Tuesday, January 31, 2012

One Word

Sometimes, the only word you have is: "Doh."

Then you find a new set, a new site, and move on.

Just keep pumpin', just keep pumpin'...

Thursday, January 26, 2012

World Domination Unrealized

Those of us in the Diabetes Online Community have long speculated that cats are plotting world domination and that eventually they'll get the better of us.

Our cat, Shadow, has been in on that plotting for awhile.

But as it turns out, Shadow won't be around to see that World Domination come to be. Her years of cat co-plotting will go unrealized.

We said goodbye to our beloved 10-year Korat recently, her story coming to an end on Monday, Jan. 23, 2012. Also fondly referred to as "Beaner," "Mitten," "Kitty," and "The Grandcat" among other names, we are now sharing Shadow's story.

She'd been a part of our life since our first year moving to Indiana in 2004, and came to us via a copy-editor that I'd worked with at the time. Shadow had been wandering outside and apparently had experienced a near-miss by a car, and she was picked up. My co-worker sent out an email asking if anyone was interested, and I took a chance. The name came because of her grey shade, and her ability to dart around and disappear like a shadow - we kept the name. The rest is, as they say. into the history books.

We had a fun ride.

A move into our first house, complete with a "trip" down the new stairs. The dog's arrival. Visiting the Kitty Tooth Fairy. Late-night writing. Her taking on various professional jobs. Meeting the DOC and learning about world domination. Hanging out in suitcases, laundry baskets, and just being scooped up in my arms. Chasing the laser level, and the invisible mice in the house. Actually scouting one out in our apartment once, and helping me capture it. Psychedelic Frisky commercials. Jumping up on the chair arms for some petting and purring. Pump tubing on the head. Blog hijacking and blood meter stealing. But overall, no matter what else was going on, the experience of having a family and being loved.

She had been suffering from kidney disease for some time, and over the past year it's gotten progressively worse. To the point where lately, she's had difficulty breathing. Her eyes have been highly cloudy. Clumpy fur, lack of self-grooming, constant water drinking and increasing signs of dehydration. Slower-moving. Eating problems. Not wanting to play, or torment the dog. Overall, just not her same kitten mitten self. We've had her on special food and have been doing some home-medication off and on, but that had run its course and more was needed, but we just couldn't provide for her.

I've known this was coming for awhile, but I've been too afraid to truly admit it. Growing up, I was never a cat person. Always wanted a dog, and never had one, but never envisioned I'd have or even want a cat. But Shadow changed that, and it's hard to imagine my life without my first pet (childhood goldfish aside).

We took her to the vet on Monday for an evaluation, and it became clear that the time had arrived. With her history of kidney disease, the vet was somewhat amazed she'd lasted as long as she had without any more advanced problems. But she said the kidneys were small and she was on that line where any little stress could do her in. Yes, we could take her home and let nature do it's thing - but there was no degree of certainty of how much time, or what quality of life, Shadow would have left. So, we opted to save her the pain and make sure her quality of life didn't suffer more than it already had.

Decision time was upon us, and there was no sidestepping it this time (I'd been delaying this and rescheduling vet visits for awhile).

A single shot was all it was going to take, the vet said. Of course, Shadow was a fighter. She had some world domination plans left in her, and so as the vet was sticking the needle in her leg, Shadow made a dash for the door and caused the vet to pop the vein with the needle. So, a sedating shot was needed and that made her drowsy. We stayed with her for the final moments until she was gone.

It was tough. I cried. And I really, really miss my Shadow Kitten. I still look around and see her, call for her and expect to feel her nudging against my feet or poke her head up onto the footrest. I never thought I'd be a cat person, but Shadow changed that.

So now, we say goodbye to our Shadow. She'll be missed - by us, by her sister Riley, by those in the DOC who are furry and not. World Domination remains unrealized for Shadow, but I'm sure the plotting will continue with her - and so many others - in mind.

Shadow (2002-2012)

Wednesday, January 25, 2012


Batteries die. Reservoirs run dry.

Devices we use simply need recharging.

These devices are just like our bodies. They need energy, insulin, motivation. A boost to get back in the game of doing what they're supposed to be doing. 

What is depleted must be refilled, recharged, reconnected.

