January 15, 2007
Question from Westerville, Ohio, USA:
I take Humalog and Humulin NPH pens, five shots altogether, three times a day. I take two kinds in the morning, one type at lunch and then two kinds at night. I would like to know what to expect when I run out of insulin, which is inevitable due to my situation. I expect I will be going into a coma, but wondered what physical sensations I would feel and how many days it would take before I am rendered unconscious.
I can’t live if I work and I can’t live if I don’t work. After two lay-offs in the last seven years, the only employment I’ve been able to find is low-end temporary jobs. Meanwhile, my school and property taxes have increased and my credit card suffered between temporary assignments. To shorten this tragic tale, I will say that I don’t qualify for any programs when I’m working and I get no holiday pay, days off, or medical benefits. These have all been jobs working for the State of Ohio.
I have been told through the Job and Family Services Agency here that I do not qualify for a medical card because I am not on Social Security. I am 60.7 years old and can’t collect Social Security until I am 62. Also, my home is in foreclosure.
To sum it up, I’m a single woman who has always worked and supported herself her entire life but, now, nobody will hire a woman my age and the only jobs in Ohio don’t pay a liveable wage, especially if you don’t have health insurance. I have tried every social program available and I’m always in a category by myself. In other words, I’m too young for many of the help program for the elderly but too old to be in the work force. So, I can’t pay for my insulin because I soon will have no place to lay my head, no income and a diabetic wouldn’t really make it in the street for long. That’s my reality.
With respect to getting insulin, you can contact Eli Lilly, NovoNordisk, and Sanofi- Aventis. All three have assistance programs.
Additional comments from Dr. Alan Schorr:
Each of the pharmaceutical companies has an indigent program designed for such patients. You need to contact your physician(s) for the appropriate paperwork and you should be able to get enough insulin for a three month period.
Additional comments from Dr. Tessa Lebinger:
It sounds like you are in a very difficult position and have tried very hard to get a job. Yes, if you stop your insulin you could go into a coma (diabetic ketoacidosis). The warning signs might first be muscle cramps or nausea. This can be fatal and you must NOT let this happen. In some people, it can happen in less than a day without insulin. In others, it might take a few days. In any case, it is an agonizing experience that can result in death or permanent disability.
If you aren’t able to buy insulin and can’t find an agency to help you either find a job or a way to afford your medication, I suggest you go to an Emergency Room one day before you will run out of insulin and tell them you will have to stop your insulin if you don’t get help. If they can’t help you with supplies as an outpatient, they will be obligated to admit you. They cannot send you home if you have no insulin. I don’t know about Ohio, but in New York, in order to qualify for Medicaid, you have to spend most of your savings. It is much less expensive for the state to help you get employed than to put you on welfare. It sounds like you are able and willing to hold down a job. I hope you can find an agency to help you find one. I’m sure there is an employer who would benefit from and appreciate your experience and determination to work. I realize it may be hard to find that employer.
If there is a clinic that adjusts its fees according to income, you would be best to go to a diabetes clinic well BEFORE you will run out of insulin and ask to speak to a hospital social worker. This is less expensive than going to the Emergency Room, but if there is no such clinic near you, you may have no choice but to go the Emergency Room right before you run out of insulin. An Emergency Room cannot refuse to see you and cannot send you home if you have no insulin. If you have to go to the Emergency Room, I would suggest doing it during the daytime when the social workers and patient advocates are at the hospital. If the doctors say they can’t help you, ask to speak to a patient representative or hospital social worker and REFUSE TO LEAVE until you have a way to get some insulin. I sincerely hope, however, you don’t have to resort to going to the emergency room.
DO NOT MISS YOUR INSULIN. You deserve help.
Additional comments from David S. Holtzman, Esq.:
The issues presented here would require drastic action. First alternative, sell your home prior to a sale in foreclosure to recover any equity you have in the property. With the proceeds, you will have paid off the mortgage and have some breathing room to pay for a period of rent as well as some medications to get you to age 62. Take a job with Wal-Mart or some other major corporation who offers medical coverage as an employee benefit.
I do not know if bankruptcy is an option for you because the new laws are stilted towards the creditors. However, if you know a lawyer, have them advise you if that is an option. One advantage is that a bankruptcy petition, even if later rejected, freezes a foreclosure from proceeding, but only for a short time.