Friday Five: WTF Happened This Week?

It’s Friday y’all. So much happened this last week that didn’t involve a certain reality TV star getting the GOP nomination. Here are some of the highlights and things to look forward to.

  1. United Healthcare teams up with Medtronic to only offer their insulin pumps and supplies to their subscribers. The Diabetic Online Community is buzzing about this. There is a lot of GOOD commentary about why this is a strange and somewhat scary decision and how all of this effects PWDs. Especially for the future of finding better care and solutions to simply exist as a normal person. I’m not going to throw more opinions out there since I’m still trying to formulate my own, but here are some  links/blogs to check out to get a background:
    Storyfy – the series of tweets, Facebook posts, and other social media tidbits from all parties involved to get the gist of the story from a facts perspective.
    How is Milk like Insulin Pumps? – Christel/ThePerfectD’s analysis of what this means in a real-world example.
    Choice is Necessary – Stephen/Happy Medium’s thoughts on the new relationship and how this helps showcase their parent company’s mission statement. (Spoiler alert: it doesn’t.)
    I Could Be Mad – Test Guess and Go’s feelings are similar to mine and I share a lot of Laddie’s thoughts. This one hit home.
    A Chain of Thoughts – Scott/Rolling in the D doesn’t post as often anymore, but I wish he would. I agree with him on the call for government oversight to end insurance companies acting like medical professionals. I also wish to use this post to squash fear that Big Government Run Health Care will act as a “Big Brother,” collecting and storing your data, so you may or may not get the care you need. Hello! This already happens in the private sector.


  2. Along these lines of healthcare, my podcast addiction, Pantsuit Politics, is actually covering the Affordable Healthcare Act next week. Between all of my Bernie Sanders friends touting  universal, single-payer, healthcare vs. my conservative friends pushing for the return to the free market for health insurance, I’m actually really anxious to hear what the hostesses have to say in their analysis. Given that this topic is hot and constantly thrown in my face, I’m struggling to figure out what the hell I want in my ideal healthcare system. Currently, the ACA IS my ideal choice, pending it actually worked properly. (Yay, public sector technology!) It’s a faux free market, which allows me to shop for a plan with a pre-existing condition, but I still (for now) can get a plan which will cover a multitude of diabetes durable medical equipment based on what my priorities are. (E.G. do I want one option for my insulin pump supplier at 100% coverage, or can I managed 80% coverage but switch pump companies as I choose?)
    Anyway, Beth, the conservative leaning hostess, posted a Primer on the ACA in preparation for Tuesday’s podcast. You can check it out for a very brief overview.


  3. It’s Spring Show Week! Quite possibly, my last Spring Show in a pro-am partnership since my instructor is moving across the country this summer. But, I’m not saying this is DEFINITELY my last showcase, because I said that one year and it didn’t actually happen. Anyway, I ran into another PWD performer during dress rehearsal. Meeting dancers with Type 1 diabetes is a rare occurrence – meeting them at your studio’s showcase is probably a 1 in 1 million shot. But, there we were, discussing where we could possibly put insulin pumps while wearing spandex and then performing.

  4. Capsule Wardrobe Related. Yes – I still have a small-ish selection of clothes to chose from in the morning and still plan on maintaining it for the remainder of the year. There have been a few hiccups lately when I realized that I didn’t keep a lot of my sparkly, trendy items in my ballroom costume bin, which probably would have helped when I was figuring out an alternative costume for my Spring show piece. (I didn’t need it, but I would have liked the option.) But I’ve moved from keeping only a certain number of items in my closet at once to making sure that what I have in my closet actually works, and that new pieces I purchase are from places with good sustainability practices. (And that my discards get recycled rather than tossed out.)

    I have been following a group on Facebook that focuses on Ethical Shopping . I don’t think I have the lifestyle (or the size) to dive into that kind of shopping head first. (Especially when simple t-shirts can cost $18+ and I have a messy toddler.) But, I figure I can do what I can by seeking out USA made items, or supporting a local business (part of the reason why I like Golden Tote so much). Second hand shopping online is super cheap and easy. And, I’ve reached a point where I don’t feel like I NEED anything in my closet – at least until the weather changes again. So – no shopping equals more money in my pocket for our vacation in November. Win win.