How long it takes, is up to us. We can remain in that place or step forward, immediately or down the road. The choice is ours.

But we move forward. Toward a place where the battery bar is full and the energy level is strong. Where the insulin is full and we have what's needed to do what's needed.

The hope is there, even in the abyss. Even when we're depleted.

Sunday, January 22, 2012

Beginning Again

I'm not gonna lie: this one is a little deep, dark and depressing.

But I have to reflect briefly before circling back to the present task of Moving Forward.

A lot has been going on in my mind. I'm not healthy, not happy. Things have been tough, and I have been at the point where I want to give up. Diabetes management is the last thing on my mind, and I've been drowning in hopelessness aside from just feeling crummy.

Sleepy all the time. Consumed by self-doubt. Reclusive. Emotionless, humor-deprived, non-focused, irritable, unhappy. Personally, professionally, emotionally, mentally, physically, internally and externally.

For too long, I just haven't been "me." In a sense, I've been wearing a mask.

Not talking or meeting or being curious as I've traditionally been. The writing hasn't seemed to flow, and what does happen to appear on my screen doesn't seem right or as interesting as I know it truly is. I'm bankrupt in the context of who I've always been. That's led me to scary mental places where I can't even recognize myself. The person looking back at me in the mirror doesn't smile, and when he does it's not real. Dark bags are under his eyes, and you can just see that he's tired - no matter how much coffee or Diet Coke he drinks.

How long has it been going on? Not sure. Probably more than a year, but it's slowly progressed and gotten worse as the months and weeks have gone on. Lately, in recent months, I've hit the tipping point more than once and have felt myself melting down.

Admitting, sharing, or even acting on this hasn't happened - that'd be my solidifying my own failures, creating "excuses" why I'm not able to handle this on my own.

The Diabetes Online Community has helped boost me, as has being around and having discussions with those that I love. But I've strayed from the path I need to be on, and lost focus. Life storms and stresses have been overwhelming, and that's just fueled the frustrations and negativity to the point where I'm completely burnt out. Everything, including diabetes - I'm so afraid of where my A1c is hovering, that I've been avoiding that needed Endo visit.

So, what's to blame?

Depression has been building, and burying me under the weight of a thousand pounds of concrete. But even aside from that, a key factor is probably that I hadn't been taking my hyperthyroid medication on a regular basis. There's honestly no reason that comes to mind, except that I've had a sense of "hopelessness" during the past year. This is probably self-circulating and I was shooting myself in the foot, but it is how life has been.

Until recently.

Some friends got together in Kansas City and a life-changing experience opened my eyes once again.

I drove 1,022 miles to be a part of that, carrying a weight that's existed for so long. There was a lot of fun and memory-making, but it wasn't until the return trip it all set in. Half-way on the drive back, as 10th Avenue North played on the radio and the sensations of that weekend replayed in my head, the full force of how far gone and where my journey had taken me finally set in. And that's when I pulled to the side of the interstate, near a road sign that said Indianapolis was 200 miles away, and cried my eyes out.

And talked to God.

And wrote, with a pencil supplied from the hotel room and the notepad I use to tell people's stories.

My heart opened, and for the first time in a very long while, I truly saw some light ahead. Even as a beautifully weary sun set below the horizon to the West, and a hopeful moon was ready for the challenges ahead.

Sharing is so important. For too long, I haven't. When everything seems to depressing, why would you want to bring others down? The guilt is just never-ending. But it's only through sharing that you can move past this.I see that I need help and I'm starting to get it. I've been ashamed of my failings and senses of inadequacy, and haven't reached out even to those closest in my life. And that's why I've only perpetuated this cycle. Not anymore.

Maybe, there is something I can do to get past this. Maybe, the message of "You Can Do This" isn't far-fetched and unattainable. Quite possibly, a light at the end of the tunnel actually does exist and can be reached. It takes effort, and one can't do it alone.

One man traveled 15,000 miles (kilometers?) to be a part of that group, and in doing so he's opened my eyes again. He has saved me. The friendship and sense of community that brought him here, that he credits for saving him, has indeed also saved me. And for that, I'm eternally grateful.

