Thursday, April 23, 2009

Have Pump, Will Travel

8 years, today.(pumpiversary, whoo hoo!)

And I'm traveling to another country this summer, for the first time ever.

England, for about a week.

And Denmark, for another week.

I'm marginally worried about having a serious hypo because I don't know a word of Danish but my hubby's relatives know quite a bit of English,and my hubby knows some Danish so that's really an unfounded fear. Besides, Danes are very intelligent, most speak several languages, of which English is certainly one of them. From a diabetes standpoint, I don't have much to worry about. It will be quite odd, being in another country where I can't understand anybody...unless they take pity on me and switch back to English. I'm trying to learn a few phrases, just because I really need to. My other concern, healthwise, is how I'm going to arrange to get a magnesium tank-up over there. Because going without, is not an option. Nor can I get a double dose prior to the trip, at the max I'm only good for 9 days between them and I start turning into a complete electrolyte mess and doing that in Denmark would be an unmitigated disaster bar none. They are both civilized countries but in the UK, someone is more likely to know what the heck is going on=better communication=solving in an orderly,efficient manner. We all speak English, after all. And making the timing of infusion such that it could be done on the "off" day,we're going through a tour group(while in the UK),and then on to Denmark.

If you think our system is a grand and glorious mess, try cross-country-ing it-I think there is no greater headache. I'm just a clueless American,not knowing as to how to go about this, so first step was to contact a London nephrologist who I'd heard about on a mailing list.
Emailed said London neph, he actually responded and said it was virtually impossible to have arranged via any sort of NHS facility unless it were an emergency.(aka person actively dying) Recommended a private facility.

Which begs the question...people who have to arrange for needed medical services, such as dialysis-how the heck do they pull it off, getting medical care in another country?

The answer came, in the form of another email reply...stating how X hospital would be happy to accommodate my need for haemodialysis (they took the "nephrology services" to mean I needed dialysis) and could I please fill out the 12 page medical report( prescription from physician, Certificate of MRSA/Virology Report medical clearance form,blahblahblah), sign, and MAIL it(faxes= a nono). That's what dialysis patients have to go through. I don't have the energy for that and I'm not on dialysis,I can see why they really wouldn't want to do much traveling(on top of feeling like crud)

Next step, was to the insurance company. That went surprisingly well,services out of country are covered just like in network(country) with the exception of having to shell out the entire cost up front and then be reimbursed. I really hope they don't charge like they charge in the States...a 4.5 hr session at the infusion center costs about $1,800. Of which, 80% is covered until you hit the deductible, then 100% is. Maybe I will have hit my deductible by then. Regardless, it will be expensive. It doesn't matter where you have it, you just have to find a doctor/facility willing to do it. Except the public (aka, what the masses go to because it is free or nearly so) hospitals don't want to do it unless you show up on death's doorstep, in their emergency room, having convulsions. Even if you could pay, apparently.

I still don't know as to whether any other type of physician(over there) came prescribe magnesium infusions, GP's (or endos) over here will not touch that issue with a ten foot pole and instantly refer you to a nephrologist or simply ignore the issue entirely. That is the situation I found myself in, in the middle of last year and I wish never to be in that boat again. You could have convulsions,funky arrhythmias,and collapse on the ground and they wouldn't care. It's a nephro thing and out of their scope of practice=not their problem. Maybe its not quite as stringent over in the UK, since they don't get sued by patients. So I asked him a few more questions regarding it, I hope he responds. While waiting on that,emailed most of the private London hospitals and most of them have responded with stony,dead-end silence(not knowing what to make of this American oddball). But money talks,and I don't see why it couldn't be arranged, why it even matters whether its NHS or private beats me. They get their money,(I get reimbursed) they're happy,all is well with the world. Unless the NHS is like some sort of Veterans Hospital,club members only,all others need not apply.

This is one time when handling diabetes will be the proverbial cakewalk...compared to the other medical issue. Regardless,I'm not going to let either one stand in my way of having a great time-I'm really looking forward to my time abroad!

Monday, April 20, 2009

The Square Root of Genius

Things have a tendency to level out, in the end.

