Convenience or Necessity

Here’s a really good topic to discuss, is this gadget or medicine necessary or simply a convenience? I have had a few cases where I have found the latter to be true. Does my life depend on getting this device or medicine? Maybe it does and maybe it does not. If I have lived for years without it and while it can, I stress the can issue, make your life much easier and convenient do you really need it.

The first item on the list is the insulin pump. “It will make your life so much better” was the selling point the doctor made. “It will help lower your A1C.” Awesome! What about the thing messing up and killing me / dumping all the insulin in at once? It can’t happen. There are safe guards in it to prevent that from happening. I agreed at that point. The company rep told me if I didn’t like it I could return it before 30 days for a full refund.

I got it in the mail and spent 3 weeks getting trained on how to use it before I was allowed to put it on. It wasn’t even a full training. I was given the basics and read though the rest but was never trained on the more advanced features. Once the company cleared me I was given a starting basal (base) dosage and it was installed (was that a good term to use?) at the doctors office roughly 3 weeks after I signed for it. Then the fun began.

The starting basal dose was 1.8 units per hour plus the bolus (units for each carb rate for meals) ratios. The first week I was woken up by the fire department 5 times. That is 5 out of 7 days. I was constantly calling the doctor who then lowered the basal rate but it was not fast enough or big enough to fix the issue. Here is my question on this issue, who or how was the starting dosage decided? Was it the insulin maker’s formula? Was it the pump maker’s formula? Was it the doctor’s formula? I was constantly eating to raise my blood sugar and gaining weight that the doctor was not happy about. I was not to be eating without bolusing for it. Why would I bolus after eating to raise my blood sugar, defeats the purpose doesn’t it? It made no sense to me. I still do this and it drives her nuts. I do not always check my sugar level before eating as when it drops it drops fast and I panic.

Needless to say I was not happy with this new device and asked the rep about returning it after having tried for only one week. Sorry it is after your 30 day trial and you will need to pay the $6000. What? Wait that 3 weeks I was being trained and it was just sitting there  was considered my trial period also? By the way it ended up that my insurer at the time paid only $150 dollars for this pump and I was stuck with $5,995 to paid over several years. Still paying for it actually.

I gave it a shot for over a year before I decided enough was enough. I had them put me back on regular insulin shots and I am so much happier and better controlled. Oh just a small look at how far off the original setting were, they started at 1.8 units per hour and although I ended up with changing rates through out the day the one for the afternoon was dropped to 0.025 units per hour. How was the setting that far off?

Another issue of this controversy is my cholesterol meds. I don’t think I need them but all my doctors have argued that because it is high I need to be on it. OK let’s look at this “high” cholesterol. I’m going off the top of my head here but I believe my last level was 205 and the “bad” level was also just over the high mark. Now cholesterol meds are known for their not being good for your liver hence the regular testing of your liver function while you are on them. Here’s the argument I give my doctor  all the time. Which is worse, having a chance of developing clogged arteries or destroying my liver and needing a transplant plus a lifetime of taking immune suppression drugs? Well that is why we test to make sure it doesn’t happen and is a small chance it will happen. The same small chance as my slightly high cholesterol level giving my a heart attack?

Now the last one, I promise, the CGM. Constant glucose Monitor is a device that is inserted just under the skin that test your blood sugar every 5 minutes all day long and all night. It does this for 24 hours a day giving you and your doctor a graph of whether your blood sugar is going up or down or staying level. I loved it at first. I had really not done too much research on it and thought once it was going I could cut back my forearm pokes to only twice a day to calibrate the monitor. I was wrong. You still need to check since the monitor is not considered accurate enough for insulin delivery. Well it gives the doctor a clear picture of how your insulin is performing. I thought that until I spent 20 minutes arguing that my basal insulin needs to be lowered since my blood sugar was constantly dropping. It was still dropping 4 hours after my meal shots so it could not have been the 3 hour bolus insulin doing it. I did get her to drop it but it was the unwillingness to do it after looking at the graph that got me. Why am I spending the money and time with this device when it is not doing me much good. Is it convenient? Yes very but is it worth the cost? The cost with insurance is $130 a month on top of all the other costs. In other words it is not replacing or cutting any other expenses to make up for it. Its $450 with no insurance.

So back to the original question, necessary or convenience? Insulin? Well that is kind of obvious, you need it, without it you will die. Cholesterol meds? I call it a 50 / 50 split. You can die of a heart attack or you can take a chance on ruining your liver. The CGM? It is very convenience but I can live just fine without it and I can use that $130 on other needs, like sex drugs and rock and roll. NO I do not need any more life challenging activities in my life. That is a good term for  those activities, life challenging. They may be fun for those who like them but the health issues they cause are shall we say less then desirable. Look at your own situation and decide, is this something I need or just something that makes my life more convenient. I am not saying dump it if it is merely convenient but look at how much it is costing you in both money and other health issues. Is it worth the cost to you? Maybe it is to you. Remember it is your life your living not someone else’s. You will have to live with the results good or bad. Just food for thought..

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