  5. Happy Mother’s Day! Which is Sunday, by the way. Make sure you call your mom, your grandma, or other maternal/parental figure this weekend to say “you’re awesome!”
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Take a Look at My Future

A hot topic in the diabetes world is health care: how expensive it is to have a life, let alone remain upright; how we couldn’t get private insurance before the ACA was signed into law; how we still can’t get coverage now that ACA is law; the fire-laced hoops we jump through just to make sure we have have a semi-normal life without going bankrupt by a disease we didn’t want.

I don’t normally jump into advocacy beyond this blog and sharing the latest news on Facebook or Twitter. There are far more influential people with diabetes out there that people will listen to that there is no sense in me trying to add my thoughts to the mix, I think.

But no! That’s the problem! If there is anything I’m learning about this goofy election cycle circus, it’s that I do have a say and a voice, regardless how pint-sized it may be. So whether I have 100 readers or 100,000, someone might hear me and also want to help raise a voice as an advocate.

Here is the current dilemma. At some point in the future, I will retire and need to rely on Medicare for my health insurance needs. (This is all assuming that nothing changes in regard to health care and insurance in the next 30 years.) Medicare currently has a bidding program to determine which and what brands of durable medical equipment it will cover for seniors enrolled in the system. Durable medical equipment typically includes diabetes supplies like test strips, glucose meters, syringes, insulin pumps, etc. – items that help administer the care of a PWD. (Versus a prescription of insulin, which is required to keep a PWD alive.) Like any government agency I can think of, the competitive bidding program was established to find the required durable medical needs at the cheapest possible price, and then having all Medicare patients use those brands only, unless they wanted to pay out of pocket.

The problem arises when taking the cheap way out actually effects the patient’s livelihood, and sometimes can mean more hospital stays or deaths. Let’s take test strips as an example. A person with diabetes will rely on a test strip and glucose meter to give them an accurate picture of where their blood sugar stands at a given moment. Brand A, while more expensive, may have about a 15 point variance in accuracy. Brand B, a cheaper generic brand, may have a 30 to 45 point variance. Both brands are FDA approved. Let’s say my blood sugar is 70 mg/dl – which brand would I prefer to have test my blood sugar? The Centers for Medicare and Medicaid Services will argue that Brand B is acceptable. Because it’s cheaper! And saves us money! And the FDA says it’s okay!

Meanwhile, I’m wondering if I need glucose tablets or correction insulin.

Anyway, The Journal of the American Diabetes Association says that the bidding program is doing much more harm than good. (Source – Abstract. Source – Full Text [requires log in] / Other Links Here.) And really, hospital stays are typically more expensive than test strips, so I’m not sure what Medicare is actually saving. Based on these findings by ADA, PWDs are calling for a halt on the bidding program since it failed to meet standards in its test areas. In July, the program will roll out to more states and effect more Medicare patients with diabetes.

It’s already hard enough just to get my insulin pump supplies from Medtronic as a 30-something female with private insurance through her employer. Since Medicare’s coverage and ideas can trickle down into the private sector, what’s stopping my private insurance from implementing the same sort of game of health care roulette?

I have a fairly diverse readership since I cover a litany of topics. (I know, all you capsule wardrobe followers are like, what gives, woman?!) But I ask, please, hear my pint-sized voice just this once and help me take action. After all, this was, and is, still technically a blog about my life with diabetes. My very long life with diabetes.

SuspendStripWarning

DPAC (Diabetes Patient Advocacy Coalition) has made it SUPER simple to write to your legislators. Visit this clicky link to fill out one quick form about where you live and it generates letters to  your Senator, Assemblyperson, and local representative and send it all for you! OMG this is so simple. And I hate writing letters like this. The more voices your reps hear, the better.

Oh, maybe I should have posted this sooner, but, DPAC has a nifty infographic you can share/read/whatever. Consider this the reward for reading through this.

DPAC Infographic (PRNewsFoto/Diabetes Patient Advocacy Coal..)

DPAC Infographic (PRNewsFoto/Diabetes Patient Advocacy Coal..)

