We're walking!

Billy and I have decided to join the walk for diabetes on September 27th. If you want to join our team or contribute, go ahead and visit this site! :)

http://main.diabetes.org/site/TR?pg=personal&fr_id=5290&px=4298176

Insurance: Grr.

I test my blood sugar a lot. I average 6 tests a day. My prescription is written to cover this type of testing, so each month I get 200 test strips to work with. Some months I still have a good 25 test strips still available to me when its time to refill, but more and more lately I'm coming close to maxing out when those 30 days are up.

I filled my last prescription on June 29th. That means my 30 days is up on July 30th. It used to be that I could fill my prescription a day or two early. Makes sense, right? I mean, if it runs out 30 days after its filled, you may want to give people a few days to get things in order. Well, for whatever reason, this time they won't fill it even one day early. So I'm not allowed to fill it till tomorrow. I have 8 tests left -- so normally I'd pick it up first thing in the morning... unfortunately, (or fortunately?) I have things going on tomorrow morning. I can only hope that I'm home early enough to fill it and that I don't have a need to test too many times. GRRR!

I'm calling my insurance company tomorrow to let them know that that's not going to fly and that if they won't let me fill earlier I'll get my prescription increased so they can pay for more to ensure that I have enough to get me a few days past 30 days. At a dollar a test, maybe that will get their attention?

While I'm talking about my insurance -- they directed me to a certain company to work with when I got my pump. They wouldn't tell me what to do, they just said "Use this company, they know our procedures." As it turns out, that company was charging me an extra 70 per box of pump infusion sets! I go through more than a box a month, so that means my insurance was paying more simply because they were too lazy to tell me their own policies. I finally discovered it and have found a new supplier. Hopefully it all goes through without a hitch.

Oh How I'd Love a CGMS

A CGMS - Continuous Glucose Monitoring System is the latest wave of diabetic technologies that's making its headlines in the news. There are now 3 different companies sampling their CGMS's on the market. One of these is Medtronic, which is the same company that produces my insulin pump.

When I bought my pump, I chose the one I did for two reasons. First, it was the only one that held enough insulin for my 3 day supply (according to the trainers). This turned out to be wrong (I use less insulin with the pump than they predicted), but that was their initial thinking. The other reason was that it was already equipped with the technology to communicate directly with a CGMS.

What a CGMS does (as the name implies) is continuously checks your blood sugars. All day long, 24 hour hours a day, 7 days a week, it senses your current blood sugars, logs them, charts them, and even (this is the part that really excites me) can be programmed to alarm if your blood sugars fall out of the desired range. Imagine the potential? In theory, I could set up a CGMS to alarm me when my blood sugars reached about 120 or below 80 (these are the blood sugars a nondiabetic expects to see). No drastic lows in the 30s that I can barely think straight enough to take care of... no unexpected highs of upwards and over 300 because my pump tubing got tangled up in a knot. Near perfect control.

So why haven't I gotten one yet? They are insanely expensive. When I got my pumps, my very kind and loving parents offered to pay for the CGMS receiver, which would have cost an additional $1000. I was thrilled (I think I even cried) because I so desperately wanted one. Well, I called to look into it and found that the initial $1000 was just a start. A months worth of supplies to keep the thing going cost $350. $350 a month? Who has that kind of money lying around? That was beyond my parents reach and mine (See, school teachers just don't make that much money). The extra cost of the pump supplies was already a bit of a worry... that just wasn't going to happen.

Well, an ariticle I read today said that some of the biggest national insurance companies are starting to pay part on CGMS systems. Its only a matter of time till more jump on board to stay competitive. I can't imagine that mine will be amongst the first to take them on, and even if they do... my 20% of that each month would mean an extra $70.00 a month (assuming these sensors don't go bad on me early like my pump sites do). So its probably a ways off... but I can dream.

Someday I'll get a CGMS. Eventually those prices will come down as the technology becomes more mainstream. Eventually my insurance will cover part of it. Eventually, I'll have the chance to manage my diabetes in a way that was beyond anyones wildest dreams just years ago.

Here's hoping!

Recording Those Numbers

Well, I'm trying to get back on track. Between the wedding, the honeymoon and trying to find a sort of rhythm to my new life as a wife, I haven't been very good about recording my glucose numbers. A few months before school let out I had finally (after how many years?) found a system I was happy with. I record my blood glucose numbers on google docs. I also use the same program to record what I eat, the insulin I took for it, etc. It was working pretty well for me. It was helpful to be able to look back and see what areas were out of my target range on a regular basis and things like that.

After the wedding, after the honeymoon, I kept putting off getting back to recording. I didn't want to try and catch up my record for several weeks. It can be tedious and the only way I stay motivated is if I do it on a regular basis. So this morning I finally decided to just start fresh, rather than putting it off even longer.

The reason I've liked using google docs so much is its on the computer. I do a lot better if I can type things into charts and such, rather than having to fill things out by hand. I set my web browsers so that google docs is my homepage. This reminds me to fill them in each time I log on. Its been a pretty good system and now that I'm starting up again, I'm sure I'll find lots of areas that I can improve. One of the hardest thing about life with diabetes is how often and quickly everything can change. You need to constantly be aware of what is going on because things that were working before stop working and you have to do something new. What a joy huh?

Anyway, so that's the message of the day. I'm back on track with recording the numbers and the daily food. (P.S. Keeping a food diary also makes you less prone to snack or eat badly... because when you know you'll have to write it down, you think 'Na, I don't really need that.')

Pumping It: How Its Changed My Diabetes

A year ago February, I finally had an insurance plan that would allow me to purchase an insulin pump. It was an expensive en devour, but one I'd spent a lot of time planning for.

Prior to having an insulin pump, I used two types of insulin. One was called "Lantus" and the other is called "Humalog." When introduced to Lantus insulin, I was thrilled at the concept. Lantus insulin is claimed to be a 24 hour acting insulin that has no peaks. That's a big step in the right direction, since prior to the Lantus I used "N" insulin which lasted about 8 hours (if I remember correctly) and peaked about halfway through the cycle. Lantus allowed for some major improvements in my management. The problem was that my Lantus would run out early -- after about 22 hours.

Splitting that dose up into two shots helped over the gaps that it left, but I was up to five shots a day minimum. Also, despite filling in the gaps with two shots, my body didn't need the consistent basal that the Lantus gave. Some hours of the day, I needed more. Others, less. Night time lows were a cruel and frequent visitor, disrupting sleep. So while it was a better system, it wasn't a perfect system.

Well, finally I got the pump. I have about 5 or 6 different basal rates depending on the day. The insulin pump works by continuously delivering tiny doses of insulin throughout the day, and allowing for bolus doses when I eat or experience high blood sugars. I can alter my basal rate temporarily if I do something that might cause me to need more or less insulin.

All in all, I'm very happy with it -- but it is a constant learning process. When Billy and I were in San Diego, my blood sugar was running consistently higher than usual. It was frustrating and I wasn't sure what was going on. While we were sitting at the airport waiting to leave, I overheard a group of people talking about how the difference in our air pressure makes your exercise more effective in Salt Lake. Well, within an hour of being home, my blood sugar dropped too low. I had to bring it up with extra sugar. A few hours after that, it dropped again. As it turns out, my body seems to have to work harder here in Utah than it did in California...

I'm constantly changing my basal rates as the events of life cause more stress or leave me less stressed. The nice thing is that I CAN make those changes now. So for that, I'm grateful for the pump. I have options -- I can skip meals, I can eat at different hours of the day, and next time I go to California, I can adjust my dosing to compensate for the easier to breathe air.