Tag Archives: work

The Same Yet Different

I just read a post from a woman who lives in the UK. She is also a diabetic as are many of the people I follow on twitter. Facebook is great for friends and such but twitter lets me find people who are like minded as far as my disease. Well I don’t go looking for them, Twitter finds them for me. I have some here in the States (one is on TWO of the new Dexcom G6 commercials) but quite a few are in the UK as well. I have learned as much from them as fellow diabetics here in the USDA.

The post I read was from a woman who yesterday ran a half marathon (10k) and finished it. Way to go!! Now some not familiar with diabetes may think so what. It’s only a half marathon and she didn’t finish first. Oh my good people, to me it is great that she even tried let alone did finish no matter what place it was.

Why? A diabetic knows the answer to that already, someone not so in touch with the problems of this disease may not. Let’s start with the basics. Diabetes is a disease where your body does not produce insulin to control your sugar levels in the blood. So a diabetic must double as their own pancreas since the one they were born with no longer works like it should. Normal people don’t get this as their body regulates it’s own insulin level. A diabetic has to do this the entire 24 hours of each day. It is a true 24 hour 7 day a week jobs and there are no vacation from this job. Now here is the first in lessons some don’t know. There are actually 2 types of diabetes and although they are both called diabetes they are very different creatures. Type 1 is insulin dependent and type 2 can still make it although not enough or sometimes the wrong chemical makeup, it doesn’t work right. There about 22 million diabetics here in the USA alone and out of those only a 10% section are type 1. That means I am one of about 2.2 million people here in the USA who depend on insulin to live. We do not make it on our own and so must take it several times each day. It is not a pill and though there has been some headway to make it easier, the only way to get it is to inject it through the skin.

“I’ve read that you can also inhale insulin.” There is only one and I do not know what complications it can cause or how effective it is. Most people, I do not know of any on this inhalable insulin, use injection. You can use pumps instead of needles but as some of my former coworkers can attest to, it is not a perfect solution. It also still goes through the skin. I was told years ago (decades really, I’m polishing my cane later) being a hormone insulin would not survive the human digestive tract hence it must be injected. As far as inhaling, I’d be more scared of an infection from that kind of delivery than an injection. In the 40+ plus years the only infection from insulin I’ve had is with a pump cannulas but it was on its 6th day instead of the 3 days recommended by the maker. I had to, sweated the first one off early so to make up I had to reuse the next one or I would have run out.

OK back to task, Type 2 diabetics are people whose body still makes insulin but it either makes not enough or the chemical makeup is not right and it does work as needed. Insulin does not actually control blood sugar but it unlocks the walls of cells so the sugar can get in and let the cell use it for energy. Think of it as a key for the lock on your cell wall door. If there is no key you don’t get in, if you don’t get in there is no power to run the cell and it will die. Type 2 can be controlled by pills or diet or both without needing insulin. Sadly, it can regress to the point where insulin may be needed anyway. My mom and both aunts where like after years with type 2.

Emma uses a pump and just to make things easier I will just say that if you have a hard time programming your universal remote a pump is not any easier and your remote won’t kill you if you screw it up. I don’t know her that well but I can guess from her post she does not run marathons on a daily basis. Here is another issue with diabetes, changing your routine is scary. I am far from a perfect diabetic but I try to eat at the same times and even the same foods on a rotating basis so I know how I react to each food and how many carbs are in each meal. Carbs are how diabetics count and calculate how much insulin they need for the food they eat. Each food has a certain amount of carbs that enter your body at different speeds and as a diabetic you need to be able to know how many are in each food and add them together and then calculate how many units of insulin you need. A pump can do this on its own but you still need to tell it how many carbs you are eating.

Since she was running a marathon her activity level was going to be so much higher than normal for her so she had to try and compensate for this. With a pump you can lower the background insulin you get on a temporary basis so she made the changes.

This where I noticed the biggest difference. She dropped her rate 2 units. Wow! My basal rate (background insulin) was at times only 0.250 units per hour! That equals 1 unit every 4 hours. There was no way I could have dropped it 2 units. Even as low as it was set, it still crashed my sugar level without extra work (running a marathon being as low as it can get on that list) and although it would shut off automatically,  I still needed to eat to bring it back up as it was low for hours after going low.

The other issue I noticed was when she described making corrections for a highs the morning of the race. Every diabetic has a rate to add extra units to prevent a high once it is started. Mine is 1 unit for every 50 points over 200. It used to be 2 unit back then when I was on the pump. She was correcting a 1/2 unit for less than 200. Amazing!

Reading about how she ran her diabetes compared to my treatment brought to mind what I frequently tell other diabetics. Everyone is different and has a different treatment routine. I have been telling people that for years now but I never had actually applied it to myself until reading that post. I had always thought I must have done or been doing something wrong to create this difference. I am me. I am not Molly, I am not Emma, I am not Amy, I am not any of the other diabetics I know.

I am not doing anything wrong I am merely doing things the way that works for me. MY correction rate works for me. My basal rates, well now doses, works for me. My diet works for me. It will not work for anyone else nor should it. I can try a technique I hear from someone but I will also need to test it to see if it will really work for me.

