I Got a Friend


cc licensed flickr photo shared by Jeff Bauche._.·´¯)

Thanks Barb.

This is amazing. On my drive down to Phoenix, I missed a phone call from my friend in Payson. She had gotten my email plea for sponsors, and as a fellow diabetic, she wanted to support me… but she almost apologized. What happened was is that her workplace had a matching donation plan for the Juvenile Diabetes Foundation, and her donation alone to the JDF was about what I have raised so far in my campaign here, and with that match, it doubles the amount going to the cause.

I don’t care if it does not count for my run (benefitting the American Diabetes Association) – it’s that it goes towards stopping diabetes. And the JDF has a great focus on research towards a cure.

And as I have been overwhelmed by the kindness of people who responded to my begging (in about a week, I am about halfway to the minimum needed to be part of Team D).

So thanks, Barb… it’s all good.

And I should give her a shoutout- she was diagnosed with Type 2 diabetes about 18 months ago. For someone… about my age, to completely do a 180 on diet (getting rid of all sugar and soda) and becoming more physically active, she has done a model job of taking on the challenge of living with the D.

I’ve got a friend and am appreciative.

Day 1. Week 2.

Second week of training, first run of the week. 30 minutes. Done.

I was feeling sluggish out of the gate, also facing a series of appointments and meetings that were spaces at two hour intervals, each an hour long, so in between, there was scant time to focus beyond the email sweeping that is my daily exercise.

I ran my “newer” loop which circles down SR 87 a bit and through the neighborhood on the opposite side of Fossil Creek Rd. It seems like there us a lot of downhill, with about 3 short uphills (is it possible to get more of one than the other?

On my iPod I am not running to music, but an audiobook — Chris Anderson’s Free: The Future of a Radical Price which is about 6.5 hours of running time. It’s a great distraction for me. I converted the free MP3 files to Audiobook format (this way, the iPod remembers where you left off and it does not get mixed in with your music shuffle).

To get a better handle on my blood sugars, I have been doing more before and after testing. Today was better- Before running I was 95 and afterward 84; I cut back my temp basal on the pump to about 2/3 what I was doing before,

Let the Nagging Begin! Sponsor me for Running? Please?


cc licensed flickr photo shared by swissrolli

With a week of successful training under my ….. well I don’t wear a belt while running, so there goes the metaphor.

But I am feeling ready to put the running shoes on for the next 20 weeks of training leading up to the January 17, 2010 PF Changs Half Marathon in Phoenix (does anyone remember 2007 when it was 24 degrees at the start, yikes!). And I’ve been tweaking the web site enough, and everything is set, but one thing.

You.

I need your help. Right now, my fund raising for the cause I am running for is at $0. (that is because today is the opening of the nagging season). If you want to know more about what I am doing keep reading- if you know the story, you can jump 3 steps ahead and sponsor my effort (thanks! thanks! thanks!)

I’m not running for the sheer joy of it (have you seen the URL for this site?). I am doing this to raise money to support research and educational efforts of the American Diabetes Association. And I would be surprised to find anyone who does not have a family member, friend, neighbor, co-worker who’s life is affected by diabetes. Check the facts– its one of the leading diseases, and rising on the kind of charts you don’t want to be rising on.

I’ve been dealing with this since October 1970- when a seven year old kid tried to fake his way out of school, feigning sickness- fortunately, his keenly observing Mom had been noticing a bunch of signs, took the kid to the doctor, and next thing you know he is in the hospital practicing giving insulin injections in an orange. They don’t let him go until he jams on in his leg. I estimate he took over 12,500 injections before starting on an insulin pump in 2006.


cc licensed flickr photo shared by Mel B.

In my 39 years of being diabetic, I have been extremely fortunate, the only issue was some retinopathy 16 years ago that required several rounds of laser surgery. That was my first wake up call to get more serious about my care, starting then with regular blood testing

The diseases never rests, and is always slowly chipping away at your body somewhere, and this year, I’m worried again as a bit of bleeding has returned to my left eye, so I am on a personal mission to get my blood sugars in better alignment.

And that’s where running comes in. Although I do not enjoy it, it is the only exercise, done regularly, that has put me in best health.

So I am running for myself (the exercise) and raising money for the diseases, which last year topped 24 million people in the US alone, and probably twice as many are on their way and dont know it yet.

But yes, I know these are tough times for many people, thanks to our lovely crumbled economy. So even if you don’t have 5 or 10 bucks to spare, that’s okay — just support me by following my progress here, tossing an encouraging comment, and that is something that will help me.

Nag. Nag. Nag.

Born Again

Born Again
cc licensed flickr photo shared by cogdogblog

Found this interesting book on Amazon (I was buying a gift for a friend’s birthday, she is diabetic, and the description of the book caught my attention.
www.amazon.com/Born-Again-Diabetic-handbook-diabetes-cont…

I liked it so much I got one for me too.

