Thursday, May 19, 2016

The Healthcare Experience

Diabetes Blog Week; Most people who live with a chronic illness end up with a lot of experience when it comes to dealing with healthcare. How would you improve or change your healthcare experience? What would you like to see happening during medical visits with your healthcare team? How about when dealing with your health insurance companies? What's your Healthcare Wish List or Biggest Frustration? Today is the day to share it all!

I know I wish all my purchasing of a new insulin pump was this easy. I started a five day trial of the Tandem Tslim with insulin actually before I decided to buy the pump. I am going with the G4 model which has the CGM as part of the pump similar to my Animas Vibe. I know I love my Animas Ping but the Vibe had so many screens to go through to do simple things. I love the fact that the Tslim G4 and Tslim have such an easy way to enter the carbs you are eating , your blood sugar and if you need a correction all in one screen. I am terrible about inputting my numbers into the Vibe. I know I was so used to having the ping sinked up that the blood sugars were already there no entry needed. 

I have to say I fell in love with the touch screen and the colors on the display are nice. I love the fact that I noticed when I was on the Tslim my numbers were actually better than when I was on the Vibe keep in mind I only was able to test the pump for 5 days. I know I am looking forward to the ease of use with this new pump. I know I loved the Vibe at first but at times the pump was just too much. So I was really pleased the placed the order for the pump last Friday and I will receive it tomorrow. This is the by far the quickest delivery I have ever had. I also was pleased that my insurance made the process so easy. I have to say the Tandem representative was great she was able to let me test drive the pump with insulin and helped me in getting the process started. I know I could not be more excited about starting my new pump tomorrow.

I have also had my share of  challenges a well. I know when I got new insurance after my new job in December. I had a difficult time getting to see the Retina Specialist. Normally they want you to see the Optomologist first then get referred but who's kidding after several years of Diabetic Retinopathy we all know I need to see the Retina Specialist not an eye Dr. I did win and I was able to go straight to the Retina Specialist but it tooks seven or eight phone calls to get this done.

I know on my old insurance plan I had to fight to get enough test strips and I also had to fight to get Novolog Insulin as well. I know if I use Humalog I bleed through my infusion sets with in hours of insertion. I know I can't ever use Humalog again but I am always worried about them no longer covering the one insulin I can actually use. It seems no matter what insurance company you have there is always issues. I know my new plan does not like to give me enough test strips thankfully I still can get the One touch test strips I use with no issue but it has taken my Dr. sending in sever request to the pharmacy to finally get some what closer to what I normally get. I know thankfully my new insurance does some things quite well but other things not so much. I have decided to just consider it part of the experience and continue to work at keeping the supplies I need available but it seems each year I am fighting harder and harder to keep the devices I need.

Wednesday, May 18, 2016

Language and Diabetes

Diabetes Blog Week Post:  Language and Diabetes - Wednesday 5/18 Link List.
There is an old saying that states “Sticks and stones may break my bones, but words will never hurt me”. I'm willing to bet we've all disagreed with this at some point, and especially when it comes to diabetes. Many advocate for the importance of using non-stigmatizing, inclusive and non-judgmental language when speaking about or to people with diabetes. For some, they don't care, others care passionately. Where do you stand when it comes to “person with diabetes” versus “diabetic”, or “checking” blood sugar versus “testing”, or any of the tons of other examples? Let's explore the power of words, but please remember to keep things respectful.

I have never been overly sensitive about what you call testing or checking your blood sugar. I have never really cared much about how it pronounced either but I think that is mostly due to the fact that I have had Type 1 Diabetes for 36 years this month. I know I find that the longer I have it the less sensitive in many ways I am about it. The part that does get me in an uproar is when they give out incorrect information about Diabetes. I am extremely sensitive about how they word and how they write about complications. I know people who have complication who have tried and they did the best they could but there is no guarantees when it comes to Diabetes.

 I know I work just as hard as anyone else does but when I walk into a Dr.'s office they automatically at time will label you as uncompliant or assume you don't work at keeping you numbers in a decent range. I know we all have stories and experiences. I hate the word uncompliant more than any other word associated with Diabetes. It to me as the patient not want to try our hardest because our own physician does not even had the confidence in our ability to handle our condition.

