Tag: insurance


playing catch-up


That’s what you can consider this post.  Me trying to update you on all that’s been going on with me and the hubs in the health and medical happenings department.

I’ve indicated a few times that he and I both have been really busy getting all sorts of tests done and then, when something comes up on a test, having some procedure or other done.  Unbelievably, this year it’s been mostly him having procedures.  More about those in a sec…

So far this year, I’ve had a mammogram (joy. not.), an eye exam (got my new glasses & can see MUCH better now, YAY!) I’ve had several blood draws, which is usual for me, I had another sleep study done (after about 8 years?!) and have a new C-PAP machine now, I had my first stress test and echocardiogram done looking for the source of my constant fatigue, that led to seeing a cardiologist and having my first-ever heart catheterization done, which came out fine, I’m finishing up my allergy shots along with getting weekly B12 injections, and now I’m going to physical therapy to get my shoulders and neck back into shape after going for years with constant stress-related pain.

Ha, I told a friend the other day if I could just get some new teeth (I want to get implants as soon as I can) and some liposuction, I’d be almost good as new!

As for my poor hubby, Tommy’s had a bunch of tests run as well.  I finally talked him into seeing my doctor and he really likes her, just like I said he would.  She has been working to find the source of his stomach problems.  He’s had scopes done, both directions, which led to the gastroenterologist telling him again to get off the NSAIDs.  He thought he WAS off them, but come to find out, the meds his old doctor had put him on for the pain in his Achilles actually was another form of NSAID, so his stomach had gotten all messed up again.

He was so worried about having to stop them since every other time he’s gone off pain meds, he has been just wracked with pain and barely able to walk, let alone anything else.  So we began looking for natural anti-inflammatories.  I found a good source for tart cherry juice concentrate and started him on two cups of that a day along with drinking “golden milk” which is a turmeric drink.  Turmeric is a very powerful anti-inflammatory as well.

After having his allergy tests done, we found out he is highly allergic to a ton of foods, weird things that are so common it was pretty discouraging to think about how we’d avoid them.  Like apples, tomatoes, and vanilla!  Just sit there a minute and think about how many foods are made with those ingredients!!

He has done really good with changing his eating habits but soon, his stomach really started to bother him.  I’ve been telling him for the past several years if he didn’t lose some weight, he was going to regret it.  He’s the type who will do the opposite of what you tell him just for spite, so he’s not been trying at all to modify his eating.  So now, with several doctors telling him it is a MUST that he eat differently, he’s finally on board.

When our doc began testing to see what was up with his stomach, she mentioned gall bladder, which put us on the search for ways to avoid having to get it removed.  That’s when we did the gall bladder/liver flush.  Tommy ended up doing it twice but still had to get his taken out.  Turned out he didn’t have stones, but instead his gall bladder was just grossly infected.

They had a horrible time getting him sedated, or rather, intubated and we left the surgery center with a letter from the doctor and anesthesiologist to keep with us in case he ever had to be sedated again.  Seems he has a very small airway along with a strange alignment of his esophagus that makes it impossible to intubate him in the normal way.  He has to have a bronchi-scope instead, which is a whole different set of tools for the anesthetist.  During his gall bladder surgery, they had to stop everything while the other tools were located and brought to the operating room.  Apparently, it was very stressful and maybe even dangerous to have to do this.  I didn’t understand all that she was telling me, but she said to make sure the doctors got that letter before he has another surgery or sedated procedure.

After the surgery, Tommy seemed to start doing better.  His terribly bloated stomach went down which made us realize that he’d probably been sick with that for a couple of years!  We didn’t realize it was bloating instead of just weight gain!  However, he has continued to have pain in his upper/mid back area.  So our doc sent him for another CT scan to check his kidneys.

This would be his fourth scan-type test this year after an initial ultrasound, then a CT for the initial stomach pain, then a HIDA scan, now this CT and then, after finding cysts on his kidneys, they sent him for another ultrasound to see if the cysts were something serious.

Turns out they aren’t and now doc wants to send him to the chiropractor thinking his back pain is muscular instead of internal.

I wasn’t thrilled about that since I’ve been a ton of times to this chiropractor without getting any relief for my neck and shoulders.  I really love the gal that works on me at physical therapy.  She’s a former masseuse so she also does some massage on my neck and shoulders, which helps a lot.  She’s trying to help me build up the muscles that are weak from years of trying to accommodate my misalignment due to pain.  The reason the chiropractor hasn’t worked for me is because all those muscles are so tight, even when the chiro aligns me, my muscles will pull things back out.  Until my muscles are retrained, any alignment isn’t going to stick.

