Stress Of Life Makes D Just A Bit Crazy

I have not been having the best of months. First my dog was diagnosed with Pneumonia towards the end of July. He is 9 1/2 years old and has been my trusty companion through a lot of adventures during his lifetime including the big move to Los Angeles from Minneapolis. He appeared to be recovering pretty well after spending over a week in the hospital but wasn't quite yet back to normal.

Then last week, I got home from work on Wednesday night and found him lying in my bedroom, unable to stand or sit-up, having wet himself and with his eyes doing some pretty strange things. He is a big dog - 70 pound Yellow Labrador Retriever - so I wrapped him up in a blanket and had a neighbor help me load him into my car. He spent that at the Vet ER and the next day our regular Vet and I discussed his prognosis.

Originally he thought it was a condition commonly referred to as Old Dog Vestibular Syndrome and it is something that almost every dog who contracts is able to recover from. But as the week and weekend progressed, his condition was not improving and so this past Monday I took him to have an MRI and Spinal Tap test done. As it turns out, he has had a stroke. His prognosis is still up in the air but I am hopeful we'll have tests results back this week and we will have a plan for his recovery, or determined that he can not recover.

In the meantime, I have basically been a mess and my blood sugars and eating have been all over the place. I sat down at my computer today to put my readings and records into the Excel spreadsheet that I use. I highlight high and low BGs with different colors so they jump off the page to both my and my doc plus I have a notes section to talk about what I am eating, or not eating. Since he went back into the hospital my numbers have been just crazy! I know this is a rhetorical question but why can't the Diabetes be easy to maintain while I deal with all of this other stuff. Why is it that everything is always more difficult because the D issues are always there and recurring? What a PAIN!!

Support Group

Ever since I went on the pump last fall, I have been looking for some sort of support group of other diabetics and others pumpers to join. See before I moved out to California, I had several friends who were also Diabetic, and it was great to be able to talk about things with them, hear about the recommendations their doctors were making, hear ideas about different ways to do things and stuff like that. Making friends with other diabetics helped me get more focused on my disease and think seriously about being more focused on my care.

So I have been looking for a group but didn't find anything that was convenient or close to where I live. So when a friend of mine told me about meetup.com I hoped maybe there might be something out there. When there wasn't I decided to start a group myself. We had our first meeting yesterday and it was great.

I have made three new friends who are also diabetic - two of them wear pumps and one used to be is back to MDI. We are going to meet once a month and also try to bring other people. I am so excited about this and looking forward to having others who share in this wacky life of a Diabetic!

I Found A New Endo

I have been delaying telling this story because I have so enjoyed coming to my blog everyday and seeing the photo of the guy in his underwear! It don't take much for me these day! (hahaha)
So last Friday I had 2 appointments - each with a different Endo. I am happy to report that I have found a new doctor. I had both my Animas pump trainer and my Gynecologist give me a recommendation. Luckily both doctors were covered by my insurance company so I was happy to meet with them both.

My morning appointment with Doctor #1(it is easier to give them numbers) was nice and her staff was pretty on the ball too, but they did get a bit flummoxed by the fact that I had an Animas pump and not a Minimed pump. I guess ALL her patients use Minimed and they are then able to download records from both the pump and their glucose meters. When the Doc and I sat down, she had some good suggestions about my basals. The first thing that sorta threw me was when I asked her my question about supplements. At first she said she didn't believe in them, that there wasn't enough research but as she continued to talk she seemed to talk only about other things that I should be taking. So, basically, she didn't think I should be taking the supplements recommended by my previous Doc, but thought I should be taking others.

Then she asked me why I had chosen my Animas pump over Minimed, and followed up her question with the comment, especially since you are from Minnesota. She was obviously a fan of Minimed. Now, yes Medtronic is based in Minnesota, and actually, I do have some history with them. Their pacemaker division was a client of mine when I was working in advertising in Minneapolis. And even though my old doctor didn't really give me a choice of pumps (and YES, that is just another in the long line of reasons she is no longer my doctor) I probably would NOT have chosen Minimed anyway. In working with Medtronic, the company, as a whole, really didn't impress me much. But back to Doc #1, she said that she wouldn't be able to advise me on how to program my pump. I found that statement just a bit odd too, because that is what I have the pump trainer for. I wouldn't have expected her to do that, or even wanted her to do that.

So the appt ended and I left with lots of free samples. We had spoken about other types of insulin and I told her that I am currently using Humalog without any incident, but since some of her other patients have found that it looses potency by the end of the third day, she felt I should try both Novalog and Aprida.

My afternoon appointment was with Doctor #2. As I mentioned, my Gyno had recommended her to me and I love my Gyno so I sorta felt that I would like her more too. And I was right. First off, her office had a machine that was able to test my A1c with results in 5 minutes using something very similar to my glucose meter with blood taken from my finger. I thought that was GREAT. So by the time the doctor and I had been talking for a bit, she looked over at the machine and told me my A1c! How convenient that I didn't have to come in the week prior for a blood draw and we were still able to discuss my acutal results. Oh and by the way, it was 5.8% - not bad!

