Showing posts with label support. Show all posts
Showing posts with label support. Show all posts

Monday, January 21, 2013

Change

Change can be hard.

It can also be also be a chance to reflect on what is important.

This sweeping statement sounds somewhat romantic until you learn that I am talking about health insurance.

Up until recently, M was covered on her father's PPO coverage at his place of employment. This worked out pretty well on the day she was diagnosed. We paid about $38 each time we visited a specialist, and about $84 per month on insulin, and $87 per month on test strips. Also, we paid about $50 every six months for lancers, since M only changes them about once per day. Infusion sets cost us about $240 every quarter, so about $800-$1,000 per year.

All of this totals roughly $3100 per year in maintenance.

All very interesting, I'm sure.

But then Daddy got a new job. And insurance doesn't kick in for 90 days.

Okay then, let's get on Mommy's insurance plan: an HMO.

The insurance itself costs less, for sure. And prescriptions are a lot cheaper: $15 for test strips and insulin. Doctor's visits are $10. But M's current endocrinologist is not on the plan. In HMO speak, this means that the insurance will not pay anything toward M's care if we see her current doctor. At least on the PPO, if M's specialist was not on the plan, we would still get some coverage, but not as much as those "participating" in the plan.

So now what?

We have to change doctors.

We have been thinking about this for a while, anyhow.

After all, M's diabetes nurse educator would frequently give us conflicting advice, and although we asked repeatedly to be part of trials, we were never even told if any were going on. I assume that we were put toward the bottom of the list due to the fact that we live over one and a half hours from the hospital.

Fortunately, we have heard many great things about the hospital just 40 minutes away.

Searching the web, I learn which doctors are on our plan, which is somewhat helpful, but I can't find any information about the doctors themselves. So I turn to my new resource: the STAR parents.

I send an e-mail to the group explaining our situation, and within two days I have the names of the two favorite pediatric endocrinologists in the Dartmouth area, as well as the name of a favorite Diabetes Nurse Educator.

I contact our PCP (Primary Care Physician) and request that we be referred to the new doctor. (For all of you Russians out there who are mysteriously reading my blog, we in the States cannot refer ourselves to our own specialists: another doctor must "officially" make the request in order for our insurance to approve and pay for the visits.)

Service was excellent, and within a week I received a phone call from the new hospital confirming an appointment with our new DNE. The copay for the visit was $10.

So an HMO doesn't sound too bad, does it? Lower prescription prices (even if they do give us 100 fewer test strips per month), lower copay prices, a specialist nearby....

Except that if the diabetic stuff hits the fan, and we need to see someone "outside of the plan", the expenses may very well not be covered.

Which is why, after 90 days, we will be switching back to a PPO through Bill's new job. I will continue to remind myself: change can be good. But hopefully after the 90 days, we won't have to make another one for a while.

Saturday, January 12, 2013

Unpopular

In the STAR program, we had a parent meeting about 504 plans. Everyone in the room talked about how hard it was for them to get teachers and administrators to follow the 504 plans for their child.

When it was my turn to speak, I admitted that I didn't use a 504 plan.

The group leader was evidently distraught at the prospect of a diabetic child running around without some sort of paperwork marking her as "special".

I explained that each year I write a letter to every teacher and coach that comes into contact with M, and cc the school nurse, who is obviously aware of her condition. I believe that for M, this is special paperwork enough: especially since (so far) I have a system of open communication with the school she attends.

A parent in the group asked me if teachers allow her the special accommodations needed to manage her type 1 at school. I responded that yes, they do, although M sometimes needs to remind them that she has diabetes.

For example, M's math teacher, whom she adores, was giving a test when M realized that the tubing on her pump was leaking. Panicked, she raised her hand and asked to go to the nurse.

"Can it wait?" the teacher asked.

M shook her head, "no" and was sent on her way.

When I spoke to the same teacher at a regularly scheduled parent conference, she admitted that she had forgotten that M had diabetes. "I assumed it was a female issue", she told me.

We took that opportunity to explain what diabetes is, and the multiple ways it can present itself in class.