I’ve been diabetic now 39 years this coming October and want to see a lot more Octobers.

I’m really enjoying this book! It seems written for me, and I am learning some practical things, like the approach to blood sugar testing:

You must understand that a “bad” number is not a punishment; it is empowerment. Diabetes is unique amongst chronic illnesses, well unique amongst all diseases, in that you are in the driver’s seat. It is one of the few self-managed diseases. You are the mastrer of your own fate, Your doctor is not in charge, You are. Your meter is the best and most important tool to help you understand and control your diabetes.

I plan to take the author’s suggestion to do more before and after meal testing to learn my own patterns, as well as exercise. Like on today’s run. I woke up with low blood sugar (I felt it, did not test for it, oops), and afterward, I had spiked to 212. I over-treated. After running (reducing my pump’s basal to about 60% of normal), my level was 186. I would normally hope for a lower test score, but this is good because I don’t want my blood sugar dropping much during running (and a 40 mg/dl drop would be a problem if my starting level as more normal….)

The author, himself diabetic, has a fun sarcastic writing style (that certainly speaks to me), which really sets this apart from “expert” books on diabetes, which always seem clinical and talking down to you. At one time I had hoped to find a doctor who was diabetic him/herself so that they would better understand first hand the rollercoaster we D’s live with.

I also enjoyed the opening, where Dubois outlined the types of diabetes and the difference between Type-1 (me) and Type 2. And he introduced me to a new variant, Type-3:

Type-3 diabetics aren;t actually diabetics at all… As far as I know, the term was coined by the folks at dLife. dLife is an empire of sorts that involves web sites, a TV show, multimedia, books, and more. The dreamed up the tag of T-3 for the family members of the other types of diabetics. It is a way of symbolizing that diabetes doesn’t just affect the patient, it affects the patient’s entire family.

So that means there are a lot of Type-3 diabetics out there- that’s you Mom, and my sisters, who have been T-3s for almost 30 years.

I’m eager to learn more from this great book!

Better, Lower Numbers

I don’t want to jump to any conclusions after a new running program that consists of 2 runs so far, but I am happy with better lower average blood glucose levels. My 30 day average (which was about what it was the last 2 months at least) was 166, and in the last 14 days, its down to 137.

This might be some positive reinforcement

One Year Gone By

It’s been almost a year since the last time I ran, the last running being crossing the finish line for the 2009 Phoenix Rock and Roll Marathon.

I still hate running.

But I need to start; as much as I did not like running (and must admit it is not horrible, I just don’t reach the endorphin flowing joy stage), it was the only thing that helped me lose weight and keep my A1C numbers low.

It’s not been the healthiest of years, and my last A1C was bad, an 8.3.

So I have to start something.

I am not sure if it will be running, but its on my mind.

Maybe a 10k.

Maybe

Insurance Lunacy

While waiting for my shin splints to heal, I am not running, but am sure getting plenty of run-around from my health insurance.

I started my insulin pump 8 months ago, getting approval and coverage shortlly before I left me previous job. It has not taken long to understand and use the pump efffectively.

However, in this 8 month time span, I have been unable to get true clarity or meaningful answers from Humana on the coverage of the pump supplies (the cover the insulin, the question is on the reservoir (a container) and the infusion set (a tube with a needle), in function exactly equal to an insulin syringe.

As syringe is covered as a $10 co-pay. However, while Humana covers the Paradim reservoiir as a perscription item at the same $10 co-pay, it provides no coverage at all for the infusion set. What good is one without the other? Hello? Is there any sanity there?

Then there was the 3 month period where the Humana web site’s perscription tools would not work for my account to even confirm my coverage. It took 4 email messages, 3 phone calls, 3 months to get them to fix their database.

But its more complicated. If I order my supplies from Medtronic directly, which does get a prescription authorized form my doctor, Humana covers only 10% of the total costs, because Medtronic is a provider of “durable goods”. My last 4 month supply cost me out of pocket $440.

So with another round of phone calls, I find out that if I can take my perscription to a place that can fill them as a prescription item, Humana will cover the reservoir at the $10 co-pay. And with some more querying of the Humana rep, I was told that I might get an “exception” to the no coverage on the infusion set, if I can have my doctor talk to their Calims Review department.

My doctor, my pharmacist has never heard of needing to go anywhere else but the supplier to get this covered (the pharmacy had to even look it up on the Walgreens system as he has never had to fill such an item). And my doctor has to waste time nagging my insurance company?

This just seems total stupid lunacy to get reasonable access to needed medical supplies — how much saving are they doing in the long run, if insurance companies make irrational coverage decisions that induce people not to get proper health care?

Crazy, I say. Stupid crazy.

