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Post by JEvans on Jan 8, 2020 16:31:03 GMT -5
I had an appointment with my Endocrinologist, Dr. Yaroslav A. Gofnung MD, yesterday in Westlake Village, Ca regarding my Thyroid issue, I do not have Diabetes. I asked him (just to get a feel for myself) if he prescribes Afrezza and he said he had and does, but the problem that he sees is the following:
1. Some of his patience complain that the insulin comes on to fast. Some say that it goes away to fast or doesn't last long enough. He stated that the initial dosing to a patient is inexact (so is Thyroid meds) and with everyone's different eating habits patients don't seem to understand what they need to do.
2. He also stated that the younger crowd seems to lean toward the pump. Though I (me, not the Dr.) have two friends with the pump and they seem to have nothing but problems, one is always in the hospital.
3. But the Main problem, he said, is insurance. No coverage
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Post by peppy on Jan 8, 2020 16:42:51 GMT -5
I had an appointment with my Endocrinologist, Dr. Yaroslav A. Gofnung MD, yesterday in Westlake Village, Ca regarding my Thyroid issue, I do not have Diabetes. I asked him (just to get a feel for myself) if he prescribes Afrezza and he said he had and does, but the problem that he sees is the following: 1. Some of his patience complain that the insulin comes on to fast. Some say that it goes away to fast or doesn't last long enough. He stated that the initial dosing to a patient is inexact (so is Thyroid meds) and with everyone's different eating habits patients don't seem to understand what they need to do. 2. He also stated that the younger crowd seems to lean toward the pump. Though I (me, not the Dr.) have two friends with the pump and they seem to have nothing but problems, one is always in the hospital. 3. But the Main problem, he said, is insurance. No coverage. But the Main problem, he said, is insurance. No coverage |
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Post by olebob1 on Jan 8, 2020 16:52:03 GMT -5
I had an appointment with my Endocrinologist, Dr. Yaroslav A. Gofnung MD, yesterday in Westlake Village, Ca regarding my Thyroid issue, I do not have Diabetes. I asked him (just to get a feel for myself) if he prescribes Afrezza and he said he had and does, but the problem that he sees is the following: 1. Some of his patience complain that the insulin comes on to fast. Some say that it goes away to fast or doesn't last long enough. He stated that the initial dosing to a patient is inexact (so is Thyroid meds) and with everyone's different eating habits patients don't seem to understand what they need to do. 2. He also stated that the younger crowd seems to lean toward the pump. Though I (me, not the Dr.) have two friends with the pump and they seem to have nothing but problems, one is always in the hospital. 3. But the Main problem, he said, is insurance. No coverage. But the Main problem, he said, is insurance. No coverageKevin Michelizzi kmichelizzi· Jan 7 Quite interesting turn of events on #Afrezza and #Tresiba with the new year/new insurance. My Afrezza no longer needs a prior authorization, and Tresiba has a $0 copay. This is with #Medica and @expressscripts |
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Post by sayhey24 on Jan 8, 2020 19:02:22 GMT -5
It sounds to me like Dr. Yaroslav A. Gofnung MD needs a visit from a MNKD sales rep who can talk to him about proper dosing time and proper titration.
As far as the younger crowd liking pumps I talked to an early 30's today who switched from an Omnipod to the new Medtronic. I am not sure what "younger" means or if early 30's is old. She just came out of the hospital due to a hypo.
I first mentioned afrezza 3 years ago and her endo never heard of it. Now her endo sounds similar to Aged's thinking it may make you lungs explode. I think the bigger issue with T1s is the endo's changing from what they know. She is now really thinking hard about starting to use it as a "rescue" tool. I sent her the 2020 SoC.
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Post by peppy on Jan 8, 2020 20:05:15 GMT -5
It sounds to me like Dr. Yaroslav A. Gofnung MD needs a visit from a MNKD sales rep who can talk to him about proper dosing time and proper titration.
