Remembering August 20, 2009
This post was originally going to appear later this week on Aug. 20, but that's Friday when I like to keep the posts on the lighter side. So, I was going to go with the day before, but then this whole "Driving With Diabetes" topic came up as one that might be included in the weekly Wednesday night Diabetes Social Media Advocacy (#dsma) discussions. So, I opted for today. To write about how my life changed on Aug. 20, 2009.
That was the day a chain came out of nowhere, wrapped around my neck, and started squeezing. Ever since, the chain continues adding more links and squeezing around my neck to the point where I can't breathe.
But for all the scariness that happened that day and since then, I owe a lot to what happened. It changed my life, in terms of my thinking about God, CGMs, real-life policy issues, financial obligations, and the overall health care and insurance system. The past year has been a time of personal reflection, a spiritual journey, as well as real change in how I deal with my Type 1 diabetes - all as a direct result of what happened that day.
Everything began that afternoon at work. A newspaper reporter, I had an interview at 3 p.m. Wrote on the board that I was leaving the office for said interview. Problem: it was a phone interview, but my mind couldn't remember that important detail. Thanks to a Low. One that I didn't see coming, as I'd just recently done a test that was above 100 mg/dL, had eaten a decent lunch, and done everything else as correctly as I could. Yet somehow, my blood sugar dropped.
I recall missing my black lab Riley, and just wanting to see her. That I needed to get home to see her. Maybe, right after my interview. Wrote on the board. Packed up my belongings, and left the office. Walked to the parking garage and got behind the wheel. Why no BG test? I'd just done one, and as mentioned, it was fine - above 100. No need. But I was already Low, and was still plummeting. Actually, I made it through most of the 10-mile drive home. But probably because my sugar was low, I missed my freeway exit and had to drive another five miles south before circling back. Instead of getting back onto the freeway, I took the back roads. Ended up getting lost on the farm roads that I normally know very well, but just couldn't make sense of in this Low BG state. Eventually made it back to my subdivision, but ended up driving back and forth and around the area, with reports that I drifted in and out of oncoming lanes of traffic. Cloudy memories of driving up on a grassy side median still haunt me. Some called 9/11. I ended up in a ditch just across my subdivision entrance, with a police officer approaching my window. I rolled it down. As this happened, I recall thinking that I had to "escape." Words came at me, but I was fumbling with my key in the ignition (the SUV was still running) and trying to put the vehicle into reverse to drive away. The officer leaned into my window and quickly grabbed the keys from the ignition, then opened the door and pulled me out. That's about all I remember, before waking up in the back of an ambulance at the scene and having glucose pumped into my system. Then, being transported to the local ER despite my repeated attempts from the back-of-the-ambulance stretcher restraints to decline that transportation.
As it turned out, my parents were visiting from Michigan that day - so in my Low mindset while driving I not only phoned my wife's cell (she was working), but I also phoned my dad's cell. So the paramedics grabbed my phone in the confusion of moving me and dialed the last number I'd called, therein alerting my parents to the situation and having them meet at the nearby hospital. It was an all around good time, indeed.
For the record: I do carry an array of glucose tablets in my vehicle as well as Skittles and some crackers. As indicated above, I also test before driving. But sometimes that's not enough, and doesn't prevent these situations from happening. Not in the same way a CGM might, in alerting the D-Driver to a dropping BG while on the road or even before they get behind the wheel after a "safe" test reading.
This was probably one of the most scariest examples of my life. In the weeks after this happened, I'd be hesitant to drive anywhere and would be even more fervent about my testing before putting the key into the ignition. I wondered countless times whether I should be driving at all, whether it's in the best interest of society for a Type 1 diabetic to be behind the wheel. I'd also reflect on the bigger meaning of all this, praying thankfully that He protected everyone else on the road and somehow saw fit to protect me. This was one of two "near-death or likely-death" examples that happened to me in the course of a month, and to me showed that He was a real force in my life looking out for me.
But there's more to this story.
Within a week of this incident, the bills started arriving demanding payment. Even before my insurance company was able to receive, review, and process my coverage for these claims from the various providers: ambulance, ER, the ER doc, and multiple others who apparently were a part of this process.
The 4-mile ambulance ride came out to more than $768 before insurance, which included $97 in mileage for the four miles - roughly $24 per mile. However, the ambulance company somehow calculated this to be $10 a mile with nine miles, even though that's more than double the distance from my subdivision entrance to where I ended up (wonder what route they took???) Anyhow, the first bill from them came within a week, before insurance could even respond. A month or so later, it was clear I was only going to be responsible for $367.
The ER bill came out to $2,797 for less than two hour visit that was largely just wait-time. Insurance picked up most of that, minus a co-pay and whatever applied to my deductible - meaning I got hit with a $468 tab.
Then you have the various doctors who popped their heads in or looked at one piece of paper, such as the unneeded EKG, and it came out to about an extra $100 on my end.
For a grand total: $933. About 25% of the total pre-insurance tab for that day.
For all its faults and headaches, insurance coverage is a savior when analyzing the total payout and cost benefit. You truly have to appreciate that. Still, I just wasn't planning for that additional $933 expense, in addition to the $454 post-insurance amount for lab tests that I'd had done just a week before.
What that amount does is make you reflect more intensely on what you could have done, if anything, to prevent this from happening. Had I had a CGM, this may not have happened. I'd done everything possible without one, and it still came to be. But had there been a device tracking my BG level and examining the direction I was going, maybe the alarm would have alerted me to this and caused me to look differently at the 100+ mg/dL snapshot that had been offered just before this all began happening.
So, that is the lesson from all this. I've found my faith and started truly establishing my relationship with Jesus and God. Saw the true real need for a CGM. Lived the dilemmas of Driving While Diabetic and what that means. And came to understand how quickly a "medical emergency" can hit your life, your pocketbook, and have long-lasting continuing impacts every day since.
I regret that this happened. But I continue trying my best to cope, to keep living, to learn, and advocate to those who could be in the same situation some day.
I'm glad you were ok. I'm glad that you got the help you needed right away. That is a blessing for sure.
I remember the bills rolling in for my husbands cancer last year. The insurance liked to deny claims because they weren't billed right. The clincher was the $32,000 dollar bill I got from the hospital saying our insurance denied the claim. Good times.
You're keeping me on my toes, if that helps you feel any better.
I don't test before driving. My diabetes educator told me that I needed to, but it's difficult to "waste" a strip when I FEEL okay. Your story is making me re-think that.
I hate that our well-being is so tightly connected to money. Why shouldn't I be able to test once right before driving without worrying about the wasted dollar? Why shouldn't you be able to not stress about ambulance bills so you could focus on taking care of the day-to-day.
Totally sucky. Glad we're both okay now.
Drive safe my friend!
I've had a few lows in these two weeks - the lowest 35 on my meter and another 38 on my meter. And in neither case did I get an alarm from my CGM - even after I had treated the low and was back in the normal range! The problem is that a CGM is registering your interstitial fluid, and not your blood. And interstitial fluid glucose reading are about 20 minutes behind your real BG. So if your BG is dropping quickly (i.e. after an injection that you didn't eat enough for) then you may get very low without any indication from your CGM. In my opinion, the CGM is much more useful for tracking highs than lows. And it does seem to be useful for overnight lows, which tend to come on more slowly.
I test 12-15 times a day. The meter is by my side and I have no qualms about using it while driving (say while stopped at a stop light, stopped in traffic, etc.) - all 5 seconds. Honestly, we can never test too much.
Best wishes and drive safely, please.
Doris J. Dickson