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By shannon, January 28, 2010 9:00 am

On October 27, 2007, I walked down the aisle in my beautiful wedding gown, with all of our closest family and friends present.  Brian and I exchanged wedding vows, danced our first dance, and cut our delicious wedding cake.  What almost no one knew was that we were already married.

When I decided to freelance, my insurance coverage went out the window.  My diabetes, considered a pre-existing condition, excluded me from private insurance.  I considered going without insurance for a while, but although I’d managed to stockpile about three months of pump supplies, I knew that when they ran out, I was on my own.  Brian proposed in January, and with our wedding plans well underway, we decided to legally marry beforehand so that I could get on his work-sponsored insurance plan.

So, we requested our marriage license, and on a sunny Friday in June, I became his legal wife.  There was no wedding gown or bouquet, no exchange of rings, and no champagne toast.  There were no witnesses other than the officiant who performed the ceremony.  It was just Brian and me, and it was perfect.

What I realized that day was that I really couldn’t have cared less about a wedding.  What mattered to me was that I was marrying the man of my dreams. It was an emotional and scary moment when we exchanged vows.  It meant forever.  It still does, and it always will.

The best part of our secret marriage was that our *wedding* day was so much more fun because we’d already done the scary part.  It was exciting having a secret that few people knew about (including some in our wedding party).  I don’t think I’d have changed a thing.

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By shannon, December 11, 2009 11:21 am

Yesterday felt like the longest day ever while I was at work.  I tired to get into the office super early so that I’d be able to leave early. Why?  Because my new Omnipod would be waiting for me when I got home.  But the bad drivers of Baltimore were conspiring against me.  I ended up getting to work 30 minutes later than I’d intended.

Once I arrived, I spent far too many minutes checking and rechecking the FedEx tracking page.  Finally, at 12:28, the package was delivered, and from that moment on, I was completely useless at work (not that I’d been all that productive anyway).  I just wanted to go home to my new present.

Does it make me a complete geek to be that excited about an insulin pump?  Do I care?  Nope.  Not even a little.  I wear the geek title with pride.  The other badge I wear, although not with any pride, is impatience.  I’m a type A personality (as if you hadn’t already figured that out for yourself).  I’m extremely high strung, and I want what I want when I want it.

Finally, at 3:30 pm, I hopped in my Tahoe and started home.  First, I had to stop at the pharmacy to pick up my new Freestyle Test Strips to use with the Omnipod PDM.  Since I’m well known at my local Walgreens, it was a quick in/out process.  Once again, I was back in the Tahoe heading home.

As I pulled into our driveway, I saw it.  Like a big, beautifully wrapped Christmas gift, there sat the plain brown cardboard box that held the next phase of my diabetes life.  I hurried out of the Tahoe, grabbed my 30 lb (well, probably not 30, but it’s damned heavy) bag that I have to carry because I must cart tons of diabetes supplies around, and bent over to pick up the box.

It was a lot heavier than I expected.  I remember all of my Minimed supply shipments being really light.  For some reason, the extra weight of the box pleased me.  Almost like the whole system had more . . . I don’t know? Substance?

Once upstairs, I ripped the box open, and the heavens sang.  It was beautiful (I should have taken a photo, but I suck).  My starter kit and five (5!) boxes of pods were carefully packed.  Also in the box:  a white silicone “skin” for the PDM, a Freestyle Flash meter (I guess to use as a backup), and a USB cable for uploading data to a PC (note my only disappointment – no Mac compatibility).

I immediately went to work setting up the PDM according to the instructions and the online tutorial I had watched earlier (while pretending to work).  I entered all of the typical date/time/etc. stuff, basal rates (I have seven!), my I:C ratio, and my correction factor.  After all the settings were done, the PDM asked it I wanted to activate a new Pod.  Why, yes.  I did!