I can stop thinking “Why does this not work for me like others?” We, the other 2.2 million type 1 diabetics, have the same disease and share common problems and issues. Our solutions though are not and should be the same. They are unique to that person. Everyone is different and should follow their won path to control.

Paying More With Insurance?

Just made an observation at the pharmacy the other day. It was the first time it had to buy insulin without insurance after switching jobs. Back in January when I had the insurance discount it was $295 for one bottle. Thursday the same bottle minus the insurance “discount” was $272 for the same bottle. So the difference is $23 a bottle LESS without insurance before the copay kicked in. I’m actually a little relieved as I’ve been hearing from other diabetics online that they pay as much as $380 a bottle for Humolog, an Eli Lilly insulin. I was FORCED by the insurance to switch to Novlog which is a very similar substitute made by Novo Nordisk, a Danish company. It just struck me as odd that the “discounts” talked about by insurance companies actually cost me an EXTRA $46 back in Jan (2 bottles). Granted I’d much rather pay the 20% copay which ends up at $65 a bottle. New insurance copay is higher, It’s either going to be 25% or 40% depending on how they catagorize the insulin, formulary or non-formulary.
Why do I bring this up? I read last week or earlier this week Trump was trying to get Canada to raise the price it pays for meds to lower USA prices. Huh? I’ve looked at Novo Nordisk and a while ago at Eli Lilly financial staements (publicly traded companies so those are online). Novo made $17.4 Bilion last year. In their statement diabetic meds make up about 81% of their sales world wide and the USA makes up 52% of the sales worldwide.
What made me look twice at it was that they list 2 sales regions, North American and International. Its obvious that the USA, Mexico and Canada are the North American region unless they have a different map than mine. Total sales in those 3 countries was about $9.1 billion and the REST of the world was only $8.4 billion. 3 countries had more money in sales than the other 188 countries they serve (190 in all according to them). Trump wants the one of other countries in our region to raise the profits for a company that makes over a billion more from us already? It does not makes sense to me other than more of my money going to keeping me alive, hence calling us a captive audience in this story. The companies will not reveal how much it costs to make any of the meds but they are required to list sales and cost of goods. Sales last year was again $17.4 billion and cost of goods was only $2.8 billion. So making the goods cost them less than $3 billion but they charged more than $17 billion for them. That means that there was about $15 BILLION more made than spent on these meds.
An insulin that is sold for $150 here in the states is sold for only $9 in the UK and only $2 in India (going off memory here so not sure if I have the right price with right country). They are still making a profit off it.
The argument that it will cut into research money is also not completely true. It will reduce the amount but if it is focused into the right areas it would help. Why create an insulin that is touted to stay in your system for 36 hours but you are still made to take it every 24 or once a day just like the other insulins? What is the advantage? That same insulin is also a newer version of an older insulin that would have lost its patent protection, gone generic, if not for them changing the chemical makeup enough to keep both the new and old under a new 20 year patent. They only spent $2.2 billion, 12.5 % of their sales, on research. Those are their listed numbers.
We need to have the government step in and do something to stop the price gouging going on in our health care system. People wanted it when gas was so high but this does not affect everyone like gas prices do, just us with chronic life threatening conditions.Trying to make other countries pay more for the same meds is not the way. I’m not a business genius but if everyone started paying more the only outcome I can see is deeper pockets to throw money at congress to get more corporate control in there.
I know a lot of people hate to see more about universal healthcare but it works for other countries. Make it a universal tax like Medicare, which we will not have anymore. Why would we? If there was a universal system in place, everyone with an income would be putting into it and getting out of it. You would think corporations would be on board for this system as they wouldn’t have to split the cost anymore. The amount of money saved could go into pay raises for the CEO or board members. The last tax break didn’t increase my income much if any. The only reason I can say my wages went up is I switched employers. Last year my weekly take home was about $415 a week and in January without overtime it was about $423. In 8 months I’ll have an extra tank of gas at current prices. Welfare, disability, social security, unemployment, and any other income would have the tax on it. My current situation would not be happening. I lost my insurance when switching jobs. A universal system you wouldn’t lose it going from one job to another. You wouldn’t lose getting laid off. I have not heard of any annual restart dates where you end up going back to deductibles or having high out of pocket expenses. Being a working class guy, I would want this system just for the fact of having a security blanket that is with you anywhere at anytime. No out of network worries or coming up with a copay to see the doctor. I just had another MRI done to be sure the “nodule” in my lung had not grown or moved. Haven’t seen the bill from the hospital yet but it will be around $170 plus the $18 bill I just got since the radiologist who looks at the film is not in the network. $18 dollars for a few minutes work.  I’ll have another one coming in another 6 months. My new job is going to be shut down in about 2 weeks for a planned upgrade/refit. I will once again be without insurance. It makes me wonder at times if the universe really hates me or just doesn’t care whether I live or not. Most of the time I go for the former but there are times that it seems like the latter.

Showing Signs

Every year I add another birthday to the list. This last March I had my 24th 25th birthday. Yes. I am still 25 but I’ve had it 24 times (I’m not doing the math I don’t think my calculator goes that high 24+25). I also quit using the term celebrate, for two reasons.

