80 Days Later…

80 days.

That’s how long it took for me to receive the letter from my health insurance company notifying me (at long last) that the pre-authorization for my Dexcom supplies came through – and more importantly, was approved.

Those 80 days were fraught with anxious thoughts. On a daily basis, I wondered…

When would I get my next Dexcom order? Answer: Almost three full months after I started my new job and switched health insurance.

Would I even still be able to use Dexcom under my new health plan? Answer: Yes, although I wasn’t sure for a long time seeing as I didn’t find out until recently that I needed a prior authorization in order to get Dexcom coverage.

Why was it taking so long? Answer: It took so long partly because this stuff can be time-consuming. I work full-time, maintain a home, care for my dog, and juggle a jam-packed social calendar…and don’t often have the bandwidth to be waiting on hold with my doctor’s office, my health insurance provider, and my Dexcom supplier. I was counting on all three of the aforementioned parties to do a little more of the heavy lifting for me when I should’ve depended on myself alone to make sure I got my supplies as quickly as possible.

What was I doing wrong? Answer: Honestly, even though I sound like I’m shouldering most of the responsibility in the latter paragraph, I don’t think it’s fair to pin this all on me. Sure, I could’ve and should’ve hustled harder to get my Dexcom supplies, but I put trust in a system that I already knew is fundamentally broken. Health insurance can be ridiculous complicated to understand and contend with. I’d never needed a prior authorization for anything before, so that concept was new to me. Throw a new health plan that I had zero familiarity with into the mix and I was bound to encounter some bumps in the road to get my supplies.

I was so excited to get this letter in the mail that I took a damn picture with it.

That’s why I almost cried tears of relief and joy when I finally got the letter from my insurance company that informed me my Dexcom supplies were approved. The waiting period was over. 80 days of fretting over whether or not I’d have access to a tool that has revolutionized my diabetes care and management was absolute agony. That period of time also represented the first time I was truly worried over whether or not I could continue with the diabetes regimen that works for me. I was trying to remember the days before my Dexcom, the days that I had finger pricks and finger pricks alone to base my diabetes decisions on.

I could scarcely remember those days. And the fact that they could’ve become my new reality if I didn’t figure out the Dexcom situation frightened me.

I feel very fortunate that I was eventually able to successfully place an order for my Dexcom supplies under my new health plan, but I also feel rage that the system made it so difficult, as well as utter heartbreak for those who don’t have choice when it comes to diabetes supplies or even access to life-altering (and life-saving) medications.

I’ve said it before and I’ll say it again…our healthcare system is broken. Choice and access matter.

They matter most of all when lives depend on it.

A Human Garbage Disposal

Sometimes, I feel like I am a human garbage disposal.

It’s not everyday, but there are occasions in which I want to eat anything and everything within arm’s reach like it’s the last meal or snack that I’ll consume for days. When I’m experiencing a low blood sugar, I’m especially likely to inhale food as if I’m a living Hoover vacuum…or as I’ve come to think of it, a human garbage disposal.

There’s no doubt about it: Diabetes has totally screwed up my relationship with food. I’ve written about this previously. I’m also just as sure of the fact that my relationship with food has gotten worse as I’ve grown older, a phenomenon that I blame on numerous factors such as the natural process of aging, social media, and society’s constant scrutiny of how women’s bodies “should” look. Add my diabetes into this mix and I feel like trash about my body and harvest negative feelings towards food (despite also loving food).

I definitely blame my diabetes for ruining my relationship with food.

So yeah, a human garbage disposal – with diabetes, no less – feels like an accurate way to describe me and my relationship with food.

Don’t get me wrong – this isn’t a “pity me” post. Not at all. This post is more so me…trying to understand what can be done to repair my relationship with food. Because I think if I can repair it, then I can start seeing positive outcomes on my blood sugar and start to strengthen my own sense of self-love. These are important things, you know, and I’ve hit a point where I’m just tired of feeling so damn negative about my diabetes, food, and my body all the time.

