New cost-saving drugs website

Mark Cuban Cost Plus Drug Company’s online pharmacy launches with the lowest prices on 100 lifesaving prescriptions.” Cost Plus is a direct to consumer pharmacy. It reflects the current need, with 1 in 10 Americans needing to skip doses of their medicine due to cost. I need to credit my friend Scott Strumello who posted this on Facebook. I trust Scott, he’s all over the cost of diabetes medications and how companies make their money.

Scott also tweeted, “So far Mark Cuban Cost Plus Drug Company has already beat the price on rosuvastatin calcium 10 mg tabs (generic Crestor), AND I had bypassed my own insurer’s pharmacy benefit to buy it for less elsewhere. His cost: $7.50 for a 90-day supply, which is half of what I was paying.

As shown above for the diabetes meds, they don’t carry insulin presently, but there are a few type 2 pharmaceuticals you might do better on. For myself, I looked up Levothyroxine, which is the generic for Synthroid. Here, I have to say they were not cheaper than the cost-saving app, GoodRx. After paying $18 for a 90 day supply on my Medicare United Healthcare plan, I found on GoodRx I could get the same supply for just under $13.00. At Cost Plus, it’s listed for $4.20 – but that’s for a 30 day supply – so 90 days will cost you $12.60, which is just about what I got it for on GoodRx.

So while you may do better, when you look up what you want to price, you might want to compare it to Good Rx or any other cheaper cost drugs app. That said, given this is the online venture of a pharmacy business, I’d say it’s a bit of hope shining through the darkness of the overinflated cost of drugs.

A page on the Cost Plus website below

“There is no vials here,” said the pharmacist

Pam and her husband Dave in the Italian countryside

Late last year I got an email from Pam Saylor, a writer living with type 1 diabetes. Pam offered to do a guest post here for you. I’m always open to guest posts by the way. This story below is from Pam. Much like her travel book, Braving the World: Adventures in Travel and Retirement, Pam’s post takes us on a journey to the Vatican City with diabetes playing a major character. Sit back, relax, have a cup of tea and read on.

Thank you Pam.

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It was hot and our bus moved slowly.  I lifted the hair off of the back of my neck and leaned towards the bus window hoping to catch a breeze.  The sounds of Rome’s morning rush hour traffic came in through the window—blaring car horns, motorcycles revving their engines, and the wheeze of buses stopping and starting.  I closed my eyes and fanned the back of my neck with my passport.  It seemed like hours but was probably only twenty minutes before I felt a gentle jab in the ribs from my husband Dave, who was sitting next to me.  Startled, I looked at him and he pointed at the electronic display at the front of the bus.  The next stop was ours.  We were on our way to the pharmacy in Vatican City to buy insulin—and I didn’t have a clue what to expect.  

Only a year before our bus trip to the Vatican City pharmacy, in 2016, early retirement unexpectedly became an option for Dave and me.  We jumped at it.  Dusting off the dream trip we had imagined for years, to live for one entire year in Italy, we began serious planning to make it a reality.   

Like giddy kids, we bought two one-way tickets to Rome.

But buying the plane tickets was the easy part.  Trying to figure out how life would work for me, diagnosed as a Type 1 diabetic only three years earlier, was harder.  Trip planning was thrilling and exciting, but I had a lot of questions. Would I be able to buy insulin in Italy?  Would it be affordable?  Would my prescriptions be accepted at pharmacies?  The unknowns of our dream trip woke me up at night. I couldn’t rely on the typical advice for short-term travelers and take “double the diabetes supplies that you think you will need.”  That advice didn’t apply to me.  I didn’t have a year’s supply of insulin to take to Italy.

