Category: Living

I Finally Had an Endo Appointment, and…

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…and it went well. Much better than I anticipated, both to my surprise and delight.

I’ve written here and here about my long overdue endocrinology appointment and my struggles deciding whether or not to pursue a new doctor. I eventually settled on taking an appointment with a nurse practitioner at my current endo’s office (mostly because I wanted advice from a professional sooner rather than later).

But my expectations for the appointment were low. I was doubtful that the NP would take the time to listen to, let alone address, my concerns. Fortunately, she proved me wrong.

My appointment – and the NP herself – really exceeded my expectations.

After we introduced ourselves to one another, I opened up to her that my previous appointment with the endocrinologist had been disappointing. I’d like to think I was gentle but brutally honest in my approach: Using kinder words than this, I explained to her that I felt like my last appointment was a waste of time and that I disagreed with the doctor’s assessment that I was doing just fine with my diabetes management. My sentiments were met with sympathy as the NP let me vent to her about where I felt I was lacking in terms of my diabetes care in the last several months.

The appointment lasted roughly 20 minutes or so, and by the end of it, several things happened: 1) I was given a new test kit and test strip prescription (I told the NP that I distrust my Livongo meter and want a reliable back-up for when I’m not wearing my CGM), 2) I had a referral to see a podiatrist due to concerns I expressed about my feet, 3) We agreed on a minor tweak to my correction factor that will hopefully help eliminate some mid-morning highs I’ve been experiencing, and 4) We set up a follow-up appointment with one another to take place in 3 months in addition to an appointment 6 months from now with the endocrinologist to make sure all of my bases are covered and I don’t have to go so long without seeing a doctor for my diabetes again.

I can’t remember the last time that I felt so heard by a diabetes clinician (or even any kind of clinician).

As the appointment concluded, I told the NP that I’m the type of person who relies on accountability in order to stay on top of my diabetes, and this appointment was the exact sort of accountability wake-up call that I needed to hold me over for the next few months until my next one.

And I daresay…thanks to the affability and receptiveness of this NP, I’m actually looking forward to our next visit in early 2022.

T1D and Haunted Happenings

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Halloween is just a few days away, and even though I don’t have any specific plans, I’m really looking forward to it.

Now that I’m in my late 20s, Halloween is less about the candy – though I still very much enjoy that part – and more about having fun dressing up, even if it’s just for my own entertainment. But this is also my first Halloween at my condo, so I hope that I get to see a decent number of trick-or-treaters and cool costumes.

Diabetes can’t steal my joy on a day like Halloween.

Thinking about Halloween as an adult got me thinking of Halloween and haunted happenings from my childhood, and I’ve got to say, T1D never once got in the way of my enjoyment of the spooktacular holiday. Sure, there were plenty of other things to do besides trick-or-treat – I watched the Charlie Brown Halloween special (and still do) every year and I almost always make a point of carving a pumpkin or two each October – but collecting (and feasting) on candy was still a key component of Halloween for me that diabetes couldn’t take away. In fact, I think that it helped me feel a little more “normal”, like I had something in common with my peers without diabetes.

I’ve seen posts over the years about treats that T1D kids can be given in lieu of candy – things like pencils, sugar-free sweets, fruits or vegetables, and stickers – and that’s perfectly okay. But I think it’s also totally okay for T1D kids to have a break from worrying about diabetes and how it makes them different from everyone else every now and then, especially on a night like Halloween. I guess what I’m trying to say is that I’m really grateful that I always had super positive experiences around Halloween throughout my childhood that were never tainted by memories of anyone telling me I can’t eat a piece of candy or that I shouldn’t partake in the holiday because of my chronic condition.

So that’s why I’m excited to celebrate it just as I always have this Halloween weekend…though maybe with the added trip to the store the day after to see how much of a discounted low blood sugar/emergency candy stash I can accumulate.

Happy haunted happenings, Cactus Huggers!

The Worst Diabetes-Related Customer Service I’ve Ever Experienced

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Roughly six months ago, I wrote a blog post in which I gave diabetes supply company Byram Healthcare a glowing review.

Now, I take back everything I said then (and have since updated the post with a preface).