Since that experience, several friends have written about their own struggles and I've related to them completely. Seen myself in what they've been writing about their challenges, and I've found hope and guidance in how they're moving forward. That's helped me make some progress in my own life, too.

Through the eyes of something bigger than yourself, you see how you haven't been alone and that you have been carried. Those Footprints that you've heard about before, somehow magically appear in the sand on the beach.

I know I can walk on, because so many are there to help walk along with me and carry my tired soul for a few steps if needed.

Moving forward, a single step at a time. One pill, one blood test, one handwritten letter rather than an email or blog comment, one actual conversation, and real face-to-face talk. Truly living. Each day.

I have an appointment at my Endo's office this week, and I've scheduled an introductory session with a counselor in the comings weeks. As I wrote recently in another post, now it begins again. Moving Forward. And I know I'm not alone.

Thank you for bearing with me, and simply for doing what you do in my own life. You have and continue to make a difference, and I can't appreciate that enough.

Thursday, January 19, 2012

Dear Paula Deen

Welcome to the Diabetes Community, Paula.

Though it’s a bittersweet welcome, one that no one deserves or hopes for, I’m grateful that your Type 2 diabetes diagnosis announcement comes at a time where you don’t have to be alone. Where you can find some friends who “get it” and know what you’re going through.

I applaud your courage and willingness to share your health story, especially in such a public way. On your own terms, your own timing.

Confession: I’ve never watched your show. Yes, I knew who you were before all this news materialized. And maybe once or twice, I’ve caught a glimpse of your cooking and personality while flipping channels or when passing through a room where you happened to be on the screen. No offense to you or your southern-creations – just not something I’ve ever embraced. And it has nothing to really do with the food types or ingredients, it’s just not something I’ve ever really paid much attention to. Even though I'm certainly a fan of food.

Now that you’ve unleashed the news for the world’s eyes, my hope is that you can use your D as an advocacy tool for the millions who watch and love your cooking show, to teach more general lessons about how we as a society need to better manage our health, our eating habits, our whole selves. That’s something you’re obviously doing, by embracing a campaign with a Pharma company and making personal changes and even re-creating some of your food dishes to be more D-friendly.

I could care less that you waited, that you held it close. Naturally, I'm cynical and skeptical and operate often on the mantra of "Your Mom Says She Loves You... Prove It." But I also have faith, and I'm trying to see the better positive side of people and not assume the worst all the time. So, I take you at your word that it was a personal family decision ultimately made for the reason you offered: Because you didn’t know anything about D then, and you wanted to “bring something to the table” before announcing this to the world. You did this on your terms, and I applaud you for that.

A lesson we can all take from this, though: You would have come out on this 3 years ago with little knowledge or information, and people would have criticized and judged you. You did this now, and people criticized and judged you. The point: you can't control human nature through timing.

Now, is there any hypocrisy in this - that you made changes personally in eating, exercising, lifestyle and health but yet continued to do everything on your cooking show exactly the same way? Mayhaps so. And just because you never said "eat this everyday for every meal" doesn't mean you preached moderation.

But none of that rises to the level of justifying claims that you "did this to yourself" or that you "deserved" this diagnosis. Not at all. I’m sorry that you’re experiencing criticism, judgment, blame…Science doesn’t tell us what causes any type, but sadly our society – even our own D-Community – can be quick to point fingers that a "contributing factor for one person" was the sole cause of another person's diagnosis. Poor media coverage fuels misconceptions and lumps all the types together, with little explanation or clarity except a big proclamation that “MILLIONS OF PEOPLE HAVE THIS SILENT KILLER.”

It's that war of battling misconceptions that connects us as Advocates, as regular People With Diabetes - beyond the blood testing and D-Management and shared moniker of diabetes. We impact each other, and what's said about your diabetes carries over into the general public's mind about anything related to any type or issue of diabetes. You’re a part of that now, just like the rest of us in the D-Community whether one "advocates" or not and regardless of a person's feelings about this type or that. Awareness through Unity is how we educate the masses, sidestepping the blame and the differences and focusing on the real information.

Maybe with your celebrity-status you can help battle some of those misconceptions and teach people what is and isn’t true about Life With Diabetes. I’ll be eager to see how you use that spotlight.

