Holy @#$! Amazing Stories, Vol. 12: Being Me – Lessons from a PWD/PSR

Ever wonder what it’s like “working for the other side?” Michelle M. felt compelled to share her story of “straddling the fence” with me, and I share it with you today. Read on.

So what’s it like being BOTH a “PWD” and a “PSR”?

What? You don’t know what a “PSR” is? Let me elaborate. I am, what most everybody hates to love and at the same time loves to hate… a pharmaceutical sales representative. Oh, and I should probably mention that I am equally as lucky since I am also a person with diabetes. Like you, I wear the “red badge of courage,” carry the burden of a disease that has a mind of its own, yet is far more controllable than many will admit.

As a person with Type 1 insulin-dependent diabetes, I am fiercely independent. I refuse to let my disease control me and strive to control it. I am a “good” diabetic, checking myself an average of 10 times per day. With my career, comes the blessing of knowledge exposure and the expectation to own it. That being said, I have tried most everything that is out there: CGM (continuous glucose monitoring), all of the “analog or mealtime” insulins and even the most recent “advance” with untethered insulin pumps. I have even tried Symlin and its counterpart Exenatide (which of course is “off-label”). I have a strong opinion by way of my travels and the knowledge that I have picked up which has given me deep-rooted opinions. I expect nothing but success from myself since I must lead by example with the career that I have chosen. I by no means write to suggest that my experience should be indicative of what you expect, but I do write to tell each and every diabetic, type 1 or type 2, to be your own champion!

I recently had an opportunity to listen to an Endocrinologist speak to myself and my peers at one of our meetings. Throughout his presentation, I kept thinking, “tell me something I don’t already know”, “give me something new”. To my surprise, I walked away with something that was so basic yet I am willing to bet that 98% of us don’t do it. What is it you ask? S imply stated, how many times do you find yourself behind the wheel driving down the road, NOT having checked your blood sugar…? Yeah, I’m talking to you. Many of us swear that we know when we are “low” and we can recognize the symptoms, which may or may not be true. I recognize when I’m low, but I’ve started to test that much more since my job revolves around driving in my car from office to office throughout the day. Without that “knowledge” of where your sugars are when you are behind that wheel, you risk the chance of hurting yourself, your family and those around you, not to mention their families. Bottom line, you owe it to yourself and those driving their cars around you — not to mention all of those families involved. Thus, my lesson -– test yourself and if you don’t like to test with the frequency that I do, invest in CGM, it’s worth it. I share with you the following story of a former colleague of mine:

A
diabetes educator who herself had diabetes and from what I was told recently
hyperglycemia unawareness. She lost her
life right before Christmas while behind the wheel of her car. While thankfully she only “bumped” a few cars
around her (as again I was told), her car careened off the road long after the
off ramp she was looking for. She left
behind her husband and two children after retiring from her full time job just
two weeks before this incident. She
won’t get to see her recently engaged child get married and she will never see
the grandchildren she desperately wanted. Simply stated, hers was a life cut short.

Pharma_sales_rep_bookAnd now, the other part of who I am, that being a pharmaceutical sales representative. The basis for my job is to bring information to the physician, to be a resource to your doctor. I am also supposed to partner with your doctors staff all in the name of making it better for you as a patient. We bring samples and supplies for the physicians so that they will get the clinical experience, and thereby expertise with our medications in addition to giving the patients a “leg up” when having to start a new medication. While there are many reps out there that seem to monopolize your doctor’s time, we are not all alike. I sympathize with you for what it may in fact appear to be or for that matter actually be… somebody who is taking your time up with the doc and making the doctor run late. Just remember: some may do that, but there are others like me that are respectful of you as the patient, the staff and physician, because I know just what it’s like to be you and I respect that. I’m different because I hold myself to a higher standard. I am empowered by my job in pharmaceuticals because the information is with me each and every day. I want for each diabetic patient to own their disease with the same determination that I have. I want each of you to be successful in the management of your disease. Bottom line is that I expect a lot from myself as the pharmaceutical rep because I walk in your shoes, and you as the patient should too.

So
next time you see one of us, stop for a moment and think. Value me for more than the samples I bring
and the time I take in the office. Also,
be your own champion and ask the questions, learn and challenge your docs, they
deserve it as much as you deserve the highest standard of care a diabetic
patient can get!