I know the word uncompliant has shown up in my medical records even thought I tested frequently had an in range Alc , logged my numbers, counted carbs and used a Dexcom CGM. I know the word uncompliant should never be used to describe a patient. I know patients do read them and also other physicians and medical personnel do as well. So it really sets a patient up for failure by using such a word that has so much bad associated with the that word. I am sure the Dr. see that term and makes assumptions that might be very untrue an could affect you treatment as the patient.

I know we sadly only see Dr.'s for several minutes each visit so when a new physician sees you they may not offer options they offer to what they would consider a compliant patient or they might feel like they are wasting there time on you as the patient. I know my last Endocrinologist did list me as a compliant patient which was wonderful to see because I do work so hard. I do get mad when just because you have a complication you are automatically considered uncompliant. This set your relationship with the Dr. up for failure because they have not taken the time to find out your story or your background. I wish Dr. would never use the term when referring to any patient in the future. It does not help the Dr. or the patient.

Tuesday, May 17, 2016

The Other Half of Diabetes

Diabetes Blog Week Post: Click for the The Other Half of Diabetes - Tuesday 5/17 Link List.
We think a lot about the physical component of diabetes, but the mental component is just as significant. How does diabetes affect you or your loved one mentally or emotionally? How have you learned to deal with the mental aspect of the condition? Any tips, positive phrases, mantras, or ideas to share on getting out of a diabetes funk? (If you are a caregiver to a person with diabetes, write about yourself or your loved one or both!)

I know each Diabetic seems to have there only ways to deal with their Diabetes. I know I tend to go overboard with it all but John my boyfriend manages his differently he is very laid back about dealing with the stress of it all while I am a control freak when it comes to my Diabetes. I know at times during lows it can be difficult to see John attacking everything in the fridge that is not nailed down. I know he had just over treated the low by a large amount and that the roller coaster effect will be starting soon. I try not to judge because I have had my moments too but at times I have to remind myself what it is like to have that feeling of never ending hunger for food while low. Since I have Hypoglycemia Unawareness I tend to get not warning and not extreme need to eat or a fast beating heart. Instead I am able to treat my low with no fear of anything even if my blood sugar is really low. I know I have forgotten in someways what the feeling was like. I know I try my best to not say anything to John but instead try to get him to eat a little less food to reduce the roller coaster affect.

It can be so easy to get wrapped up in your numbers at any given time and forget that you are not the only Diabetic in the household. I know I handle my stress with my Diabetes by blogging and John just keeps busy with other things and that works for him. I know to make sure I am not over stepping my bounds I have found that leaving the decision up to him and if he is struggling still then offering help. I know I have learned so much from all the bloggers in the community and I love to share what I have learned but sometimes other Diabetics don't want to know this neat trick you know. I know with John most of the time if I let him ask me it gives us both the space to figure out things. No matter what way we deal with the hard days the important part is that we are giving it our best shot. I know he has his way and I have my way. I know my crazy wonky ways of dealing with things can drive him crazy but other times he loves the little things I do. Like he steals my Bard wipes to help keep the Dexcom sensors attached and loves the Opsite Flexfix that I use to keep them attached even longer.

I know we all have our tough moments so at times it is good to see how another deals with issues and learn some things. I know I tend to be so hard on myself and John is teaching me in his own way that I need to be more forgiving with myself because at the end of the day we are all still human and we make mistakes. I know I try my hardest to support him even when I disagree with how he is handling things but at the end of the day it just works for him. I know I have learned so much about what works for me but also an appreciation for other ideas that have the same results at the end. I know I have struggled at time with my Diabetes and especially with 

Monday, May 16, 2016

Message Monday

Today’s topic is Message Monday.  Lets kick off the week by talking about why we are here, in the diabetes blog space. What is the most important diabetes awareness message to you? Why is that message important for you, and what are you trying to accomplish by sharing it on your blog? (Thank you, Heather Gabel, for this topic suggestion.)

I guess my blogging journey began once I got Hypoglycemia Unawareness eight years ago. I know right after I had a bad low while driving I knew I was in over my head. I scared and I needed advice. I searched for studies and I looked for blogs about losing the feelings of low blood sugars. I did find one article about a year with a similar story to mine where she could no longer feel lows and so she found a trainer that trained Diabetic alert dogs. I know continued to search and look for any information on the subject and to find another person experiencing the scary moments of waking up to EMS several times. I know for me I noticed there was very few blogs about complications. 

