Thursday, May 7, 2009

Update

Since my last post re: the Omnipod, I had another appointment to see the endo where we officially decided that we would go ahead and try the Omnipod. He says he's normally not a "pump-pusher" (his words, not mine) especially when his patients are in relatively good control, which I guess he feels I am. But there was an exception to that rule. And that is when his lady patients are looking to get pregnant. This is such a balancing act for diabetic women that he prefers they have the fine tuned control that a pump can provide. And since pregnancy is a subject that Brad and I are talking more and more about lately (Eeeeee!! Excited!!), my endo and I thought it would be a good idea to go ahead and start with the pump. So now I'm dealing with pump reps, letters of medical necessity and insurance issues. Fun times . . . note the sarcasm.

I actually got a call from the Omnipod rep asking if I could provide blood-sugar logs showing multiple highs or lows. I didn't exactly tell her that I don't keep logs (bad diabetic!) since I could easily download my sugars. But I did tell her that I didn't think she'd see that many wacky numbers, I have spurts of badness but usually my sugars are pretty okay. Then I asked her if it would be a problem getting approved. My last A1C was 6.7. I guess that means I'm not a great candidate for changing my routine. I explained that the switch was mainly due to the fact that I was planning to try to get pregnant soon and thought the pump could help me tighten my control. She said that I should definitely ask my MD to include that reasoning in the letter of medical necessity.

I'm a little frustrated because I feel like I might be punished for being in "good control." I sure don't feel like I'm in good control! I don't think any of us should be judged by our numbers, so please don't think I'm trying to insult anyone whose A1C is higher than mine . . . but this disease sucks and it's scary and the complications are unimaginably horrendous. I'm thankful that my numbers are better now than when I was a kid (more like 7's and 8's) but if I'm not mistaken 6.7 is still above "normal" and for my health and for my child's health when I'm pregnant this is not acceptable. Plus, if I'm in such great control why do I still get high and low a few times a week? Because I'm not perfect, that's why! And if there is anything I can do to improve my control, to tighten my numbers and to get rid of the peaks and valleys, I'm going to do it, damn it! Why is that a bad thing? Why do insurance companies believe that this type of expense is frivolous or wasteful? If getting a pump means that have all my fingers and toes and my eyesight and my kidneys 50 years from now, I guarantee that I will have saved them hundreds of thousands of dollars. And, uh, I'd be a tad happy about that too, ya know? Keeping all my parts is kinda my goal in this thing here. Sheesh. Anyhoo, rant over. Just cross your fingers for me that I get approved.

Moving on . . . I'm expecting the transition to the pump to be a little weird. I'm sure my numbers will have a mind of their own while I try to transition from MDI's (multiple daily injections) to a new routine that includes a basal rate rather than Lantus to carry me through the day. Honestly, I'm pretty nervous about the whole thing. I am so comfortable with my routine. It's easy and I feel like I know what to expect. And diabetes can be a real bummer when it starts throwing curve-balls at you. Now don't get me wrong, I don't think I will hate the pump. I think I will like going to an adjustable basal rate. My numbers do different things at different times of day so it will be nice to be able fine tune based on my own rhythm. But my inner realist is telling me that it may take a while to get everything just right with this new routine. Plus, it's a foreign object dangling off my body and between that and the tape issue, I'm sure I'll get annoyed from time to time while I get used to the change. Until then, frustration (read: highs and lows) and diabetes melt-downs are sure to ensue. (Poor Brad. Baby, I'm sorry in advance.) But if it means lower A1Cs and overall better control, it's worth it for me . . . and for a potential little one later on. ;-)

Finally, at my last endo appointment I got the opportunity to sit down with his new nurse practitioner, Julie. For all who know me IRL, you know I'm a big fan of practitioners (doesn't hurt that I am one!) So I love dealing with practitioners and I'm all about supporting "the cause." If you've never made an appointment with a nurse practitioner and there's one in an office you go to (any specialty), give them a shot. Trust me. On one of those occasions when you need to be seen sooner rather than later and your regular doc is booked up, ask for the "NP." You'll be surprised with not only how easily and quickly you can be seen, but also how much time you get to spend with her/him. And more often than not, the folks I've talked to who see NP's love them. I've heard from so many people that, at first, they were nervous or annoyed about being forced to see an NP, but that once they did they realised how friendly, knowledgeable and easy to talk to they are. And they can spend so much more time with patients because they don't have to see as many. I can't speak for every single NP out there but ask around, I'm sure you'll hear rave reviews!! Anyway, true to form Julie was awesome. I love her and I'm so glad she came to this practice, where she is absolutely an asset. Easy to talk to, knowledgeable, great listener, and values my input. We just clicked. All things that are so necessary for me from my endo.

I guess that's all. Again, I rambled but that's how I roll.

~Layne

1 comment:

  1. Hey Layne!
    I found your blog through blog hopping on other diabetes websites. I am type 1 and was diagnosed at 27 about 3.5 years ago. I will start on the Omnipod system June 1st in hopes to start a family soon as well. I look forward to hearing about your journey! I haven't found many who have used the pod during pregnancy. Thanks for sharing your story.
    Jamie

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