She was sincerely fascinated, and we nearly ran over the allotted time.

A parent in the group said that rather than having to give "mini lessons" like this to M's teachers, a 504 would educate them. and save me time. Then she told me about her yearly ritual: she holds a meeting with all of her child's teachers at the beginning of the year to explain what diabetes is, and how to care for her child. Then each teacher is handed the 504 and the care plan, and asked if they have any questions.

I listened to her, and what she said made sense. But arguing that the 504 would somehow save me time was not true. I could hold such a meeting with M's teachers and never hand them a sheet of paper.

I was smart enough not to say this, however.

But the group leader leaped on the parent's comments and took the opportunity to press the issue with me. As the entire group looked on, she explained that since the 504 is a legal document that it would protect our family. "From what?" I wondered. If something serious happens to M in school, all a 504 does is give me the right to sue the school, which, considering that I had already laid it all out in a letter, is probably true anyway. Suing a school wouldn't help me, and a 504 is no guarantee that she would get the care that she needed. I mean, I know it couldn't hurt, but with only two and a half years left of public high school, was it really worth the effort? After all, when she was in a teeny-tiny Montessori school, M didn't even have a school nurse and managed quite well.

The group leader told me that she would be happy to help me with the legalities and formation of the document, to which I shrugged and replied, "You know, it's a lot of work, and I just don't want to do it."

After that little tidbit popped out of my mouth, a nano-second of doubt occurred: a tiny moment where I felt sure that I had said the wrong thing and would be upbraided in front of my peers.

But nobody said anything, and we just moved on to another topic.

Yea me!

Now we'll see if anyone talks to me at the next meeting.

Monday, August 29, 2011

Charlie Kimball

Almost immediately after M was diagnosed with Type 1 diabetes, Bill and I learned that recently confirmed Supreme Court Justice Sonia Sotomayor also had Type 1. We were excited to be able to hold up a prominent role model with Type 1, so that M could see that, even living with Type 1, many possibilities were within her reach.

Sorry Sonia, just not cool enough for an 11-year-old. WE love you, though!


Unfortunately, M was 11 years old at the time, and a supreme court justice with Type 1 did not impress her.

Nick Jonas, on the other hand, did.

At least M notices you, Nick. Even if she prefers your brother.

She watched the Jonas Brothers TV show, and although she preferred Kevin, she admired Nick's handling of the disease. She even bought the Nick Jonas dog tags that helped support diabetic research. And she wore them almost every day.

A few months later she heard about Brett Michaels, some old 1980's rock star, who had Type 1, and she thought it was nice that he won Celebrity Apprentice and donated his winnings to the American Diabetes Association.
Live to rock, rock to live, Baby!

But this year, her father learned about a race car driver who had Type 1. Being a car guy and a mechanical engineer, he found the story of a man driving a car at over 200 miles per hour while managing his bg fascinating.

The man's name is Charlie Kimball.

"Hi, I'm Charlie Kimball!"

Now, if you think that what M goes through every day sounds like a royal pain, you should hear what a normal day at work looks like for this guy.

When she turns 16, M will have to check her bg before starting her car each and every time that she drives. This is so M can treat herself prior to operating the machine if she needs to. If she does lose consciousness, she might hit a tree, or another person/car/cat, and someone could be hurt or killed.

If Charlie has a dangerous low on an ordinary work day, he will likely do millions of dollars in damage to many cars, and most certainly injure or kill someone along the way. Charlie says that no one in the race circuits has ever expressed concerns about his diabetes. I suspect that they really don't understand the disease.

Of course, Charlie is VERY responsible and keeps a doctor on staff in the pits with him.

Instead of a water tank in the car, Charlie has a water tank AND a sugar-water tank, in case his bg slips down a little.

Well, you may be thinking, how does he know what his bg is? It's not as if he can pull over and check his bg with a lancet and some test strips. Well, Charlie has a CGM (continuous glucose monitoring device). This nifty device constantly reads bg, and indicates a trend line showing whether his bg is climbing or descending. Pretty nifty, huh? He straps the monitor to his steering wheel, and calls out his bg readings to his doctor over his headset. She then lets him know what corrective actions to take, if any.

