Blue and organization!

Slacking on my Diabetes Month Photo-a-Day posts!

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I may not always wear blue on Fridays (I really try though!) but I always make sure I sport my “Cure Type 1 Diabetes” bracelet! Thanks JDRF!

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My pump supplies cubbie. Don’t worry, I just placed an order today!

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My test strips/extra Rxs/Random D stuff drawer. Anyone want to have a BG testing party?

Sadly, I don’t have a fun spot for my Dexcom supplies.  They just stay in their box in the bottom of my closet.  I feel I need a cute (blue) basket for them!

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Wordless-ish Wednesday – 8/7 My Bug-Out Bag!

Inspired by my husband’s guest post about prepping with diabetes, I have made a Bug-Out Bag.  OK, fine.  I traveled last weekend and left all my supplies packed to be my B.O.B. This bag is something that has enough supplies to get me through a few days with Type 1, should there be a fire or other emergency which makes us have to escape our home quickly.  In it I have:

  • 100 test strips
  • Glucose Tabs
  • 4 infusion sets/reservoirs for pump site changes
  • Alcohol swabs
  • 2 CGM sensors
  • Syringes
  • Old box of insulin with Rx info

So should there ever be an emergency, all I really need to grab is insulin.  I used packaging that sheets came in and I really like that it’s clear so I can see what is in there, has a zipper so stuff won’t fall out, and is plastic so at least water-resistant.  And it has a handle.  Woohoo!  It would be great to also throw in a Rx for Lantus, extra battery, and glucagon.  But, this is a start and with the addition of insulin, would be enough to get me through a week or so until we received help from outside sources like the Red Cross.

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Doomsday Preppers – Type 1 Diabetes Style

The other day my husband was poking around on the interwebs and came across a forum where someone was discussing “Prepping” with Type 1.  This prompted him to ask me if I had ever thought about it, which lead me to say I’d be screwed and he has permission to eat me should he ever need to.  We used to live in a hurricane prone area, so one would think that I’d be prepared but the great thing about hurricanes is…you usually know they are coming.  Of course, since the husband kinda digs me, he decided to come up with a plan should the crap hit the fan due to a fire, blizzard, alien invasion.  So, without further ado, here it is…

A Guest Post by Laura’s Husband

The funny title and all joking aside, I wanted to try to make an informative guest post about “prepping” – an often sensationalized topic in this day and age.  I wouldn’t say that Laura and I are “preppers” in the sense of the pop culture stigma.  However, I was a Boy Scout when I was a kid and as the motto goes – I like to “Be Prepared”.

In case you’ve seen it, please know that I don’t like the TV show “Doomsday Preppers”.  I think they highlight more of the eccentric personalities of prepping more than providing any useful real world education.  I am however a big fan of TV shows like “Lost, “Revolution” and movies like “Castaway”.   So I ask – What have you done to help prepare yourself or your loved ones for any real life emergencies related to the treatment of diabetes?  How about a situation like one that may come up on TV or in the movies?  Those are obviously the extreme and if you think about everything up to that extreme – you’ll be prepared for anything in between.

Preppers often organize their preparedness into a number of different “bags”.  I thought it would be good to create a quick primer on these different types of bags and some of the situations where you might like to have them with you.

Day Bag
This is most often your purse, a small backpack, or a laptop case – something that you have with you at all times.  Men – this is not a “man purse”, it’s a satchel.  Indiana Jones wears one.

Most T1 diabetics are already great at keeping their “Day Bag” stocked out of necessity.  Obviously you’d keep your daily insulin, meter & test strips, syringes, alcohol swabs, pens, tips, and glucose tablets here.  Laura likes to keep some small snack foods in her purse, such as a granola bar or a rice crispy treat.  Maybe some small candies like Smarties.  Not ideal ways to treat lows, but there if you need them.

Get Home Bag

I like to think of this bag as the bag that gets you through the 12 hours you get trapped in your car on the interstate during an ice storm.  This isn’t something that happens often where we live, but when it does happen every few years it is crippling.  This is a bag that is kept in the trunk of your car.

Related to the D, this bag might have a reservoir, an infusion set, more syringes, lancets, more pens and tips, some extra pump batteries, maybe a spare meter and test strips.  If you’re not carrying your Glucagon in your Day Bag, one would be here and you would tell everyone that its there.  This would also be a good place to have more snacks and maybe a few bottles of Coca-Cola and obviously bottled water.  This is an area where some extra care is needed, especially in the dog days of summer where a soda might explode due to the intense heat.  I don’t care what Mythbusters said, it is totally possible.

Since folks may not be used to having a bag like this in their car, this bag might also have some things like comfortable shoes, extra layers of clothes, gloves, hat, sunscreen, headlamp / flashlight, knife / multitool, dust mask / handkerchiefs, matches / lighter, extra money (around $100 recommended), etc, etc, etc.  Laura currently works about 9 miles from our house.  This bag should have the supplies needed to literally walk those 9 miles home if needed.

Bug Out Bag
The one that gets made fun of the most… but be honest – if your house caught fire, do you have a bag ready to go at a moments notice that will help you survive the next 48 to 72 hours related to T1D?