Again, thanks for sharing and being willing to advocate on behalf of yourself and others who are at various points in their D-journeys. At least you’re on the food channels, and not MTV where your “True Life” D-story would take on a different tone. No, that’s a whole different blog post right there…

Wednesday, January 18, 2012

Not Going Dark, But...

Many players in the online world are protesting the pair of Congressional proposals that target the online universe- Stop Online Piracy Act (SOPA) and Protect Intellectual Property Act (PIPA).

I'm not going dark here at The D-Corner Booth - in part because this is a diabetes blog, and I can't block out my D for a day. Blood tests and insulin-doses are ongoing, as are the thoughts in my head. So there.

But know this: I'm not a fan of censorship, and if this legislation does what critics think it will, then I'm totally against it. I'm not a lawyer, I only cover them as part of my real-person job, so I don't have any worthwhile insight about what the law says or doesn't say and how that may hold up. My experience covering legislatures and courts tells me that lawmakers typically are vague in crafting legislation and don't understand the impacts or practical realities of what they're drafting or passing into law, and the courts consistently find this when ruling on enacted laws.

So, take what you will from that.

I'll have none of this, Congress...

Now, I'm going to now refer you to a passage from a CNN story posted today about this whole web-protest to the Congressional efforts that sparked this controversy. I find these particularly insightful, personally.

SOPA's supporters -- including CNN's parent company, Time Warner, and groups such as the MPAA -- say that online piracy leads to U.S. job losses because it deprives content creators of income.

The bill's supporters dismiss accusations of censorship, saying the legislation is meant to revamp a broken system that doesn't adequately prevent criminal behavior.

But SOPA critics say the bill's backers don't understand the Internet's architecture, and therefore don't appreciate the implications of the legislation they're considering.

My thoughts based on the above notes: It doesn't matter what the law was "meant" to do or not do, the point is what's written and what it CAN be used for if someone chooses to do so down the road. The path to Hell is paved with the best intentions, as the saying goes.

Here's a couple news stories I found informative:

And if you care to protest, then here's where you go:

Power to the People, whether it's online or in person! Use your voice - we have one for a reason!

- - - - - - - - - - - - - - - -

"WE DID IT!!!"

Headline One:
"SOPA and PIPA postponed indefinitely after protests"

However, it may not be over just yet:
"Protect IP, SOPA supporters vow not to give up fight."

And so, we keep watch. As good U.S. citizens must do. We won't give up the fight, either. Count on it.

Thursday, January 12, 2012

Your Lows May Vary

As Bennet has wisely established as a mantra, Your Diabetes May Vary.

The same applies to Lows. Kerri (Shelby?) wrote about this very recently, which was actually funny timing because I'd had that same topic on the mind after a conversation the day before with my own mom. She's lived with Type 1 for more than five decades, since she was a young kid, and we were doing an interview about our own individual, joint, and differing D-Life experiences. Lows came up, and that got me wondering how our experiences varied.

I've written about some of my examples in the past - violent thrashing and struggling, believing my wife was an alien or robot or Communist trying to gain control of me, the dog trying to eat my head, and the dream-like states of being outside my body and then waking up to the paramedics hovering above me. You get the idea.

But I wanted to know about my mom's, so I asked. She responded by email:
I did (have reactions) and remember my mother pouring juice down my throat. She also always carried one of those little boxes of raisins in her purse to give me when I didn't feel well. The only glucose tabs were those white ones, which I would lock my jaws against and refuse. When I was a kid, a lot of it had to be done on what I said I was feeling, because there was only urine tests and they were so far off. They might show you weren't low but you could have dropped low in the meantime. Also I only took Lente insulin, a pig and beef combo, and it wasn't real stable. If you didn't eat your meals on time and didn't eat all of your food, you had lows. There wasn't anything you could do about it as that was all there was.
I never had anything bad like the seizures you did. When you first had them, we were terrified. The endo clinic said it wasn't because of the diabetes and by the time we could get the seizure under control and do a blood test, you wouldn't be real low. So they never thought it was from low sugar.  They made us see a neuropsychic guy who did a bunch of head tests, like CAT scans and stuff, but they never figured out what it was from. The seizures only lasted a couple years and then they stopped.
It wasn't until years later that some other parents at a JDRF meeting said their kids, usually boys, also had seizures with low sugars.
If by violent lows, you mean kicking and striking and generally being mean, I do do that.  It's just that your father is much bigger than me and can easily sit on me and keep me down to cram stuff in my throat. It was easier when you were small and I could sit on you to get juice down you.  Once you became as big as me, it became much more difficult.