I might feel like a human garbage disposal lately, but “human” is at the forefront of that phrase. I’m human, I make mistakes, and my relationships with my diabetes, my food, and my body are bound to ebb and flow over the years.

At the end of the day, I think it’s just a matter of making peace with that.

Highs Won’t Ruin My Happy

High blood sugar isn’t fun.

When I experience it for prolonged periods of time (say, 2+ hours), I’m far from a happy camper. I anxiously check my Dexcom every 5 minutes until I see my blood sugar start to come back down to range. I gulp down glass after glass of water. I stack insulin (only sometimes). And I will even march or dance around in place as a means of getting my number to come down faster.

Needless to say, my mood tends to be pretty foul when I have a high blood sugar…

…except on the occasions when I refuse to let it steal my happiness.

One such event recently occurred. I was away for the weekend to attend a wedding that I was so dang excited to go to. I couldn’t wait to get all dolled up and spend some quality time with my partner and his friends. It was the first large event that I was going to since the pandemic began, and I admit there were some nerves despite being fully vaccinated. However, I felt better knowing that 1) everything was taking place outdoors, 2) I was surrounded by other like-minded individuals, and 3) I would still be taking extra precautions (e.g., using copious amounts of hand sanitizer all weekend long) to make sure that I was protecting myself and others, too.

I just wanted to have fun without worrying about the what-ifs…delta or diabetes be damned.

High blood sugar was no match for me and my happiness bubble.

And I just wanted to live in what I’ve since dubbed my “happiness bubble”, otherwise known as my own personal la-la land, in which everything is lovely and safe and none of the world’s many issues can penetrate.

An ignorant and naive place? Yes, for sure, but one that allowed me to embrace everything about the weekend:

It allowed me to enjoy every bit of food and drink all weekend long, even though it caused crazy high blood sugars.

It allowed me to forget about my diabetes for awhile and just soak up the company of others and the (truly beautiful) environment that I was experiencing.

It allowed me to feel bliss that I hadn’t really felt since before the pandemic.

Sure, it’s not sustainable to live this way all the time, and it definitely is not an effective diabetes management tactic. However, it was beyond worth it, just for a weekend, to live in my happiness bubble that high blood sugars or diabetes couldn’t ruin, no matter how hard they tried.

Diabetes, The Great Interruptor

I sat down to write a blog post and didn’t make it past the first sentence when I heard a loud beep emitting from the pod I was wearing on my leg.

The beep was signaling to me that it was time to change my pod. And because I wore it for a full 80 hours, it couldn’t wait even 15 minutes – it had to be done immediately.

That little interruption got me thinking about how diabetes it the greatest interruptor that I know.

Diabetes makes my 10-month-old Sheltie seem like she’s got the patience of a saint.

Let me name just a few of the ways diabetes interrupts me on practically a daily basis:

  • When I’m exercising and I have to stop because I have a low blood sugar
  • When I’m in a work meeting and a high blood sugar gives me brain fog that prevents me from making any meaningful contributions
  • When I’m sleeping and a high or low alarm goes off
  • When I’m trying to cook dinner and diabetes refuses to wait any longer for food and makes my blood sugar go low, causing me to have to eat a snack before eating a full meal which is totally counterintuitive
  • When I’m in the middle of work, a conversation, or any ordinary task and my devices beep incessantly, not caring that they’re being obnoxious

These are just some of the scenarios I can think of in which diabetes is unrelenting in its immediate demands. It’s like taking care of an extremely fussy baby that doesn’t ever get any older. It’s exhausting.

Diabetes is truly the great interruptor, one that people like me living with it have learned to cope with…which definitely makes us some form of superhero, IMHO.

Switching Jobs Means Switching Health Insurance: My 4 Tips on How to Make the Transition Easier

Hi, my name is Molly and I have type 1 diabetes, and although I am extremely grateful for health insurance, I also hate every aspect of it.

