My Bank Account : My Diabetes

Yeah, so it’s been a while. And while I think of it, I should pay my student loan bill for this month since it’s due…today. Brb, brah.

Ok, that’s done. I just hope they don’t consider it late because the “payment effective date” is tomorrow (2/22/12)…I think there’s a 6-day leniency or grace period or something to that effect. This date didn’t catch me by surprise. The payment is due on the 21^st of every month. I knew it was a-comin’ but monetarily…I wasn’t exactly prepared. So, today, after work I bee-lined to the bank to deposit my check so that I’d have enough in the account to pay the bill. Turns out, there was plenty of money in said account because another check I had written out last week still hasn’t gone through. I didn’t want to take that chance, though, and pay before being able to deposit said paycheck. With my luck, I would have been hit with an over-draught fee. Or whatever it’s called. Nobody likes it when that happens.

What does all this have to do with diabetes and circus, you ask? Well, personally…I was in such a rush to get out of work asap that I didn’t do a blood test before leaving work at 2:45pm. Actually, I hadn’t done a blood test between when I woke up (around 6am) and when I got back home from my day (around 5pm). So…none of my usual mid-morning, or at least noon-time testing. I didn’t really eat lunch, either. I had some leftovers: veggies, a muffin, some brownie crumbs. Then, in my car I had some almonds and a “firecracker” mix of sesame sticks, wasabi peas, peanuts, and I think soy nuts. I bolused (stupid auto-correct made that into “bloused”…what does that even mean?) what I thought was an appropriate amount, but since I didn’t know what my blood sugar was, I probably played it “safe” (i.e. underestimated the carbs/insulin). So, when I got home my blood sugar was 350 mg/dL. I should also mention that part of me is trying to cut back on tests per day because insurance only covers up to 5 tests per day…and my average is probably 7 or 8 tests per day, sometimes as much as 10. This doesn’t even count those times when I waste a strip or 2 because there isn’t enough blood for the meter to read the glucose but enough to trigger the testing to be done, so that it can tell me that there was an error because there wasn’t enough blood on the strip for it to figure out how much sugar is in the blood. That is the most annoying thing…ever. I digress. I had 4 strips left at the beginning of the day, so I needed to buy test strips today, anyway. Where am I going with this? Oh yeah, I was going to tell you how my bank account relates to diabetes in a more analogous or abstract way, and at the same time bitch about the insurance company and the doctor who wouldn’t even try to put in a prior approval form to said insurance company.

Similarities between bank account and diabetes:

· Checking your bank account balance is like checking your blood sugar.

· If you’ve got a lot of money, you can spend a lot of money.

· If your blood sugar is high, you need more insulin, or more exercise. You can “spend” more blood sugar (in the form of exercise).

· If your bank account is low, you should put more money in before spending more money. If you spend money that you don’t have, you get fined. Nobody likes getting fined.

· If your blood sugar is low, you should eat more food. Or take less insulin next time. And you shouldn’t exercise until you’ve brought it up to the safe zone. If you exercise or take insulin while your blood sugar is low (i.e. “spend more sugar than you have”)…you could faint. Nobody likes to faint.

· How do you know how much money is in your bank account? You keep track of it. You do this by balancing your checkbook. Or, if you’re like me, you check it on the ATM machine or the slip of paper they give you when you deposit or withdraw money. I used to balance my checkbook well…oh those were the days. I try to have a rough idea of how much is in my bank account based on deposit vs withdraw habits, but sometimes I’m wrong or payments haven’t gone through yet (like today).

· How do you know how much sugar is in your blood? You check it. I find it pretty hard to “just know” how much sugar I have stored in my blood. Sometimes I have a rough idea, like if I’ve just snacked all afternoon and not bolused for everything, it’s probably high. Or, if I feel cranky, it might be low. But sometimes my guess is totally off and “I really shouldn’t have bolused for that piece of toast, now I have to eat another?! Seriously?! Annoyed.” So, to balance my insulin doses with food and exercise to achieve good blood sugars I check regularly.

· And that is how bank accounts are just like diabetes.

P.S. I still haven’t forgotten about the pull-ups update. One of these days…

Doctors, Insurance Companies, and Test Strips, Oh My!