As far as the younger crowd liking pumps I talked to an early 30's today who switched from an Omnipod to the new Medtronic. I am not sure what "younger" means or if early 30's is old. She just came out of the hospital due to a hypo. I first mentioned afrezza 3 years ago and her endo never heard of it. Now her endo sounds similar to Aged's thinking it may make you lungs explode. I think the bigger issue with T1s is the endo's changing from what they know. She is now really thinking hard about starting to use it as a "rescue" tool. I sent her the 2020 SoC. or the physician could turn on the video and this physician will tell him exactly how to dose. then he could give the link to patients. |
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Post by peppy on Jan 8, 2020 20:06:57 GMT -5
. But the Main problem, he said, is insurance. No coverage· J an 7
Quite interesting turn of events on #Afrezza and #Tresiba with the new year/new insurance. My Afrezza no longer needs a prior authorization, and Tresiba has a $0 copay. This is with #Medica and
@expressscriptsthis is the afrezza news of the day. |
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Post by slugworth008 on Jan 8, 2020 20:31:20 GMT -5
I had an appointment with my Endocrinologist, Dr. Yaroslav A. Gofnung MD, yesterday in Westlake Village, Ca regarding my Thyroid issue, I do not have Diabetes. I asked him (just to get a feel for myself) if he prescribes Afrezza and he said he had and does, but the problem that he sees is the following: 1. Some of his patience complain that the insulin comes on to fast. Some say that it goes away to fast or doesn't last long enough. He stated that the initial dosing to a patient is inexact (so is Thyroid meds) and with everyone's different eating habits patients don't seem to understand what they need to do. 2. He also stated that the younger crowd seems to lean toward the pump. Though I (me, not the Dr.) have two friends with the pump and they seem to have nothing but problems, one is always in the hospital. 3. But the Main problem, he said, is insurance. No coverage I thought that's why Kendall was hired??? |
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Post by shawnonafrezza on Jan 8, 2020 22:27:35 GMT -5
My thoughts on 1-3:
1: Come on too fast is odd. Maybe they're dosing before the meal? Away too fast I agree. Hence the second dose which if they're not being taught...
2: I get the appeal of a pump and double that for young people. Slap on an Omnipod and the disease is all but invisible to the world. A few button presses on a phone looking thing vs inhaling are opposite spectrum on discrete.
3: Not much to say there, insurance companies just suck no matter the disease. They are a stain on this earth.
Number one is the easiest to fix. Pump companies have pump reps. They will literally spend a few hours setting it up with you and going through how to use it all. Maybe Afrezza needs that.
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Post by agedhippie on Jan 8, 2020 22:47:37 GMT -5
My thoughts on 1-3: 1: Come on too fast is odd. Maybe they're dosing before the meal? Away too fast I agree. Hence the second dose which if they're not being taught... 2: I get the appeal of a pump and double that for young people. Slap on an Omnipod and the disease is all but invisible to the world. A few button presses on a phone looking thing vs inhaling are opposite spectrum on discrete. 3: Not much to say there, insurance companies just suck no matter the disease. They are a stain on this earth. Number one is the easiest to fix. Pump companies have pump reps. They will literally spend a few hours setting it up with you and going through how to use it all. Maybe Afrezza needs that. At one point they wouldn't give you the pump until you had been given the training. Do they still do that (it's been a while...)? |
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Post by shawnonafrezza on Jan 8, 2020 22:50:12 GMT -5
My thoughts on 1-3: 1: Come on too fast is odd. Maybe they're dosing before the meal? Away too fast I agree. Hence the second dose which if they're not being taught... 2: I get the appeal of a pump and double that for young people. Slap on an Omnipod and the disease is all but invisible to the world. A few button presses on a phone looking thing vs inhaling are opposite spectrum on discrete. 3: Not much to say there, insurance companies just suck no matter the disease. They are a stain on this earth. Number one is the easiest to fix. Pump companies have pump reps. They will literally spend a few hours setting it up with you and going through how to use it all. Maybe Afrezza needs that. At one point they wouldn't give you the pump until you had been given the training. Do they still do that (it's been a while...)? From what I've seen you will have it but you're told not to hook it up. |
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Post by Deleted on Jan 9, 2020 11:20:12 GMT -5
I had an appointment with my Endocrinologist, Dr. Yaroslav A. Gofnung MD, yesterday in Westlake Village, Ca regarding my Thyroid issue, I do not have Diabetes. I asked him (just to get a feel for myself) if he prescribes Afrezza and he said he had and does, but the problem that he sees is the following: 1. Some of his patience complain that the insulin comes on to fast. Some say that it goes away to fast or doesn't last long enough. He stated that the initial dosing to a patient is inexact (so is Thyroid meds) and with everyone's different eating habits patients don't seem to understand what they need to do. 2. He also stated that the younger crowd seems to lean toward the pump. Though I (me, not the Dr.) have two friends with the pump and they seem to have nothing but problems, one is always in the hospital. 3. But the Main problem, he said, is insurance. No coverageThanks for the comments. I'm not sure why Patients nor Doctors can't make the adjustment on when to take Afrezza. Common sense would tell you if it works too fast then take it after you start eating. I think the problem is that Diabetics are so used to take their insulin shot 40 minutes BEFORE they start eating so naturally Afrezza has already worked before the food is digested. I can see the younger crowd leaning towards the PUMP for now but when they realize all they have to do is where a CGM (which I'm sure is built into the Pump) and inhale a small device......They will switch to Afrezza. I believe insurance will improve when Pediatrics is approved later this year. Parents of kids will have a louder voice and will force better coverage especially when they see they can inhale and not take a shot. School nurses will be over joyed to give Afrezza and not deal with a needle. |