When I aged out of my parents’ health insurance plan two years ago, I was completely lost and overwhelmed by choosing my new plan. How much would I have to pay for my supplies? Would everything be covered? Could I keep my doctors? How much money should I put into my FSA? The answers to these questions took me a good chunk of time to figure out, and I only started feeling good about my knowledge of my old job’s health insurance plan in the last year or so.

As a result, the only thing that made me less excited to start my new job was the burden of having to figure out a new health insurance plan. And for good reason, it turns out, because it has been a challenge to say the least. But there are a handful of things I’ve learned along the way that I don’t think I’ll ever forget so that I can have an better experience the next time I need to change health plans. Here are my tips for making the transition from one health insurance plan to another as easy as possible:

1. Take stock of ALL my supplies before starting the new job (and before losing my old job’s health coverage). This was, without a doubt, the best thing I could’ve done for myself before I started my new job. In my last few weeks with my former company, I looked through all of my diabetes supplies and inventoried them. I kept a running list of the most important items (things like insulin, Dexcom sensors/transmitters, and pods) and decided that even if I had plenty of those things, I would still place an order for them before losing my health insurance. This ended up being a fantastic idea because it took me a solid couple of weeks at my new job to figure out which health plan would work best for me, and in that span of time, my supply stash was dwindling. On top of that, it took several more weeks for me to get all my prescriptions straightened away (more on that in tip 3), so I was especially grateful that I had seriously stocked up before leaving my old job.

2. Compare plans extensively. Like I mentioned above, I spent a couple weeks reading through my plan options before I finally settled on one. It took me so long because I wanted to feel 100% comfortable with my new plan, and I knew that I had a 4-week period to complete my research before committing to a new plan. Plus, my new job uses a website that offers a health insurance plan comparison tool (a super cute one, to boot, that explains all things insurance in layman’s terms) that I was happy to take advantage of during the decision-making process.

What tips would you have for someone who is switching health insurance plans?

3. Send as many messages and make as many phone calls as it takes until everything about the new plan is crystal clear. For me, this including calling my local pharmacy and sending toooons of online messages to my doctor’s office, as well as my new health insurance provider. I honestly felt like I was playing a game of telephone – you know, that game that kids play where they have to whisper a message into each other’s ears as a test of listening and communicating effectively – because it seemed that nobody would take accountability for sending my prescriptions to the right place or understanding exactly how I needed help. So in the last few weeks of July (leading into the first few weeks of August, really, ‘cuz I’m still working on this), I made a vow to myself that I’d get to the bottom of everything and get my prescriptions fully straightened away. I’m happy to report I’ve made substantial progress, but I’d be lying if I said it didn’t require a lot of my spare time and energy.

4. Talk to coworkers and ask for their feedback on plans. This might be unique to me because I work for a diabetes organization and my colleagues have an intimate knowledge of health insurance hurdles combined with a chronic illness, but even so, I remember asking coworkers at my previous job about their thoughts on the health insurance offerings and I got some solid feedback from that. So that’s why I decided to ask around at the new job, and of course I was met with helpful replies that made my transition a little smoother.

The biggest lesson I learned throughout this process? I realized I need to give myself a little grace. This stuff isn’t intuitive to anyone (unless you’re some sort of health insurance guru). I shouldn’t beat myself up because the system is more complicated than it needs to be. And bottom line is that I need to focus on the fact that I have choice when it comes to health insurance, period, because I know that there are too many people out there who can’t say the same.

So I guess in a way I am glad for the challenges presented to me by my health coverage.

How I React to People’s Diabetes “Horror Stories”

I attended a family reunion earlier this month and got into a conversation with a relative who’s well into her 90s. She was asking me what I do for a living and I kept my explanation fairly high-level: “I work with college students who have diabetes”.

(Which, side note, I help handle the communications side of things for CDN and so far, I don’t often interact with the students…but I figured this was still a semi-correct answer that spared me from getting into the social media aspect with someone who’s probably never even heard of Instagram.)