First, there is no celebration, party or even special dinner. I try to get that day off work but it is not must have. Most people don’t know it’s there until someone posts about it. By the way, the day listed on my Facebook page is not true. It is in March but it is not the 1st. I don’t want people knowing what day it is. It really irritates me when employers feel it necessary to display my personal information on public boards. I asked to have it removed once and was told they couldn’t do it since they would have to change something in the computer (I think it was a program that automatically grabbed the information). I could have gone to court to have it removed, it is MY information anyway, but decided against it since it would only have added to the unwanted publicity.

Second, why would I celebrate getting older? When you are young, you enjoy getting older. You get old enough to drive, to vote, and to drink. When you get up there far enough it’s like whoa, slow down Nelly. I am loath to admit it but I am no longer as fast, strong, or active as I once was. Goin off 4 hours of sleep does not work well for me anymore.

Now there are advantages of reaching this point in life. My knowledge has grown with everything else. I know when to just sit back and not get excited about things, they will even out later. I know enough to pick my battles as I can’t win them all. I have so many job skills it is almost scary, I’ve been a railroad laborer, I’ve been a machinist, I’ve worked in a plastic conduit factory, I’ve worked in several different health care positions (both physical disability and mental health issues), and many factory positions just to name some of them. I get board easy so I like to move around when something gets to be routine. The other issue is that I can remember a lot about each job to quickly get back into it.

The down sides I have already talked about. I am no longer as strong as I once was. My mind tells me I can get back there if I work hard enough. My body give me an argument every time. I have been, still am, and always will be a believer in the human body’s ability to adapt and over come obstacles in life. It’s how body builders gain such size and strength. If you push the body to its breaking point, it grow back tougher and stronger than it was before. I believe it happens for both physical and mental aspects of life. After my shoulder surgery, they told me I may never be able to do a flat bench press again. Ha, ha, ha. Never tell me there is something I can’t do. A year and a half later, I was pushing 300 pounds for a max. I also got back to work in only 2 1/2 months. The doctor said it would be 3 months or maybe 6 months since I was a diabetic. I’d be lucky to get 190 up now I think. I have forgotten what the inside of the gym looks like anymore.

Speed is another down siding piece of my life. I was fairly fast in high school, for my size. I’ve always been big, broad shoulders and solid build. I never had to be fast as with that size as I didn’t bug me to get hit. I didn’t go looking for fights. My dad would have kicked my ass if I had. He had a short temper and I pushed it too far more than just once. I have inherited more than just my lack of model looks from him. I feel I have a better control of it though. I don’t beat on other people. I take it out on objects instead. This is going off on a tangent but this is why I fear a low so bad. I DO NOT want to be like my dad. When my sugar is low I get very combative and aggressive, kind of like dad. Like to think I have grown up better than that. Back to task, I am no longer as fast as I was back then either. Age has slowed not just the muscles but the response time as well. When I worked at a health care facility I was on a home with people who were very high functioning. They could eat on their own, go to the bathroom on their own, even do their own laundry with prompting. When they went off it was epic. Thrown chairs, phones, punched TV screens, and of course inanimate object were not the only thing they went after. It helped being fast and strong to deal with that kind of thing, ducking a punch or grabbing an arm before it hit someone else. It’s as much being able to talk to them and calm them as doing a take down. They will tell you that being calm yourself will help calm them down, it is not a lie. Knowing I could deal with almost anything that came my way helped keep me calm. I couldn’t do that anymore I believe.

As much as I’d like to believe it isn’t true, a person goes down hill later in life. You can’t stop it but you my be able to slow it down with practice and exercises but it will happen. Just a few years ago I was able to get by on just 3 hours of sleep, but now if it is less than 5 I get worn down. Having been a diabetic for nearly 41 years has only added to all the normal old age issues, joints going bad, eyes getting bad, and metabolism slowing down. That last one is one that may actually be a bonus. I have for many years now believed that my metabolism is higher or at least more reactive than most people. If I sit down my blood sugar spikes and when I start doing things again it drops. If it slows through aging will it magically level out? One can only hope.

One of the things I’ve heard people comment on with getting old is that you come into this world naked and helpless and that is how you go back out. Not the most politically correct terms but it is mostly true. After a certain age you starting loosing the skills and abilities you need to survive in this world. I am so looking forward to this, not. I’ve learned to be a fighter. I’ve learned to work hard to survive, all diabetics have to. I will tweak my life as I need to continue to live but there will come a point when it just will not work anymore. That does not mean I’m going to roll over and quit. Ever.

Making decisions for me

I just got done posting something along these lines on Facebook. I read a post that struck a cord with me. It was about not making decision to make others happy but to make yourself happy instead. I feel that comment strongly represents my outlook on life currently.

Why? I came to the conclusion a while ago that there is no one out there looking after me but me. So many decision I’ve made in the past have to help others or my workplace out. Can you work this day? Can you help me move this furniture? Can you tow my car/truck? Can you help fix this or that?

Don’t get me wrong, I’ll help out the next guy (or girl) if I can but do not look at me with an evil eye if I say no. I’m not here on earth to make everyone else happy. Be it work, my health, my finances, or anyting else in my world it has to work for me whether others are happy about it or not.