I filled a new Pod with Novolog according to the instructions (the PDM walked me through each step of new Pod activation), removed the needle cap and adhesive backing, and stuck it on my arm.  I pinched the skin, pressed the magic Start button on the PDM, and felt a tiny prick as the needle inserted the cannula.

That’s all it took.  I looked through the little window on the pod, confirmed that the cannula was inserted properly and that there was no blood, and I was done.

I removed the Minimed infusion set, pulled the battery, and placed it in the small box that the Omnipod PDM came in.  I felt a moment of sadness – this pump has been with me through most of the recent big events in my life.  But, when I lost faith in Minimed, my pump had to go.

As I was completely wrapped up in my new device, cooking dinner was out of the question.  We decided to order a pizza, which meant . . . The Pizza Bolus.  It was the first test of my new Omnipod, and the extended bolus worked perfectly.  I was in love.

I tested my BG before bed, calibrated Dex, and crashed.  I slept great!  I woke up once to use the bathroom, and for the first time in years, I didn’t have to search for my pump before sliding out of bed (I often dropped it during that process).  I didn’t have to clip it to my pajama bottoms when I got up this morning, and I didn’t have to disconnect anything before taking my shower.  And my loofah didn’t get stuck on anything!  It was a beautiful moment, and I almost cried.

When I got to work this morning, I download the CoPilot and Extension software to my new Netbook (more on that later), connected my PDM, and uploaded my pump settings and data (so far).  It was painless, and I’m impressed with the software (I just wish I could use it for my DexCom, too).

So, after 18 hours, I’m a very happy Pod person!

Comments (4)

By shannon, November 18, 2009 1:27 pm

Which is better?

Next year, I’m going to get a new insulin pump.  I’ve used a Minimed 722 pump for three years, and while I like it, I don’t *love* it.  I admit to some pump envy.

At this point, I’m torn between the Omnipod and the Animas One Touch Ping.  I really like both of these guys for similar reasons.  

I LOVE the idea of remote bolusing.  Now, before you tell me about Minimed’s remote control for the 722, let me say that I have it and don’t like it.  I’m not a math person, so if I have to calculate a bolus, without the luxury of a “wizard,” I’m not happy.  So, score one for the Omnipod and one for the Ping. 

Next, I’m tired of tubing.  I’m constantly getting it wrapped around a doorknob or caught in my dog’s feet (he’s a bit of a lap dog).  I feel limited to certain pump sites because of the tubing issue.  Point for the Omnipod.

I’m somewhat intimidated by the size of the Pod.  I don’t want it to be visible under my clothes.  This is especially true because I’ve gotten used to using my arms and legs as pump sites.  My abdomen is so scarred that absorption is pathetic there.  I keep my DexCom sensors on my arms, and they’re already pretty visible, so what will adding a Pod to the mix do?  Point for the Ping.

So, I’m back to square one.  Which is the better pump and why?

Comments (4)

By shannon, November 4, 2009 8:30 am

I’m not a proponent of the current “Healthcare Reform” bill.  I don’t really see this proposed solution as healthcare reform.  To me, it seems like a very easy way for the government to tell me how to live my life.  I strongly agree that we need to reform healthcare in this country, but I oppose this bill.

Granted, I haven’t read all of the current bill.  I doubt anyone has because it’s almost 2000 pages, weighs 20 lbs., and is written is legalese.  It calls for the creation of 50 new agencies, mandates, commissions, etc.  How can any American claim to be educated on something that most lawmakers (who have a vote to cast) can’t even get through.  

As a diabetic, I’ve had to make some difficult choices when it comes to healthcare.  I’ve had to stay at bad jobs or accept sub par offers from companies simply because I couldn’t afford NOT to have health coverage.  I freelanced for a while and found that without my husband’s employer-provided health insurance, I’d have been completely and utterly screwed. 