Her response to my job description was…interesting. She started telling me the story of a “young bird” she once knew who had diabetes, needed dialysis, and then got her foot amputated. And then died.

This is a classic diabetes “horror story” that people often seem to tell when they discover that the person they’re speaking with has diabetes. It’s a story that’s told as a knee-jerk reaction: Either the person expresses their sorrow for the fact that the other person has diabetes, or they tell the tale of someone they knew who had diabetes and suffered immensely from it.

It’s a strange phenomenon, for sure, but one that happens across the board to people with diabetes.

You might be wondering…how do I react in situations like this? Is there a right or a wrong way to handle them?

Diabetes horror stories are not among my favorite kind of tales.

I chose to navigate this particular interaction by nodding sympathetically. While I truly was sorry to hear about this “young bird” and her fate, I was also very uncomfortable by the story. I’ve never felt “okay” about discussing diabetes complications because they scare the living daylights out of me, and I also was completely caught off-guard that a simple question about my job was enough to trigger the telling of this vignette. So for me, this wasn’t exactly a teaching moment in which I could correct this distant relative of mine and explain why it can be harmful to tell these horror stories; in fact, this whole incident made me realize that I don’t think I’ve ever truly reacted to a diabetes horror story when it was told to me.

And I think I’ve finally figured out the reason why…I just don’t want to engage with a person who’s going to react to my diabetes by telling me about the terrible outcome experienced by someone with diabetes who they may or may not directly know. What’s the point? What else am I supposed to say besides I’m sorry? I can’t really think of a graceful way to turn the conversation around, so for me, it’s always felt easiest to just nod, smile, say something compassionate, and then end the conversation by walking away or changing the subject completely. It’s not right or wrong, per se, but at least I know that I’m doing right by myself and my comfort levels.

This tried-and-true tactic of mine just goes to show that not every diabetes anecdote can be turned into a teachable moment – at least, not in my opinion or experience.

Diabetes in the Wild: Go-Kart Edition

Diabetes in the wild moments happen when they’re least expected.

I mean…I never go out anywhere in public assuming that I’ll run into another person with diabetes, or a person who will recognize my Dexcom sensors or OmniPods as diabetes devices. It just happens organically and it’s always a unique encounter. But given that my other most recent diabetes in the wild experience left me feeling awkward and uncomfortable, I wasn’t exactly looking forward to having another one any time soon.

But on my vacation, I did indeed have one that I’m pleased to share was much more pleasant than the last.

Yes, this is a graphic of an insulin pump taking a trip around a racetrack.

I was waiting in line for go-karts – as one does on vacation – when the woman in front of me spotted my Dexcom and asked me if I was type 1, to which I replied that I am.

This launched a short conversation about diabetes technology in general. She expressed knowledge of the OmniPod and I told her that I was wearing one, and she nodded eagerly and said how much easier it makes her life in the summertime, when she’s frequently swimming and doesn’t have to worry about disconnecting her tubing before going for a dip (a comment which I wholeheartedly agreed with). We exchanged a few more words about our diabetes devices, and before she turned her attention back to her group, she thanked me for taking the time to chat with her.

I couldn’t help but smile after the whole interaction. After all, it was kind of nice knowing that another person who just “gets” diabetes was standing inches away from me and looking forward to a carefree go-kart race, too.