As a confirmed planner and anxious list-maker, I researched every single detail that I could before we left the country in 2017.  I found an online group of expats in Rome who assured me that all Italian pharmacies would have insulin.  That was the good news.  They also told me that Italian pharmacies would not accept my American prescriptions.  That was the bad news.  Another helpful expat chimed in to tell me about the Vatican City pharmacy inside Vatican City.  This pharmacy not only accepted American prescriptions, but it had cheaper prices and lower taxes than a typical Italian pharmacy.  And so that is how, after only a few weeks of living in Rome, Dave and I came to be on a bus headed to the Vatican City pharmacy ready to test the advice of an anonymous online source and buy insulin.

Arriving in Vatican City, we hopped off the bus.  With passports and prescriptions in hand, Dave and I walked to St. Anna’s Gate, a little north of St. Peter’s Square where the Pope held his weekly outdoor audience.  I went first through the gate and handed my paperwork to the guard on duty.  Slowly and carefully he examined the papers and then handed them back.

“You must leave.” The guard sounded stiff and unhappy.  My stomach dropped and I looked at Dave with wide eyes. Now what? The guard continued talking. “It is not yet time to open.”  I glanced at my watch.  It wasn’t 8:30 yet.  We left and after an espresso, returned to the gate where the same guard slowly and carefully examined my paperwork again—as if it might have changed in the last 10 minutes.  These security guys did not mess around.

Once through the gate, we went into the small office next door and handed over our passports to a guard behind thick bullet-proof glass in exchange for a clip-on visitor’s pass.  Following the signs outside, we walked to the building marked Pharmacia and entered.

The room was already full of people.  On a screen near the ceiling, digital displays flashed red numbers.  This was a familiar setup—like the deli counter at the grocery store back home.  I needed a number.  Squeezing past packed bodies, already smelling faintly of sweat in the hot room, we got to the ticket machine and I pulled out a numbered ticket.  Waiting for my turn with a pharmacist, I wandered around the room looking at the shelves of cold medicines, lotions, and soaps for sale.

When my number flashed on the overhead screen I hurried to the window and handed my insulin prescription to the pharmacist in the white coat.  He disappeared into the backroom and returned with a box of insulin pens instead of the insulin vials I used to fill my insulin pump.

“Do you have insulin vials?” I asked.  Opening my purse I pulled out the small bag of diabetes supplies I carried.  I handed my vial of insulin to the pharmacist.  He turned it over in his hand and read the label, frowning, he disappeared again into the backroom.  When he came out, talking to another man in a white coat, I saw them shaking their heads.  Returning to me, he said, “There is no vials here.”

Some insulin was better than no insulin and I knew I could use the insulin pens to fill my pump, so I accepted the pens in place of vials.  One box of NovoRapid a/k/a NovoLog insulin pens (five pens per box for a total of 1500 units of insulin) cost a total of €46 or $56.

After paying for my insulin, I found Dave in the crush of people and we left together to collect our passports and catch the bus home.  I bounced down the pharmacy steps into the warm sunlight with the all-important box of $56 insulin in my purse.  

We still had eleven months of travel in our futures and I did not know then if I would be able to buy affordable insulin down the road.  Visa problems had forced us to change our travel plans and now our year-long dream trip would include living in Croatia, London, and Venice.  

But my trip to the Vatican pharmacy gave me confidence that things would be all right, somehow, one way or another.  I would find a way to solve problems.  This adventure didn’t come with an answer sheet and that was okay.  I would figure things out one day at a time and wasn’t that what diabetes had already taught me?

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Pam is a retired paralegal and a contented travel addict. Her book, Braving the World: Adventures in Travel and Retirement, is her first book and is available on Amazon at http://www.amazon.com/dp/B091BCNVWQ To see pictures of her year of travels, visit Pam’s website at www.bravingtheworldbook.com

How to deal with higher blood sugar from a cortisone shot

As much as I know about diabetes, I really wasn’t sure how to deal with the blood sugar rise from cortisone shots. And yes, I’ve had cortisone shots before – one for my trigger thumb last year, one some time ago for another sticky finger, and most recently shots for a tailbone that decided to grow a bone spur, or at least make me aware one was there.