In the past I have been for the most part silent when moved from place to place at work or asked to do extra tasks. In several jobs I have been cross trained in different duties because I pick things up quick. At a lawn mower manufacturer, I ended up cross trained on almost everything but welding. I worked in receiving, shipping, line material handler. parts picking, assmebly, weld parts picking, and was willing to do the other chores that got added over time. The breaking point was when they started to lay us off for months at time instead of only 2 weeks each year. I can not go without that insurance so I found another job and quit.

In my current job, I started as a material handler but was apparently not very good at as I was alwasy getting told all the mistakes I was making but never if I was doing anything right. OK it took me almost 3 years to earn a spot as a machinst but apparently I was not very good  it either. Always heard “you need to work faster” or “do we need to retrain you” so I must not have been very good at it. Funniest part was my coworkers thought I was doing a good job, it stopped there though. I found another position about a year later but even though it was going back the same job description I had before, material handler, I was demoted and had my pay cut but I was happier there so I took the position. Then just a few months ago I was forced into a position I had been cross trained in. When asked when I woud be able to go back to clearing tables I was told it was going to be permenant. Sadest part of it was I really liked clearing the tables. It was hard work, I think that is what I actually liked most about it but no one else seems to.

My solution was to ramp up my search for a new job. I had been looking since I reallized things were not going to get better in the machine shop years ago. I’m giving up 4 1/2 years of seniority and decent vacation but that senority does not seem to mean much since I was the one forced into a position I did not want. I had been told a few times that I was good and people seemed to request me to do these many different things because of that. Now I am stuck in a postion that I am happy to fill in on temp basis but it is not temporary change.

I can’t stop there. Work is not the only place I have made my own decisions which do not always agree with those around me. My healthcare is a big sticking point as well. For many years my now former endocrinologist and I had discussions or maybe even closer to arguements about what my treatment was or where my treatment was going to go. I was talked twice into trying a pump but both times it ended up not going well. She told me just like at work what I was doing wrong all the time but she did not realize I was not a “normal” diabetic. We finally got to that point when after the second pump didn’t work she had me tested and admitted she didn’t know what to do with me. I left her care shortly after as it didn’t seem she was really listneing to me. I had been telling her I was not normal since I first met her. I argued against the pump but after promises were made I agreed. After it failed to stop lows and ended up raising my A1C, we argued about where to go. She wanted to set me up on a med that she apparently forgot she had me try before going back to the pump again. I ended the argement by starting back on the same insulin I had been on before without her complete agreement.

OK, the point I am making is that I am the only one truely looking out for me. Employers will look at what is best for them, doctors on what is best for them, and friends for what is best for them. I don’t fault them too much for it but I can’t just sit there and let them decide my fait as they are not going to live it, I am. Getting my pay cut and placed into a position which I did not want pushes my decision to go elsewhere. The doctor pushing me to try a pump the second time then seeming to fight me getting off it, even though she said she woud support that decision, made me find another doctor.

My opinions are not meant to match anyone else’s as they are for me, not them, and they do not live my life. You can have your opinion as it should fit your life but not anyone else’s. We are all different and have different needs. If I can I will help you out but don’t expect me to surrender control of my life to make yours easier or to agree to your opinion. My decision are made by me for me, not you.

Different Strokes for Different Folks

I read a post from a fellow diabetic this morning and after possibly breaking her site with a lengthy comment, I though why not continue it here on my own blog.  A polite way of describing the people I want to talk about are back seat diabetics or armchair diabetics. These are people who either are not diabetic and think they know what is best for us/me or they are diabetic and think their solution is the absolute cure to this disease so everyone needs to follow their advice.

Molly, at huggingthecactus.com (hope I got that right Molly), was talking about a recent experience she had while out to eat and her sugar dropped. Been there, done that. I loved her approach. It mirrored mine so much, great minds think alike. She used common easily obtainable items to prevent a low.

I have been for years told by my, now former, endocrinologist that I should carry a glucotab bottle or get some of the paste to keep with me for any lows I get. I just laugh. I had tried that years ago and found it very not my style. One, they taste terrible. They are very strong sugar substances that use sour flavors to try and conceal the very sweet  taste. Yes, I used the term TRY. It does not work in my opinion. Second is the low sugar content of each pill/tablet. Each one when I bought them was about 3 grams of sugar and 3 grams of carbs. Duh, sugar is a carb. I would down the entire 10 tabs and still have to get candy from a machine to get back to normal. 30 grams plus to get back to normal.

I currently, like Molly did, use regular soda to boost my sugar level when it gets low. A Mountain Dew has 46 grams of carbs in a 12 oz can. Some days it only stalls my drops instead of reverse it and then at other times it will send me into low earth orbit, well at least my blood sugar.

My point here is there are no two identical people on this planet. Even identical twins are not doing the exact same things at the exact same times hence what may work for one would not work the other. There are about 8 billion people on this planet so even if they all were diabetic, thank God they are not, there would be 8 billion different treatments for lows. Every person is different so every person must find their own fix to each incident. Let’s be honest about it, the same fix does work every time even with the same person. Just go back and re-read the last paragraph.