I know I was so busy during that time writing a blog felt like an overwhelming thing to be doing until I started to figure out how to get my life back on track. I know I will never forget how alone I felt and how terrified I was to be going through it alone. My mother the only Diabetic I had know had passed away just before my diagnosis of unawareness. So I know I never wanted anyone else to feel the way I felt. I knew I needed to blog about my experiences to help others struggling with the same issue to know they are not alone. I know I have never been afraid to share the difficult parts. I know I wish people did not view others so harshly for having complications. I know I have experienced so much of that from Dr.'s , nurses and even other Diabetics. I know complications are scary but I have also found that they can be managed. I do spend a great deal of time making sure I manage things tightly. 

I know when Diabetic Retinopathy showed up I knew I would be fine but I needed to keep my diabetes well controlled as possible. I also recently found out that there is also complications from too tightly controlled Diabetes. I know I have not had high blood sugars often and I rarely ever go above 180. So I know I was shocked when I got Diabetic frozen shoulder. So I learned that even having dramatic drops to low blood sugars could also contribute to complications as well. So I know through the past several years that I have loved sharing the good, the bad and the ugly with you all.

 I will continue to share my journey because I think we all need someone who experiencing the same struggles as others. It makes the tough journey a little less stressful. I also have to say I have meet some of the most wonderful people who are bloggers. I know I have been so bad with blogging I am hoping this blog week will get me back to more frequent blogging again. I know complications are scary and I know I  never wanted to have complications but I also want people to know I still live my life to the fullest but just with modifications. Life is still wonderful but with quite a few extra obstacles but I know I can now say I am really getting better at solving difficult problems because I have faced so many weird situations. 

I know I have some new things to share about my Diabetic frozen shoulder over the next couple of months. I am hoping at the end of the day that I have at least helped one person be less afraid or at least made them laugh at my adventures with Duchess. I know some times laughing can be the best medicine or just relating to another experiencing a similar situation you can relate too. Thank you for taking the time to read my blog. 

Tuesday, April 19, 2016

Surprising Issues and No Real Answers

The past couple of weeks have been dealing with issues. I know Duchess had been having issues running into furniture and other items at home after we moved them. I know my local vet said she could see some slight retinal changes in her left eye. So I had scheduled an appointment at UC Davis Veterinary hospital in Davis California. Which thankfully is not too far from my home. So I anxious for several weeks and all I knew before my appointment is that I wanted more information. I know there is two conditions that a dog could suffer from that can cause permanent blindness. So as I waited several weeks for her appointment to arrive. I know since Duchess is my whole world it was extremely difficult. I know with my frozen shoulder I was also dealing with complete frustration over dealing with my daily exercises which I am truly struggling to keep up with.

I know the day I was driving to UC Davis my stomach was upset and I was extremely nervous. I know I was extremely worried but unsure what would happen. So I saw the student and then meet with the professor who started with basic tests. I know they said the noticed the same thing that my local veterinarian noticed. There was changes in her left eye. So they needed to run further test which would require me to leave her there for several hours. I know I was pretty upset to leave her there but I knew they needed to do further tests. I knew if the test was negative she would need to see the neurologist as well. So I went back to UC Davis to check back in and see the results. The student came out and told me that the test was negative so she was being transferred to the neurologist to make sure there was no tumor or other issue from the eyes to the brain. So I was on my own again and thankfully my blood sugars were cooperating through the time without here but since I am rarely ever without Duchess it really make me feel so incredibly vulnerable in many ways that I had since forgotten about. Having Duchess has really given me so much freedom from the constant worrying. That day was such a reminder of how blessed I am.

I waited in the waiting room to hear back from the Vet. So they finally call me back. As I was waiting they finally brought me back Duchess who was so overjoyed to see me again. I know I truly felt the same. After all the waiting all they could determine is she has really early signs of retinal degeneration which means changes in her retina but since I found it so early they could not determine the cause. They did discover that Duchess also has neurological changes in her left eye as well. She does not blink or have normal reaction in that eye. So she is seeing pretty well from what they are saying but I know most of the time the incidents happened when it was dark. They also said her left hind leg which she had injured over two years ago had neurological changes as well. Which that I was not surprised by. So after talking with the vet they could not figure out the cause of the running into item completely and they were unable to explain why she was eating and drinking more water. She also had some other small things going on as well.