I got the cortisone shot Friday afternoon around 2:30 pm and within a few hours I was already watching my blood sugar rise, and rise, and rise (on my Dexcom CGM). And even though I was injecting half unit, after unit, after half unit, it was like I was treating with water. I really got the visceral experience of being insulin resistant, which I am not. I was fearful, frustrated and fretting.

Of course the fear is of taking too much insulin and when it will all kick in, particularly while sleeping overnight. Through the evening my blood sugar rose to just over 180 mg/dl and then came down to about 167 and hovered there all night. That afternoon and evening, all I did was keep dousing myself with extra insulin, and watching the numbers on my CGM.

The next day I googled what to do about this. Surprisingly, this did not occur to me the first day, fool that I was. The best article that I found was on Healthline, “Yes, Steroids Spike Blood Sugars – So Beware.” The bottom line is, as diabetes educator extraordinaire Gary Scheiner, actually had emailed me the last time I had a cortisone shot:

– most people need to raise their basal insulin by 50% starting about 6 hrs post injection, then double their basal on days 2 and 3, then taper down.  Some need to triple their basal.  The humalog doses can remain as-is (correct any highs and cover meals as usual); the extra basal takes care of the insulin resistance caused by the steroid.  

So that’s exactly what I did. I took my Tresiba dose of 6 units/day up to 9 units for days two and three, and watched it. Today, day 4 I’ve dropped it down to 7 units and tomorrow anticipate going back to 6. Watching my blood sugar today, it looks like it’s back to normal.

This simple tip has worked like a dream. Still, it’s scary when you normally take a small amount of insulin and merely think of doubling or tripling it let alone do it! Terrifying actually. But unfortunately that’s what’s required for most of us when we get a cortisone shot.

I hope this offers some help next time you get a cortisone-induced rise in your blood sugar. I’m confident you’ll sleep a whole lot easier. I know I have.

Connected to the circle of life: Go forward with kindness

I was going to write a sort of year end wrap up and post it last night, but perhaps it was fortuitous that I was at my mother’s house and so could not access my blog. Perhaps it is better that I just post today an email I got in the last few days with a sentiment I so appreciate, a way to go forward into 2022.

The email was an email blast from a site/podcast called Sounds True. Sounds True was founded by Tami Simon and she’s the interviewer on the podcast. I have enjoyed many of the “new age,” spiritual interviews I’ve listened to. I also notice that during this time of incredible distress for the world and us, pockets of spirituality are sprouting everywhere. So I’m going to share this email with you on this, New Year’s Day.

Dear Riva,

I was on a solitary retreat in the Colorado mountains when I discovered how a very small action can make a huge impact. 

I had been meditating for several days as part of a 10-day solo retreat. And I had gotten in the habit of taking a walk each day toward the sunset hour when it felt like it was definitely time to stretch my legs and get outside.

On one of these walks, I saw a person in the distance headed toward me. I hadn’t seen a human being for several days, and I felt a strange adrenaline rise as I noticed him in the distance walking in my direction. This person I didn’t know continued to approach, and when we were about 10 feet away from each other, this stranger smiled at me with a genuine sweetness … and kept on walking.  

That was it; that was the small action. 

And for whatever reason (maybe because I had been meditating all by myself for several days), this human act of softly reaching out to me with a gesture of connection broke my heart right open.

Your words matter. Your phone calls matter. Your emails matter. Your genuine smile matters. The way you hold space for another matters. With the smallest of gestures, we lift each other up

Here on the last day of 2021, I want to remind us all that we matter … to each other. My sense is that we have no idea how many people we touch in small ways with huge impacts. Thank you for every act of compassion you share. I feel grateful to be in connection with you.

I’m committed to bring more kindness into ordinary days. Little feels more important right now. As Simon says, “With the smallest of gestures, we lift each other up.” As I have often said, even with diabetes, look up and see your possibilities.

Happy New Year