In our household, Suzi and I have an understanding that if I'm in "violent Low mode" and she can't easily get at me with frosting, juice, or glucagon, then it's best to step back and summon the paramedics. That's just how we do it.

Reiterating the questions I'd asked in my post back in late 2009, I'd be curious to get feedback on others' experiences when Low.

- How often you do/have had these happen (maybe pre-CGM days, if applicable)?
- Stories that stand out, for better or worse?
- Worst (most dangerous) examples?
- What brought you out of that reaction?
- Scariest part - the dream state, emotions, guilty, etc?
- Lessons learned?
- Whatever else might be pertinent, relevant, or randomly of interest

Whatever our experiences might be like, hopefully they are few and far between. And, you know, the aliens and robots don't really take control of us.

Wednesday, January 11, 2012

The First, 90 Years Ago

Everyone has for the past year, even a little longer, has been going on about the anniversary of when insulin came on the scene and changed the face of how people with diabetes could live, not just survive.

First, there was the date on Halloween 1920 that the esteemed Dr. Banting actually came across the idea for what would become life-sustaining insulin.

Then, there was the development of that idea in 1921.

Of course, then there's the date that creation came to fruition and the first person actually received the benefit of insulin. That was Jan. 11, 1922 - exactly nine decades ago.

A 14-year old boy named Leonard Thompson was dying at Toronto General Hospital, but it was this newly-developed drug known as insulin that gave him a chance to live. Even though it was initially unsuccessful, a revised formula was successful and it changed everything. No one really paid much attention outside the medical community, until August 1922 when the now-infamous Elizabeth Hughes hooked up with Dr. Banting in Toronto and made headlines with her receipt of insulin.

Elizabeth chose a lifetime of silence about diabetes. That was the way of the world, at the time. She's especially meaningful to me, not just because of her history-making insulin injection but also because as an adult, she was able to move to Michigan and become one of the founding trustees of Oakland University where I went to school and graduated. Elizabeth became Elizabeth H. Gossett, married to the then- general counsel for Ford Motor Company and a pivotal player in the local arts and civic community - but diabetes wasn't a part of that. Her adult endo was Dr. Frederick Whitehouse in Detroit, the medical professional my own mother now sees. I had the chance to talk with Dr. Whitehouse a handful of months back, and he talked about his experience with Elizabeth Gossett.

"It's my opinions that Ms. Hughes Gossett was a 'closet diabetic person.' These people with diabetes commonly did not 'wear their disease on their shirt sleeve' like many do now. I believe the current atmosphere for the person with a chronic disease is much more healthy than before. You had diabetes, (that meant) you were 'damaged goods' and might have no job, no insurance, no full life, and be advised not to reproduce, etc. The family often kept their chronically ill family member in the back rooms."

When Elizabeth died of pneumonia and a heart attack at age 73 on April 25, 1981, her Michigan obituaries didn't mention diabetes or signal her significance to the Diabetes Community. Actually, I remember reading something in diaTribe written by James Hirsch at one point that Elizabeth had actually gotten ill during a trip overseas and came back with sky-high blood sugars in the 700s. Dr. Whitehouse confirmed all of that from memory, connecting dots that her pneumonia led to blood sugar craziness and eventually, well. It's all history, and her diabetes wasn't something she wore on her sleeve like so many do now. It wasn't until years later her family even started mentioning it and talking about it openly.

Still, Dr. Whitehouse describes as really a "remarkable woman" who did what she did to live successfully with diabetes, regardless of how much or little she talked openly about it. She set the standard for how generations lived and managed their conditions from the very start in 1922, and created the foundation for living successfully.

Just as we celebrate those who've accomplished their dreams despite diabetes, from driving race cars to climbing mountains and swimming or skiing in the Olympics, Elizabeth was one of the first to reach that dream of living a "normal" life. We owe so much to her, and to Leonard.

