Type 1 Diabetes and medicals

[Rosa1035]

Hi all,

We have been instructed to book for our medicals now, which we will be doing this weekend. My son (aged 19) is coming over with us as a dependant, and will be doing his medical too. He is a Type 1 diabetic, and I was wondering whether anyone knows what criteria is used to assess a a T1 during the medical process (eg. HbA1c needs to be below 7), or whether they just do a physical and rely on information from his Endocrinologist?

I have asked our agent - he seems fairly relaxed about it, and says there is nothing to worry about. But when you have got this far, you don't want a medical to be the thing that shuts the whole process down!!

At least if there is something specific, then we have something to work towards over the next few weeks until we go.

Thanks so much!

[riaanbre]

I do not think if they have thresholds set, I believe that as long as you can show that the condition is being managed properly you should not have a problem. A letter from the endocrinologist might be appropriate to take along to the medical. TB, HIV and disabilities (I think) is what's on their radar.

Lots of support for diabetics here - http://www.ndss.com.au/ (so there is that to look forward to)

[Rosa1035]

Hi there,

Thanks for your response, I think a letter would probably be a good idea. Coincidentally we are going to the Endo on Monday (booked app in Feb when we hadn't yet applied), and I will chat to him about that. Holding thumbs it's nothing more complicated than that.

And thank you for the link too, I have had a look at it, and it's great to know that there is govt. support of the condition. Having being on the Diabetes Management Program here through the CDE, one has almost become complacent of everything just 'working', and it's a bit scary not knowing where to start. At least we have something now, thank you.

[Bronwyn&Co]

Rosa I can't comment on the visa situation but I can maybe ease your fears about living in Aus with diabetes. It is very well managed, you will not have problems with the medical care. I don't know specifics but I know two children with serious diabetes and they have dedicated/specialised nurses & doctors who look after their care. It's all very advanced.

Edited July 26, 2014 by Bronwyn&Co

[Rosa1035]

That's great news, Bronwyn, thank you. Gosh, we can't wait to make it over - time cannot roll on fast enough!

I will update this post with the specifics of the medical after we have completed it, just to let any future T1's or their parents know if there is anything specific they need to be aware of.

[JackieO]

Hi Rosa, My T1 Son is 7 and did his medicals when he was 6. He was diagnosed in Australia (we were on work visas at the time)

You definitely need a letter from the endo. As long as he has no complications he will be fine. My sons HBA1C is 6.6, but that wasn't even on the letter.

If the endo letter states all good with no evidence of complications then the medical does not even get referred, its an automatic A grading.

Hope this helps. If you have any questions re. care and costs etc feel free to PM. Not sure if your son is MDI on pumping, but at least your pump options will increase when you get to Aus and the consumables are subsidised, as are strips. Also Dexcom 7 is available in Aus!

[Rosa1035]

Hi Jackie,

Thank you so much for your advice and offer of assistance. I am really holding thumbs that the Endo won't find it necessary to put on his HbA1c - his last one was 8.2 When they get older it gets harder to threaten them with their lives if they 'cheat', and compounded with that he went on the pump 2 months ago and we are struggling to get all the settings right. Despite this he is very healthy, and has no complications, so I really am hoping that will be what counts.

That is fantastic news about the Dexcom 7, it is on our 'wish-list' of what we would love!

I will most definitely be in contact as soon as the visa has been issued (positive thoughts!) to find out more about the day to day practicalities of how to get him sttled and sorted.

Have a fantastic week!

[JackieO]

Rosa ask the endo NOT to put the A1C on the form, but even if he does I dont think you would have an issue, compared to some of the teens I know of 8.5 is great!. One thing you need to keep in mind is that if he wants to get his drivers license the criteria here for T1s is different to the average Joe. He will need to get an endo to sign off on his medicals, and the hba1c has to be under 9 (Or it may be 8.5 can't remember), so loads of parents use that as motivation to keep their kids compliant.

Keep me posted on how you go, I will pm you my email address. Good luck!

[AndreaL]

It will be fine, the onus is on proving that your condition is managed and will not cost the taxpayer/medical system lots of money.

When you get here get a letter from the Doc and fill in a form to join NDSS, hubby is type 2.....a pack of his test strips is about $50, but if you are registered with NDSS it is $15, plus you will get needles and a sharps box from pharmacies for a dollar or 2.

[Rosa1035]

App with the Endo went great yesterday - his HbA1c has come down to 7.8!! So delighted, high-fiving in the doc's office!! He is willing to give a 'glowing' report, so I am hoping that alone should be enough.

Thank you all for your advice, will give you an update as soon as he has passed the medical with flying colours!

Have a stunning day!

[Bronwyn&Co]

App with the Endo went great yesterday - his HbA1c has come down to 7.8!! So delighted, high-fiving in the doc's office!! He is willing to give a 'glowing' report, so I am hoping that alone should be enough.

Thank you all for your advice, will give you an update as soon as he has passed the medical with flying colours!

Have a stunning day!

Awesome news! Yay.

[Rosa1035]

Hi all,

Just to let you know that we got our visa - found out yesterday! Woohoo!!

With the letter from the Endo and Dr Cobb's report, he wasn't referred so no hiccups whatsoever! I think if he had a high HbA1c it would have been a different story, but the fact that it was so recent, as well as within limits it wasn't even a factor.

[Mara]

Wonderful news, congratulations!

[JackieO]

Fantastic news!!

Since you mentioned Dexcom is on your wishlist I thought I'd let you know we recently started using is with Nightscout technology.

Allows remote monitoring of his levels. Im at work right now but can see his level is 6.9 post breakfast and holding steady.