Where Am I and What Am I Doing Here?

I’ve been asking this a lot.

And I’m sure you have too since I haven’t really posted anything in the last week.

I’m here… mostly. Like many, I seem to be experiencing a bit of an inspirational dry spell when it comes to content. That, and I’m just busy. But not really “fun busy.” The 9-5 job picked up a bit, but it’s simply busy work and herding a few cats that don’t want to be penned up. And since everyone is slammed and traveling, I can’t really justify blogging at my desk anymore.

I had my first real encounter, as an adult, with someone who knows of this great natural remedy/treatment/pill/thing that lowers blood sugar. I can’t really remember the name. It was loud where we were speaking and I kind of tuned out after she said, “you should try this… my husband’s on it.” <sigh> I’ll shelve it with all the roots and cinnamon myths that my parents dealt with when I was a kid.

This was after my rant about how the medical insurance industry is ruining my dreams of working for myself. Or just having decent insurance… which I kissed good-bye today. Apparently, you can’t have COBRA health insurance AND group coverage at the same time. So when my group coverage kicked in on the 1st, my COBRA was deactivated on the 31st. There goes my $1800 deductible. At least Medtronic just kept sending me supplies for my pump without charge for the last 6 months. I kind of have a bit of a stockpile in my home office. But my new insurance is terrible… just… ugh.

It’s also been an emotionally draining week. Between arguing with my mom about whether I should start searching for another job because I dislike the backasswards thinking and the fact that my talents reach beyond being someone’s assistant, but it’ll look bad on my resume. Insulting a close friend unintentionally thus causing me to rethink all of my interactions, both past and present, and wondering if I’ve dug the hole too deep this time. Listening to my husband’s complaint about the local weather and desire to move elsewhere and faintly considering it. Wondering if I’m just an emotional weepy mess because of hormones or stress or all of the above – which means my cycle starts again… and I’m probably not pregnant again… and how much longer do we need to go before we consult a pro?

On the bright side, I did learn today that it’s National Hug Day. Because the interwebz said so and stuff. I’m sure my problems may seem like mindless drivel to others with much bigger fish to fry. So I offer a collective hug to my readers for taking the time to peer into my reality, or, a virtual hug to console you if it’s needed. Or if it’s not needed. Or something.

There’s No Such Thing as a Free Lunch, eh?

I’d like to just comment on the generosity of friends and family. I’ve been out and about a bunch so that I don’t go stir crazy. Mostly to meet with people connected in a variety of different places that might contact me if a job pops up. I’ve been wined and dined. People buy me drinks… buy me lunches… breakfast… coffee. I can’t complain really, but it’s starting to feel a bit uncomfortable being treated to everything. Like the “thank you” after the meal and the company isn’t an equal payback. I don’t want to be a charity case and I know this won’t last forever… but, when will people stop feeling sorry for me and start to wonder why I’m no longer a productive member of society?

Of course, when my COBRA bills start rolling in, I’m sure I’ll want as many free meals as possible. (Because I won’t have them otherwise, I suppose.)

Off to do more interviews…

Where is Jen?

Funny how that now that I have all of this free time, I can’t seem to bring myself to sit and blog about it. 

Hi. I’m Jen. I still exist. I’m still unemployed. Sort of.

Let’s be real though. I’ve spent a majority of my mornings combing through CraigsList and Simply Hired ads, sending off my resume to jobs I don’t really want, but need for survival. (Read: medical insurance.) Yeah – I know. It’s probably a little bit of career suicide to fall off from a senior non-management position into an entry level admin position, but I don’t really have a choice. 

In the mean time, I do have an interview on Monday for a part time position. Which probably won’t pay squat and require me to stand in the elements during the extreme parts of summer. But – I’ll go to get back into the swing of things. (There also has to be a reason WHY they called in a CMP for an event assistant job, so I’m mildly curious.) I’ve also picked up a few more hours at the studio to keep me busy/motivated. But – 8 hours of work a week is not enough. Hopefully the EDD will understand that and still offer me my hard earned tax dollar funded benefits. 