I cannot imagine trying to drive 185 mph, two feet away from 35 other cars while managing any health problem, so my hat goes off to Charlie. Our whole family is - in the New England vernacular - "wicked impressed."

While at diabetes camp, M has heard from skiers and bicyclists who talked to campers about managing their Type 1 while pursuing their athletic dreams. This year, it was Charlie Kimball who came to speak to them.

M loved him. She said that he was interesting, kind, engaging, and that he was smart enough to know to repeat some of the quieter questions from the crowd so that everyone could hear.

As a mother, I appreciate Charlie Kimball. He has faced his diagnosis without fear, and has embraced the diabetic community. He, although diagnosed just four short years ago, has begun giving back to that community.

I wish Charlie the best of luck. Our whole family will be watching him!

Monday, August 8, 2011

You too?

There are times in life when one must talk to someone that he barely knows, or perhaps has met for the first time. Maybe he is in a long line at the supermarket, or watching his toddler play at a park, or eating lunch during a seminar required by his employer.

During those times, one makes small talk.

One chats about the little niceties: where he is from, how he got into the business, how old his kids are.

And sometimes one discovers that the person with whom one is speaking shares something in common.

"Hey, my family is from Connersville too!"

Or "No kidding, I also studied in Seville in 1988!"

Or, "Oh my goodness, my in-laws live in the house where you grew up!"

Or, "You must have gone to high school with my cousin!"

In these situations, where small talk is paramount, diabetes rarely comes up.

But sometimes it comes up ... later.

I am pretty involved in my church, and due to my involvement with said church, I know a great number of wonderful, kind, generous people. People who would give you their right arm if you asked for it.

This week, one of those people walked up to me after mass. It had just been announced that a new person (not me, this time) would be chairing the Christmas fair this year. I figured that this woman, with whom I had volunteered many times, wanted to ask me about my decision, or make the observation that my life should be "a lot more relaxing now".

The assumption stemmed from the fact that several people had already approached me about it BEFORE mass.

But this woman caught me off-guard by asking me a totally unrelated question: "Does M have diabetes?"

When I responded yes, she told me that she had Type 1 diabetes herself.

Now this puts us in the weird position of having the "Wow! Me too!" conversation often overheard in airport lounges. Weird, because we are "happy" to know another person with diabetes. Weird, because, in reality, we don't want anyone in the world to have diabetes.

But there is a sense of relief in knowing that one is not alone, isn't there?

I have known this woman for about 10 years, and never once did diabetes come up. But recently, the woman's daughter had gone to "Jesus camp" with M, and noticed her insulin pump, thus prompting my friend's query.

With giddy chatter, we shared our experiences.

We discussed the diagnosis whens and hows: M's ( age 11, sick for 3 weeks) and hers (age 8, sick for 2 weeks).  The evolution of D technology ("Wow, it's been really amazing"). Pump or injection (Pump). Support systems ("Not really, I don't know anyone else with diabetes"). Family history of Type 1 (none for both).

I asked her about her two pregnancies ("That was really hard").

I thanked her for telling me, and told her I was glad to know that she had Type 1. After all, she looked pretty normal to me, which gives me hope for M. It's nice to know that she has a shot at being a 40-something mom with two teenaged daughters, too.

I left church feeling blessed, which I guess is the purpose of church, really.

But I have a plan for the next time I go to church. I plan to pray that soon there will never be a need for someone to feel happy that someone else has diabetes, just so they will know they are not alone.

Heck, I'll pray for it now.

Amen.

For everyone.

Friday, June 24, 2011

Lions and Angels

After M was diagnosed, several people told me that I simply must send her to diabetes camp, that it did wonders for their child, niece, grandson, the neighbor's kid.

The fact of the matter was that M was diagnosed at a very inconvenient time. Inconvenient because a) I was broke, and b) camp sign-ups were already done for the year.