Molly talked about working out earlier, before her incident, and that brings up another issue, exercise. Everyone reacts differently to it and does it in different amounts and intensities. Please do not tell me I’m correcting it wrong simply because I’m not following my “prescribed” treatment to the letter. I have had 40 plus years learning my body and how it responds to my environment. I can probably tell you what will drop my sugar level or raise it and how fast before I even touch a food or weight.

I tried an insulin pump (twice), one that was supposed to be fully automatic. That means it decided how much basal insulin it was going to give me with no input from me such as having to set a specific basal rate at a specific time. It would read my sugar level and make the changes on the fly. It works great for a lot of people but not for me. My diagnosis as a type 1 diabetic was called into question because of the settings we were using and the way I reacted to it. The results are yes, I am most definitely a type 1 diabetic. You know what the kicker was for getting a C-peptide test (a test of whether your body makes any or enough insulin of its own)? When I was going to start the pump I ran out of Toujeo insulin (basal) and the insurance company did not authorize a refill. I don’t blame them. They just paid for an $11,000 pump. I ended up going for 3 almost 4 weeks without my basal insulin. I can hear the gasps out there. Relax. You really could not tell I wasn’t on any. Sugar level were higher at times but not nearly as high as they should have been.

The pump suspended my insulin for nearly 4 hours (insulin half live was 5 hours) at times and I still had to eat to get it back up. Here’s a trick if you have enough will power, Skittles are like little sugar pills (they taste far better though). First, don’t swallow them as soon as you get them in your mouth. Chew on them until they just don’t seem as sweet. My opinion was it got the sugar into my system much faster. Second don’t eat the whole bag. A small bag from the vending machine has 56 grams of carbs in it. I just did about 3 to 4 of them at a time to slowly get it back up, unless it was crashing hard. They are very easy to scale to my need at the time. That whole bag is like a meal in a bag when referring to the carb count.

Like I started out saying, everyone is different and what work for one person may not work for another. I do listen to others for advice but please don’t expect me to blindly follow your example. I may use part of it or none of it. I listen learn and adapt it to my needs and wants. You should to. I will willingly tell you what I do, have done, or would do but you need to see what if anything actually works for you. I don’t think most people could get by eating 3,400 calories a day without gaining weight. I’ve eaten like this for at least 20 years and not gained (or sadly lost) any more than 5 or 10 pounds in that time.

While I was on the pump the doctor kept telling me I was eating to many carbs. I needed to cut back on them and eat more protein and fats. Hey I’d do it if I wasn’t already cramming cars to stop lows. That 150 gram “magic” carb count number is based off a 1200 or 1500 calorie diet. So at 3400 calories if you do the math, I should be up to about 310 or 320 depending on which base number you use. When I started the pump I was at about 420 carbs a day and had dropped it to about 280 to 290 a day by the end so I actually did cut them down. Using the original numbers, I was under the carb count persentage. She didn’t see it that way. It’s one the reasons I decided to leave her and go another route.

Here’s the basics of this speech. Don’t feel you have to follow the path of another find diabetic bliss. Make your own path, it is the only one YOU can follow. Listen to others who are experienced, be it more or less, with this disease. They may give you an answer or least a clue to help you find your path, just don’t feel obligated to dot the i’s and cross the t’s. Doctor or no doctor, you decide what does or does not work for you. They can look at your Dexcom or Medtronic sensor log but they are seeing only part of the story. You have lived it. Like I said listen but be realistic about how and if it will work. I argued with my former endo about said reading and won the argument, well at least I got her to agree to me trying my idea. A good doctor will listen to their patients as much as the patients should listen to the doctor. Tell them your fears and goals. Tell them why your sugar shot up because 2 hours earlier on that same graph your sugar was at 80 and falling fast. You over corrected. Look for patterns on the graphs. Again you know if you were working hard or chilling in front of the TV. It can affect that graph just as much as what you eat. Blaze your own path in this world, just be smart about it.

The Fears of Being Diabetic

Why the fears of being diabetic? Why not? I didn’t call them phobias, they are not debilitating. A good diabetic will acknowledge the risks and prepare for them. Risks in my opinion are simply controlled fears. Will I run out of insulin today or drop the bottle and break it? Past incidents have led me to be very careful of where I set it when it is out of the case, aka been there done that. There are so many of them I can’t possibly bring up and talk about them all. The whole point to this post is letting people know that there are many risks to being a diabetic and not everyone knows them or wants to talk about them.

By knowing the risks you can either avoid them or minimize the chances of them happening. My big fear is having a low. Its not as bad with the CGM (that leads to another fear all diabetics have) since it lets me know where I’m at with my blood sugar and most of all which direction it is going. I can avoid the lows by knowing they are coming before they get too bad. I carry Skittles in my pocket so when I know I’m going somewhere I will not have easy access to snacks. Cutting back on exercise is never an option for me. I was not raised that way and can’t get past wanting to give 100% at whatever I do, at home or at work.