I’ve been to the PT three times now.  Yesterday was an unusual day, though.  I was late getting there, which made me nervous and stressed anyway.  She put me on this bike to do hand pedaling and then over to the pulleys to do some exercises when I began to feel extremely tired.  Tommy texted about that time to tell me my sugar was pretty low.  I had seen it about the same time and walked over to my purse to get something to treat the low blood sugar with…but all I could find was one solitary Tootsie Roll!!  My little zip bag I keep stuff for lows in was empty!!  ARGH!  I remembered then wiping that out when we were on vacation but never thinking to restock it once we got home.

By this time, I was beginning to sweat and feel shaky.  I texted Tommy, who had been planning to come by the therapy office to get his computer out of my car.  He had already come and got it though, so he was already gone when I asked if he could bring me a Mt. Dew or something.  By this time, the therapist had noticed something was up with me.  I told her what was going on and she spotted the number on my CGM app on my phone… it was 54 at the time and trending straight down.

She said, “Is that what your sugar is?!?”  “Um, yeah,” I told her.  Then she and the receptionist both started to wig out a little.  I felt so stupid having to tell her I had NOTHING to treat the low in my purse NOR did I have my glucometer with me.  I’d left it at home charging, thinking I shouldn’t even need it.  But now, I could have used it to be certain what was going on … to determine if the CGM was correct or not.  Obviously, it was, though because I began feeling really crappy.  The therapist ran to get me something she’d brought to work with her.  They were some kind of health-food choco-peanut butter things and I ate them, feeling like an idiot having to eat up her food!!  She told me it was fine and said: “they aren’t that good, but here…”  LOL!  I guess maybe I was doing her a favor by eating them??  Ha!

I knew they weren’t going to do the trick though since they weren’t very sweet and had a lot of protein in them.  Tommy called me about that time and told me he was coming to bring me something to eat.  Then I felt horrible that I was making him have to come all the way back because I’d forgotten to restock my purse.  I told the ladies (only the receptionist and therapist were there at that time) that my husband was bringing me something when the receptionist said she had a Mt. Dew and some honey in her car.  I told her not to bother, that he would be here soon.

The therapist said, “Go get your stuff.  I’m not going to sit here waiting on him while she passes out on me.”  Sigh.  So, I downed the soda when she came back and handed it to me, mumbling ‘thank yous’ and ‘I’m sorry’s’ between gulps.  They both assured me it wasn’t a problem, so I relaxed a little.

By the time Tommy got there, I was in the middle of getting the post-hypo freeze and slowly, my numbers started to come up from LOW to 42. He sat down on the table beside my chair and during the recovery, the subject of his medical stuff came up and he asked the therapist some questions about what would be best for him to do.

When I was finally up in the 90’s, they had decided between themselves that the therapist would text our doc to ask if she could see Tommy and try to help his back before the chiropractor.  I ended up not having any therapy yesterday, which stunk, but I think Tommy and I both felt better about him possibly getting to be in with the therapist instead of the chiro.

We will see what becomes of it all.

By this point in the game, we only lack a few hundred dollars meeting out out-of-pocket limit, so we are going to get all the therapy and tests done that we can and take full advantage of our insurance!  Lord knows we’ve sure spent a buttload of money on our health this year and it’s barely April!!

I sure do wish I could get my teeth done on the medical insurance, though!!  Siiigh.  Oh well…

Oh!  I forgot to tell you that in the middle of all this, we took a short vacation to Destin!!  It was actually “prescribed” when I was back in with our doc, talking about all the various appointments we had already had and those coming up soon, she said, “You guys need to take a vacation!”  I asked her to write a script for it.  Ha.  Anyway, we had bought this three-day package last year and it was going to expire soon, so we decided to just do it.

It was fun and nice to get away, but next time we go to Florida, it definitely needs to be longer than just three days.  Hopefully, that can happen before we get too old to travel by ourselves.  Heh.

Okay.. I think you’re all caught up now!!  Later!


frankly friday: more info = more control in T1D


hypo-unawareness is like walking blind toward a cliff-CGM lets me focus on the scenery instead

Happy Friday, folks!  I’m getting a late start, but that’s been my norm the past few weeks.  I won’t bore you with how flippin’ tired I have been and how much I’ve been sleeping, but trust me.  It’s A LOT and I’m getting really…*heh*… tired of it.  *psh!*

In other news… I just read this article about a study to see if more information (ie: blood sugar testing ..I assume via CGM) can improve the life and health of PWDs.  My first thought?

DUH!?!!!

As you probably recall from previous posts, we purchased out of pocket (we’re still paying for it, actually) a CGM transmitter for me early last year in the hopes that our then-insurance company would soon cover them so I could get sensors to use the CGM.