In my opinion (as a diabetic and a fiscal conservative), the type of “reform” that we really need is this:

• Health insurance should be 100% portable.  It shouldn’t be tied to a specific employer, and it shouldn’t terminate if you lose your job.
• Pre-existing conditions clauses should be illegal.  We might not like to admit it, but insurance, by its very nature, is a pyramid scheme.  Some people will pay for coverage they never use, which benefits those with chronic conditions like diabetes.  When insurance companies only cover healthy people, they’re always at the top of the pyramid.
• All pharma-to-consumer advertising should be abolished.  If advertising wasn’t an option, pharma companies could charge significantly less for thier products, and still make plenty of cash for R&D.  Why do these companies *need* to spend billions of dollars advertising to *us* and not doctors, anyway?   
• There should be a cap on health insurance premiums.  It should be affordable to everyone regardless of a person’s income.  I don’t think it should be free, but I don’t think it should cost $1,000 per month to insure a family.  
• There should be a dollar-to-dollar tax deduction for out-of-pocket medical expenses.  Having to wait until your expenses exceed 7.5% of your income is just ridiculous.
• If you don’t want to pay for health insurance, you shouldn’t have to.  However, if you get hurt or sick, and need medical assistance, don’t expect the rest of us to pay for your care.  
• If you truly can’t afford health insurance, then the existing entitlement programs will have to sustain you.  The fact is that when you work hard, and make more money, you get better stuff.  Whether that stuff is a nice car, or home, or big TV, or better health insurance, the payoff for hard work is the greatest incentive there is.  
• Healthcare is NOT a right.  It’s a benefit.
• Taxing things like soda and juice drinks to (allegedly) help with the “obesity epidemic” is really just another way to take in more revenue and fund this proposed healthcare system.  If the real goal is reduce obesity, then instead of punishing (i.e., taxing) people for eating poorly, why not incentivize them to eat healthier.  Provide a tax break for purchasing fruits and vegetables, and people might be more inclined to ditch the cookies and cupcakes.  

Our government wastes millions of dollars everyday.  We bleed money.  Wasteful spending is a reality in all aspects of government, and it’s naïve to think that the proposed healthcare reform bill would be any different.  This is not change; it’s more of the same.

Comments (3)

By shannon, October 23, 2009 10:16 am

CGM Wars: Get Ready to Rumble.

For over a year, I used Minimed’s Continuous Glucose Monitoring System.  It was a logical choice since half of its technology was already built into my pump.  For over a year, I dealt with highs and lows much better than I’d ever done before.  My A1c dropped to 6.8 – the lowest it had ever been.  I didn’t go low as often, and when I did, I knew it was coming.  Sometimes.  See, I thought the wide variations between the CGM and my meter were normal.  I knew it wasn’t 100% accurate, so I accepted the false highs and, far more often, false lows as part of CGM life.  I dealt with the painful, bloody insertions as “a small price to pay” for better overall health.  But, as time went on, I began to trust it less and less.  It was just wrong a lot.  The constant calibration errors and “Meter BG Now” demands were seriously cramping my style.  

All that changed a little over a month ago when I switched to the DexCom CGM.  Right away, I was impressed.  Not only did this company fight for me to get insurance coverage, they rectified a rocky beginning by going far above and beyone.  These folks know customer service.

When I received the box, I tore into it like it was Christmas morning.  I impatiently waited for the receiver to charge, inserted my first sensor (totally painless and NO blood), and I was off.  This thing lasts for (at least) seven days, and the readings are consistently accurate.  My current sensor has been chugging away for 12 days (restarting a sensor after the initial seven days is super easy), and until I start getting funky readings, I’m sticking with it.  (Note:  DexCom does not condone this behavior.  They say to wear the sensors for seven days.  PERIOD.  What they don’t know won’t hurt ‘em.)  

Unlike the Minimed sensors, I don’t have to use any kind of surgical tape to keep my DexCom sensors stuck.  Their adhesive is very similar to what is used for my pump’s infusion sets, which is (thankfully) non-irritative to my sensitive skin.  I used a little Skin Tac to help it stick better, and I’m good for the entire seven days.  For wearing the sensor longer than seven days, I will use some waterproof bandage tape, but that’s it.  You don’t have to cover the entire sensor with tape so that it stays down.  

