The Soggy Orange

Blind Spots

2010-02-19T10:10:00.009-05:00

Even writing this post makes me nervous. Lately, I've been having some problems with my eyes. I have what feels like a small blind spot in my left eye. My diabetes instincts kicked in (i.e. I freaked out a bit) so I called the Beetham Eye Institute at the Joslin Clinic for an earlier appointment with my opthamologist. I wasn't scheduled to see her until November and last November everything checked out okay.

This is one of my least favorite parts of diabetes (not that there are ANY favorite parts). The waiting and worrying part. I've had diabetes for just about 18 years now, so when I have a health issue, I can't help but think about how it might be a complication. I've tried to keep my sugars in range, but as a teenager, my best was never really good enough and how could it have been? As a teenager I had the mentality that nothing bad was ever going to happen to me, and college wasn't that much better. It's hard to think of your health in the future when you're young and everyone else around you seems to be so carefree.

Now that I'm almost 28, every health ailment leaves me feeling like a ticking time bomb. Sometimes, it feels like complications are inevitable. After all, I've never heard a doctor ask, "Any complications," without following it with "...yet?" All I can do is try to stay hopeful and wait until Tuesday.

I'll focus all my energy on enjoying the weekend. I'll try to find joy in the little things (like finding a new coat at the Wrentham Outlets!!!) but it will be hard to riffle through the racks of discount coats with my fingers crossed for Tuesday's appointment.

Diabetes forces me to find hope in the smallest of tasks and I hope complications never get in the way of that.

Me: Hello?!

2010-02-17T15:56:00.009-05:00

I started drafting this post last week, but I had to stop because I started to type some curse words that I don't want to subject anyone to reading. Then yesterday, I read Kerri's post over at SixUntilMe, and she gave me the inspiration to finish up this post. After I read her post, I was happy because I could relate, and I was also unhappy...because I could relate.

My latest insurance company woe started last week. I received a bill from Medtronic Minimed for a $30 co-pay dated November 2009. Normally, I would expect a bill from Minimed, but this bill was the first bill I had received for all of 2009. I called Minimed to inquire, and after a few minutes of conversation with a customer service rep over there the conversation ended with this:

Me: Okay, so I have to call my insurance then, the error isn't on your end?
Minimed: No, it's not on our end, it shows in our records that you're covered 100%, I don't know why you owe on this one.
Me: So, when I get an answer from Blue Cross Blue Shield, can I call you back directly?
Minimed:.....Um, I have a direct extension...but.....
Me: You don't want to give it to me?
Minimed: No, not really. Just call the general line, they can help you.

I would have found this funny except for the fact that I was at work and this was taking up a ton of my time. Plus, any call to BCBS usually leaves me either fuming, crying, or throwing something. None of which I really wanted my bosses at work to witness.

The next three hours I spent on the phone with BCBS were excruciating. It took me three hours to get to someone who would finally own up to their mistake, and that was mostly because I backed them into a few corners. The last customer service representative finally told me that in 2009, BCBS had been billing my Minimed supplies against my prosthetics benefit, for which I'm covered 100%. Then, in November of 2009, they realized that I had a pharmacy benefit, and my Minimed supplies should have been going through that benefit for 2009. She told me that going forward I'd owe a $30 co-pay on both my infusion sets and reservoirs, and that I couldn't receive more than a month's supply at a time.

Me: So that's $60 a month for 2010, a total of $720 worth of co-pays in 2010 just for pump supplies. So let me get this straight, BCBS finally realized that they were making a mistake, and when they discovered this, no one picked up the phone to tell me?
BCBS: (silence)..............
Me: Hello?
BCBS: Uh, hold on please......yes, ma'am we're very sorry for the mistake and we won't bill you for 2009, but we need to bill you going forward.
Me: Well being that no one ever picked up the phone to give a call, and I had to do 3 hours of detective work to figure out what was going on, and I only now have received a bill from Minimed tipping me off to your mistake, I didn't know about this expense when I was electing my flexible spending amount and now the election period is over. That means that not only do I have to scramble to budget an extra $720 into my expenses for 2010, but now I can't even save money on that $720 pre-tax. Is that what you're telling me?
BCBS: (silence).............
Me: Hello?!
BCBS: Uh, hold on please.
I could just picture them thumbing through their "objections" binder trying to find a way to appease me.
BCBS: Ma'am you're going to have to pay the co-pays in 2010.
Me: So basically, if I can't afford my supplies because of your mistake and my health deteriorates, if I need a foot amputated and replaced, my prosthetics benefit will cover me 100% for that? But you won't bill my pump supplies against that benefit? That sounds logical. Listen, I know this is not personally your fault, but you have to understand why I'm upset. It was BCBS's mistake, not mine. I want you to continue to bill my Minimed supplies against that prosthetics benefit. The world didn't end when the mistake was being made. The world isn't off tilt now. Continue to bill me through that in 2010, and in 2011 I'll budget for the co-pay.
BCBS: (silence).............
Me: HELLO?!!!!
BCBS: You're going to have to write to the grievances email address.