This doctor had a really great bed side manner, went through all my questions and gave me some great recommendations. She also made some very good observations on my numbers that I hadn't even noticed. Her other patients are also on Minimed, but she wasn't anywhere near as aggressive about my Animas pump as Doc #1 had been. She felt that if I was comfortable, then she would be too.

I guess you can probably tell by now, that I chose Doctor #2 to be my new Endo. Now I just need to get my old doctor to get my records over to her office. I did request them over a month ago and was told they had been mailed out four days before my appointment. They were not there by last Friday - the day of my appoinment and when I checked in with them today, still no records. I'll be adding that to that long list I mentioned earlier!

Great New Discovery

I did end up choosing a new doctor and will be writing about my experiences soon, but I felt compelled to talk about this great new product I discovered. They are called iBoxers!

I usually sleep in shorts and a tank. I know, super sexy - right? Well my main sleeping companion as of late has been my dog and he thinks I look good in anything! But my big issue is that not all of my shorts have pockets so where to put my pump where I sleep can be a bit tricky. Plus I sleep on my side primarily so having my pump in a side pocket gets a bit uncomfortable when I turn over.

About a week ago there was a thread on the IP site about these boxers. They are men's boxer briefs that have a little pocket for your iPod. Now I am not really sure why men need a pocket in their underwear for their iPod but it is PERFECT for my insulin pump. The little pocket is on the front of the shorts and so when I toss and turn, I never even know the pump is there. They are wonderful!!! And they come in some very bright colors - again, not sure how many men I know would be comfortable wearing orange or lime green underwear but really, I am not complaining!

And as a bonus - if you do have an iPod, when you purchase two pair of the shorts, you get some free downloads from iTunes. What a great little added value!

Looking for a New Doctor

I have decided it is time to find myself a new Endocrinologist. I have been feeling this way for quite a while but things were going so well with my Diabetes, that I didn't really want to rock the boat. This all changed when I received the last bill from her office.

See about a year ago, she decided she would no longer be participating in any insurance programs. Basically making her an out-of-network physician for all her patients. She has a small one doctor practice and specializes in metabolic disorders so obviously she felt she had enough patients who would stay that she could eliminate the hassles of dealing with insurance for both her and her staff. The unfortunate thing is that when she made this decision, she didn't send a letter or any form of communication to make her patients aware of this change. I found out when I went in for my next appointment and upon signing in, was told about the change. At that time, I was NOT happy and basically got incredibly upset. So much so that when the nurse came in to take my blood pressure I lost it and she had to take it three different times because the first two were too high due to my emotional state.

I did get over my initial irritation and frustration and decided to keep seeing her because I do respect her knowledge about my disease and it's treatment. Plus at that time, I was seeing her about once every 3 - 6 months so the costs were not likely to be that crazy. I did still have insurance and at least part would be covered. She would just be considered an out of network doctor.

Well this all changed when we decided it was time to try the insulin pump. This changed the entire schedule of how often I would be in to see her. In the beginning it was once a month but she assured me we would get to a point where she would only need to see me twice, maybe even only once a year. That was great - but honestly we never got to that point.

So while I am struggling to get comfortable with the pump and all the adjustments, she makes another financial change in her office. She decides that for those patients who have been with her a while, she would still submit her bills to insurance FIRST and then allow the patients to pay the difference. But to offset the timing, she wanted a $75 co-pay from each patient when they came in each time. My insurance co-pay had been $20 - which is considerably less than $75 per visit. Again, no letter about the change, just a comment the next time I came in to see her with my check already written for $20 and being told that the payment amount was $75.

I am sure you can imagine my frustration at this point but these two final incidents put me over the edge. The first had to do with some medication and supplements she has prescribed for me. Not sure if you know this but vitamins and supplements can not be claimed on cafeteria plans UNLESS they are prescribed by your doctor and you are taking them for medical reasons. Back in February when she first put me on supplements and Meridia, the company that manages our cafeteria plan asked that my doctor fill out a form for each of the different medications. The form asked three questions (one being what is my illness - Diabetes) and then required her signature. I faxed them over and her staff completed them and faxed them back with her signature.

Well now in May when she prescribed four new supplements, I faxed over the same form because I knew I would be required to have the same thing if I hoped to get reimbursed for the expenditures to purchase these. This time I received a call from her office telling me that she had instituted a charge of $25 PER PAGE to complete forms like this. So basically I had to pay $100 to have one her nurses write the same three sentences on four pieces of paper and for her to sign each page. Then when I asked when this charge was put into practice I was told since the first of the year. (again, no letter was sent to me) But I challenged this because there had been no charge when she first filled them out in February. After some checking on their end, I was told that I had been fortunate then but was not this time.