Highs and lows, toward the perfect(or not so perfect) a1c.

The ingredients in a recipe, toward the sweet,salty,sour or bitter primary taste/sensation.

And it stands to perfect reason, that in a class of about 24 individuals, the only two type 1’s will end up at the same table, the same half of the same table, the same lab group of 4. They’ll have the same insulin pump, have gotten diabetes at the same age, but their the similarities come to grinding halt. Then the other two people in the lab group will drop the class so its only its only the type one’s. (I am a type 1 magnet,some people say they've gone their entire lives without meeting another one..I met my "first" about 4 days after diagnosis,in the ER room next to mine she heard that I was newly diagnosed and came in to offer her condolences/reassurances.Since then,I've probably known hundreds of D's,both type 1 and 2.)

Because there’s the smart(best grades in the class) one, with an a1c in the mid 6’s.

And there’s the doing-just-better-then-surviving one, with an a1c in the low 8’s.

Some people have an easier time with their diabetes, and are geniuses to boot. Somehow, I always tend to end up at the lab table where they stress endlessly over the 1 or 2 measly questions they got wrong on the exam(s). I am not that person; knowledge does not penetrate and soak into my gray matter very easily.(I cherish any and every good grade) So it works out ok, she supplies the right answers and I keep my mouth shut + try to learn something. And we average out perfectly, with the rest of the class. As it applies to diabetes,I am the veteran but this isn't a Diabetes 101 course.I know too much about too little.

Wednesday, April 15, 2009

Celebrating the Lowly Lipid

Give me steak, lots of steak, with the gooey stuff I love
If 200 is normal, I know mine is way above
Let me eat lots of milk,eggs, and hunks of cheese
I eat what I want, and what I want is grease
Load me up with bacon, pass the gravy please

Just turn me loose, keep the skillet good and greasy
Honey, where's my Lipitor..
And if I eat all the steak that I shouldn't,
What the heck are these pills for?
Let me eat what I want till I'm stuffed or through
Do the bypass, do what you have to do
I want my steak, and I want to eat it too

Oh, give me pepperoni pizza, french fries and two Big Macs
Let my arteries fill up, with many a roll of plaques
I won't eat nothin' lest its grilled or fried
My tastebuds rule, my hands are tied
My doctor had low cholesterol and then he died..

-Glick and Philips, Volume 1(2005)

And speaking of bloodwork, mine has come back. TSH in range. Microalbumin clear. Magnesium inching up, for the first time in 5 months.
LDL- 77
Triglycerides: 43
Personally, I thought it was a report worthy of a A++, but my doctor thought otherwise. Scribbled "ok for now" on the report. I'm not sure if he expects all his D's to have an HDL in the 90's and non-existent triglycerides,(or just wanted to rain all over my parade) how much better can it be? Granted, the a1c=needs lots of work, but the rest of it is looking pretty great in my book. And for the record,I love cholesterol...and ridiculously saturated hydrogenated everything but I try not to eat much of it,it doesn't love my weight(or improve the action of insulin!)

Monday, April 13, 2009

A New Twist on "Edelweiss"

And in case you haven't heard, a grand-kid on the way.America loves the Duggars!