I know after they told me I was angry because after hours of being there all day all I had was more questions and not one answer. So now I am documenting any changes in her sight such as recording dates times and other issues in order to help figure out the issue. I know I am watching Duchess very carefully but it also is a reminder that how fast the time is going. In August we have been a team for 6 years. I know I feel lucky each and every day I get to have her as my service dog and my best friend. I know now I am looking at finding and planning on when and how I will get my next service dog. I know how the scent training works so looking at getting a dog who does not make it to being a guide dog is what I might look for in fact John meet a guy from the local Guide dog organization and told him they would love to find a dog that could be trained to alert me to low and high blood sugars. So I considering that and I know I can use what knowledge I do have to help. I also know so many that I know It won't be that difficult to get them trained with having Duchess around. I know I am hoping that day does not come soon but I must realize Duchess is really not young anymore. She considered a senior according to the vet. So preparing for changes to made in the next couple of years as she ages. I know one day she will have to retire but I am really hoping that is some time from now.

Monday, March 28, 2016

Twenty Four Hours- How Fast Your Life Can Change

I know with all the changes in my life things really seemed to be going so well. I know a couple weeks ago I was going to leave the house to go grocery shopping with Duchess. I getting ready to walk out the door. Then Duchess was heading to the left when I turned back to turn the lock on the handle before I left. Something startle Duchess and she pulled and I ran into the door with my shoulder. I dropped my purse and the leash. I had to go sit down because my shoulder hurt so badly. I know I sat on the couch for an hour before I got up to try and go to the store again. I know my shoulder hurt for a while and I iced it and hoped that would take care of the injury. I know over the next couple of weeks the pain in my shoulder seemed to increase. I know I was having trouble at night sleeping. In fact one night I rolled over and there was a big pop sound from my shoulder. I know I had issues being able to put my hand behind my back on the left side. I was thinking at first maybe I pulled something or irritated something. I decided then I needed to schedule an appointment but because of my job I try to schedule only in early morning or late afternoon to avoid missing much work. So I scheduled an appointment but it would be several days before I could get in due to trying follow the times my work prefers.

I also had noticed when I was having shoulder issues that Duchess seemed off. I know when I hurt my shoulder I thought it was odd because normally that would never happen. I know we were doing some changing at our Condo so we moved some furniture around. I noticed after we did this that Duchess started running into things. I know one morning I was in the bedroom getting ready for work and I heard a really awful yelp from Duchess. I run out of the bedroom and she had run into a table. I know I was concerned as it happened some more. I started to write down her symptoms such as she seemed to get antsy when it came time to feed her. In fact I know today I have to make sure she is in the room when I pour her food in the bowl so she knows its there. At times she dances around like she does not see her food. So I decided to schedule an vet appointment. So first came my appointment with a Physician who thought I should wait. If it did not improve I should then go to Physical therapy because my arm had limited movement.

So Duchess vet appointment came first then my Physical therapy visit. I took Duchess into her new vet's and was pleased with how incredible the veterinarian dealt with Duchess. She handled her so well and made us all at ease. I know we told her about the increased thirst, increased appetite, running into objects, passing around once feed and other symptoms. So she got out her light and looked at Duchess eyes. She noticed some things so she got another device out to look again. Sure enough there is currently retinal changes in her eyes. At this time I don't know what that means for Duchess until she see's the Ophthalmologist in a week and a half. I know I was relieved that we were addressing the issue but I was incredibly troubled by what the veterinarian was telling me. I know I had some dread coming up with the appointment. So I know I was beyond stressed because Duchess had been my DAD for almost six years. I know she is my best friend and I am nervous what this can me for her health. I know I am hoping for the best but I guess I will know soon.

So the next morning at 7:30 am bright and early I went to meet my Physical therapist for the first time. I knew the would evaluate me and my movement of my left shoulder. I know I already had a bad feeling that I had Diabetic frozen shoulder. I know John and I had discussed it several days before this appointment that I thought it could be that. I know the Physical therapist did her exam and I was really in a great deal of pain. At we were able to discuss my exam. She told me I had Diabetic frozen shoulder. I know then she told me the fastest way to get to what they call the thaw faze is usually an inter-articular join injection. I know she was referring me to an orthopedist to get the injection done. At this point I was like great a cortisone injection into my joint in my shoulder.
It really hit me hard as I was rushing back to my office I had Diabetic frozen shoulder. There goes my plans of doing my AFF sky diving training this year. I know I can't even put my arm behind my back on my left side, I was really hit with how much this is going to affect my life. I also was advised no heavy lifting which I should be able to lift around 50 lbs on occasion at my job. I know I was really upset and I know I was even more frustrated with the fact that the prescribed injection might not work.

