REQUEST FOR CGMS: DENIED BY INSURANCE

I didn't ask to have to worry about whether I will go low when I go for a run or even a walk, go to sleep, or God forbid, while I drive. I keep my blood sugars higher than recommended sometimes because there are so many unknown variables and the lows are debilitating. In case you are wondering, it's not a simple case of counting carbs and taking the right insulin doses. There are hormones, activity levels, and stress to try to "quantify", which is of course impossible. That is where a CGM could really help. Since we cannot account for everything, the best we can do sometimes is react to it. A CGM will help us to react faster, and to avoid the short term disaster of a severe low behind the wheel, as well as some of the long term damage that our bodies are racking up due to BG's that are too high as we try to avoid those lows based on as many test strips as we can afford. It would also help me to not lose heart in my battle to remain as healthy as I can.

My doctor suggested I look into getting a CGM, but so far I have found that I cannot afford it. Aside from the initial outlay for the device, the ongoing costs are roughly $400 per month. Trust me, I have no desire to wired up like a cyborg with my insulin pump and yet another device. But it is difficult to know that I cannot afford to come one step closer to a normal life. I don't know whether to address this to the insurance companies, the CGM manufacturers or our government, but I sincerely hope that all of them will hear our plea.

I Just Might Make It

It seems like a long time ago that I signed up for the Diabetic Runner Challenge (see emblem on the lower right side of my BLOG). The challenge was to run 500 miles this year. I know the emblem says 1000 miles, but I picked the wrong emblem :(.

The last 6 months has not been a stellar time for me in terms of logging a lot of miles, but I did enjoy a few 5K's in the spring with progressive personal records, and have been doing a few shorter runs per week. Now it's mid-year, so figured I'd check my mileage total. Total miles logged on my Garmin....284. Woooohoooo, I just might make it!

Keep on Keepin' On

Is it just me, or have others of you searched the news from the ADA conference looking for something to get excited about and come up lacking anything of substance?

Don't get me wrong, I'm so grateful for the tools that I have to manage my diabetes and realize how far things have come. I'm also grateful for the researchers who take a long term view and are patient enough to conduct their studies. But taking a shorter term view, say of the last 5 years, I just don't see anything that changes the way I LIVE with this disease. None of the studies and none of the devices. There still is not a closed loop pump/monitor. Continuous glucose monitors are not finding favor with insurance companies. There is continuing debate about the costs/benefits of tight vs. supertight control of blood glucose. I'm still not sure if the variability of my BG or the average is more important in preventing long term complications, and I don't know if it's more important to avoid the lows (other than to make myself not feel horrible in the moment and avoid passing out). I exercise because I like the way it makes me feel, but still don't know if the surrounding BG excursions do more harm than good. I haven't even seen meter sizes shrinking to smaller than my current Flash, or a pump that makes it worth ditching my Cozmo.

I guess I'll just keep on keepin' on! I'll admit I haven't read everything that has come out of the conference, so maybe I'm missing something big. How about you, anything coming out of the conference going to change the way you LIVE? Maybe I'll ask my endoc the same thing tomorrow.

p.s. I almost forgot, I did like the study that suggested it might be a good thing that I have gained a little weight since diagnosis. Still don't find it to be particularly useful though.

Walking Barefoot on the Beach

Hubby and I just returned from a beach vacation in Destin, Florida. It was absolutely beautiful, and we had a wonderful time just relaxing, enjoying each other and doing "beachy" things. We were also celebrating our 20th anniversary. I cannot believe I've been married to the most wonderful guy in the world for 20 years!

The sand in Desitin is a beautiful white and almost looks like snow, and the water ranges from turquiose to emerald to blue depending on the depth and the weather. So splish spashing our way along the beach together was a favorite passtime. I felt like such a rebel because I walked (shhh...don't tell the diabetes police) BAREFOOT every day in the sugar white sand. Yes, I realize that I was literally risking life and limb to do this, but sometimes you just have to throw caution to the wind. Hubby even got a little cut on his foot, but I continued in my daredevil ways. Some people parasail, some surf, and some swim with sharks, but I rubbed my toes in the sand, dagnabit!

It is amazing though, how much I thought about it. How lame is it that it was this big daily conscious choice? I'm also a "food tourist", so ate all sorts of hard-to-bolus-for things. Again, I enjoyed every moment of it, but thought about it a lot, puzzling over the carb counts and fat delays.

What would we do with all that mental energy if we didn't have diabetes?

Diet Matters

The ole BG logging truck is definitely broken down and on the side of the road. That's the bad news. The good news is that I'm logging Weight Watchers points instead. Hubby is doing the online version, and I'm doing my own Excel worksheet version. I've been inspired by many of you in the OC who are losing weight with Weight Watchers. I lost 10 lbs with them a few years ago, and....ahem...need to re-lose at least those 10 again. After one week, hubby lost 5 lbs and I lost 3. I'm pretty sure that's the most weight I have ever lost in a week!

It is definitely making a difference in my BG's. I pulled the numbers out of my meter for the last week and here they are:

Average BG 108
Standard deviation 46%
41% in range, 39% low, 20% high

The number of lows is not acceptable, and I'm tweaking my ratios to try and get a handle on that. It's a little concerning since my BG upon waking in the morning has been in the 40's for 5 of the last 7 days. Not a good way to start the day!