Of course, to Dr. Banting and all those who set in motion what happened 90 years ago.

Now, we just need to make sure everyone has access to insulin when they need it. That becomes our mission that we can hopefully do something about by the time we reach the 100-year anniversary.

Monday, January 9, 2012

I'm Surrounded By...

This clip captures my mood perfectly right now, as I reflect on our country's politics and those vying for the presidency.

I'm surrounded by assholes, apparently. But I guess I already knew that. (Sigh).

Presidential hopeful Rick Santorum apparently thinks that insurance companies should be able to deny coverage for people with pre-existing conditions. He's also of the belief that those who aren't denied should have to pay more to receive benefits, because they're sick and cost more to insure.

Not all the fools GOP political hacks presidential wannabes think the same way, and some have specifically said that despite wanting to repeal the Affordable Health Care Act they want to make sure insurers can't prevent pre-existing denials outright.

But apparently, that's not how Rick rolls. Or so his sometimes-inconsistent video statements seem to indicate.

To a New Hampshire high school class, on why people with pre-existing conditions should be denied coverage:

More recently at a New Hampshire event, discussing the "sick-person premium" concept:

I saw these above clips after seeing an impassioned post Friday evening by a friend and fellow D-Advocate, Kelly K, over at Diabetesaliciousness. It's worth a read, if you haven't had a chance.

For me, I think that some of what he's said has been taken out of context. I get the business, economic arguments about what insurance is and isn't supposed to be and some of his logic seems sound to me. In a free market system, that's how a product-buying system should work - and while there are many aspects that influence the health care insurance discussion in that context, it's a simplistic and not-outrageous way to look at it. In the context of pre-existing conditions and people "causing" their own health issues, that DOES happen a lot. Sometimes, people get chronic conditions as a result of their lifestyle choices. It's the way our culture and global society operates. Obviously, not for everyone. Not to most in this Diabetes Community of ours, since many of us didn't do anything to "cause" the conditions we're living with. He's painting with a broad brush, but it does have some legitimate foundation.

But with that said, let me be clear on what I think overall about Mr. Santorum:

Rick, you just don't get it.

You think that because your child has a genetic disorder that's dubbed a "pre-existing condition," and you have the resources to go out and actually buy insurance for a little more than everyone else, that you're suddenly at the American people's level in understanding what we deal with?

I'm sorry, you don't. As a former senator who voluntarily left his job and is anything but cash-strapped, you're just not able to. Here, let me look to this recent Associated Press story that pretty much justifies the claim that you're out-of-touch with middle American on this "just pay a higher insurance cost" message:

Losing his Senate seat might have been the best thing that ever happened to Rick Santorum's bank account. In 2006, the Republican presidential hopeful earned about $200,000 from his Senate salary and book royalties. From January 2010 to August 2011, he earned at least $1.3 million as he cashed in on his 16 years in Congress by working as a corporate consultant, political pundit and board member.

Rick, I invite you to sit with me and any of the other 2.5 million others out there in the U.S. who are living with Type 1 as adults, or the million or so Parents of Child With Diabetes. Most of us are the ones who don't have the luxury to say, "Gee, I was diagnosed with a chronic condition through no fault of my own but it's OK to just pay a little more for my care." Or: "Really, insurance companies, if you want to just deny coverage because you think it might be bad for your business to insure me, go ahead - that's cool."

There isn't much choice to NOT have insurance, you see, because we already spend so much of our wages on D-care and supplies (thanks to crappy insurance coverage) that we can't afford to pay any sort of "sick person's premium" just to have the same or worse crappy coverage. We simply need it, and if we can't afford it, our lives are drastically different.

I didn't ask for a lifetime of this, of medications and a never-ending cycle of management, but that's my reality whether I can afford it or not. You and your well-to-do political buddies (many of whom have GOLDEN LIFETIME INSURANCE COVERAGE) telling me that I can negotiate a price with Blue Cross or UHC for something I have no control over is absolutely absurd. That's assuming I can even get past the entry-level customer service reps who typically don't grasp the basics of what I'm talking about anyhow.