I’ve been advised to look into contract work and other part time positions to make ends meet and have been figuring out ways to cut back. No more manicures, shopping excursions and other fancy things until the paychecks start rolling in again. At least we can still pay our mortgage and bills. (I have medical through the month… let’s hope COBRA isn’t atrocious.)

I’ve been trying to fill my time with as much activity as possible because when I don’t, my mind idles and I get depressed. I pretty much wanted to waste away under my covers on Wednesday because I just didn’t want to face more non-responses to my emailed cover letters, the endless pile of applications, and answering the same damn questions over and over again. All the while, having your professional references tell you how “you’ll bounce back fast…” and “you won’t be unemployed for long; you are too talented and someone needs you on staff…” Yeah – tell that to the other 300 people that apply for these jobs. 

At least insurance companies think I’d be a worthy candidate. Their macros keep sending me emails saying I should be an agent based on my resume posted online. However, the email says to send in a resume. Ha. Cute. 

The other side effect of unemployment that I find odd? The fact that I’m tired. All. the. time. I’m not really sure why beyond the fact that my CGM wakes me up quite often. (Last night – I was up around 5 times.) But for not dealing with cranky clients and co-workers, I really shouldn’t be this exhausted. But – interrupted sleep isn’t very restful I guess. (At least I’ll be ready for when kids start showing up.)

Until next time…

Unemployment – It Looks Good On You

Said no one… ever.

Especially me.

Long story short – the risk I took in late September to switch careers to a start up came back and bit me in the ass today. I had a sinking feeling that my company wasn’t doing well. I didn’t think that layoffs were possible because winter quarter had gone so well. But the bonuses stopped coming and the expenses kept piling on, and workloads got emptier. So someone had to go. Since I was the semi-PR girl that had the least amount of actual PR experience… I got the ax.

Am I upset? Sure. I join the the writhing masses clamoring for every job post on Craigslist. The future of my dance career and family expansion will ultimately be put on hold until I can find something more stable. (Luckily all of my Showcase items for May are mostly paid for.) The hubs and I may have to reschedule our vacation in May because no employer is going to give me that kind of time off right off the bat. I had to bail on my competition this weekend because I couldn’t afford the travel expenses right now. And don’t even get me started on what the hell I’m going to have to do for medical, especially since I paid that GIANT deductible at the beginning of the year.

But honestly? I’m relieved. I’m not up for the PR lifestyle at all. I didn’t like who I was becoming. The stress case who worried about clients 24/7 and the mindset that my day didn’t end when I left the office. I’ll miss the flexibility and the other benefits the company presented. But I definitely missed event planning while I was away from it for 8 months.

My plans now? I got a decent severance and applied for unemployment. I still have my hubby’s medical as a backup even though it costs an arm and a leg. I’ve got people helping me out as well.

Keep me in your thoughts. Thanks!

Why I Should Be Allowed to Have Nice Things

Finally getting back into my routine habits after being on my death bed two days ago. (Figuratively.) This included a trip back to dance class and some exercise that I sorely needed to get the blood sugars back in check.

I almost didn’t make it.

ParadigmRevelPump_ProductImage

Oooh… shiny.

Let’s start back at my endocrinology appointment yesterday. In addition to the non advice I received, I was also told that upgrading my pump for the shear need of experimenting with .5 and .25 insulin to carb ratios is unnecessary. No one is ever really affected by giving a .5 extra unit of insulin per carb, right? I conceded and said that I wouldn’t pursue getting a fancy new Revel because my current pump still has 2 years left on a 5 year warranty. And if I really wanted to try it, I could just do the half ratios manually. Maybe he was right and I was just making up excuses for the lack of control on the fact that I simply must have the latest pump model out there. (Even as I type this, that doesn’t make sense, medically.)

Well today was bad. It started off great with an 84 mg/dl and just went downhill from there. I’m pretty sure I fried my mini blender trying to process pineapple for a breakfast smoothie. Hated the smoothie after realizing how much fat was in it. Proceeded to eat a piece of toast to cover the insulin I had already administered for the smoothie I was no longer drinking. Stayed elevated all afternoon for no reason, other than I consumed more fat than I thought. (Another reason for me not to switch to paleo… I don’t think I could handle the high fat meals with my insulin resistance.) Debating my breakfast choices, I finally come down to a decent sugar around 1:00, only to be treated to a lunch of appetizers and wine. (Well, there goes my afternoon.)

