)

So what to do with all of these supplies? Well, there’s iPump.org for the supplies. For my insulin? Well, I never end up with extra insulin, but there’s a list of places to donate insulin, too, at iPump.org. I’m sure an Internet search can turn up dozens of other places to donate, as well.

But have I donated any of my supplies? No. Will I? I don’t know. I want to. But then again, I worry about the “what-ifs.” What if something happens and I lose my insurance and can no longer receive the great coverage I have? What if, by donating and continuing to knowingly receive more supplies than I’m currently using, I’m committing some type of low-grade insurance fraud? And what if I did contact my medical supply company and changed the quantity of some of the items? If I lower the number of something (say, for example, the number of test strips), then if I want to or need to, in the future, increase the number of tests I perform daily, will they allow it? And even if they do, do I want to spend the time necessary to jump through all of the hoops, go through all of the phone calls and the inevitable confusion between doctors and insurance providers and supply companies?

No. No, I do not.

So instead I’ve kept the status quo and continued to accumulate diabetes goods on the ever-expanding medical-supply shelf in my closet (it’s expanded into a dresser drawer now, too).

I think someday soon I’ll ship some supplies off to iPump. Really. I will.

Do you send off your extras? What do you do, those of you fortunate enough to have this problem? Sit on ’em? Throw ’em out? Use all of them?



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