So, there it is.  My independent assessment of the Minimed vs. DexCom CGM.  For a year, I believed that all CGMs were the same, with the same pros and cons.  They’re just not.  I’m glad I took a chance and found the one that works best for me.

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By shannon, September 24, 2009 10:41 am

For almost 10 years, I’ve been told different things about my diabetes. I was diagnosed as a type 2, despite my young age, “normal” BMI, very high A1c, and no family history of type 2.

I was put on oral meds (metformin), which did nothing except make me incredibly sick. I vomited almost everyday while taking it, and my blood sugar remained high. This pattern continued for six months, with a few ER trips for DKA-type episodes in between. I changed doctors twice, but neither thought to test me for type 1. In fact, one even said that such testing would be stupid because if I was a type 1 and not taking insulin, I would be dead within a few days.

Like a good little patient, I believed them. I went to the required CDE classes, learning all about how my poor eating habits and lack of exercise caused my diabetes. I was the youngest and smallest person in the group.

After one year of taking metformin and losing 40 pounds (yes, 40!), I made an appointment with a new endo practice. I was immediately placed on insulin, which was an entirely new experience for a reformed needle-phobe. My doctor told me that I probably had type 1.5, but she did no testing to confirm. Since my treatment would be insulin, it didn’t really matter what type I had (or so I thought).

After many years of MDIs, I decided to make the transition to insulin pump therapy. My endo at that time was a proponent of Minimed, so I went with their Paradigm 722pump. Eventually, I decided to ditch my doctor (she treated me like a child – threatening to withhold pump supply prescriptions if I changed any pump settings myself), and I found a new endo.

I began seeing Dr. S. about a year and a half ago. Our relationship started off well. He was more interested in my opinions and feedback than any doctor I’d ever met. He encouraged me to adjust my basals and worked with me to get a Minimed CGM.

When the subject of my “type” came up, I told him that I had never received a definitive answer. He ordered a c-peptide test, which came back low. Despite this, he decided to classify me as a type 2. I know why he did this. In the years since I began taking insulin, my weight has crept up to its now “obese” BMI. There are some underlying reasons for the most recent weight gain, but they’re not really relevant to this issue.

Flash forward to last month. After using the Minimed CGM for 18 months, I decided that I’d had enough of painful insertions, bleeding, and sensor errors. I called DexCom, requested and completed the materials to get approval, and waited for my new system. I couldn’t have imagined what happened next.

When Dr. S. sent the Letter of Medical Necessity, he classified me as a type 2 diabetic. He did this in spite of the evidence to suggest otherwise (lack of insulin resistance, low c-peptide, etc.). He also told the DexCom folks that I expressed concern over the cost of supplies as a type 2. While we did have a hypothetical discussion about the need to know what type I am so that insurance would cover my supplies, it wasn’t with the understanding that I was a type 2. His statement insinuated that I was trying to pass myself off as a type 1 so that I could get “stuff.”

Naturally, as a type 2, insurance is reluctant to pay for high-ticket items like pumps and CGMs for me. I immediately sent an email to Dr. S. to find out why he’d told DexCom such a thing. His response was that he “really doesn’t think I’m a type 2.” He ordered antibody testing to be sure, but he felt confident that his diagnosis (type 2) was correct.

I received the following email from Dr. S. last week:

” . . . labs showed a positive GAD antibody. In addition, with a fasting glucose of 146, the c-peptide was low . . . This is consistent with Latent Autoimmune Diabetes of the Adult, a form of Type 1 DM. I was not sure before, but it is clear now that you are a Type 1 diabetic.”

To say I feel vindicated is such an understatement. I feel like I had to fight for this diagnosis for one reason: my weight. Doctors really need to step out of the box when diagnosing patients.

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By shannon, April 24, 2009 7:46 am

*Originally posted on 7/1/08*