I truly believe that Byram gave me the worst customer service that I’ve ever experienced as it relates to my diabetes…and maybe that I’ve ever had in life, in general.

I take back every nice thing I had to say about Byram six months ago.

It’s a long, messy story – one that spans half of this year – but I’ll break it down for you.

Basically, I found it in January 2021 that Dexcom would no longer be directly supplying their products to customers. I’d be automatically transferred to Byram Healthcare, a medical equipment distributer. However, I didn’t want to use Byram and called them after I got my first order in the mail a few months later to see if I could 1) return the supplies to them, 2) get a refund for said supplies once they were returned, and 3) cancel my account because I wasn’t going to be using them.

At that time, I was told yes to all three of those things. I got a return label from them so I could mail back the supplies, which I did within days of making that phone call to customer support. That way back in early May.

Imagine my surprise when I started receiving bills from Byram in June that stated I owed them $263 for those same Dexcom supplies that I had mailed back and was told I wouldn’t have to pay for because I never used them – I never even opened the original box!

So of course I contacted Byram. I was told to ignore the bill, that a note would be made on my account (mind you, the account that I’d closed) that I didn’t owe any money. Sounds like it was simple and easy to take care of, right? Oh, so very wrong. I received at least two more bills in the mail from them (which immediately reignited my anger both times). Naturally, I called on both of those occasions and was assured TWO MORE TIMES that I didn’t owe money and that I should ignore those bills because they were being automatically generated by their billing system, which was being falsely triggered because my mailed-back supplies weren’t checked in at the warehouse yet.

Stupidly, I believed them and assumed that the whole nightmare was over when the bills stopped coming in the mail…but everything changed the day that I got the collection notice.

Yup, that’s right – Byram had a collection agency COMING AFTER ME because according to them, I had failed to pay the $263 bill THAT I NEVER OWED IN THE FIRST PLACE. The moment I read that notice, I felt pure rage roiling in my core. I couldn’t believe my eyes. I thought this whole saga ended months ago! Now I’d have to use time I didn’t have – because it was a workday afternoon and I was trying to get real-life stuff done before the weekend – to sort this mess out.

I was beyond upset. Life with diabetes is hard enough, but throw this BS into it and it’s just not fair that getting my regular 90-day supply of a key component of my diabetes toolkit turned into something so stressful and potentially expensive. I was determined to get answers and get reassurance once and for all that they were in the wrong here, not me.

I was able to look up the USPS tracking number for the mailed-back supplies which turned into the proof I needed for both Byram and their collections agency that I had, indeed, done my end of the bargain this past May. When I finally got into contact with their billing department after nearly 30 minutes of being on hold (oh, and after a first attempt to call them during which I “held my place in line” using that option on the service line, only to never get a damn phone call back), I heard the lamest excuse for the whole thing about how they’d recently switched warehouses for this sort of thing, which explained why the billing system wasn’t registering my returned order…

…how do you think I reacted to that news? Like that’s MY fault for their company’s obvious disorganization!?

Needless to say, I didn’t care about excuses, I just wanted assurance that this whole nightmare would go away as soon as possible and they’d do everything possible to accomplish that…which I received in a short amount of time after speaking with the customer service rep.

So yeah, to say that I am displeased and untrusting of Byram Healthcare is a bit of an understatement. I thought it was important to share this story here on Hugging the Cactus not because I want to damage this company’s reputation, but because I want to help anyone else with diabetes who gets Dexcom supplies to avoid going through anything similar. Take my experience as a reminder to advocate for yourself and always hold onto records and receipts from your supply distributors…

…because you never know when you might need them to defend yourself.

Apple-ing Blood Sugars Post-Apple Picking and Pie Baking

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I’m gonna forewarn you now – this blog post is gonna have a bushelful amount of puns. If you don’t find that appealing, then it might be fruitful for you to walk away now – I’ll seed you out.

OKAY JUST KIDDING, I actually think I used up all of my good apple puns in that opening paragraph. I can’t think of any evercrisp ones at the moment…

For real, I’m done now (at least for the time being).

So the title of this blog post (and all the ridiculous puns) will indicate to you that I recently went apple picking! And turned some of those apples into yummy pies!