– Michelle M. in CA

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15 Responses

  1. Adam Becker Sr
    Adam Becker Sr January 25, 2008 at 8:04 am | | Reply

    Hey, Michelle, some of us *do* appreciate the sales reps. Truth is, being detailed by sales reps is the only continuing education some docs get. Sure, I’d rather they be taking online, high-quality CMEs. But that ain’t gonna happen.

    Without disclosing your employer…can you tell if the product line you detail covers diabetes-associated conditions?

    I’d like to see some more posts from your point of view.

  2. Scott
    Scott January 25, 2008 at 8:30 am | | Reply

    I think she may have written the wrong thing when noting “A diabetes educator who herself had diabetes and from what I was told recently hyperglycemia unawareness. ” HYPERglycemia unawareness poses no immediate threat to anyone (unless of course, they have to make a quick run for the restroom while behind the wheel), while HYPOglycemia unawareness is a condition that causes patients blood glucose levels to dangerously low levels without the traditional warning signs, and is attributed to the lack of counterregulatory response caused by the autoimmune attack which causes type 1 diabetes (it is quite rare in type 2 diabetes even if beta cell failure occurs, as they retain the functions of other cells needed to trigger the epinephrine response). While HYPOglycemia unawareness is too often attributed to patient error may, in fact, be the result of manufacturing insulin via recombinant DNA technology, as several studies and meta-analyses seem to suggest. However, a lack of post-marketing analysis has never investigated this issue as it has with other drugs.

    Regardless, you may want to double-check to ensure it was not a typo … hyperglycemia unawareness means a patient cannot tell their blood glucose levels are elevated, and it affects millions of “pre-diabetic” patients worldwide, none of whom have endangered other drivers because of their condition.

  3. Corey
    Corey January 25, 2008 at 9:48 am | | Reply

    Hyperglycemia unawareness? You must mean HYPO, not HYPER.

  4. CALpumper
    CALpumper January 25, 2008 at 9:52 am | | Reply

    While the POV of a PWD and a PSR is very interesting and can offer an array of information….anyone who posts here offers that also.

    My point in saying that is while Michelle is very opinionated, which I welcome and encourage, I feel the need to point a couple things out:

    ” As a person with Type 1 insulin-dependent diabetes, I am fiercely independent. I refuse to let my disease control me and strive to control it. I am a “good” diabetic, checking myself an average of 10 times per day. ”

    1) While these statements are important to the PWD psyche, categorizing diabetics as good or bad is a fine line.
    2) I have had Type 1 for 23 years and simply put, I am still here… when I was a child my parents had the insurance. As an adult I have been on and off insurance due to job changes (mostly because of how I was treated or simply fired).
    3) I am good at paying attention to what my body needs, what it is telling me, what works, what does not. I have habits, don’t always do the right thing. Does not make me bad though…..

    ” I have tried most everything that is out there: CGM (continuous glucose monitoring), all of the “analog or mealtime” insulins and even the most recent “advance” with untethered insulin pumps. I have even tried Symlin and its counterpart Exenatide (which of course is “off-label”). ”
    and
    ” Thus, my lesson -– test yourself and if you don’t like to test with the frequency that I do, invest in CGM, it’s worth it. ”

    1) Must be nice to have access to such medicine and technology. Please remind yourself that many do not have the insurance, the money or the resources in order to “strive to be their own champion.”
    2) I have struggled to obtain my basic needs: insulin and test strips. I use a pump and luckily my doctor’s office and a Pump Sales Rep “hook me up” while without insurance.
    3) I would LOVE a CGM. Among other things, like a support group in my area for Type 1s. I would love to have a series of labs done to see what else would benefit me. I would love to attend more appts in order to get a better handle of my blood sugar levels, my carb intake, my mental health, etc etc etc.