I wrote to the grievances email address (yes, there's an entire email address dedicated to just grievances), and big surprise, no response yet. The saddest part of every phone call I make is that nobody cares, nobody takes accountability. At my job if I make a mistake, I at least have to own up to it.

These insurance companies have to realize they are dealing with actual people. They have to start taking accountability for their actions and mistakes. Friday starts my telethon, where I call BCBS every day until they give me what I want, or at the very least, a heartfelt apology.

300

2010-02-17T10:33:00.000-05:00

No, I'm not talking about the movie that I wouldn't go see because I was afraid of the blood and guts, I'm talking about blood sugars. They shouldn't reach the 300's. I've had a couple of rough nights. The Dexcom vibrates and beeps (which is especially annoying because our headboard is metal so the Dexcom vibrates throughout the entire bed frame) in the middle of the night and just when I'm about to grab for a juice box, I look at the screen - 314?! Why?

I've just recently started to use the dual wave bolus (thanks to my nurse at the Joslin Clinic) which for the most part, causes me guilt every time I see it on my Minimed. I pretty much only use it when I'm eating things that I shouldn't (i.e. the best foods - pizza, ice cream, yum). It really does help to stave off any highs that would normally creep up 2 to 3 hours later, but maybe I need to tweak it a little more? Or, maybe I can be the diabetic I know I can be, and stop eating fatty foods for dinner. Novel concept.

"Let's just try to eliminate any blood sugars in the 300's first," my Joslin nurse said the last time I was there. Just when my head is about to explode, she finds a way to break it down so I can manage my diabetes, my emotions, my life. There's something different about these highs though, they feel different than when I had high blood sugars when I was diagnosed at ten years old. I don't get the same feeling as when I saw a high number in high school. What's different now? I've grown up enough to pull my head out of my, er, bum, and now know the long-term consequences of a high number. The short term consequences I can handle - the heavy head, dry mouth, lethargy but the eventual neuropathy, dialysis, any big scary condition you can think of, I have a hard time handling that. I know all the consequences now, so seeing a high number, and not knowing the cause of it feels different now.

I'll deal with these high numbers the same as any other diabetic problem. I'll set the Dexcom alarm for a lower blood sugar to try to catch them earlier. I'll try to track them, try to keep better logs to show what's going on before they spike, and talk to my Joslin doctors and nurses about them, but in the meantime, it's frustrating, like so many other aspects of this disease. I'll take it one step at a time and try to eliminate the 300's. It will not only help me avoid future complications, but hopefully it will help me avoid the vibrating Dexcom headboard and waking up to what I often think is the Apocalypse. For now I'm on to researching low fat dinners.

Better Late Than Never

2009-11-04T12:45:00.000-05:00

I'm a bit late posting this, but this month I am participating for the first time in NaBloPoMo, National Blog Posting Month. I have dedicated myself to posting every day in the month of November. As you can see, I missed a couple of days at the beginning of November, but I'm going to overlook that, it's more of a personal goal for me and the NaBloPoMo website has been keeping me motivated. So what if I found out a bit late? Life is busy! Cut me some slack! I think this will be a good thing. Maybe I can make up for the couple of missed days with an extra post here or there. Let's see if I can go the distance. More to come!

Dexcom

2009-11-03T16:38:00.000-05:00

When I was a kid in Jersey, I tested my sugar on strips that you had to wipe the blood off of and compare to a color chart. I never thought I’d see the diabetes technology that exists today. When I first heard about a Continuous Glucose Monitoring Device, I knew I had to have one. Well, my Dexcom arrived about a month ago after a lengthy insurance and ordering process that almost forced me to pluck every hair from my body, one by one, just because it would have been less painful. I’m here to firmly state (hopefully without my husband getting jealous) I’m in love. I’m in love with my Dexcom.

Like any love affair, Dexcom and I have been through some tough times since we first met. My starter kit came with two sensors that gave me the “Sensor Failed” notification, but Dexcom replaced them right away, I’ve since learned some helpful tricks thanks to researching some forums on Tu Diabetes, as well as talking to my Diabetes Nurse Educator at the Joslin Clinic.