That was a dream.  It never happened, so when the four sensors that came with the transmitter were done, I had to put the thing in the cabinet and there it sits.  Pretty sick feeling to send a payment for something you paid over 5k for and only got to use a month.  Ugh!

So I’m looking forward to getting the CGM, in case you didn’t realize.  *ha ha*  I know they’re not perfect, but people, when you are walking around, helping move heavy furniture, thinking you’re fine as frog hair only to test because your honey thinks “You look kinda pale, hun.. why don’t you test?” and find that your sugar is 27??  That is NOT a good feeling!  It’s terrifying to know that you can’t tell when your sugar is dropping.  To clarify for you non-Ds, a low is more of an emergency situation most of the time.  You can drop so low, or so quickly…or BOTH that you COULD DIE from it!!

Did you catch that?  I could DIE because I am unable to tell when my sugar is falling.  My body no longer sends me signals to warn me that I need to eat something or suspend my pump and chug a can of Coke or scream for Tommy to come and help me until I begin to feel that being-pulled-out-of-myself feeling that I can only imagine means I’m about to pass out.  It FEELS like I’m about to die.  Seriously.  I detest that feeling.  It’s terrifying and I’m looking forward to not dealing with that, not having to worry when I’m by myself somewhere or when I’m driving.

Is more information important for people with type one diabetes?  You bet your bottom dollar it is!!  Why do we need a study to prove that?  I guess because insurance companies are still denying CGMs to people who have documented hypo-unawareness and doctors’ letters saying their patients need them.  Because people out there still don’t understand how T1D affects us or how serious it is.  (remember me telling you my friend thought because I had a pump, that “took care of everything” and I really didn’t have to “do” anything regarding diabetes??!!)

hypo-unawareness is like walking blind toward a cliff...CGM allows me to focus on the scenery instead

So yeah, information is crucial.  Knowing what our bodies are doing with the replacement hormone we inject ourselves with daily in order to live is kinda important.  Knowing whether our blood sugar is too high or too low or just right is vital to our safety,  not to mention the safety of our children or YOU, in the case of driving or operating machinery.  Think about it.  If YOU didn’t know your body was doing something…for instance, if your body didn’t recognize that it was blind or deaf, do you think that might cause a problem?

That’s silly, you say?  The only reason it’s silly is because you can visibly see (or not, as the case may be!) when a blind person needs help or a deaf person needs assistance.  It’s not at all visible with diabetes.  All our dysfunction is on the inside, but it affects the very system that controls our entire metabolism!

*sigh*  I’m thankful for the technology of CGMs.  I’m looking forward to having it and feeling more confident and safe when I’m by myself or with people who may not understand diabetes enough to help me if I needed it.

I’m curious what this study will determine.  I can’t eve imagine it concluding anything other than more info equals more power to control our disease.  At least more ability to keep ahead of it!

What do you think?  If you’re not a PWD, have you or are you learning anything more about T1D from these posts??  Please let me know.  Interaction is like air for me!!  Like the posts or comment!!  I am dying to know what you guys think.

Have a beautiful weekend & a blessed Lord’s Day!

G~


#13: things that make a t1d scream!


Advisory:  this post is likely to contain ranting and growling.  You have been warned.

So I am on my last bottle of test strips.  Like, halfway through it, matter of fact.  I get my pump and testing supplies from a mail order company.  Most brick-and-mortar pharmacies don’t carry such things, at least I’ve never experienced that in our area.  I have ordered from this one company as long as I’ve had my pump, so over 12 years now.  I’ve had various insurance companies in that time and never had a problem.

Until now.  The supply company will usually call about a week before delivery is scheduled to make sure of what I need them to send.  I got that call about three weeks ago.  All I needed on this shipment was test strips.  Fine, they say.  Two weeks later and no strips.  I call to see what’s up.  I’m on hold off and on for quite awhile.  The lady seems confused and finally tells me someone from shipping will call me.

The next day, I get the call and am informed that the company (CCS Medical, for clarity) is not contracted with my “new” insurance (new since January!) and I’ll have to get supplies elsewhere.  When I asked for some suggestions, I was told, “Call your insurance company.”

So I did.  That lady seemed a little confused too or at least she had problems finding any suppliers for me to contact.  Finally, she gives me a company, Liberty Medical (of all places!) so I hang up with her and call the number she gave me for Liberty.  I’m on hold forEVER listening to the endless “We will be with you shortly” messages until suddenly the message changes to “If you’ll leave your name, number and info, we will call you back.”  Okay, so I did that.  Two days later, NO call back.

I’m pretty ticked by now, as you might imagine.  I go online and send Liberty an email.  The addy is something like libertycares[at]liberty-blah-blah-blah… yeah.  I’m not buying that!  I have STILL not received ANY response whatsoever!!