One of the best things you can have in this bag is a copy of all your prescriptions and a thumb USB drive with your health insurance and medical information.  Next is some cash and a credit card to begin replacing anything you might need, refilling those prescriptions, etc.  In this bag are also more infusion sets, extra sensors for your CGM, an extra charger for your CGM if you have one, more batteries, more Glucose tablets, more syringes and most importantly – Insulin.  Unfortunately insulin is the biggest challenge with prepping for someone with T1D.  It’s recommended to stay cold, has an expiration date, and once opened needs to be used in a month or so.  This bag should have a small cooler or something like an insulated lunch box for your insulin.

The exit plan from your house is completely dependent on the situation at hand, but if time allows there are 3 stops that are made and all can be done in less than a few seconds.

1) Grab the B.O.B. (obviously the bag, not the fun times B.O.B., but hey, I’m not one to judge your priorities)

2) Grab insulin from the fridge and ice packs from freezer.

3) Grab important papers from the safe such as passports / birth certificates.

In a fire, I might be able to make those 3 stops… maybe not.  Obviously, get yourself and loved ones out if the situation is dire.  But if I didn’t have that bag prepared, there would be many more than 3 stops and probably no chance at making them.

Long Term / Permanency
It’s obviously not likely that something like “Revolution” will ever really develop… but if it did, there would be some significant challenges related to T1D.  Test strips run out, there is no way to keep insulin cool, it also runs out, etc.  Unfortunately, we don’t have the means to buy a ~1 year supply of T1D treatment supplies to keep a stockpile… but it might make sense to try to stockpile expired insulin or those old test strips and meters from the brands you didn’t like or the insurance company stopped covering.  If you find an expired vial, don’t throw it away… clearly mark it and save it.  It may not be as potent as fresh stuff, but if you’re at the end of the rope and your life depended on it – wouldn’t it be better to try than nothing?

For many reasons, I used to think about getting Laura a diabetes alert dog.  Though now that she has a CGM, I don’t really think about it.  Again – it’s extreme from a prepping perspective, but without test strips an alert dog might be a way to help monitor blood sugar.  Unfortunately, you then run into the challenge of needing to prep for your dog!  This won’t be something we really explore as we don’t have the funds to properly train a service animal and with the price and availability of CGM it simply doesn’t make much sense financially.

We’ll save the discussion of burying a cache of insulin somewhere out in the woods for next time.  Just kidding about that last part, but as you can see – being prepared never ends.  You don’t need to be a Doomsday Prepper, but any step you can take to make sure you can take care of yourself in an emergency is a positive step to being prepared!

If anyone has suggestions on better T1D preps, please leave a comment below.  Insulin is by far the area where more thought and consideration is needed.

Until next time…

Laura’s Husband

So, as you can see, my husband is definitely the planner in the relationship.  I even ran out of insulin the other day, so should the crap hit the fan, I’d likely panic or forget something of major importance.  I think it’s a great idea to have a bag ready to go with a week’s worth of supplies that you can just grab and go.  This is something I’ll be organizing in the coming weeks.

Friday Fives: July 26, 2013

Five things that are annoying about traveling with diabetes:

1.  The amount of space diabetes stuff takes up in your bag – Pump supplies, snacks, batteries, extra test strips, CGM sensors, Insulin.  This is valuable clothes-packing real estate!

2.  The wonky blood sugar levels that always seem to happen with long car rides.

3.  Feeling guilty about not bringing copies of your Rxs like every good travelling diabetic should.

4.  Attempting to test your blood sugar in the car – why is it that we always hit a bump just as I’m about to prick my finger?

5.  Being out of your diabetes comfort zone.

Have a great weekend, everyone!

 

Not a week goes by….

… without fighting with my insurance company.

Warning: this post is rather venty and may contain some adult language.  Parental Guidance Suggested.

For the past few months I’ve been in one battle after another with my insurance and/or pharmacy benefits company.  Luckily, everything went smoothly with obtaining my insulin pump and CGM.  However, there have been a few headaches that I’ve had to deal with that are really starting to piss me off.  As if we PWDs don’t have enough to deal with, but insurance makes us jump through hoops (of fire, it seems) to get things done.