We're not buying a car or maintaining a windshield here. We're talking about living and dying, being able to be in a condition to live our lives and work and play. Let's keep the debate on track, Rick. After all, I'm not going to make my case for sunscreen by praising how bright the moon gets at 2 in the morning... Apples and oranges, Rick. I'd hope you can grasp that.

Driving a car is not the same as living a life with a defect in a major organ. Rick, you have no clue what it's like to live in this world TOTALLY dependent on the medical system to survive. And so, with every ounce of passion in my heart, I write:

Screw you and your rhetoric, Rick.

It's time to stop blaming "sick" people for the sins of corporate greed.

Life, Liberty, and the pursuit of Happiness - those words are supposed to mean something. They're unalienable rights and aren't supposed to be contingent on a person's pocketbook having enough green to allow for it.

2012 is my chance to secure those rights and what I see going toward ensuring them, for myself and others. This country's elected leaders derive executive and legislative powers from the consent of the governed (Read: ME AND MY FRIENDS), and if you become destructive to the ends of taking away our unalienable rights, then it's our constitutional right to abolish your governing.

Consider it done, Rick. Bring on the election, assuming you even get that far. Tell your friends. It's on.

Oh, hey Hannity... before I forget: You're an idiot, too. Just wanted to tell you that.

Now, I'm going back to my own Indiana lawmakers who are boycotting the Statehouse over the right-to-work legislation... again. Seriously, people. Can't we stop this political nonsense?!?!?

Wednesday, January 4, 2012

Moving Forward

I haven't been to see my Endo since March.

By my hand-counting, that's close to 10 months.

There's been a couple visits scheduled, one in the summer and one a few months ago. But, knowing that I've been slacking on the D-Management front and dreading the expected A1c that I know is higher than it should be, I have been putting the visit off.

The last time my A1c was done, it came out at 7.9% - up slightly from the one just before Christmas 2010 when it was 7.5%. I'm sure it's higher now, probably somewhere closer to 9%.

(My 30-day meter average is 220, which comes out to 9.3 and my past couple weeks are about the same - as are the past few months or so.)

For inquiring minds, it's not a matter of not knowing what to do. No. I am testing about six times a day, have a pump and now a Dexcom 7+. And while I'm certainly no expert and probably know little in the grand scheme about diabetes management, I've been doing this for 27 years... so I know what's at fault and what isn't: Simply, it's a matter of willpower - or lack thereof.

I've been struggling a lot in the past year on several personal fronts, and that's all led to some depression that has clouded pretty much everything in my life. Sometimes, I just don't care. More to the point: I feel that way a lot lately. Even when I'm testing often, the numbers are commonly in the 200s and 300s and that's what I have grown accustomed to.

There's a matter of underlying hopelessness, that nothing I do really matters. That it doesn't make a difference and it's really not worth it. Even the brightest moments and sparkles of happiness aren't enough to counter the corrosive, pervasive, and overwhelming feelings of depression.

I've kept a lot of this bottled up and have guarded this, but despite that effort it's been spilling out into most areas of my life. Recently, I've started taking some steps to deal with that and that's a work in progress.

After reading some recent posts my friends in the Diabetes Online Community - (Kerri's post here, Jess wrote one, and Melissa wrote one - I've made an appointment. This was in December and the soonest available was January, so that's planned for a few weeks from now. Actually, to be honest: I didn't take the initiative to schedule it. After I reached out to my Endo and CDE about getting a referral for someone in the counseling world, my Endo's office phoned to let me know the referral was in the mail and that my Endo wanted to get me in for a visit ASAP. So, really, it was her, not me.

But the visit is finally going to happen, regardless. That's the point. I'm hoping that I haven't hit the double-digits, but no matter the result it's a matter of asking "What Now?" rather than focusing on the judgmental and critical aspect of the number.

To be clear, if my A1c is high, it's not going to be a surprise. And it's not a matter of not knowing how to improve my D-Management. It's not like we're talking about changing some bolus or basal rates here in order to fix what's going on, although that may be necessary. It's a matter of dealing with the emotional and mental mind games that are causing my slacking.

So, I'm ready to do what's necessary. I've been avoiding it for too long. Now it's time to move on, deal with my demons, and get back in motion on my D-Management. Really, my life.