But that’s not all, folks – I did both of those activities, in addition to actually eating slices from those pies, while maintaining excellent blood sugars!!

Pictured above: the brown sugar bourbon apple pie that is the best kind of apple pie I’ve ever had, hands down.

To this day, I still don’t really understand the sorcery that must’ve been at work in order for me to accomplish such a feat. I have a theory when it comes to the apple picking – I was walking all around a large orchard for like an hour, on a quest for the most perfect apples possible – and all that roaming up and down the rows of apple trees kept my blood sugar levels steady, even as I sampled upwards of 10 different types of apples (and I even had to eat an entire apple as I exited the orchard because my blood sugar was, in fact, beginning to dip). So that helps to explain why my blood sugars were so good when I was picking the apples.

But with the baking and eating of the pies…I have no idea how I dodged a high blood sugar. My boyfriend and I made the most decadent apple pies we could think of – one had a peanut butter crumble topping and the other was a brown sugar bourbon apple pie with an ooey gooey caramel sauce. Surely, I thought as we chopped apples, folded ingredients together, and did latticework with our crusts, my blood sugar is gonna suffer when we dig into these pies later tonight.

Much to my utter befuddlement and delight, though, my blood sugar never rose above 150, even after I had two decently portioned slices of pie with caramel sauce generously drizzled over them.

Maybe I nailed the carb counts. Maybe I know my body’s reaction to pies – which I only ever eat at Thanksgiving, normally – better than I thought I did. Who knows, but there’s one thing that’s for sure…

I was happy to my core over my delicious pies and sweet blood sugars!

The Biggest Diabetes Mistake I Made on My Trip to California

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A couple weeks ago, I shared about my fears over flying again for the first time since before the pandemic.

Fast-forward to now and I’m happy to report that basically none of those fears came to fruition over the course of my trip…

…but of course I did experience one snafu that was definitely avoidable.

All smiles in scenic California in this pic, but I definitely wasn’t grinning like this when I made my mistake.

The biggest diabetes mistake I made on my trip to California was neglecting to charge my OmniPod DASH PDM as often as it (apparently) needs to be charged.

I’m not going to make excuses for myself because I should’ve planned better, but I will say that I’ve only been on this system for about six weeks or so now…and I’m still getting used to some of the PDM’s quirks. In particular, I have yet to figure out exactly how often I need to charge my PDM. It runs on a lithium ion battery, which is the same thing that most cell phones use. So one might make the assumption that I’d need to charge the PDM daily, but that’s definitely excessive – I’d guess that I only use about 20% of the PDM’s battery each day, but of course that depends on how frequently I need to bolus or play around with my basal rates. However, using that rationale, I’ve been charging the PDM every 3-4 days, or whenever I notice the battery falling to a 20% or less charge.

My logic failed me, though, when I falsely assumed that my PDM’s battery would last a day trip into San Francisco when it had a 40% charge.

I still have no idea what happened – all throughout my day walking the hilly streets of San Fran, I was careful to turn off my PDM screen whenever I wasn’t actively looking at it, and I was only turning it on to bolus slightly more than usual (I was basically snacking my way through the city the whole afternoon).

I consider myself pretty lucky, though, because I made the discovery that my PDM battery was dead towards the end of our day, right when we were headed on the subway back to our Airbnb: If there was a time for this to happen, it’s definitely better at the end of the day’s activities rather than at the beginning or somewhere totally inconvenient.

At least, this was what I tried to futilely tell myself in an attempt to feel better about my negligence.

Instead of feeling better, I was beating myself up over making what felt like a rookie mistake. I should’ve charged the PDM because, after all, there was no way that I was about to go into a brand new city for the first time with my phone battery at 40%, so why on earth did I think it was okay to do that with my PDM? Moreover, how the heck did this happen in the first place – does the battery really just drain super quickly and/or easily?

I knew there was no point in trying to figure out why it happened at that point in time – it was more important for me to charge the PDM as soon as possible so that my partner and I could experience In-N’-Out for the first time on our way back to the Airbnb as we had planned.