A buddy of mine from church also asked if I was planning to send M to diabetes camp. I told her that I would like to the following year, but I wasn't sure if I would or not. She was wise enough to read between the lines, and told me that she was part of the Lion's Club. These are the same people that collect old pairs of glasses to help people who can't otherwise afford them. She said that they usually have scholarships for kids going to diabetes camp. I told her I would keep it in mind for the following year.

The following year, my buddy reminded me to apply for a scholarship for M. I didn't think we'd qualify, and I was afraid that even if we did, we would not be able to pay the balance. We were getting by, but things were really tight. I thought we might have to pass up camp again this year.

Then Auntie Jeanne stepped in.

Auntie Jeanne is M's godmother, guardian angel, and fantastic human being. In fact, when I discuss her with people outside our shared social circle, I refer to her as "Auntie Jeanne" so that she will not be mixed up with any of the other, less important, Jeannes in my life.

Auntie Jeanne offered to pay for a large chunk of M's diabetes camp.

I cried.

Then I applied for the scholarship.

The Lion's club paid $900 of M's camper fees, leaving only $300. Jeanne paid the balance.

I am so grateful for groups like the Lion's club, who make it possible for kids like mine to attend a camp that would otherwise be out of their reach.

I wept again after dropping M off at camp, so grateful that my daughter would have this opportunity to be with other kids who had to watch what they eat and inject themselves with insulin. I am not glad that there were so many of them, but I was glad that they weren't alone: that they had to explain nothing to anyone. Although the focus of camp is diabetes, in some ways it is like a diabetic vacation.

M was a big hit at diabetes camp. She went bass fishing, wrote at the camp newspaper, made videos, went swimming, and generally had a ball. People hugged her like mad when she left.

And she can't wait to go back.

Monday, January 17, 2011

Look who else had diabetes

As a Spanish teacher, it is practically required that I be the advisor for the school's Spanish Club, which I am. One of kids in the club has Type 1. On one particular day, he had a low during our meeting. I will discuss the details of his low another time. We got him out of his low by feeding him, and made him feel better by having him drink water.

There is a parent who usually tags along for these meetings, primarily because his daughter forgets to tell him to pick her up later that day. In addition, she is a kindly daughter, who doesn't mind other kids knowing that she has parents. She does not make her father sit in the car for an hour while she is in the meeting. This parent is relatively unobtrusive, and periodically makes helpful comments or suggestions to the group about whatever project we are doing.

During my student's low, this parent seemed to have a strong handle on what was going on. He did not freak out, say unwise things, or feed into the slightly panicked feeling that some of our club members were feeling when our Type 1 friend said that he felt dizzy. Nor did he try to step in and take over.

After everyone had left the meeting, the parent and his daughter stuck around for a moment. I went in for the kill.

"May I ask who in your family has diabetes?"

Dad said, "I do."

Ah. He really is an expert.

"I've had diabetes for 43 years. I got it when I was 11."

Holy smokes! I am 43 years old. Forty-three years with diabetes sounds like a long time. What a bummer.

On the other hand, I hope M gets to have 43 years or more of healthy looking life. Without diabetes would be better, but seeing this parent makes me think the alternative might not be so bad.

Long story short, Dad has a pump. He is very grateful to have a pump. He thinks that large doses of Lantus are dangerous, and that we should work to get M on the pump right away.

This statement is a direct contradiction to what my cousin, who has Type 2, told me. He told me that the only two friends he had who used a pump are dead. He told me that I had better REALLY research the pump, because it's dangerous.

You might see how parenting a child with diabetes can be scary. Basically, you are looking for the treatment that is less likely to kill or do permanent damage to your child. It stinks.

Pump users can be pretty persuasive, especially after you pepper them with all of your well-thought-out questions. The questions that have been keeping you up at night. After speaking with this parent, and with the parent of my Type-1-low-member-of-the-Spanish-Club, I may be leaning toward the pump. M and I have an appointment with her Diabetes Nurse Educator in a few weeks. Will keep you posted.
Now it's time to pepper the DNE with questions.