    Opinions are great. Those that can strive, it is so great to see them do so. Do not get me wrong Michelle, good for you! You are in between a rock and a hard place, as a Type 1 people misunderstand your disease, as a Pharm Sales Rep, well I am sure you have heard it all. I have no problems with reps, let alone diabetics. I have no problems really but I just ask that you remind yourself while you are striving, expecting and being your own champion that there are so many others out there Struggling to do so……

  5. jadesr
    jadesr January 25, 2008 at 6:57 pm | | Reply

    Thank you for sharing your info., and I don’t mean to discourage you from doing so in the future, but I do have to say:
    Only someone with access to unlimited free test strips would test themselves three times a day. If I did that, I would spend over $300 a month on test strips alone. Not something that everyone can afford. I can’t help but wonder how much cost is added to each strip I use by the fact that the manufacturer of the strips employs an army of very well-compensated individuals such as yourself to wine and dine doctors, ply them with swag (how many landfills do we have to fill with Humalog pens?) and convince them to push their products on their patients, resulting in higher sales and a higher stock price for their shareholders.
    I am not saying you are responsible for the system, just that the system is not ideal.

  6. jadesr
    jadesr January 25, 2008 at 6:59 pm | | Reply

    That above was supposed to read TEN times a day. I edited, badly.

  7. Alice Gaffey
    Alice Gaffey January 26, 2008 at 10:44 am | | Reply

    I came across this site from the news week article. I like it very much. Being the parent of a 5 year old dx with type 1, 9 months ago, I am still learning about this disease. One thing mentioned that I had not heard anywhere else is the relationship between Reynaud’s and Type 1. I have noticed symptoms of Reynaud’s in my older daughter, who has not been dx with type 1, (she is 18, and away at college)I need to research this further. Thanks for the great site.

  8. jadesr
    jadesr January 26, 2008 at 11:17 pm | | Reply

    Oh. My. God. Thank you for posting this. I demonstrated Reynaud’s since age 5, and Dr.s laughed at me and my mom!
    My symptoms were so acute, I moved to Florida rather than deal with a northern climate-all the while Dr.s were telling me I was insane, and I just needed to wear gloves.
    I subsequently develped adult-onset Type 1 … at the age of 32! I am now researching this further. Thank you so much for sharing this information!

  9. Diane J Standiford
    Diane J Standiford January 26, 2008 at 11:59 pm | | Reply

    Do people in your career work on commission? Do doctors ever turn you away? You do not walk in popular shoes these days–does that ever bother you? Why can’t samples be dropped off w/info? Why must reps go in person? I feel like I’m missing something.

  10. Sara
    Sara January 27, 2008 at 11:12 am | | Reply

    Amy – I just ran across your Newsweek article from my google alerts. I didn’t even notice your little nugget on the top left. How about a little post about it so nobody else misses it?! :D

  11. whimsy2
    whimsy2 January 27, 2008 at 8:19 pm | | Reply

    I had mild Raynaud for a year before my type 1 (LADA) diabetes diagnosis at age 60 ten years ago.

  12. camille johnson
    camille johnson February 1, 2008 at 2:50 pm | | Reply

    While educating the doctors you visit, be sure to inform them that EACH strip costs almost ONE DOLLAR. Even those with insurance can’t afford that since insurance companies are so arrogant as to decide how often we need to test — they will only pay for 4 test strips per day! ! ! Since when do insurance companies decisions take presidence over doctors orders? AND remember, it is your responsibility to “teach” physicians about that too.

  13. June S.
    June S. February 3, 2008 at 5:25 am | | Reply

    Yes, Yes, Yes … Always check before you get behind the wheel of a car. While I myself have never had any accidents behind the wheel, I have heard of numerous cases where someone did lose consciousness behind the wheel. In fact, I keep thinking, when I hear that someone’s insurance company won’t pay for multiple blood glucose test strips -
    why not get a supervisor from the insurance company on the phone and say “Well, if you’re against drunk driving because you care about your life and the lives of your loved ones, you should convince the higher-ups in your company that an insulin-dependent diabetic behind the wheel who becomes hypoglycemic is about as safe a driver as a drunk person is. Without a large enough supply of blood glucose test strips to allow a diabetic to test his blood glucose before he gets behind the wheel of a car, you are inviting a possible vehicular accident.”
    My only hope, of course, is that the insurance agent would not then lobby to get all insulin-dependent diabetics off the road at all times!

  14. Health Business Blog » Blog Archive » Tales of a PWD PSR, aka a diabetic drug rep

    [...] Diabetes Mine for a first-person account of a Person with Diabetes (PwD) who is also a Pharmaceutical Sales [...]

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