Test Strips – My blood sugar meter “talks” to my pump.  Yay, Animas!  It’s a One touch meter, not some fancy unique brand that no one has ever heard of.  Well, my strips cost $95/month.  I’ve reached my out-of-pocket max for this benefits year (a perk to making major cyborg-living purchases!) so since they are classified as Durable Medical Equipment, they should be covered 100% for the rest of my benefit year.  Of course they weren’t so I called and was told they aren’t the preferred brand so if I want them covered 100%, I need to switch meters.  Pisses me off.  My pump supplies (remember, my meter “talks” to my pump) are covered, no questions asked.  So, fine.  I’ll switch meters and only use my meter remote when I will need to bolus from it (wearing a dress).  Worth it to save $$ and not a huge deal since I bolus from my Ping 99.7% of the time anyway.  I call to order my new meter (Verio IQ) and they are back ordered/recalled/they don’t like me so they won’t send me one/something.  So, guess who is on her last pack of strips and has to order more at $95 for a month?  THIS GIRL.  I am tempted to call and argue that they should cover this month’s worth of strips since it’s not exactly my fault that I don’t have my new meter yet.  But, I really doubt I’ll win that fight and frankly, I’m tired and don’t even feel like putting forth the effort.
Insulin – Previously, I used Humalog.  Was always covered with no problems.  Well, my doc switched me to  Apidra.  However, when I first got back on pump therapy, my pharmacy didn’t have any Apidra in stock so I used a vial of Humalog that I had to get started.  Worked fabulously.  But, my Endo wanted me to try Apidra so once the vial of Humalog was empty, I switched to it.  I feel like I’m not reacting to it as well as I did with the Humalog, so I asked to be switched back to see if this is the case.  This is all within the last 6 months.  Endo says, no problem, writes me a script for a 90 day supply of Humalog.  I mail it in to my mail order pharmacy and now my pharmacy benefits people are saying it’s not covered.  Something about the “formulary changed”.  Oh, I can get it, I just have to pay out-of-pocket.  So now I have to use a sub-par (for me) insulin because some higher up in some office decided that they weren’t going to cover my insulin.   Granted, it’s not like my control with Apidra is all over the place (if it was I’d be sure to appeal!), but I wanted to see if I’d do better with Humalog, like I think I would.
Dealing with insurance shit makes me rage.  I don’t expect anything to be free, but I’d at least like reasonable options when it comes to my diabetes management.  $1200/year just to test my blood sugar is outrageous.  Telling me what insulin I can and cannot use??  What the French is up with that?!
I don’t often get diabetes burnout.  Sure I’ll have a day here or there where I’m temper-tantruming against the disease.  But, man.  Insurance company burnout?  I have that 24/7.  I just don’t understand why it has to be so hard to make dealing with diabetes or any other chronic illness just a little bit easier with maybe a few more choices so we can make the best decisions for ourselves to manage this disease that we live with every day.
Maybe some day, this will be me.
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Sensor conundrum.

Today marks the two week birthday of my current sensor.  *throws confetti*  This frugal diabetic is psyched that I am getting extra life out of this sensor.  I am wearing it on my right thigh, in a location I’ve never even used as a pump infusion site.  I must say, I really like this area of real estate and anticipate my next sensor to be on my left thigh.  Sometimes I forget about it when I’m pulling down my pants for the 9,000 daily trips to the ladies room, but the not painful snag of my pants on the sensor reminds me.  Other than that…absolutely no major issues with this site.  Sensor is accurate, it’s comfortable, I dig it.  Yay!

As much as I love this spot, I have a conundrum.  I feel that the tape is peeling a bit more on my thigh than sites on my belly (Likely due to additional rubbing of clothing, I’m guessing), and my patchwork job to reinforce the tape is not very attractive.  I started the sensor with my donut-hole OpSite Flexifix and have been patching up the corners with squares of IV 3000 as needed.  However, despite this, the sensor is still working and working well.  Fellow CGM-ers…what do you do?  Replace the sensor when the tape gets nasty or keep reinforcing until the sensor finally poops out?

My current plan is to keep the sensor alive as long as possible.  Since Diabetes ain’t cheap to treat, and each sensor costs about $20, I think I can put my vanity aside for a little while in order to save a few bucks.  I suppose starring in that Nair commercial will just have to wait.

You’re not the boss of me!

Argh.  I have a love/hate relationship with insurance.  Love it because w/out it, well, I’d be selling my kidney and firstborn to pay for my diabetes care.  However, that being said, even with insurance, diabetes is expensive, man.

One of the perks for buying my new pump and CGM early on in the year and all at once was that I have met my out-of-pocket max for the year.  Hello, 7 months of lower diabetes costs!  Woohoo!  I called my insurance company to see what exactly was now covered at 100% and was told “all diabetes supplies.”  I clarified with her, “So, pump supplies, CGM sensors, test strips, correct?”.  It was confirmed, yes, these things are covered.  Parrrrrrty!

Imagine my surprise when I went to the pharmacy today and I was asked to pay for my test strips.  Now, this isn’t a $20 co-pay, it’s close to $100 for a one month supply.  The young lady at the pharmacy assured me that they ran it through my insurance/prescription coverage so I paid and told her I’d take it up with them.

I called my insurance company first who connected me with the prescription folks and told me yes, my strips are covered at 100% if I use Accuchek.  I use OneTouch, and they are not covered at 100% under my plan and despite meeting my out-of-pocket expenses, I still have to pay the $100/month.  The way she made it sound was that Accuchek strips are covered 100% all the time, no matter if the out-of-pocket max has been met.

I told her this is ridiculous and she needs to give me the phone number of whomever I need to speak to regarding this.  I have left a voicemail and am looking forward to receiving a call back.  It just makes no sense to me that my pump supplies are covered yet the test strips for the meter that talks to my pump are not.  Does.not.compute.

It makes me pretty angry that some random person gets to decide what is covered and what is not and make decisions about MY medical care.

Wish me luck when dealing with the insurance company!