My 40+ years of dealing with diabetic issues have led me with a few near phobias with the lows being at the top of that list. I have been told what I am like when my sugar gets low and that scares the hell out of me more than anything else. I become a very combative, aggressive person. People who know me can tell you how calm and passive I am normally but lower my blood sugar and I become a different person. When I was 12 I threw a nurse across our living room, I’ve knocked orange juice out my mom’s hand so many times I lost count, and I woke up with 8 EMT/firefighters holding me down on my bed to get an IV started. At work I have told them to never try to force me to eat or drink anything. Just call the EMTs and let them handle it. The fear is hurting someone I care about. My old doctor hated the fact I run my sugars so high to avoid it.

Another fear that I alluded to earlier is how I am going to pay for all the meds and supplies I need to stay alive. It is sad to say insulin is not the only med with this issue but it is the one I am most familiar with. The cost of the bottles of insulin have gone from $115 about 10 years ago to $295 currently. That is also with the insurance company discount. Buying it without insurance I’ve heard is more like $380 a bottle. The CGM is also a big cost. Each month with insurance I pay about $120 for the sensors. Without insurance they are about $450 each month. They are only meant to stay on for one week but to save money I will leave them on as long as I can, 3 weeks at times if the adhesive stays put. The transmitters are another thing. I pay about $250 for one transmitter that last only 3 months, $1,000 a year with insurance. Without insurance, I would ben  paying $1000 each for them, $4,000. What happens if I loose my insurance? It keeps me up during the day, I work nights so that is my sleep time.

Up comes another fear/risk, loosing my job. I hate to break it to those who feel the ADA protects them but I have been in situations where employers have been, lets just say creative, in forcing me to leave. I don’t think I’m a bad employee. I show up for work on time 99% of the time, I don’t call in sick very often, I do what I am asked to do whether it is a part of my “job” or not, I get along with coworkers well, and am willing to work overtime when needed. I’m not going to get into the politics of it but “right to work” states also allow an employers to let you go without a reason. They will not use the word diabetic in any letter or phone call since that involves the ADA. They can just give any excuse and let you go, if they respond in the first place. As far as getting hired, that is another nightmare all together. The easiest form letter to use is “we have gone with another more qualified applicant” one. Have they? I have wondered how many times they hear about previous situations of low issues and decide to not hire over it. I’ve read the fine print at the tale end of the applications. You give permission for the company to run background checks on you which includes credit, criminal, and employment. You give them access to your employee files from former employers.

An everyday fear/risk is not calculating insulin does correctly. Did I count the carbs right? Did I get the right ratio? Did I do the math right? I’m not perfect. I’ve screwed this up more than just once in 40 years. Don’t panic and make the correction. Eat more if you go low. Take a bolus if you go high. This one is really easy to manage. Its more annoying than anything else.

Fear is a constant companion for a diabetic. One you need to become friends with instead of being paralyzed by it. I could  die by walking out of my house and down the street today, but I’m still going to do it. I could screw up any of the diabetic things I’ll do today but I’m still going to do them. As I said it in past blogs, I’m 9 years past my expiration date so in my mind I’m not loosing anything if I died today. I can hear the gasps from here. It’s life. I’m going to die, everyone will die. Its just when will I bite the big one. I realize the issues of being a diabetic each day and I work with those obstacles. I control them and move on. Enough said.

Wow! Already?

I read a post a little while ago from another fellow type 1 diabetic on accepting her “broken” body. I have to agree with her, our bodies are broken. Our immune system attacked and killed the beta cells in our pancreas that made insulin. Yes I said made because they are gone and have been for decades. We make no insulin on our own like type 2 diabetic so to live we must inject it everyday several times a day. To me although they are both considered diabetes type 1 an type 2 are separate diseases, different causes and different treatments.

Reading the post brought back memories of my life years ago when I was resolved to live with the knowledge that I was going to die much sooner than most if not all my friends. I would have to make sacrifices each day just to stay alive. The last few years of high school and the years shortly after I had given myself an expected life span of 40 years. Why you ask? I had been hearing for the last 10 to 20 years that I was more likely to have a heart attack, stroke, loose a kidney or an eye, loose a foot or leg, or one of many other possible bad things that are more likely for diabetics.

Well I am happy to report that my supposed end date was wrong. I have turned 49 so I’ve gone past my expiration date by 9 years already. I’ve had issues such as bad infections that apparently, according to my family doctor, was not expected to survive it was so bad. I also have had retinopathy in one eye but it is controlled and no further problems have been found. Just had them checked last week.

Now to the nitty gritty of why I’m writing this post. As much as diabetes has impacted my life, it has molded me into who I am today, a driven, resourceful, proud person. Some who know me might question that last description.

Proud? Yes, very proud. I don’t ask for help unless I’ve already proved I can’t do it alone. I don’t rely on others others to do things for me as I am completely capable of doing them myself. Maybe at times more headstrong than smart as I tend to push things to the limit to find where it is.

When I first became a diabetic, age 8 (1977), I had tried to hide it from others around me. I was different now. I had to pee in a cup to check for sugar in my urine. I had to get shots twice a day to stay alive. I had to get blood drawn once or twice a week to make sure the dosages were right. I had to watch what I ate at meals and in between. That was the worst as I had to get up in the middle of class to get a snack out of my launch box with everyone in the class watching. How was I supposed to hide that?

Diabetes is invisible. I don’t have a missing arm or massive scar on my face to mark me as a diabetic. Its why we all are expected to carry something like a med-alert bracelet/necklace. Even EMTs can not tell unless they are told. Makes it easy to hide.