I have been injecting the sensor into my love handles, which are now truly LOVE handles because they help my Dexcom work better. That spot seems to make the sensors happy. Also, based on a recommendation from my DNE, I have been injecting a new sensor at night without actually starting the sensor, and then starting the new sensor when I wake up. My DNE said that doing this will help the sensor get used to my interstitial fluid. It seems to be working perfectly.

The honeymoon period must over though. The sensors sometimes just refuse to stick, prompting me to yell, out loud in my apartment, “Stick. Dammit!!!” The upstairs neighbor must be confused. Also, I’ve been frustrated because the sensor seems to jut out from my skin quite a bit, ruining the look of cute outfit, and getting in the way of walls, cabinets, and husbands. One night my husband hugged me and knocked the sensor out of my skin accidently. He says it was an accident, but I suspect he did it in a fit of jealously because I’ve been quite open about my new love affair with Dexcom, but I’ll let it slide.

Dexcom has its flaws, but I continue to accept all them because going to bed, exercising, and sitting in meetings at work without being worried about an unexpected low or high makes me so happy, I can’t describe it. And the thought that Dexcom will help me to lower my a1c and be healthier overall provides a calm that I don’t remember experiencing.

I’m so excited to see what’s in store, not only for diabetes technology, but for me. Who knows what I will accomplish now that I’m not constantly worried about blood sugars. Maybe I will now be capable of being uber organized, baking without burning anything, and spending more responsibly. Is that too much to ask from a medical device?

I don't have time for this

2009-05-13T20:43:00.000-04:00

My sugars have been decent for the last couple of days - only a few highs here and there, but for the most part, they have been hovering between 90-150 mg/dL.

I think most of it has to do with the fact that I finally went grocery shopping on Sunday and bought some healthy foods. I was on a diabetes high (not the bad kind, the good kind that has nothing to do with bloodsugar). Then...today struck.

I feel like I'm getting a small cold which always causes my sugars to get a little wacky. So today at lunch when my sugar was in the low 200's, I corrected for it. An hour and a half later, my sugar dropped to 55 mg/dL. As most people with diabetes know, lows at work are particularly frustrating, especially if you don't work in a job related to the diabetes industry. Your brain is foggy and if someone happens to catch you being less than sharp, you have to explain to them what's going on. They always seem to walk away concerned but yet, equally bored with your ramblings.

I drank a soda (not the healthiest of corrections but I didn't have a ton of other options and would have rather eaten actual chalk at that moment than a chalky glucose tablet) and tested a half hour later. My sugar was up to 150 mg/dL. I felt normal again and continued with my work. Then, at 4:30 p.m. as I started to get excited at the thought of leaving, I tested once more on to see a result of 65 mg/dL. What?! I hadn't even corrected for the 150 earlier. How could it have dropped without anything happening? Is my pancreas working again?

I came home exhausted from the lows and the inevitable cold coming on. I better figure out what's going on here. I don't have time for this.

5K

2009-03-27T10:46:00.000-04:00

I ran a 5K marathon on St. Patty's Day weekend. For those of us in the U.S. who for some reason still refer to these races in kilometers, a 5K is a little over 3 miles. Sadly, I needed to train to run those 3 miles to save myself the embarrassment of being wheeled off in an ambulance and appearing on the nightly news. I could hear the newscaster: "What was supposed to be a fun and routine St. Patty's Day 5K took an unexpected turn as a woman who clearly has not run in years had to be taken to the hospital." With all of the scenarios that were running through my head, I could never quite pin point what I would be taken to the hospital for, but it would indeed be something out-of-shape related and my friends and family would ridicule me for years.

So, I trained. I trained with a Cool Running program called "Couch to 5K." The program title did wonders for my self esteem. One of my biggest worries was my blood sugars dropping mid race. During my training I kept a close eye on my sugars and for the most part, they cooperated. My first training triumph was going for a 2 mile jog one weekend and finishing in 20 minutes. Quick math - that's a 10 minute mile. Not too bad for someone who feels like a uncoordinated whale when she runs.

Race day came and my goal was a 30 minute 5K. I set my iPod complete with Nike+ (I love that thing) for a 5K, turned up my music (some really embarrassing running song choices on there) and set off for the finish line with a huge crowd of people. After my first 2 kilometers, I decided I not only hated running, but I hated life. Runners (who no doubt were training for the Boston Marathon and had probably run at least 3 miles before they ever got there that morning) ran by me with the speed of a gazelle being chased by hunters. My shins hurt. I had to walk a bit which translated to defeat for me.