Where should I start? So, my insurance company has a maximum limit of test strips they will cover each month at 150 strips, or 5 tests per day. I test more than that. This is a face of life I have come to expect. Recently, I changed primary care physicians because I changed insurance and my old doctor is not covered by this insurance. Ok. I had an appointment with the new doctor and told her I test 8 times per day because I am active and am insensitive to lows and that I would need a prior approval. She said, “Ok, when you go to the pharmacy, have them send a form to us which we will send to the insurance company.” As it turns out, she could have gotten the form online and sent it directly to the company covering prescriptions. So, there was some wasted time and energy already. Then I call the office on Friday to tell them this (it kind of felt like I was telling them how to do their job). They call back and long story short make an appointment for Monday (yesterday) so that I could talk to my new doctor. I suppose I should note that I told them I test 10 times per day. It really varies between 6-10, but why not just say the maximum? Seems easier that way, but I guess not. At the appointment yesterday she told me she was concerned that testing 10 times per day is an indication of anxiety. And that people with controlled diabetes often test only once per day, and those with uncontrolled diabetes test 4 times per day. So she didn’t think I should be testing 10 times per day. This frustrated and confused me so much I lost my composure and started to cry. So, I did a blood test because I usually cry when I’m low. I wasn’t. I was just soooo angry that I cried. That sometimes happens. Am I so far out of the loop that everything I’ve learned, read, and been told is now obsolete? I thought the recommendation was a minimum of 4 tests per day for Type 1 diabetics. That would be testing before breakfast, lunch, dinner, and bed. Makes sense to me. Then, last I knew, it is recommended to test before driving to avoid driving while low. Driving with low blood sugar is like driving drunk. So, that would bring it to 6 tests (assuming a round-trip). I’m pretty sure it’s recommended to test prior to exercise, too. And after. I just don’t see how someone could have well controlled diabetes on one test per day. There was a while that I was only testing 1-3 times per day and my A1c (which is an average glucose measurement of the last 3 months) was above 8.0%. My most recent A1c was 7.6% (when I was testing 6-10 times per day). The target A1c is less than 7%. In terms of glucose readings you’d normally see: 8.0% = 183 mg/dL, 7.5% = 169 mg/dL, 7% = 154 mg/dL. It seems that with more tests, my blood sugars are, on average, better. On top of this, the American Diabetes Association says, and I quote, “To get tight control, you must do the following: Measure your blood glucose levels more often.” http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/tight-diabetes-control.html It makes me feel a little crazy that I should be taking advice from this person, this doctor, who should know the right information, but it’s almost opposite of everything else I thought I already knew. Alright, I’m done ranting.

So It Begins

Today is my little brother's birthday. He turned 23. It's 11pm and he's currently in the ER because we think he has diabetes. Happy Birthday, right? It occurred to me earlier, shortly after I did a blood test on him (and it was over 600 mg/dl), that I've had diabetes for longer than he's been alive; and yet, it greatly upsets me that he now probably also has it. Even though this disease is manageable, I don't want him to have it. I wish he wouldn't have to go through the daily frustrations associated with it. He has the worst luck, too. As our dad said, "If it wasn't for his bad luck, he'd have no luck at all." If only he had mentioned something last week, this birthday could have been a little better. Oh well.

That brings me to my first point: symptoms. These are the reasons we did a blood test in the first place. My brother was exhibiting some classic symptoms of diabetes, which include frequent urination (every hour or so), extreme thirst, unexplained weight loss, feeling generally bad, like sick to the stomach, run-down, tired, spacey, pale skin, and bags under the eyes. Yes, some of this could be due to sleep patterns and being over-worked, but when they're all together, it's best to see a doctor. Luckily, he was not throwing up.

Ok, so according to the American Diabetes Association, symptoms of Type 1 Diabetes are:

• Frequent urination,
• Unusual thirst,
• Extreme hunger,
• Unusual weight loss,
• Extreme fatigue and irritability.

So if you or anyone you know has these symptoms, talk to a doctor, or encourage them to see a doctor.

Now that that's out of the way, a word about the purpose of this blog. About a week ago I got the idea to write a blog about dealing with diabetes and not letting it dictate life. That is to say that I have this goal of attending the New England Center for Circus Arts (circus school), and there's no way I'm going to let diabetes stop me. It hasn't stopped me from playing softball or soccer, rowing for the UMass Women's Crew Team for 4 years, or bicycling across the country. Basically, I want to use this as a way to give other people hope and encouragement. Sometimes it is difficult finding others with this disease who have not let it slow them down. Then, when you hear about them, it's easy to say, "Well yeah, they could do such-and-such a thing because of such-and-such a reason, and I don't have that kind of resource or whatever." I've said it. Many times, these people were already participating in sports, ballet, swimming, or mountain climbing before they were diagnosed, so it might seem like they already have an advantage. Well, I've never done circus before. I learned how to do a cartwheel on the playground at recess in elementary school. That's it. I know it's a cliche, but you just have to want it, whatever it is. I know sometimes that's not enough; you also do have to work for it, because it's not just going to materialize out of thin air, but that goes along with wanting it. If you want money, you have to work for it, right? I know it's really not that easy, but you have to start somewhere, and sometimes it means jumping in with both feet. Now I'm just rambling. I'd better stop before I type complete nonsense. And my decaf tea is probably cold now. Shucks.

Anyway, a note to my brother, if he ever reads this, and to anyone and everyone else who is feeling down and overwhelmed: it could be worse. Really. Just take it one day at a time.