Thursday, April 09, 2009

The Summer of Sixteen

Reading Kerri's post about LADA's, childhood onset, and all assorted in between made me think back to that summer of 1998(pre-diabetes). I have alot of prediagnosis memories,diet (anything)was a four letter word and something I never even considered following. I ate what I wanted,at regular meal times and in-between "snacks"wasn't something we did, if you were hungry you just tanked up at the meal.Rarely got sick,rarely went to a doctor, was pretty healthy. Chicken pox at 6(it was en vogue,we all had to go get infected and get it over with), Shingles at 14...and 2 years later my immune system kicked into high gear and the first insidious symptoms appeared. Thirst.Hunger. Moodyness. Ah, that moodyness, which my parents attributed to being a teenager, turned a sweet naive child into a raging hormonal, door-slamming maniac. I was ready for adulthood.(at least, in my mind) Adulthood=drivers lisence and piercings, so I took Drivers Ed and got the piercings.Ironically,the piercings were the only thing not to get infected(as I took good care of them). The summer progressed,along with the number of gray hairs on my parents head and my symptoms, which they could only see the outside forms of.I really don't think they understood how living with undiagnosed diabetes can make you act, nor would they still. It was an entire summer,fall,and beginning of winter before it would be diagnosed as diabetes.(May-December) That was the summer I started to grow up,people diagnosed younger must still have a partial responsibility but at that age you must take immeadiete ownership of it and not depend on your parents. My parents never gave me a shot, although they occasionally drew up doses/provided the carb counts at meals. It always felt like my disease, and not their responsibility. I am not saying that parents should not take care of their kids,but when the kid is almost an adult it needs to be the kid doing most/all of the management. So it is always prediabetes....and postdiabetes,a childhood that ended at 16. Before, when the functions of my body were not of mortal concern, and after, when everything had to be watched, monitored, and recorded. I was not the best teenager with diabetes(probably a fact of little surprise) but I survived,and now I think that when I got it,wasn't really such a bad time to get it. It is hard for parents to let go...and especially where diabetes is concerned. The best time to get it would probably be at age 86, when one has about 2 months remaining of life but rarely do things work out that way. Diabetes feels like a part of me but it doesn't feel like something that I've known forever because I haven't. I remember summer days with ice cream trucks and slurpees and winter sledding parties with hot cocoa/marshmallows galore/cookies/snacks with no carb counts/calories/dietary restrictions.I'm glad for those memories,not just for me but for my parents/those who know me because its harder on them sometimes then it is for the PWD. I still had to adjust to alot of things-food restriction was the biggest of them. For an adult with newly diagnosed diabetes,it must be very tough to change everything you've ever known.For a child, its really hard but it eventually becomes the norm.Thats why many older type 2's just don't get it...they are so used to their eating habits that changing them is unthinkable. As a teenager I fought food restriction tooth and nail but eventually came to terms with it(getting a pump really, REALLY helped). Now it is all so normal that if there were to be a cure for diabetes tomorrow,I think it would take decades of therapy to stop thinking like a PWD.(if there is a cure, the support group meetings will no doubt turn into that!)

Friday, April 03, 2009

Goodbye, ER

Parting is such sweet were the(at one time) best. At least the finale was a knock-your-socks off affair. I'll miss it, the newer shows just haven't withstood the test of time like this classic.
(And now, it belongs to the ages)

Thursday, April 02, 2009

Out of the Blue

There are places in this world that clearly, are a very bad idea to go low at.

In the middle of a lake....(one example)

It's been a week of firsts, I've gotten low at two brand-new places. First, at the movie theater. I have never gotten low there and I've been to quite a few movies in the 10.5 years I've had diabetes. (usually high, or barely not high)Bolused too aggressively for the popcorn. Fortuantly, I had juice and gel and was able avoid stumbling down the stairs in search of a sugary drink.It was an emotional low too, and as soon as the theater cleared I let it all out as I'd also lost my hat and it was all too much to handle.We were with some friends, so by the time my husband came back to see where I was, the glucose was back up to 73, the hat was found, and I was ready to be drug off the the Food Court to drown my sorrows in Diet Coke/Chinese food. Thankfully, nothing involving strangers and 911 calls.

The second, was at my dentists. Novocaine is another one of those drugs that pretty solidly seals the 200+ mg/dl post-session numbers but...


"Yes, Heidi?"

(theme music from Karate Kid I is playing softly in the background while the dentist debates his assistant on whether or not Michael J.Fox's wife is really going to leave him.I like my dentist's office + my dentist(just not being there)


"What?" he inquires, withdrawing a tortuous looking implement from my mouth.

"I think I'm low and I need to check my blood sugar."

"Go ahead." He patiently waits.


"Yes I'm low I gotta drink juice, sorry!!"

"It's ok, do what you have to do."

Down goes the juice, here comes another cavity! (but I guess dentists have seen it all)

It really goes to show you can't ever just mentally check out and assume you're safe from a low, those lows can come from anywhere and everywhere and you've always got to be on the lookout, check/treat promptly, so they don't turn into major affairs.