Monday, March 21, 2016

Would They Cover It or Not

I know with the move to California meant getting new Physicians. I know I was so nervous my first visit with my family practice doctor at Kaiser Permanente. I know I ended up really liking the physician I ended up getting. She listens well and has helped me to navigate how Kaiser works. I know I am so used to having a health plan where I don't need referrals to see a doctor. I know the appointment that has made the most nervous so far was my visit with the Endocrinologist. I was so incredibly blessed to have had my old PA Amy who is my favorite physician I have ever worked with. I know I also had heard things about Kaiser not covering Dexcom sensors or CGMS in general except for certain patients who meet a special criteria. I know I have used the Dexcom for three years now and I don't know what I would do without it. Duchess does not alert at night so that leaves me incredibly vulnerable at night. So I was really scared that the new Endocrinologist would not give me the prescription for more Dexcom sensors.

When I went to my appointment I only had 3 Dexcom sensors left. I know John and I discussed that I would have to pay out of pocket worst case scenario for the sensors. I know that I needed the support during the appointment. I know when I meet him he was not a fan of how low my Alc is but I honestly don't work hard to get all my lows in general I tend to go regardless even when trying to run higher at times. I was surprised when the Endocrinologist asked for the list of supplies I needed he agreed immediately to put in a request of refills on my Dexcom sensors. I know the Endocrinologist made quite a few changes to my pump settings and wanted me to see the CDE. I know they wanted the CDE to assist me with looking at my numbers and Dexcom graphs monthly to help reduce the number of bad lows. I know after the recent seizures I was not surprised by this. I know I will only see the Endocrinologist twice a year through Kaiser. I also was really surprised that the Endocrinologist agreed to let me make the changes to my pump or discuss them before we make changes. I like to be treated like an adult and not a child when it comes to my health care.

Overall I was really pleasantly surprised by the Endocrinologist and was happy that he treated me with respect that I need in a physician. I know I feel like I was happy with my family practice Dr.'s referral and like that they listen to me as the patient. I know my Diabetes can be difficult to manage but I am happy that I do like my Dr. so far. I know my CDE was really great as well and she listens when I explain why I do things in a certain manner. She has very helpful and I hope that I will continue to work well with her. I know honestly getting my Dexcom supplies so quickly and not having to much except call was so nice. I know I was not sure if the different type of health plan would work for me but it really has been really good so far. I know I feel silly being incredibly stressed about being able to get the Dexcom Sensors. The best part is that John like my Endocrinologist now he is going to see him as well. 

Thursday, March 17, 2016

I Wish They All Could be Prevented

I am sorry for all the delays on the blog. I know starting a new job really requires a great deal of my time making sure I am learning as quickly as I can.  Sadly several things have happened since I last blogged. I had several seizures. The seizures one I think could of been prevented if only we had listened to Duchess. I know I had several lows that day and I was on a machine that massages my back so I was taking my turn on the machine when Duchess started to freak out. Once I was done I did test immediately and I did treat the low. So then John and I were headed to go get dinner and we were really close to the restaurant when I started to seize in the car. Thankfully we were right next to a parking lot where John had pulled in. Right before the seizure I had three different errors on my insulin pump. So I decided to take care of the pump not primed issue by changing the tubing. I was in the car trying to take of that issue when I started to seize. This seizure I felt everything as it was happening.  When I first treated the low I was 48. So I thought I was good until we got to the restaurant and all the pump errors distracted me from treating the low with more glucose tabs or other things.

I know now it is imperative when she does alert to check even if not convenient normally I do really well at doing so normally. It is always a good reminder to follow your normal routine especially when it comes to lows. So instead of going to a restaurant for dinner we decided that I needed something quickly to keep my blood sugar up after the glucagon injection. Thankfully I have been seizure free but some major issues have showed up within a 24 hour period of time which I will share tomorrow. I know all the change in my life it can be difficult to decide where to start.

I know my second seizure was two days later in the morning hours on a work day. I know  there was nothing I could have done differently dealing with my Dawn Phenomenon at times is the most difficult for me and always has been. I know I tend to take more basal overnight than I do in the day. I know most nights I get my blood sugars jump up around 2 am most mornings. It it seems it will continue to be a challenge. I know I am trying to keep my stress down and other things to help me deal with the seizures. So I am now at a point where I have been seizure free for a couple of weeks so far. I am trying to keep things simple at this point. Thankfully I have been able to keep my lows to a lower number which is helping.