How I Learned the Importance of Carb Counting

This blog post was originally published on Hugging the Cactus on April 6, 2018. I’m reposting it today because most people know that carb counting is important to a person with diabetes, but they might not understand exactly why. This post features an example that demonstrates all too well the negative implications associated with neglecting to carb count. Read on to learn how I figured out the importance of carb counting…the hard way…

One recent evening, I was rummaging through the kitchen pantry and noticed a bag of “veggie stix” stashed away, waiting to get opened. The sight of the bag instantly brought back memories of a time I was blatantly irresponsible with my carb counting and insulin dosing…

I learned the hard way that neglecting to count carbs can lead to scary high blood sugars…

…It was my junior year of college. I had plans to meet with a friend for dinner at seven o’clock. While that’s a standard suppertime for many people, it was kind of late for me. So that explains why I decided to treat myself to a snack a couple hours before it was time to go, just to hold me until I had my meal. My snack of choice? A bag of veggie stix just like these were sitting in the kitchen of my on-campus apartment. I thought I’d help myself to a few, believing (naively) that I had enough self control to know when to stop shoveling them down my gullet. That’s right, instead of doing the right thing and counting out a bunch before stowing the bag away, I was blindly consuming handful after handful without dosing for a single stick.

I can’t even use the defense that these veggie stix are strangely addicting – they really are, they taste a little like those potato sticks that used to come in cans – because I knew what I was doing wasn’t good for me. I just didn’t care. I had munched my way through half of the bag when it dawned on me that it would probably be smart to stop myself from eating more. I rolled up the bag, returned to my room, and did some homework until it was time to meet with my gal pal.

Little did I know that my blood sugar was rising to potentially dangerous levels.

I didn’t find out how high I was – over 400 mg/dL – until I reached the sandwich shop and had a plate full of chicken pesto carb-y goodness waiting to be consumed. My face must’ve shown my shock, because my friend asked me if I was alright. I quickly explained to her my mistake, and took an extra large bolus to cover my food and correct my blood sugar. Once that was done, I somehow managed to stop panicking long enough to enjoy the dinner with my friend, even though I couldn’t eat a bite of mine until an hour or so after injecting my insulin.

Although it sucked to go through this, I’m kind of glad that it happened because I learned a major lesson from it: ALWAYS count my carbs. It doesn’t matter if I WANT to be lazy or pretend that my diabetes doesn’t exist, I HAVE to hold myself accountable. It may be mentally draining and a bit of a nuisance, but it’s my own health here. It’s up to me, and me alone, to manage it.

And by the way, I did just help myself to the above bag of veggie stix. I had exactly 24 pieces, which equals exactly 5.4 grams of carbohydrates – a much smaller amount than what I ate that one night five years ago.

My Close Encounter with the Keto Diet

Remember that time that Oprah Winfrey did a Weight Watchers commercial and proclaimed loudly and proudly before the cameras that she loves bread? (If you don’t know what I’m talking about, here’s the link to the ad with a little doctoring done to it – it is worth a watch.)

Well, I can relate to Ms. Winfrey – except my obsession with carbs extends beyond bread. I love cake, candy, chocolate, pizza, pasta, sushi…and just about every other carbohydrate-laden food that exists. So while I think it’s awesome that many of my peers with T1D choose to follow low or close to no-carb diets, that’s not the kind of thing that works for a girl like me: I’m happy managing my diabetes in tandem with a moderate carb intake. But that’s not to say that I don’t eat lower carb sometimes or that I don’t have an interest in the principles of the keto diet, just because it’s so restrictive.

At least, that’s what I used to think about it.

Would my love of carbs prevent me from trying out aspects of the keto diet?

When my boyfriend decided to go on the keto diet back in May (he’s had experience with it before), I was simultaneously impressed with his dedication to it, but also a little worried. We have dinner together a few times each week and since I wanted to show him that I support him 100%, I knew that I’d have to change up my cooking so it adhered better with the dietary guidelines of keto.