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Post by mango on Jan 9, 2020 12:18:52 GMT -5
I had an appointment with my Endocrinologist, Dr. Yaroslav A. Gofnung MD, yesterday in Westlake Village, Ca regarding my Thyroid issue, I do not have Diabetes. I asked him (just to get a feel for myself) if he prescribes Afrezza and he said he had and does, but the problem that he sees is the following: 1. Some of his patience complain that the insulin comes on to fast. Some say that it goes away to fast or doesn't last long enough. He stated that the initial dosing to a patient is inexact (so is Thyroid meds) and with everyone's different eating habits patients don't seem to understand what they need to do. 2. He also stated that the younger crowd seems to lean toward the pump. Though I (me, not the Dr.) have two friends with the pump and they seem to have nothing but problems, one is always in the hospital. 3. But the Main problem, he said, is insurance. No coverageThanks for the comments. I'm not sure why Patients nor Doctors can't make the adjustment on when to take Afrezza. Common sense would tell you if it works too fast then take it after you start eating. I think the problem is that Diabetics are so used to take their insulin shot 40 minutes BEFORE they start eating so naturally Afrezza has already worked before the food is digested. I can see the younger crowd leaning towards the PUMP for now but when they realize all they have to do is where a CGM (which I'm sure is built into the Pump) and inhale a small device......They will switch to Afrezza. I believe insurance will improve when Pediatrics is approved later this year. Parents of kids will have a louder voice and will force better coverage especially when they see they can inhale and not take a shot. School nurses will be over joyed to give Afrezza and not deal with a needle. It will certainty be life changing for children! Great point about school nurses, I can easily see that too, not to mention the mountain of stress and inconvenience having to inject mealtime insulin, especially for a child. Afrezza Pediatric approval can’t get here fast enough. |
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Post by peppy on Jan 9, 2020 12:28:07 GMT -5
Thanks for the comments. I'm not sure why Patients nor Doctors can't make the adjustment on when to take Afrezza. Common sense would tell you if it works too fast then take it after you start eating. I think the problem is that Diabetics are so used to take their insulin shot 40 minutes BEFORE they start eating so naturally Afrezza has already worked before the food is digested. I can see the younger crowd leaning towards the PUMP for now but when they realize all they have to do is where a CGM (which I'm sure is built into the Pump) and inhale a small device......They will switch to Afrezza. I believe insurance will improve when Pediatrics is approved later this year. Parents of kids will have a louder voice and will force better coverage especially when they see they can inhale and not take a shot. School nurses will be over joyed to give Afrezza and not deal with a needle.It will certainty be life changing for children! Great point about school nurses, I can easily see that too, not to mention the mountain of stress and inconvenience having to inject mealtime insulin, especially for a child.Afrezza Pediatric approval can’t get here fast enough. Susie Sunshine here to point out, school districts all over the US of A will need to change their meal time insulin protocols. RAA's are given 30 mins prior to eating. children are sent down to the nurses office before lunch. Afrezza is taken at first bite of food.
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Post by shawnonafrezza on Jan 9, 2020 13:28:18 GMT -5
I've heard a lot of inaccuracies here on insulin timing, both RAA and Afrezza. People will typically pre bolus RAA 10-15 minutes before a meal, kids might be sooner. Most people don't pre bolus (it shows). Afrezza should be taken ~10 minutes post meal (except candy) or when you see the rise start on a CGM.
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Post by mnkdfann on Jan 9, 2020 13:47:12 GMT -5
It will certainty be life changing for children! Great point about school nurses, I can easily see that too, not to mention the mountain of stress and inconvenience having to inject mealtime insulin, especially for a child.Afrezza Pediatric approval can’t get here fast enough. Susie Sunshine here to point out, school districts all over the US of A will need to change their meal time insulin protocols. RAA's are given 30 mins prior to eating. children are sent down to the nurses office before lunch. Afrezza is taken at first bite of food.Are such children sent down to the nurses' offices before lunch so that nurses can do the injections? Or because the schools do not want children carrying insulin with them, and so it is stored in the nurses' offices? Or some of both? |
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