The final straw was when I received my last bill from her. It was for 3 different office visits - one on May 5th, one on May 12th and one on June 12th. All three visits had a different charge for the office visit. One was for $180, one was for $205 and the last was for $250. I called herb billing department and was told that she basically has two different charges for office visits - the difference between the $180 and the $205. Plus as of some day in June, she had raised her prices and now the visits would be $250 or $280. That was it. I was done dealing with her and her poor communication!

I have appointments scheduled this Friday with two different Endocrinologists. One was a recommendation from my Animas pump trainer and the other was a recommendation from my Gynecologist. Both doctors are on my current insurance plan so this means my costs will definitely go down! I have a list of questions for each, have copies of all my records and information and sincerely hope that I connect with one of them. This whole situation has been such a pain in the butt!!!

I'm Back and I'm Bitching

I know I haven't posted in a while and I think that is because things seem to have been going really well for me the past several months - at least on the Diabetes front! (For other topics, namely the dating front, check out my other blog!)

My Endo put me on Meridia back in December and so far I have dropped around 20 pounds. My last A1c was 5.7 – isn’t that what many NON-Diabetics have? Plus, I have been feeling good and have had lots of energy. There wasn’t much to say, except for bragging about how good I was doing – and honestly, who wants to read that!?!?

But of course that can’t continue forever. I saw my Endo in early May and she ran a rather extensive blood test, something called the “Berkeley”. It is supposed to help in predicting any issues related to heart disease. My usual factors like cholesterol and triglycerides were well within normal range (in fact, the doc was surprised at how good my cholesterol numbers were currently and figures they will continue to get even better as I continue to loose weight.)

But there were two numbers on this test of Advanced Cardio Risk Markers that were not so good. One is CRP and the other is Fibrinogen. For CRP, anything above 3.0 is an alert value and mine is currently 3.3 and for Fibrinogen, anything above 350 is concerning and mine is 375. I could go into all the details about what these numbers mean and measure but honestly, I am still a bit freaked out by all that I read and I don’t really want to think too much about them yet!

The good news is that neither is too far out of range. My doctor decided not to put me on more medications (thank goodness) but instead prescribed supplements which should help to lower these numbers. The only trouble is our lovely federal government has determined that supplements are not covered by the medical cafeteria plan unless they are prescribed by your physician. So, in order to have the additional $158 per month it is now going to cost me for these supplements reimbursed, I have to have my doctor fill out forms and how it will be enough to get them covered. That is until my cafeteria plans runs out for the year which I think is going to much sooner than originally anticipated!

This really shouldn't be difficult because we have done this before. We had to do it back in March with both the Meridia plus the earlier batch of supplements she gave me to help lower blood sugar levels so I figured this was another no brainer. Then I get a call from her office explaining about a new policy and they have to charge me $25 for her to fill out forms. Actually, her staff will the forms out and she may or may not even sign them but either way, it will cost me $25. I think that is RIDICULOUS!!! Especially since back in March, I was not charged for the exact same thing. I questioned the person who called me about this and she really didn’t have much of an answer. This is the 2nd time my doctor has changed the rules financially on me in the last 6 months without as much as a letter alerting me about this.

She finally gave me more than just one month’s prescription for my Meridia so I think I am going to take a couple of months off from seeing her –see how I do with these new supplements and then go see her again at the end of the summer. Otherwise, I am NEVER going to be able to afford to do anything fun if all my money is going to pay for drugs, vitamins and doctor’s visits! PHEW!!

Questions, Questions

So this past weekend, I went out to dinner with a guy I had gone out with a few times last fall. Back then he got a bit overwhelmed with his job, working on a film and he was not able to find the time to continue dating. So we exchanged some emails and now that the film was done, he was finally able to go out on another date.

Anyway, we were out having dinner, and of course, when I test my bg the topic of my Diabetes came up. We had talked about it before, so it wasn't really a big deal. But then out of the blue, he asks me what I do with my insulin pump during sex. This was only our 3rd date and the guy hadn't even tried to kiss me yes, so this made me laugh. I am pretty open about things so I told him. But I felt this question was COMPLETELY out of left field.

The funny thing that he does not know, was that last weekend was the first time I had had to deal with it during sex. I only started pumping last fall, and the situation and not come up until then. So the story, was very fresh in my mind! Once I answered his question it becomes very obvious where it came from. He launches into a little story about how he is sure he is going to get Diabetes later in life. A bunch of his relatives have developed it as they got older and he always has himself checked with he goes to the doctor. Now if the date had been going better, I probably would have just let his comment slide by but I couldn't. I told him that even if he did develop Type 2 Diabetes, it was not the same disease as what I have.

I went into full education mode and tried to explain it to him as easily as I could. And then I realized he was worried that some day he would have to deal with a pump, and that was why he asked the earlier question. Anyway, the date did not end well but I thought it was funny that he asked me that question!