So for the last two months, I’ve had a lot of exposure to the keto diet, and this is what I’ve learned about it:

  • It’s not as restrictive as I thought it would be. I figured that eating strictly keto meant that the only food groups we could eat were meats/proteins, fibrous vegetables, and cheese. That wasn’t 100% true. While we stuck to proteins and vegetables for most dinners, we also had plenty of snacks that kept things fun and interesting. I developed a mild addiction to cheese crisps and chicharrons (otherwise known as pork rinds). I also had a lot of fun trying different keto dessert options out there, including cookies, ice creams, and peanut butter cups (the latter being my absolute favorite).
  • Snacks can get expensive. One of the keto peanut butter cups that we ate cost $10 for a bag of 7. That’s an insane price. When you factor in the cost of other more expensive grocery items, like beef jerky or nuts, things add up quickly, which is definitely a downside to the keto diet.
  • My blood sugars tended to respond well when I ate keto…for the most part, anyways. Eating keto dinners was mostly great for my blood sugar and it stayed relatively steady more often than not. On the occasions it didn’t, it was because I was trying to bolus for the amount of protein or the negligible amount of carbs in the veggies I was consuming at dinner, and I would go low as a result. There’s an art to bolusing on the keto diet, for sure, but since I was half-assing it (really quarter-assing it) and not following it all the time, I never got a grip on how to account for minimal carbs.
  • Keto can inspire creativity in the kitchen. The best thing I made, ate, and loved throughout my experience with the keto diet was cauliflower crust pizza. I found the best recipe for it that was so easy to make and yielded delicious results. I always assumed that cauliflower pizza crust would be too difficult to make or not satisfying in the same way that pizza is, but that isn’t accurate at all. I grew to appreciate the challenge that keto presented me to come up with new things to eat that were tasty and filling, which I didn’t expect but liked.

Swimsuit Season is Here and My Diabetes Gadgets and I are Not Ready

A “yay”: Summer is here!!! Hooray for warm weather, beach trips, and backyard BBQs! (Not to mention VACCINES!)

A “nay”: My pods and my CGM sensors are about to bare themselves for the world to see and we are NOT READY for it.

My confidence in my appearance is rarely, if ever, high. But I like to fake it ’til I make it and act like I’m rocking my summer wardrobe instead of stressing about how my legs or arms look in the staples of the season that are designed to show more skin.

Usually, I have a lot more success in feeling good about how my medical devices appear on my body. Whether they’re hidden under my clothes or out for the world to see, I typically don’t care because these gadgets are keeping me alive!!! And that’s a lot more important than any negative body image connotations they may create.

A picture from a time during which I was very okay with PDA (public displays of my arms).

But something about this year feels different to me. I am so not looking forward to the extra stares that my diabetes technology attracts. I’m not sure if it has to do with being sheltered in the last year and a half because of the pandemic, but whatever the cause may be, this is something I’m grappling with as the temps creep up and the temptation to hit the beach grows stronger.

I know I’m not the only one dealing with this. In fact, I was in Maine for a couple of days with my parents and I was wearing my pod on my leg, whereas my mom had hers on her arm. And we had multiple people approach us about our pods! They weren’t necessarily rude in their approaches – curiosity drove them to speak with us and that’s innocent enough – but it’s still weird to know that people are looking closely enough at our bodies to see our devices and feel comfortable enough to ask us about them. Plus, I felt extra self-conscious about it because in typical Molly fashion, I had a sunburn all around my pod thigh site…when applying sunscreen, I almost always miss the area directly around my pods because I’m afraid of the sunscreen making my adhesive weaker or interfering with the pod’s functionality. So not only did I have this big chunk of plastic sitting on my leg, it was also red all around the site, drawing even more attention to it. It was a relief when I was able to put shorts on over my swimsuit and cover up both the burn and the pod.

So while I’m not loving how wary I’ve felt lately about baring my diabetes devices, I’m also coming to terms that it’s just a sort of phase that I’m going through right now. And that’s okay. I’m also trying to remind myself that I don’t have to feel obligated to go into detailed explanations when people ask me about my pod or CGM. It’s a natural tendency that I have to use it as a teaching moment and be a good diabetes advocate, but sometimes I just don’t have the energy for it. I’m keeping my fingers crossed that as the summer season goes on, my comfortability with my diabetes devices increases and I worry less about the looks they tend to draw.