I rounded the corner for the finish line past a 7 Eleven. "Yum...Slurpee," I thought and figured that a thought like that proves I am not a runner. I finished in 35 minutes. Not too far off from my goal, but I was still a little bummed. Nothing that a Guinness didn't fix later that day.

The irony of this 5K is that even though I didn't fully enjoy the running, my training was the only thing keeping me motivated to work out. Since the race, I haven't been running once (although I plan to get out there tomorrow for a run). I'm slowly learning what my motivators are for keeping healthy and ironically this cruel practice that people call "running" is one of my motivators.

I hate to say it, but I need to sign up for another 5K. Hopefully the gazelles will stay home this time.

Diabetes Travel

2009-03-18T10:57:00.000-04:00

I'm heading off to Las Vegas tonight for a much needed weekend getaway with my husband and his family.

Unfortunately, along with a fun vacation comes some diabetes worries as well. One of them being the time change traveling from the east coast to Las Vegas.

I usually fix the time on my pump right when I land to start my body getting used to the time change. I've never really experienced any problems, but it's a pain in the ass to monitor my blood sugar carefully for the few hours after I change the time. Especially if we land late at night and I want to go to bed.

Not to mention the other "little" things that add up to a big thing when traveling with diabetes. I have to make sure I have enough test strips, insulin, insulin pump supplies, and batteries. I have to make sure I buy a juice or soda when I get to my gate to carry with me during my trip because I have to throw my juice box out once I get to the security check. I have to make sure all of my supplies are on me and not in my checked bag. I have to make sure that I take my pump off before the metal detector to avoid the dreaded "pat down." My diabetes checklist sometimes gets in the way of my "normal people" travel checklist. My brain gets full.

This is just another example of the little things that make living with diabetes difficult. It's not the injections, it's not the finger sticks (although both are annoying). It's the interference with jetting off carefree and having fun in a crazy city.

You have to make the best of it though. Here's hoping for minimal diabetes slip ups and great photos.

Diabetes at the Office

2009-03-12T14:18:00.000-04:00

Not too long ago, I started at a new job that has nothing to do with diabetes. Before I took this job, I was employed at a diabetes related organization which ironically, was the worst job of my life so far. I hope to never have a job as horrible as my last.

With this new job came excitement. The environment seemed healthy, the people seemed nice, and my boss didn't seem like a diabolical psychopath.

The one worry that kept lingering was the fact that I didn't know how to introduce my diabetes into an environment that didn't deal with it everyday.

It's been about six months since I've started at this job, and almost everyone knows about my diabetes. I tried to bring it up in casual conversation. Some people saw my diabetes kit. Others saw my insulin pump. Regardless of how co-workers came to learn about my diabetes, there was one common theme between them - they don't care. In the best way possible, no one really cares. No one avoids me. No one seems to look at me differently. I couldn't have asked for better reactions. My worry about disclosing my diabetes is lessened, which could potentially advance my career in the future because I am no longer intimidated in the corporate world because of diabetes stigmas. It's a great feeling.

I even found out that someone else in my office was just diagnosed with type 1 diabetes. Although I am sad to hear of another person who will have to deal with this disease everyday, it's also nice to have someone to share information with and talk to about challenges.

In the course of the last six months, I'm happy to have learned an important lesson - don't be scared to disclose your diabetes. Not only is it safe and necessary, but if you do it in a way most comfortable to you, it will feel like you're just talking about another aspect of your life, because that's what diabetes is - just one aspect of your life.

Winter Diabetes

2009-03-11T14:33:00.000-04:00

Punxsutawney Phil clearly does not have diabetes. If he had diabetes, he would know that if you live in New England or another cold climate you can't help but let the weather affect your blood sugars a bit. It's because of that fur ball that we will experience a longer winter and I will have more trouble with my blood sugars.

In the last month of winter, I get hit hard with the winter blues. I can't run outside, I crave bad-for-me comfort foods (like the brownie that is sitting on my desk begging me to eat it) and my energy is low. I'm striving to snap out of it and hang in there until the spring so my A1C can reap the benefits of the warm weather and I can experience Spring/Summer Diabetes.

My blood sugars are just better in warmer weather. The days are longer encouraging me to jog after work. The food I cook is lighter. I walk to and from work which regulates my sugars. And, as crazy as it sounds, having the windows open in my apartment just makes me feel better. All of these factors contribute to better numbers. The downfall of the summer is more undetectable lows. It can get pretty hot in city during the summer and with higher temps come faster insulin absorption.

I'm working on getting my DexCom covered by my insurance company though (my strongly worded letter is in the works) so that would make me extremely excited for the summer. A little less worrying goes a long way.

Here's to spring being just around the corner! (Also - what is going on in that picture?!)