I stop on the way home around 5:30 pm for gas. I’m 153 before I hit the road again. In another 10 minutes, I’m home and decide to correct for that 153. My dose is .3 units of insulin with some still on board. Fine. Obviously what I had on board wasn’t enough.

An hour later, I’m 97. We’re about to serve dinner. I convinced the hubs to cook quinoa instead of rice so I can enjoy “grains” without actually having them. Quinoa is perfectly measured according to calorieking.com. Bolus four units for dinner and eat. Half way through I’m not feeling right. My dinner insulin hasn’t even really started working yet, let alone finished coming out of the pump. I finish eating and check again. I’m now 58. WTF!?

I need to leave for class… 5 minutes ago. Now I have to treat a low with 4 units of insulin working against it. It was the first time ever that I had gotten three consecutive readings of the same (low) blood sugar. After three glasses of juice, some graham crackers, some cheese… I hit 81 and I’m safe to drive. (Or at least, if a cop were to pull me over, I can safely show that my last blood sugar said it was safe to drive.) I start class at 116. I end class at 181. Sigh. Rebounds.

So .5 units doesn’t really affect anyone huh? I guess .3 wouldn’t either, hmm?

I’m really hoping these last couple weeks don’t sincerely mess with my A1C too much. At this rate, I’m hoping for 6.5% or lower, just because it means I can hold this type of control for 6+ months. Though I’m going slightly crazy trying. Especially since it’ll all change whenever I end up pregnant.

On the bright side, I have a shit-ton of quinoa to enjoy at breakfast. That stuff doesn’t do jack to my blood sugars. Maybe I’ll try some quinoa oatmeal.

And then maybe I’ll fire my endocrinologist.

The Headache that is Health Insurance

PWDs are very familiar with and all-too-aware of the “joys” of health insurance. (The expenses, the hassle, the constant fear of being denied…) I had my own mini panic attack over the last month and am curious what others think the solution is. No – this isn’t going to be an Obamacare praise/hate post. Though, I am excited I will have the flexibility to shop for different insurance and not be denied… or if I want to be a stay at home mom next year, or a part time worker, I don’t have to worry about health insurance for myself come 2014… but I digress…

Anyway, it was time to order my pump supplies from Minimed; the same pump supplier I’ve had for the last 6 years. I recently changed my insurance because of my new job. New hospital, and new doctors. But I’m ordering the same prescriptions. Since I was getting close to opening my last boxes of reservoirs and infusion sets, I called early upon the recommendation of my CDE. Mostly because Minimed had to send the paperwork to the doctors, the doctors sign it and fax it back, and Minimed sends your order.

Since my insurance plan has a hefty deductible that resets at the beginning of the year, I decide to only order one more box of each because I will have to pay full price for everything. (And I didn’t want that giant expense at Christmas time to hit my bank account… only to have to cover it again next year.)

I called shortly after Thanksgiving.

My pump supplies should be here next Friday.

What happened in between? About 3 hours of phone calls back and forth to Minimed, my doctor’s office, my insurance company, and my CDE. Of the 5 Minimed reps I spoke with, no one had consistent information or requests. Only one of them really wanted to help me (the gal who finally overrode my restrictions for my items to ship.)

First I was told that I the authorizations from my insurance (my doctors) hadn’t been received yet. My docs all told me they were faxed on December 3rd.

Then I was told, that even though I’d been a pump user and was simply needing a supply order, I needed to send Minimed 60 days of blood sugar readings, a copy of my recent A1C, and doctor’s notes from the past two months. (I’ve only been on my new insurance for two months, mind you.) I found this to be a bit invasive for a re-order, so the CS rep said, oh wait, there is a conflict on our end; we’ll take care of it, don’t worry. In the meantime, my CDE says “no, why do you need to give them all this? You just need us to send this in, etc…”

So I wait a week and I hear nothing. Called back and speak to both a CS rep and a floor supervisor that says I still need all of these blood sugar results and that my insurance needed to sign the authorization. I cave and send in some really crappy sugar results (which I had, thanks to my Diabetes App) and a screen shot of my most recent labs. I don’t have doctor’s notes, which I think are a ridiculous request, but whatever. I call my doctor’s office back and tell them to send the authorizations again along with all of this other fun stuff. My CDE gets on the phone with Minimed herself and speaks to someone who tells her that the blood sugar thing is all a big misunderstanding and she re-faxed her copy of the authorization.

