Left out

It happens.

I try to understand that it happens.

I tell myself that I would rather have a person tell me that they are not ready for the responsibility of watching my daughter during a sleepover party, or on a trip to the beach. I tell myself that if they are not able to deal with my daughter having Type 1 diabetes, then I do not want them to be in charge of her care in a situation when I might be out of contact for even a few minutes.

But it hurts.

It hurts me to even ask them.

And even though I understand it, it upsets me that some people are unwilling to take the risk.

She has not been hospitalized, lost consciousness, or flipped out since she was diagnosed. She knows to call me when her bg hits certain levels, just so that I can be part of her action plan for the day. And realistically, she can handle it all herself for a few hours. Odds are, nothing will go wrong.

But you never know.

If she loses consciousness, if she grows unreasonably angry, and the person in charge doesn't know what to do, it's a problem.

M's bg levels had been crazy. All over the place crazy. 595! 33! 578! 41! It didn't stop for days!

And when we finally had two days of it more or less under control, M was to go to a friend's house overnight and then join the family at Anime Boston to honor her friend's birthday.

The plans had been in place for weeks.

M was the only person that her friend invited.

Everyone wanted M to be able to go: M, her friend, me, the friend's mother.

This friend's mother is fantastic. She has traditionally been unafraid to take M for days at a time. But this was unusual. M's bg has only been back under control for a day or two.

I knew I had to make the call, and I hated it.

I explained the situation to the mom. She listened carefully, and asked several good questions.

I told her how much I hated asking her to take M under these circumstances, but I thought it was only fair that she fully understand what she was getting into.

After a few more questions, the mom stated that she would take M. She asked for contact numbers for the entire time she had M, as well as permission to treat letter in case of an emergency. Then she told me that the girls would refrain from the birthday cupcakes that she had planned to share.

I started to protest that M shouldn't be any more of a burden to her than necessary. She said, "No. It is not all right for my daughters to pig out in front of M when she can't enjoy it. We will save the cupcakes for later."

I have a friend who once told me that I can juggle a million things, and I am always in control: until my kids are sick. It unnerves me.

So, at this point I snapped: not in a bad way, but I could feel tears of relief stinging my eyes. My voice was trembling as I thanked her for her kindness, and told her how much I appreciated that she was willing to accommodate my daughter.

And I really did.

Anime peeps. Long story short, a good time was had by all.

No choice

So a few weeks ago I receive a letter from our insurance company.

It states that my daughter is on a medication that is "no longer a preferred medication".  And I think to myself, "Really. The only medication that she uses is insulin. Did you have an alternative for insulin you HMO bastard pieces of shit?" (We actually have a PPO, but I just love that quote.)

Upon further investigation, it seems that Caremark has decided that it no longer wants to work with Humalog (from the Eli Lily company in Indiana), and prefers to work with Novolog (from Novo Nordisk, a company in Denmark). They stated in their letter that failure to switch to the preferred medication may result in loss of coverage for the current medication.

This makes me nervous.

Why? Because the one student I know for sure uses this stuff has very wild swings in blood sugar during the day. His mother and I spoke about different kinds of insulins at a school event. She was touting Novolog as better because it works faster, more like natural insulin.

I thought that maybe we would try it, eventually. Maybe it would work more effectively with M's lifestyle, but we would wait to do it over the summer, if we did try it, so that we could monitor the effects of the change on her system without too much life getting in the way.

But the insurance company threw off my time line.

I asked another diabetic student about which insulin she used. She said that she uses Humalog, and that she had tried Novolog, but after trying it, her doctor wrote her a letter stating that she needed to switch back for medical reasons.

What were the medical reasons?

She wears her pump very discreetly, snaking the tubing from a pocket in her jeans to the infusion set on her thigh. While using Novolog, she said that she was developing divots on her thighs at the infusion site. Her doctor noticed that her muscles were withering where the Novolog entered her system, and successfully appealed the insurance company mandate.

I was a little alarmed.

I brought my concerns to our DNE, who immediately poo-pooed the idea. She had never heard of any of the problems to which I was referring. She told us that "There is no difference between the insulins, and anyone who tells you otherwise is blowing smoke."

After careful consideration, we chose to give Novolog a try without appealing the decisions of the insurance company. We hope that all will go well, and that we won't have to fight for an appeal in the future.

With lacrosse season starting up, I am hopeful that this new medication will interact with M and her lifestyle smoothly.

But I know better.

No adjustment is simple in D-world.

I will be sharpening my swords for battle, just in case.

Please don't make me use this.