Diagnosed at 13 months old, my daughter started her time with diabetes on tiny doses of insulin. The NPH was measured in half unit doses, so with the smallest insulin syringe we could measure that dose accurately. The Humalog dose was often best measured in increments of .25 or less. It was much safer and easier to prepare those doses with diluted insulin.
The pharmacy at the children's hospital diluted our first batch for us. We did some research and discovered we had what's called a 'compounding pharmacy' very close to our home.
Per Wikipedia, "Pharmaceutical compounding (done in compounding pharmacies) is the creation of a particular pharmaceutical product to fit the unique needs of a patient. To do this, compounding pharmacists combine or process appropriate ingredients using various tools. This may be done for medically necessary reasons, such as to change the form of the medication from a solid pill to a liquid, to avoid a non-essential ingredient that the patient is allergic to, or to obtain the exact dose(s) needed or deemed best of particular active pharmaceutical ingredient(s)."
Initially, this service was ideal. We got to know the head pharmacist well, and he took a shine to my daughter. The pharmacy was also a fabulous gift and card store, and had fun toys to check out while we were there.
After nearly a year of seamless insulin pick-up, the pharmacist retired. He explained that other staff members knew how to dilute the insulin and that we should have no problem.
One afternoon, I picked up my insulin and brought it home. I took it out of the box, and noticed it looked different. It was full strength Humalog. If I'd measured 5 units of that on my insulin syringe for my daughter's .5 unit dose, it would have been disastrous.
I took it back. Someone diluted it. The next time I checked before I left the store. It wasn't diluted. I pointed out the problem to the pharmacist.
"We don't ordinarly dilute insulin. You should really be having your vet do that for you."
"My vet?"
"Yeah...they do that all the time."
My daughter was next to me, holding my hand. "I've never taken my daughter to a vet before."
A blank stare.
"It's for her," glancing down at my little girl, "not a pet."
"Oh...I'm so sorry, maam."
At our next appointment, the educator taught me how to dilute my own insulin.
That is so horrible , yet hilarious at the same time. We were taught to dilute from the get-go and when the hospital wouldn't supply us with the supplies anymore, we had to figure out a work around because nobody in our area would dilute and I would have had to drive 45 minutes each way every month to get a new vial. No thanks!
ReplyDeleteThanks for the laugh!