I no longer hide the fact that I am a diabetic.  I do not go around spouting out to everyone I pass about it but readily will anyone who asks or inform coworkers to make them aware. One of the reasons is the growth in diabetic awareness. Not to mention the fact back then there were estimated to be 6 million of us. There are now 22 million of us with only 10% of them are type 1 like me.

As much as it has changed my life and made it harder, diabetes has also made me who I am today. I am driven to manage more than defeat this problem. I watch what I eat and try to control my sugar level but also live like a normal person. I don’t avoid sugar. I also don’t hide from work. I’m not going to call myself a workaholic but it would be close. My job is a material handler at a factory. Yes I do drive a fork truck but most of what I do is by hand. I can honestly say that depending on the night I lift and move maybe 1 to 2 tons of steel. 2,000 to 4,000 pounds of steel. I use an air grinder to remove burs and slag off parts. Try it for at least 4 hours before you call it easy, you do flip the parts you are grinding and some of them weigh close to if not over 100 pounds. Its hard work and I love it. My problem at work it I do so many different jobs that I don’t know from one moment to the next what I will be doing. Friday I started out unlading a torch table then moved to grinding parts and then sat on a fork truck for 4 hours. Even then I couldn’t take it. I kept the radio with me but jumped off to finish grinding the parts I had started earlier. I also jumped back off at the end of the night to help load the plasma table to get it done faster. I’m such a pain in the buttocks.

I guess it has given me a chip on my shoulder. Because I have diabetes I feel the need to proof myself more than others. I need to prove I can work with the big dogs instead hide under the porch. I have never and will never use my diabetes as a crutch. I can do anything normal people can with some special conditions. Foremost among them is being able to eat when my sugar level drops too low.

I guess to wrap this up, I’m done hiding (have been for years). I don’t broadcast being a diabetic but I don’t hide in bathrooms to do my shots or check blood sugars anymore. You can’t stand the sight of blood or needles? I’m sorry, turn your head then. I’m not going to apologize for being a diabetic. I didn’t go looking for this and am sure as he11 (don’t want to sware here but………..) not going to feel less than human for having it. I guess my feeling anymore has gone to the point of if I have to live with this then you are just going to have to cope with the ways I have to use to deal with it. You don’t have to do anything other than leave me to deal with the shots, sugar tests, and food intake. Its all I ask of you

Back in the Old Days

I read a tweet about a girl who gave herself an insulin shot in a classroom setting and managed to disrupt someone’s world. I’m being sarcastic. My response would not have been so polite, at least if she had made a second comment.

It brought to mind how I do things differently in modern times compared to back in the day when Fred Flintstone and I rode around together, feels like that at times. Back then if we went out to eat, my mom or dad went to the bathroom with me and drew up and injected right there in one of the dirtiest rooms possible. Why? Stigmatism. In those days if you saw someone with a syringe in a bathroom it was, what drugs are you using? That was on my mind each and every time we did that. It made me self conscious that I was making someone else feel uncomfortable.

I spent years trying to not offend or irritate people I didn’t know or really care about. My dad was really bad about this. “Let’s go in here to stay out of the way.” Seemed more like a “lets stay hidden so they don’t know we have issues” kind of move.

Now, I don’t care if someone sees me shooting up. I even call it that. Shooting up is usually a term used by druggies getting high, not diabetics saving their own lives. I never go into a bathroom to inject anymore. If someone flushes a toilet you just got sprayed with fecal bacteria. Does not matter much that you used alcohol or other disinfectant because once it dries it no longer works. That bacteria could hang in the air for several minutes before landing on the counter or faucet. Sorry to ruin people’s meals but this is reality.

I’ve had people come up and ask if I was diabetic, while I was injecting. There are so many of us now it is not as odd to see someone injecting in  a restaurant or store as it once was. 22 million of us in the USA alone and about 10% of them are type 1, insulin dependent for those not versed in the language. I make no apologies as I have come to terms with the fact that I die without it and refuse to say sorry for that.

My first response to someone who says they are not comfortable with me injecting is to take into consideration their timing. If they say something while I’m drawing the insulin from the bottle I will politely excuse myself to another area to jab and go.  Some people are sacred of needles and I get that. If they have waited, watching me draw it up and then say something while I have the needle stuck in my skin, well, they just out of luck. I am going to continue. A person who waits until it is too late will most likely be the person who pitches the biggest tantrum as well.

That is when my inner ass comes out. He is not nice nor is he well behaved. He will tell you most likely what you do not want to hear. I try to leave him at home but there are people in this world who seem to just be hunting for him. If you wish to be rude do not expect that to be a one way conversation. The worst mistake you can make is to think that because I am an “inferior” diabetic that I can’t defend myself. lol Game on.

My savior, the ACA

I know this is a hot topic for many people. I had a guy I know stop by while I was watering my new grass the other night. He and I got into it about the Affordable Care Act. I know it is broke and needs to be fixed but repealing it altogether is not the answer. Without this law removing the pre-existing condition clauses in most private insurance policies and leveling the cost for those of us who truely need it, life would be much harder to live.