On the job front, I'm starting a part-time, work from home accounting job tomorrow, and really looking forward to getting started. Pet sitting has picked up a bit as well, and I met with a really nice new client last night. Actually, all my clients are great. People who love their animals just tend to be my kinda people. Best of all, I found out last week that a new satellite church is opening soon in our area. The pastor and his wife were both used by God in my introduction to Christ, and my husband really respects them as well. We are both interested in helping with the new church.

Logging for Superbowl Week

Superbowl Sunday was pretty fun this year, even without the Cowboys. Our family came over to watch, and we had some bad-for-you football food. I made Sloppy Joe's w/ lean ground turkey and Rotel Dip w/ a little sausage thrown in. Can you guess which one we ate more of? We didn't even make the attempt at putting out a salad or veggies. And why is Rotel Dip so addictive anyway? Had a post meal high of 227, but brought that down to 117 by bed time. I did spend much of the day raking, mulching, and pulling weeds in the back yard, so maybe that counted for something.

As for logging, I'm sorry to report another not stellar week of keeping up with it. I did log my blood sugars, but mostly a day or two after the fact. At that point, it seems too difficult to remember what I ate or when I exercised, or to pull the bolus amounts out of my pump history. The only way I'm going to keep up with it is to do it at least daily. Here are the results. They highlight why my A1C comes back better than I think it should. I'm all over the place, but the average is decent. That "normal range" sure is slippery to hang onto! Guess that greasy Rotel Dip (and the chips) didn't help! Is anyone else willing to share their standard deviation with me? I know we're all different, but I just wonder how out of line mine is in comparison w/ other "living real life" Type 1's out there?

Avg BG -- 171 (wk1), 161 (wk2), 140 (wk3), 156 (wk4), 141 (wk5)
Normal Range -- 25%, 43%, 40%, 34%, 34%
High -- 64%, 49%, 40%, 56%, 48%
Low -- 11%, 8%, 20%, 10%, 18%
Average Daily Standard Deviation -- 64, 65, 62, 55, 62


I did get my resume updated, contacted my references and other contacts, and even got a little action on a couple of jobs I sent in for last week. Took a while to get myself psyched up, but I'm starting to get a better feeling about being able to balance some part time accounting work with pet sitting jobs, and still maintain some lifestyle flexibility. I have a phone interview this week w/ a local firm who wants someone part time with a home office set-up (check), one of my former employees may want me to do some work for his family's business, and I have lunch set up with my old boss who may need me to do a little contract work for the old job AND have a pet sitting job for me. May also help a friend with a team photo shoot and the related processing, which would be fun. All of this is rather preliminary, so not counting my chickens before they hatch, but it's at least encouraging. This free-flowing work life thing is still new to me, and part of me loves it. The other part still obsesses about making the right choices, how much to charge, how much work to take on, etc.

Wheels Off the Logging Truck

Confession time. My logging for last week stopped on Wednesday. It wasn't really a conscious choice, and at first, I wasn't sure why. But it just occurred to me that I had a couple of fairly stressful events around that time. They are not valid excuses, but do give me some insight into why I might have fallen off the logging wagon.

First, on Tuesday, I was out jogging with my dog Katy, a medium sized mutt. We had barely started running when a loose Boxer approached us. I thought things were going to be OK and they were going to be friends, but then another Boxer came tearing towards us and immediately jumped on Katy. He was twice her size and the fight was no match. A man out in the yard thankfully ran over and pulled him off of Katy fairly quickly. I checked her over quickly, and thought she had emerged unscathed. Then, the next day (Wednesday), I found a nasty looking gash on her neck/chest area.

It was somewhat obsured by her fur at the time, but I still can't believe I missed it. So off to the vet for antibiotics. It was already slightly infected so they didn't want to sew it up. Think she'll be OK, and the boxers' owner has agreed to pay the vet bills. But it was obviously upsetting, and also emotionally difficult to summon up the courage to confront the owners about the vet bills since I didn't discover the wound immediately.

Second stressful event was that hubby and I had agreed that I would look for some part-time accounting work since pet sitting is really slow this time of year. This is hard because it sort of feels like I'm giving up on pet sitting, even though I know that doesn't have to be true. At bible study on Wednesday, I mentioned that as I was chatting with my discussion leader after class. She then suggested I meet the Finance Director at the church as they had a need for someone on a part-time basis to analyze stats, giving trends, etc. We discussed the opportunity and I told her I'd consider it. It was totally out of the blue, and I had to do some serious praying and soul searching to see if that was something I should pursue. Although I have seen lots of confidential financial info in my career and learned not to let it impact my attitude, I have not done so for a church. I'm not a member of this church, just go to a ladies' bible study there. Although it did not shake my faith in Christ, my previous church had a serious financial scandal that rocked my confidence in churches being good stewards. Giving is an area of challenge for me right now, and I've always hated the constant touting of membership numbers etc. that is prevalent in many churches. So I opted not to pursue that job.

Meanwhile, back to the point of this post. It would seem that spiritual and emotional struggles impact my staying on track with logging. I had plenty of time to enter everything in my log, but apparently I am still really struggling deep down with not spending too much emotional energy in facing those numbers on a daily basis. I thought I was cool and analytical about it, but there is more to it than that.

At any rate, what I DID learn is that NOT logging also has an impact, and it's not so good. Even though I didn't log, I did go back and catch up on entering my BG's to see the overall trends. See the week 4 numbers below.

Avg BG -- 171 (wk1), 161 (wk2), 140 (wk3), 156 (wk4)
Normal Range -- 25%, 43%, 40%, 34%
High -- 64%, 49%, 40%, 56%
Low -- 11%, 8%, 20%, 10%
Average Daily Standard Deviation -- 64, 65, 62, 55