I am fuming now, so I call the lady at my endo’s office who sets patients up with new pumps, CGMs and checks insurance coverage for such things.  She was supposed to be seeing about getting me a Dexcom CGM since this new insurance is supposed to cover them.  (more about that in a moment)  I dial in her extension directly and get her machine.  I leave her a message with the info, letting her know that I’m going to be completely out of strips soon.  That was around 10 am, so I really expected to get a call back, but nope.

Next day, I wait til after lunch and call the office again.  This time I dial the DNE (Diabetes Nurse Educator) who happens to be my endo’s wife as well.  Her message informs me that she’ll be out of the office til Tuesday, but I leave a message for her anyway in case she’s checking them while she’s gone.  Seriously, this office has always been great about returning calls so I am really puzzled by the lack of communication from them.

I then hang up and call right back to leave basically the same message for my endo’s assistant.  I make sure to tell ALL of them that I am going to be OUT OF STRIPS soon.

For those who don’t get this, test strips are crucial to knowing what’s going on with my sugars, to deciding how much insulin to give or how much to eat/not eat.  They basically tell you what you need to do to keep your diabetes in good control.

angry face

Yes, I can go buy them out of pocket, but I would MUCH rather not have to do that, as you might imagine.  I HAVE blasted insurance for this very reason!  ARGH!!

So, I STILL have no contact, no response from ANYONE and I’m skipping tests to try and make these stupid things last til Monday hoping that SOMEONE SOMEWHERE will flippin’ contact me and get this straightened out.

I am SO mad you can’t even imagine.  WHY do they do things like this?  From stupid CCS (who could have informed me instead of just not sending the shipment) to Anthem who could have been a lot more helpful in making sure I could get my supplies to flippin’ Liberty which is a total fail in the customer service department and who I will NOT do business with if there’s any way around it.  And now my endo’s office!??!  SERIOUSLY, PEOPLE?!?!

screaming man

Sorry for the rant, but this is so unnecessary.  If these industries were TRULY for the patients, this wouldn’t happen.  I guess I’ll be heading to Wally’s to pick up some cheap-o generic strips til I can get someone to do their job out there.  sigh

Happy Mom’s day & have a great weekend!!  🙂

Blessings,

G~


frankly friday: Eli Lilly & the rising cost of insulin


humalog insulin

I dunno if this Frankly Friday thing will stick, but for today, let’s roll with it.  I apologize to my non-diabetic readers, but this is a huge issue for us and if you love a diabetic, you should be upset about this too.  Let’s face it, it won’t be long before you could face this same issue with a medicine that you need!

humalogHUMALOG insulin: the stuff I, and tens of thousands of other diabetics, depend on to stay alive

I came across an article on Facebook about this and it just made my blood boil.  WHY are these companies allowed to do this?  deep breath  Sorry… I should probably let you in on the secret, huh?  Some jerk CEO at Lilly made some really callous, idiotic statements regarding the rising cost of one of their most popular products, Humalog.

eli lilly

Here’s a quote from this jackwad, Lechleiter:

Asked on the earnings call about the current debate over drug pricing, John Lechleiter, chief executive officer, said higher prices make sense because it helps the company fund the research needed to find better treatment methods or a cure.

Excuse me?  “higher prices make sense because it helps… fund research to find…a cure”?!?!?  Um, no.  I would love to know the total revenue generated by Lilly over the years they have produced insulin and find out exactly how much of that goes to researching a cure.

I don’t know who he thought he was talking to but all of us out here “in the field” trying to survive day after day with this disease know full well that no diabetes medication manufacturer is looking too hard for a cure.  They make too much flippin’ money selling us stop-gap measures, granted we need them to live, but when they make comments like that and tell us they’re trying to fund research while jacking the prices up for the ONE thing that keeps us breathing??

Nope.  You’re full of crap. Sorry if you’re offended by my watered down language.  I’m mad!!  I’m furious that this is allowed to go on.  It’s not bad enough that we have to deal with insurance companies that dictate which medicines we can or can’t buy if we want their policies to cover a fraction of the costs, it’s not bad enough that they can deny coverage of some things telling us they’ve been deemed unnecessary.  I have always believed that big pharma and insurance companies are in bed together.  Premiums go up, co-pays go up, covered percentages go down, cost of medications go up… you see the trend?  The only people this crap “makes sense” for is all those suit-and-ties in these companies who are making billions off all our pain and suffering.

I gotta get off here and try to calm down.  This stuff just sends my blood pressure through the roof.  What kinda price-jacked medicine do you want to sell me for that, Lechleiter?  puke

Wishing all my peeps a beautiful day.  mwah!

G~