My thought is we should have a national health plan like Canada or England or France or even Cuba has a national plan. I looked it up and the term 1st, 2nd, and 3rd world country is no longer used. Cuba is ranked 51st out of 177 countries. It is more 2nd world than 1st world and yet they can pull off a national health system. Why can’t we?

When I started a job recently, I was surprised to find out they had a pre-existing clause in the health insurance for the first year. Lucky I was making $400 a month more then than now. Still don’t knwo how that works, I make about $2 an hor more now than then but it is what it is. Point is most of my diabetic meds and doctors appointments for anyting diabetes was not covered.

Here is another worry about that protection being removed. I hurt my foot the last month of that clause and went to see the doctor. His first words were that I had broken it with a Lis Franc fracture. This is a rare dislocation fracture where you don’t have actually break the bone. The joint between your toe bones in the upper part of your foot seperate. He also claimed it was a diabetic issue. We are more likely to get these is what I gathered.

Awesome! They did high resolution X-rays, Cat scans, and then an MRI to find any evidence of the damage. None was ever found but the damage to my pocket book was done already. One of the 2 doctors who I had seen wrote it was diabetic related in their report to the insurance company. I was stuck with $5000 in tests for an injury they could not find or document and I got left with the aftermath.

I fought by contacting teh insurance company but they said as long as the doctor had wrote it into the repoprt there was nothing they could do. I had to talk to the doctor and get him to change his report. I never asked outright but he always referred to it as a diabetic complication. I never found anything about diabetics being more likey to get this break than a normal person.

It sounded more like a preformance issue to me. Horse riders get this when they fall off a horse and get their foot stuck in the stirrup forcing the foot to flex backward, hard. It also happens to football players who plant their foot hard while turning on the field. Kind of like turf toe.

This is the scary part, going farther with this, if you have ever been to a doctor and had a high blood pressure or high cholesterol, you now have a pre-existing condition. You might not have any issue currently from it but if you loose a kidney later it is because of your high blood pressure. Your high cholesterol may have caused your heart attack so it is not covered either

Yes, the ACA is broke that is obvious. Ever read it? I downloaded a copy and got through about 100 pages of the 2,000 plus page law. The first thing I noticed were the numerous amendments to it. It also struck me that in the section I read, most were there to add the term individal where it read group or employer in the original bill. Why?

I heard so many times back when this was being run through congress that the GOP was trying to block it. Did they add all those extra amendments? The GOP congress has already been into this law to change who gets penalized for insurance coverage for small companies. The penalties are gettiing much bigger this year, $100 a day for each employee not covered. That’s $36,500 a year for each employee.

Even if they decide to keep the pre-existing coverage they can still get around the issue by removing the conditions from insurance coverage. Just the last week or so congress and the president worked to remove pre-natal care and other women’s medical needs from insurance coverage. Michigan had a state representative who tried to remove pre-natal care, diabetese, mental health care, and anti psychotic meds from insurance coverage. Really? You want to remove a person from the meds keeping them stable? Look it up, it’s called the Drazcowski amendment. It scared the crap out of me with all the thing he was trying to remove from coverage.

Here’s my opinion on this this, if you remove these things from coverage, lots of people will drop their coverage since it will do them no good anymore. Insurance companies will love not having to pay out so much until they realized they also are not getting as much in either. I will end up on disablity and  Medicaid when I loose a foot or my sight from my blood sugars being so out of range due to not being able to afford my meds.

Dear Mister Trump and members of congress, I need you to FIX the health care situation, not make it worse for me. A true universal health care plan such as Canada or France’s plans would also help out employers. They will no longer have to shoulder the cost of these insurance plans. That means more money for adding employees or maybe going back to using more full time employees instead of cutting back  to more part time to avoid the insurance penalties. It depends on how the taxing is modified to cover the cost of this plan. With it being a larger inlfux of cash from a larger group of people putting in, the over all cost may actually come down.

Preparing for a new job

One of the challenges of being a diabetic is to be able to adjust to changes in life on the fly. I’ve got one coming up very soon, read that tomorrow. I will be starting a new job and will need to make changes to my pump. Can’t you just change the settings before you start? I can hear that comment being made by eager beaver home grown experts in diabetic therapies. OK my question is this, how do you change the settings? You will be working harder and longer than before so you need to lower your insulin, right? Not so fast. You can not possibly know how hard you will be working not to mention your daily activities will change even after they get set. Unless you have been trained top know how much insulin to drop to keep you steady.. That’s not to say I have no control over this. For 9 weeks I have been growing roots on the couch, well more than normal at least, so going back to work will be quite the change in life style. Of yeah it’s also on 3 rd. shift at night. It was the shift that really messed me up at a former job. The pump is a diabetics best friend as long as you know your body and understand the pump. What is most likely to happen is a temporary basal setting. Maybe 50% of normal to keep me from having to eat a bag of skittles every two hours. lol Until you know how your activity is going to change and how your body is going to react, you should not be making any permanent changes. Of course eating will also change so there will added compensation for that. Remember it is a three way balancing act to control diabetes. My last comment is an apology to anyone who follows these posts. Things got a little out of hand the last couple weeks with a home project as well as Mom ending up in the hospital and now in a nursing home for a while.