There are a couple of good FB support groups and if you go with a private endo (highly recommend since he will be too old for the Childrens clinics) then you can get some recommendations on Endos and DE's.

The management here is different to RSA (my Dad also has T1). I frown at some of his management he frowns at some of ours

Once you arrive you need to arrange a GP and then get them to fill out an EPC (Enhanced Primary Care Plan). This will enable your son to get some allied health services from Medicare. Allied health (Physio / Chiro / Podiatrist / Diabetic Educator etc) is not usually covered by Medicare but will be with an EPC. He will also need a medical person to fill in a report for his Drivers License (in QLD anyway - think the other states too) so would be wise to get that sorted asap.

If he is studying he will probably also qualify for a Health Care Card on top of the NDSS. This will bring his strips down to about $2 per 100 and then the maximum he will pay for insulin (and other) prescriptions is about $6 (I think).

Leaving this info here instead of messaging you for future searchers

Good luck with all the preparations.

[Rosa1035]

Thank you so much for the info Jackie, I am sure it will be beneficial to many, not just me!

My son and his dad actually arrived in Adelaide this last Saturday, visiting family and investigating studying options should we have got PR. As luck would have it, PR was issued the day before they left, and he was able to activate his visa! I have sent all the information through to them, and I am hoping that they will start setting up everything now with the doctors, so it has all been completed by the time they leave in a few weeks. At least then when he goes over in Jan (without mom and dad to handhold), we will know that everything is taken care of in regard his diabetes. And the thought of stalking his readings with Nightscout!? I love that!! :D

Thanks again everyone for your help and advice!

[GarethBianca]

Hi Rosa

 

I hope you are well.

 

I have recently arrived in Sydney. I'm 38 and a type one diabetic. I have my PR. I have insulin for the next few months but obviously need to get on to Medicare and then get my insulin through it. 

Can you advise the process? When I register for Medicare what do I need to take with me? How do I then get insulin/strips/needles etc? Is there a cost? 

In SA its all free through the CDE and as you know so are all the doctor's appointments. How does it work here?

 

Lastly, my wife and 2 kids will arrive next month. Am I able to register them on Medicare without them being here and without their passports?

 

Thank you so much for your time and reply.

 

Gareth

[DavePE]

Hi Gareth,

 

Fellow type 1 who has been in Sydney for 2 months so I can advise you on the process. 1st step is to register for Medicare which is as easy as pie. Should take an hour max. You'll then get a Medicare number printed on a piece of paper and your official card will arrive in the post 1 week later. Make sure you have proof of address and your passport when registering for Medicare. You can ask your bank to print your a proof of residence, so make sure your first stop is to the bank you'e opened an account with. 

 

You can access medical services immediately with just the piece of paper. You can book an appointment with your nearest GP online, at least the medical centre I went to allowed you to book online. For your first appointment make sure it's a "bulk billing" centre, that means Medicare will pay for the appointment and you don't pay a cent. Tell the doctor you're a Type 1, preferably have a script from SA to prove it, but I dont think you actually need any physical proof. The doctor will write out a script for you there and then for the insulin. Take the script to your nearest pharmacy and they'll supply you with the insulin. I paid $78 dollars I think for 5x boxes of Lantus and Humalog which will last me probally close to 6 months so its not badly priced at all.

 

The Pharmacy told me about the National Diabetes Sevices Scheme which if you're a member of will allow you to get free needles, and test strips. You need a doctor to fill in part of the form saying you're a diabetic so best to print this out before going to your first doctors visit. You can get the form here: https://www.ndss.com.au/

 

Any other questions please shout. More than happy to help. I know it was quite intimidating moving over and not knowing how the Healthcare system works.

[WayneACT]

Thank you for all the information on this thread. Not sure how I didn't find it in my searches on Diabetes. My son is 12 and is a T1 diabetic. Endocrinologist has given a glowing report with HbA1c at 6.7, so it might be time to move from the 457 and get the PR ball rolling.

[Rosa1035]

Hi Gareth, 

 

You are actually one step ahead of us, we still have 19 more sleeps until we leave for Aus!   My son was going to go over and start studying at the beginning of last year, but sadly his dad was diagnosed with cancer just before he was supposed to go, so all plans were cancelled. After his dad died, we decided we couldn't deal with him going off alone, so we decided to wait until my daughter finishes matric (16 more sleeps!) and then we would go together.

 

We also use the CDE here, and will be having our final appointment with Dr Landau next week. He has been fantastic, and has increased our allowance over the last few months so that we have about 6 months supply of everything. Our nurse, Jen, gave us 2 brand new test kits yesterday "just in case". 

 

Thanks Dave for the info - I have already printed out a copy of the application form, which I plan to take along to that first GP appointment.  I have heard from other parents of diabetics over there that they pay about $5 a box of strips for their kids, as long as they are still studying, so hopefully my son will still qualify. 

 

Best of luck to you all, and Wayne - I would get that ball rolling! Diabetes certainly doesn't seem to be a hinderance at all.

 

Ros 

 

 

[GarethBianca]

Hi All

 

Thanks for the replies.

 

I waited in the queue today to register for medicare. They needed proof that I am now living here and not going back to SA. 

She asked for 2 documents from SA (sale agreement for house, cancelling insurance policy etc) and 2 documents from Oz (rental agreement, enrollment of kids into schools).

Obviously, I had exactly...zero....of these with me. So I will be back tomorrow.

 

Rosa, I'm sorry to hear that. We were supposed to come here 5 years ago and lots of things have happened to us too which have delayed the process. 

Dr Landau is a superb doctor; You won't have any hassles from a diabetic point of view. I didn't and my sugars are far from where they need to be. The letter from the doctor helps though.

 

Will keep in touch

 

Gareth