Once I sent the last letter posted to Senator McCain and that letter was forwarded by his office to the appropriate officials at the VA, I started to see results. Senator McCain received a letter from Sharon Hellman, the Hospital Director now on administrative leave pending the outcome of an Inspector General investigation into the Phoenix VA “list scandal” which could include a recommendation that criminal charges including treason, sedition, perjury, mutiny, and murder be brought against Comrade Director Hellman.
This letter indicated that the diluent for use with Novolog insulin had been ordered. Apparently this caused a big ruckus between the bureaucrats at Novo Nordisk and the VA bureaucrats over paperwork. The vials were still forthcoming and in typical fashion someone made the assumption that I would no longer need a prescription for Regular insulin. This is the type of insulin I primarily use for meal boluses, indicating that there was still a failure on the part of some to comprehend the basis for my requests and thus necessitating this final letter to the Senator.
I went to see my Dr. at the VA last week and we made some changes. Unfortunately what ended up happening was what I knew would happen because this kind of thing always ends up happening when you try to force everybody into the same system and the people who run the system are making decisions for everyone based on fundamentally flawed assumptions:
This is what I need:
A prescription for Levemir Insulin for use as basal insulin: Basal insulin injections are doses of insulin designed and intended to maintain level blood sugars through the fasting state. I currently do have this prescription which is something of a minor miracle. I didn’t even think it was part of the VA formulary and hence covered because most Dr’s. prescribe Lantus because its been marketed as a 24 hour insulin. It’s not. Furthermore Lantus has been linked to an increased risk of cancer and costs more. Dr. Richard K. Bernstein, an eighty year old type one diabetic and clinical endocrinologist states in his definitive text Diabetes Solution, “Why use an insulin that has even a very small risk of promoting cancer when an equally good and less costly one already exists?” Why?*
A prescription for Regular Insulin for meal boluses: This is what Dr. Donald Boles, my VA primary care physician, has prescribed for me to use for meal boluses. Bolus insulin injections are doses of insulin designed and intended to maintain level blood sugars during the fed state or used to correct high blood sugars to target. According to Dr. Richard K. Bernstein, if on a very low carbohydrate diet, Regular insulin is more effective at maintaining level blood sugars when used for meal boluses rather than the faster acting analog insulins such as Novolog. Dr. Bernstein insists that low carbohydrates are essential to the treatment of all diabetics and my own Primary Care Physician Dr. Donald Boles of the Gold Clinic concurs.
A prescription for Novolog Insulin and appropriate diluting medium for correction boluses: While Novolog insulin can be used for meal boluses when time is tight such as when dining out, its primary purpose is for correction boluses. Unfortunately, it is one and a half times more potent than regular insulin and according to Dr. Richard K. Bernstein a single unit can be expected to lower the blood sugar of a 140 lb. type one diabetic whose pancreas produces no insulin by 60 mg/dl. When I recently performed a series of fingerstick measurements of my blood sugar when elevated and while fasting in accordance with my best interpretation of protocols set forth by Dr. Bernstein in his text, I discovered that one single unit of Novolog lowered my blood sugar by 75 mg/dl over a six hour period.
Without diluting medium I am unable to correct elevated blood sugars unless it is elevated at least 75 mg/dl above my target blood sugar level thus making my attempts to normalize my blood sugar unnecessarily difficult and dangerous. When using Novolog insulin diluted at a 5:1 ratio I can safely make corrections when my blood sugar level is elevated by as little as 13 mg/dl.
A prescription for empty sterile vials: In order to prepare and store diluted insulin I must have a way to contain it. According to Dr. Bernstein empty sterile vials are appropriate for the preparation and storage of diluted insulin.
A prescription for 30 unit insulin syringes with 1/2 unit markings: When I saw Dr. Boles last he entered the prescription into the system but now there is not even an active prescription listed for insulin syringes in the system. Furthermore, I suspect the next time I receive a supply of insulin syringes they will not have 1/2 unit markings as I suspect the pharmacy does not stock them. When I previously asked for syringes with 1/2 unit markings from Comrade Wlatka Peric-Knowlton of the endocrinology clinic she told me they were not stocked by the pharmacy because the were more expensive. This is a lie. They aren’t more expensive, I know because I’ve purchased them before. Because most Dr.’s and Diabetes Educators inexplicably deny the value of normal blood sugars and erroneously insist diabetics must consume a very high carbohydrate diet in order to avoid an increased risk of heart disease and severe hypoglycemia, dosing in 1/2 unit increments is not prescribed.
My present target blood sugar as determined by Dr. Boles and myself using our best interpretation of the guidelines set forth by Dr. Bernstein is 100 mg/dl before, during, and after meals. Dr. Richard K. Bernstein concludes, “Americans now eat an average of about 156 pounds of added sugar per year, something the average human would not have experienced in a lifetime 10,000 years ago. Nowadays fast-acting carbohydrate accounts for the largest part of energy consumption, So if we ignore elevated blood sugars that may be encountered shortly after high carbohydrate meals, a “normal” value would be 83 mg/dl, perhaps even lower…… Since those who inject nontrivial amounts of insulin cannot turn off injected insulin as their blood sugars drop, there always exist the possibility of going too low (hypoglycemia). I therefore throw in a small safety factor and ask such such individuals initially to shoot for a target of 90 mg/dl…..we try to correct blood sugars when they are above or below a target. Since we follow a very low carbohydrate diet OUR TARGET REMAINS THE SAME BEFORE, DURING, AND AFTER MEALS…..” (my emphasis added).
I sincerely appreciate and acknowledge the efforts of those at the Phoenix VA who have recently worked diligently to secure a supply of appropriate diluting medium from Novo Nordisk, particularly Dr. Donald Boles and the entire staff of the Gold Clinic along with many staff members of the pharmacy. We can’t sit back and watch another Marine die because the American Diabetes Association, the United States Department of Agriculture,and the Department of Health and Human Services have scaremongered most Doctors and Pharmacists into believing they’ll be sued for malpractice if their patient’s die of severe hypoglycemia and have scaremongered most diabetics along with the general public into believing that diets high in saturated fats cause heart disease at the insistence of the marxists, darwinists, and freudians who have upended and ransacked our colleges and universities. In the Corps, we have a word for what is going on at the Phoenix VA its called fratricide. You’re shelling your own troops with this bullshit. High blood sugar isn’t low blood sugar. Normal blood sugar isn’t dangerously low blood sugar, not even for a diabetic. While the dangers of low blood sugar are grossly overstated by the marxists, darwinists, and freudians who have seized control of a number of key government and paragovernment institutions including the American Diabetes Association, hypoglycemia can be genuinely life threatening and is almost always caused by industrial doses of insulin prescribed in conjunction with high carbohydrate diets. “It’s only logical…” Dr. Bernstein states, “…. to look to elevated blood sugar and hyperinsulinemia for the causes of what kills and disables so many of us.”.
LCpl USMC (retired)
So now my prescriptions are as fixed as they are going to get. Of all the changes I requested only syringes with 1/2 unit markings have not been provided.