So, because he is brilliant and calm in “emergency” situations (unlike me), he came up with a plan: I’d head over to In-N’-Out, order our food, and wait for him in our rental car while he ran up the street to a nearby CVS to see if they sold any USB cables (you know, the types of charging cables that everyone has because most electronics are charged with those). And his strategy worked out beautifully. Soon after I had our bag of In-N’-Out in hand, he arrived at the car with the charging cable and I was able to plug my PDM into it so I could bolus for dinner right then and there instead of having to delay it. (We could’ve just waited until we were back at our Airbnb, but then I would’ve either had to eat a cold burger [blech] or eaten it fresh and run the risk of my blood sugar jumping up without the necessary insulin in my system. Obviously, we went with the more appealing option.)

All things considered, if that was the biggest diabetes mistake I made in California, then I’d say I did pretty good – more to come soon on my strategies for maintaining decent blood sugars while on vacation.

As for now, I’ll leave you with this – In-N’-Out is kinda overrated.

4 Things to Consider When Camping with Diabetes

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Up until last weekend, the closest I’d ever come to going on a camping trip was that time I “camped out” in my parents’ backyard when I was 5 or 6 years old. (And that barely counts because I only stayed outside long enough to roast marshmallows before I decided I hated the idea of sleeping in a tent and ran back inside, leaving my dad and my brother to fend for themselves in our suburban wilderness).

Fast-forward 22 years later to when a real camping opportunity presented itself to me: I decided I should give it a real try and guess what? I had a great time!

But also guess what? Beyond thinking about how I might keep my insulin cool, I put very little thought into my diabetes before going on this camping trip. There was no logic behind this decision other than I decided to just wing it; after all, I’d only be gone for 2 nights.

I recently got a crash course in camping with diabetes.

My lack of careful planning caused me to experience a crash course in camping with diabetes. Here’s what I learned (and wished I’d considered before I left for the trip):

  1. Keeping insulin cool isn’t as simple as tossing it into a cooler filled with ice packs. The one part of my trip I assumed I didn’t have to overthink turned out to be not so simple. I thought ice packs would do a good job of keeping my insulin at the right temperature. What I did not think about was all the other food (raw meat, veggies, etc.) that had to stay cool, too – which meant that the ice packs were pulling double duty and not staying as cold as I thought they would. This problem was easily solved with the addition of bagged ice to our cooler, but that, in turn, created a smaller issue by getting my insulin carton wet (meaning I had to throw the packaging away when we returned home). Not a big deal, but next time I’ll definitely bring an extra plastic bag or something else to help keep my insulin vial and its protective carton dry in addition to cool.
  2. Setting up a campsite lowers blood sugar just as quickly as any other type of exercise. When we arrived to our campsite, it was around dinnertime on Friday evening, which meant we only had about an hour and a half before the sun started setting – so it was important that we prioritize setting up our tent instead of eating food. Hauling all of our stuff from the car, moving things around, blowing up our air mattress, and other steps taken in order to set up a cozy campsite meant a lot of physical steps taken, which lowered my blood sugar pretty quickly. Fortunately, I had plenty of snacks on hand, which leads to my next point…
  3. Bringing tons of extra low snacks is a wise decision. I have my partner to thank for thinking to buy a package of gummies at the store (on top of s’more supplies and trail mix) that would help supplement the snacks that I’d already put in my backpack before we left for the trip. These gummies proved to be one of the best purchases of the weekend considering I had to eat three packs of them in the middle of the first night of our trip! It just goes to show that there’s no such thing as too many low blood sugar supplies.
  4. Pre-bolusing isn’t conducive to cooking over a campfire. I’ve gotten into the habit of pre-bolusing for my meals, which means that I take insulin somewhere between 15 and 30 minutes before I actually start eating. This was not something that would work out well when my meals were being cooked over a campfire because we had no clue when our food would be ready. Turns out, it takes a lot longer to cook a single burger over a fire than it does to cook a whole package of them on the grill! This wasn’t a huge deal – it really just meant that I experienced a couple more immediate blood sugar jumps than usual.

All in all, camping with diabetes turns out to be something that really doesn’t require that much extra prep or special considerations. While it undoubtedly would’ve made it easier to know these things beforehand, they’re also things that I only could’ve learned from going camping for real – not just out in the backyard.

80 Days Later…

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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

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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

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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

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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.