When your life is clouded by the darkest clouds, and you have the ability to manipulate the weather, how can you possibly not try to move those clouds out of the way for some needed sunshine?

No more avoidance.

The time to move forward is now.

Sunday, January 1, 2012

Liquid of Langerhans

Fellow diabetes blogger Kelly K reminded me the other day that, with the year's end approaching, it was time to refill my prescriptions. That brought a check of the fridge butter compartment and a realization that I was, in fact, on my last bottle of insulin.

Wait a sec...is that BUTTER in that butter compartment?! WTF?
I phoned in a refill late in the night a day before Christmas, so we vowed to avoid the next day's shopping craziness and pick it up after the holiday. Another day passed and Suzi grabbed it on the way home from work. All was good and I had another three bottles (one month's supply) safe and snug in the butter compartment. That was that and all was well with the world.

But after reading a recent post over at Six Until Me, my mind started working about that insulin lounging in the butter compartment. I got curious about the real cost of the life-sustaining medicine being pumped into my body on a daily basis. The real cost. Not the after-insurance "feel good" amount that takes away the reality of what it truly costs to have this life-sustaining, Liquid Langerhans.

My mission became clear. I had to know.

Unable to find the receipt showing said cost of just purchased insulin, we made a return trip to the local retail pharmacy to retrieve that financial 411. There was someone at the counter ahead of us, so I perused the nearby D-supply shelves and toyed with the idea of buying a home A1c test or snagging an extra jar of glucose tabs. Suzi snapped me back to reality once it was clear the Nice Pharmacist Guy was patiently eying us and waiting for us to approach the counter.

Me: "We were just in the other day refilling a prescription... well, actually, she was for one of my prescriptions... and we needed to get a copy of the bill showing the cost breakdown. Is that possible?"

NPG: "The co-pay amount?

Me: "Actually, the full retail cost before insurance. Does it have that?"

NPG: "Of course. Just a receipt? I can do that."

We laid out my identification and told him it was for the Humalog, and he quickly hit a button on the keyboard and made the printer came to life. NPG grabbed it and brought it over, asking if that's what I was looking for with the co-pay amount of $40 listed on it. I glanced at the top of the sheet, to the left of that amount, and saw in fine print a different line that said, "Retail Value: $419.99."

An internal "YIKES" tried to escape, but I suppressed the sticker-shock.

Me: "That does it. Thank you, very much."

He went about his pharmacist duties, and we left to walk around the rest of the store for a bit as my mind tried to process the D-Math of a different kind.

Looking at that number again, it simply astounds me - $420 a month, or $1,260 for a three-month supply of insulin. Geez, there must have truly been gold in that liquid of langerhans!

Of course, it's tough to not recognize and be VERY thankful that we have health insurance that wipes out a majority of that total. Luckily, I'm paying less than 10% of the total cost. For all it's woes and failings, insurance is an incredible blessing. I just hope that those without the option currently are someday soon able to get at least a taste of the coverage... (keep the health care reform, cough cough).

Anyhow, knowing the total cost of my insulin addiction, it was now time to check for money savings that might be available elsewhere. Doing some online research with our insurance company, I learned that getting a three-month supply of insulin through the mail order ExpressScripts (Medco, who?!?!) would save us about $20 a month ($80 per year).

Backstory: Through a previous insurance plan with a longtime employer, we had the luxury of a 90-day supply from the same retail pharmacy for about the same as it would have cost from out-of-state medical supply company, so that's the option we chose. Insurance changes in early 2010 switched up insurers (and decreased coverage) and capped the retail pharmacy supply at 30 days. I didn't have the energy at the time to switch to mail-order, and so I just stayed with the local shop. Fast forward to now. After Kerri's post, I wanted to know what it really cost to get insulin and whether there might be some money-saving options available elsewhere.

It looks like mail order might be on the horizon! There's something reassuring about having a butter compartment full of insulin, rather than being on that last bottle and bringing all the uncertainty of possibly running out or dropping and shattering it at the worst possible moment when BGs are sky high. So, once this monthly supply runs thin, it looks like we'll go after the mail-order method.

In a world where this Liquid of Langerhans appears to be laced with gold, any little savings helps out.