Insulin – do you have a backup plan?

For a person with type 1 diabetes, having access to your insulin is critical. If you don’t get your next injections (multiple each day) or your pump runs dry, you’re going to have an emergency on your hands. If your supply at home has run out or spoiled, in Australia we have quite good pharmaceutical supplies and your local pharmacy can usually provide more in short order.

Luckily we also have PBS subsidies, and buying another batch of insulin is usually not going to break the bank. We also have NDSS (which is linked to your Medicare number if you don’t have your NDSS card with you) for subsidised consumables.

Have a current prescription

We all use different amounts of insulin. With my own current usage, one repeat of Humalog will last me over 170 days. So I don’t go through prescriptions quickly, but I can’t go without the insulin itself.

Always have a current insulin prescription filed away so in an emergency you don’t need to visit your doctor as well as a pharmacy.
As soon as you use the last repeat: get a new prescription.

But when we’re away from home, the spare insulin in the fridge at home might be an hour’s drive away, or it could be a week’s travel away. We only have the insulin that’s with us.

As I outlined in an article on travel planning, having a backup supply with you is important. But even that could be damaged/lost. If you needed replacement insulin, where would you get it from?

  • If you’re within Australia, your prescription can be taken to any pharmacy. They might not have your particular insulin in stock, but in most locations it can be filled fairly quickly.
  • If you’re outside Australia you’d have to track down a new supply from a pharmacy (possibly at a hospital) promptly. Your Australian prescription won’t be filled directly, but can still provide excellent documentation if you need to convince people that this is indeed your usual drug. It’s also useful if customs officials query why you’re carrying the drugs.
    There are some countries where you can buy insulin without a prescription, but don’t rely on that.

What if you don’t have it with you?

Some people go so far as to have their prescription always with them, even if they’re just travelling across town. I don’t do that: I don’t carry a handbag, and the paper script won’t survive very long bouncing around in my wallet (which is full enough as it is!).

When travelling overseas I do try to make sure I have paperwork with me for all prescription drugs in my bag. When travelling interstate I’ll often do the same, but there are many times I’ve travelled within the state and sometimes interstate without all that extra paperwork. Sometimes there doesn’t seem a huge difference between driving for an hour to a speaking engagement across town, or 1-4 hours into the countryside to get to a job, and many times I don’t go through exhaustive packing (other than throwing some extra pump cannulae and swabs into my bag).

Quite apart from times that you didn’t leave home with the prescription, there could also be times you lose it. Losing a bag (through theft or accident) can happen to anyone.

But then what if I need more insulin? What can I do? Other than die of course: that’s not an option. I could travel to a hospital ER and convince them to help me. But that’s hugely disruptive for everyone, especially me!

Visiting a non-local pharmacy

N2_B30On one occasion on a Friday in a remote country town I found my insulin was going to run out over the weekend, and found a local pharmacy. Luckily they were open and had the insulin type I needed. But I didn’t have a script with me. I was able to phone my doctor’s clinic back home and get them to write a fresh prescription, fax a copy to the pharmacy, and then mail the original to them.

On the strength of that the pharmacy was able to dispense the insulin for me and my problem was fixed. But what if my doctor’s clinic was closed? Finding someone to write a prescription for me on short-notice in this country town would have been a challenge.

Some people give their PBS prescriptions to their regular pharmacy to manage on their behalf, and in that case getting the pharmacies to talk to each other would probably work.

But there’s another option too.

Modern technology to the rescue

When travelling I used to take chunky travel guide books (e.g. Lonely Planet). But luggage space is limited. These days I store PDF versions on my phone and laptop. They take up no extra weight or space. In fact for my photo workshop trips I often have all the manuals for the participants’ cameras as PDFs to be able to check details and assist anyone who needs help even if I’m not already familiar with their particular gear.

I have PDF copies of my travel insurance documentation, my e-tickets, and everything. Scans of my passport, credit cards, etc.

Currently I store all of these in my Dropbox, so they’re synced across my laptop, desktop, phone, tablet, etc. On my phone in the Dropbox app I set some folders to be available offline, so if I’m stuck in a remote country with no Internet access I still have the important files with me. Or I can access the files via any web browser. Maintaining good Dropbox security is important of course.

Scan your prescription

Once you fill it, an original prescription is accompanied by a PBS Repeat Authorisation form. I scan both of these together as one page.

I name the PDF file with the date of the scan so I know at a glance how old it is. I save it in PDF format rather than an image, as if I have to provide the file to anyone the odds of them being able to print it are much higher.

Whenever something changes (I get a fresh prescription, or get a repeat filled) I replace the scan with a fresh one.

I have discussed this with my local pharmacist and they agree that this is a useful backup plan. If I can give the PDF file to a pharmacy (the cleanest way of doing that would be to email it to them) and then when I get home post the physical paperwork to them, that should be enough for the pharmacy to dispense the insulin I need on the spot.

It’s a simple backup process that should save me from stress and drama if I ever get caught without a prescription again!

3 thoughts on “Insulin – do you have a backup plan?”

  1. Andrew Bassett-Smith

    Being the tech head nerdy problem solver and problem identifier I am, I wonder about the following

    Imagine you’ve scanned a script, whatever number of repeats (insulin wide, the 3ml penfill is usually 1, 10ml vials is usually 2). You then fill that script. But have the scanned copy on hand.

    Is there anything on the chemist computer systems to identify a mismatch if you presented that “script”

    1. Yes I believe you wouldn’t get away with that for long.
      Not only the fact that you need to present the actual paperwork eventually, but I’m sure there are anti-fraud procedures built into the PBS system.

  2. On arriving in London 2 years ago I realised I’d miscalculated how much insulin to take – I didn’t have enough for my travels through Europe. I visited the nearest NHS clinic. They would only supply 5 days worth (1 flexpen). I ended up going to see a private doctor for £170 and purchased a box each (5 flexpens) of my basal and bolus insulin for £160. It was an expensive mistake.

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