Insurance Bite For Pump Supplies

Back in February of this year I put in the papers with my employer’s insurance to get approval for my insulin pump. It was only a few weeks before my job changed that it came through. At first I hesitated, wondering if it was “right” to get a pump from my old plan, until someone whit some wisdom (my wife) said, “That’s silly- you paid into that plan for years/”

That was good advice, since it was 100% covered under my old insurance and I am sure it is not covered under my new insurance (I went from a large organization of more than 10,000 employees to one that has 6!). Then, I got one of those statements from my old insurance company that I usually glance and discard, a “THIS IS NOT A BILL” statement of coverage– and noticed they paid the full cost of my meter- $5000!.

Woah.

So I got my meter, my first box of supplies, and was off to happy pump land, and saw drastic improvements in my overall blood sugar levels, like a 30 mg/dL drop in my averages.

And in June, it was close to the time to order some new supplies and I wanted to verify my coverage. I checked Humana’s web site (which is a great online tool, much better than I ever had with Blue Cross), and found my Medtronic insulin reservoir listed as a tier 1 co-pay, but could not find the infusion set. So I called Humana, and they said, I had to ask the supplier to put in a request. So I called Metronic, and explained I was trying to find out if these items are covered. They said the only way was to put in an order (which sounded odd, but that was the game).

A few days later, I got a message from Medtronic that said the coverage was confirmed. Cool, I thought, my supplies are going to be easy to order. And it was, my box came.

Then I got the bad news. My claim did not show these items as a $10, $30, or even $50 co-pay, but a total charge to me for this supply of $443! That must be a mistake.

But its not. Under my plan, Humana does not consider these bits of plastic and tubing as a perscription (and what is the difference between the insulina reservoir and a syringe??), but what they term a durable medical supply…. which means I have to meet my deductible first, which is now $1000. a quick calculation showed the $443 box was a 4 month supply, so in a year, I’d be putting out likely another $1000 bucks for these items.

So this brings home what many others have known long before me– how haphazard, and inequitable the US health care system really is. The quality of care is not correlated to the medical needs, or a medical diagnosis, but a financial one, e.g. how comprehensive is one’s insurance. My costs are not based on a medical opinion, but an arbitrary insurance company decision, a bottom line of profit margin.

And I am not ready to burn something in protest. When it comes down to it, I have the means to pay for this, and I will. And there are people who pay a lot of bucks out of pocket for other life critical drugs.

But it brings home a larger truth, that a medical advance for diabetics like an insulin pump is not going to be available to the working poor who are lacking insurance, or reasonable insurance.

It just smells wrong. I had some naive assumption that insurance was there to support the best possible health care. Silly me.

Pumpdate

It’s been about two months since I started using an insulin pump (Medtronic Minimed), which followed 35 years of insulin injection routines. Overall, I am very satisfied with the pump, though, as always in diabetes care, there’s always room for improvement in self-management.

My biggest hurdles are the estimating the carb counts; previously, I pretty much just ate and did not think much beyond skipping the sugar. I am bit more restrained now, but still sometimes just take some wild guesses at the right amounts.

My overall blood glucose numbers are lower than before (maybe averaging 120-130 where before it was more like 150-160), and the real show is in a month or two at my next A1C test, where I had been running in the low 7.0s and maybe a 6.9 now and then. At my June doctor visit, we made some adjustments to the basal rates (setting higher rates for day time) that have helped a lot.

I have been wearing the pump while running and it’s not too much in the way, as I was already carrying a small fanny pack anyhow to hold glucose tabes, keys, and the ipod.

And actually for being out and about and work-related travel, it simplifies things as I do not have to cart around needles and insulin containers to meals; I just need my blood tested (with me or before I go).

So the pump update is… I am gald I started on this as a new routine.

Running In Cleveland

Not Walking in Memphis… and I sure as heck have lapsed on Running in Phoenix, but today my shoes hit the pavement in Cleveland. I am here all week as my organization is running their annual conference. I was pooped from the travel yesterday, the time change, but it is time to stop making excuses and get out there more than once every 2 weeks or so.

So I did a slow 30 minutes, just around the University Circle area, just taking a right here, a left there, enjoying some new and unknown scenery.

I am also about 4 weeks into my insulin pump routine, still getting adjusted (it goes whereever I go). My sugars were super out of whack all day yesterday, and I chalked it up to travel, but when I woke up still high I decided that maybe my last infusion set change the morning I left was not smooth (it did not go right in on the first attempt). Sure enough, the little tube was crimped, so I was not getting any insulin over the last 18 hours or so.

The hardest part is getting the meal estimates right, and telling myself to pass on those hefty seconds. The first 2 weeks I had the lowers consistent numbers eveer, nothing higher than 130, but I’ve been bopping a bit up and down since, much because of instable routines.

But so far, no problem at all running while hooked on the pump.