You’d think we’d be good by now. Nope. I call again on Friday after the floor supervisor emails me on Thursday to tell me that the insurance authorization still hadn’t been received yet, even though we faxed them directly to her. (Seriously? How many fax machines do you own???) I’m thinking that I’m not going to get this order by the end of the year anyway, so I might as well cancel it and just wait until January to push through a larger order. According to this CS rep, my order is “now in review” but has been red flagged because the quantity ordered doesn’t match the quantity approved. (Huh?) And says that I could cancel my order, but I’ll be in the same conundrum come 2013 because I will have stopped the insurance review process. Gahhhhhhh!!!! So I agree to keep the order standing and think about it for the rest of the afternoon. (What if they deny my order? Can they deny my order? I’m going to run out of supplies before they figure it out.)

I call back again later that afternoon and speak with Anita, who actually DID something about it. I asked if there was something I could do to make their lives easier (ha. ha. ha.) and if I needed to order, what I assumed, was a three month supply of my shit, then I’d bite the bullet and pay. I just wanted my supplies and I’ve been on the phone with you people for the last month and nothing is happening. So Anita starts looking through my account in silence, then puts me on hold. I’m on hold for 15 minutes. (And I really need to go grocery shopping.) She pops back on the line saying she’s trying to override my order with a supervisor. Oh – action! Good – I will stay on hold for the next hour if I have to.

Luckily, it’s only for another 15 minutes. She comes back online and says that my insurance authorization was received, but it wasn’t linked to my account. (Papertrail fail!) It’s been approved and should ship in 3 business days (Huzzah!) However, my authorization only covered one box of supplies at a time. (??????) Naturally, I ask that since it seems to take forever to get supplies ordered now, when should I call to order. So she puts me on an auto-fill system which ships my supplies automatically and then she alters the date of processing to make sure there is no lapse in my supplies. Thank you, Anita!

I’m not sure if I just got unlucky with a slew of non-customer service people, or if this is just the state of health insurance today. So I’m kind of anxious to see what changes when EVERYBODY has insurance.

What It Really Costs to Be a Diabetic

I was on a very good medical plan for about five years. All of my durable medical supplies were 100% covered. (Durable medical: supplies that help maintain your condition or administer the medicine required to take to keep you alive. So test stripes, pump supplies, etc.) My medicines were generally inexpensive in the grand scheme of things.

When I switched jobs, I knew my new medical was going to be a challenge. But I was kind of sick of my old hospital’s care, so I figured now would be a good time to switch.

My new insurance has an $1800 deductible. So that means I need to pay full price for all supplies and doctor appointments until I meet the $1800 minimum. And then after that, everything is 100% covered. I was told it was going to suck blowing through that much money to get the full coverage. Especially since I’d spend that much on a three month supply of all of my prescriptions.

Only now am I realizing the grandness of this problem. My glucagon kit, which I unwillingly filled this weekend, cost me $145. It’s a one dose medication that expires in ONE year. I most likely won’t use it. <knocks wood> But – it’s just to put my doctor and my hubby at ease in case I have a problem. Boom – $145 gone.

My test strips is another sad example. A box of 100 test strips for my machine retails for $118 at my local Target. And since I’m now testing about 6-8 times a day, that’s about $118 every 13 days or so. Yikes!

I don’t really want to think about what my pump supplies and insulin cost. Or my multiple upcoming doctor visits.

But again – after three months, I won’t have to. It just sucks right now.

On a happier note, it’s beginning to feel a bit more like winter out here, even though it’s still November. We’ve got the fire turned on most nights and it’s quite cozy. The kitties certainly have been enjoying it. I even started Christmas shopping today.

Cozy comfort