Dead Dexcom

Last night before going to bed I got a low battery alert on my Dexcom.  So, when I crawled into bed I plugged it into the USB cord on my bed like I always do and drifted off into dreamland.  I had polished off a few remaining Christmas sweets earlier that night and was a little high but had taken a correction bolus before bed. All through the night I was awakened by Dexcom alarms.  Each time I would assume it was me still being high, glance at the screen through blurry eyes and go back to sleep because things were trending down toward normal and I didn't want to deal with a midnight low.  It wasn't until this morning that I realized what those alarms really were.  After waking up with two tiny humans crawling all over the bed I drearily rolled over to check my by status.  I was surprised to see a low battery warning on the screen.  I assumed it had come unplugged at some point when I was checking it during the night so I tried to plug it back in but something did not seem right.

Upon further investigation I saw the USB port had been pushed up inside the Dexcom receiver and was freely wiggling aroun inside.  I tried unsuccessfully to pull it back to where it should be a few times before giving up and throwng it on the bed in disgust (I'm not a morning person, especially after a night of constantly interrupted sleep).  I stewed in my frustration for a few minutes while I tried to decide how I was either going to afford a new receiver or adjust back to life without a CGM.  The Pretty Lady in My Life kept her cool and found online that this had happened to a few other people and Dexcom had replace theirs under warranty.  I was relieved but not looking to spending time on the phone fighting with customer service representatives (It's that whole not a morning person thing again).  I called the customer service number on Dexcoms website, ready to have to answer a million questions and try to justify why this should be covered by the warranty but I was wrong.

I followed the phone tree to technical support, was on hold for maybe 30 seconds and was greeted by a customer service rep (whose name I wish I could remember).  I explained my situation and she asked for the serial number from my unit and confirmed that it was still under warranty.  She asked if the unit had been dropped or exposed to water and made sure address was correct.  Next she told me the new receiver would be sent out today with overnight shipping but probably wouldn't be here until Thursday because of New Years.  I was in shock.  No long hold times?  No twenty questions?  No attempts to get out of covering the replacement?  The whole process took less than 5 minutes.  She even threw in a free sensor because I would have to change mine prior to the 7 days when the new receiver arrived.  Hands down the best experience I've had dealing with a customer service from any company, for any issue.  Good job, Dexcom.  You are doing it right.

Insurance perils

            I have been unsatisfied (that’s putting it lightly), with my insurance company for several years now.  Basically, as long as I’ve had it.  First, it was because I hated paying so much into it that I would never get back.  When it was just The Pretty Lady and I we had no chance of meeting our deductible.  Even now with two kids, one with asthma, and myself with a chronic disease we barely have a chance of meeting our deductible.  This year was the exception because of added expenses after my diagnosis being changed to Type 1 which meant extra doctors visits and tests and more expensive medicine, my son being hospitalized for the second time in 6 months, and my daughter having surgery to put tubes in her ears.  On top of that we took advantage of having our deductible met and I took the plunge to get a CGM (best investment ever, if only the insurance company understood the money this would save down the road), and my daughter had her tonsils removed.  Not only did we meet our deductible, we hit our out of pocket maximum.  Despite that, and the fact that we met our deductible last year, I was still sitting on over $5000 dollars in doctors’ bills.   So, this is my gripe; in the last 2 years I have racked up in excess of $5000 of bills, not including co-pays on insulin, test strips, oral medications, CGM sensors, and inhalers, paid over $7000 in premiums, and haven’t really seen a pay increase at work because the rise in premiums has negated it every year I’ve been in my current job, yet I don’t really feel like I’ve gotten $12,000 worth of service out of them.  And this week I came across what was essentially the straw breaking the camels back on another blog.  And thank the stars that I did find out now instead of the first time I tried to fill a prescription in January because bad things may have happened.

            My insurance originally used Medco for our pharmacy benefits, which merged or was swallowed up by (I forget which) Express Scripts a few years back.  Initially that was of little or no impact to my coverage until this happened.  Express Scripts has announced that they will have a list “excluded drugs” that they will not cover because “clinical data shows there are other products effective in the marketplace.”  I realize that insurance companies are for-profit entities and they answer to shareholders, have to make a profit, etc.  I also understand that pharmaceutical companies have increased the cost of medications and that most of the ones on the exclusion list are more expensive.  I get that the profits of the insurance company take a hit if I fill a prescription costs $200 and pay a $30 co-pay as opposed to filling a $100 prescription with the same co-pay (I’m bad at math, but not that bad).  This move hits me twofold.  I use Apidra as my rapid acting insulin to bolus for mealtimes and treat high blood sugars.  I use an Accu-Chek meter and test strips to monitor my blood sugar and calibrate my CGM.  My son uses Advair as a controller medicine for his asthma.  All three are now on Express Scripts exclusion list.  They recommend Humalog as the equivalent for Apidra.  Although the times it takes for the two different drugs differ, as do the peak times, I am sure I can adjust to this and still manage my blood sugar just fine.  There is a bigger problem with my son’s inhaled steroid.  He was recently switched to Advair by his pulmonologist because Symbicort was not effective at keeping his asthma under control.  The Advair, however, has been great.  He has had no attacks and no need for his rescue inhaler since changing over. There are 2 suggested alternatives to Advair on the Express Scripts list.  And if you guessed that one of them is Symbicort, then you my friend are correct.  There is one other alternative as well, but if it does not work either we will be stuck paying full retail price for this drug.  Express Scripts pays an outside group to analyze the drugs in each group and determine what ones are comparable and do the same thing.  That group apparently has determined that Symbicort and Advair are effectively the same drug.  They are used to treat the same condition and same symptoms, but my son is proof that they are not the same drug and both have different benefits for different people.  If that is true in his case, I have to believe that the same is true for many other people on the other 47 drugs that are excluded from coverage.  Which according to the articles I read, factors out to 2.6% of Express Scripts customers.  Which seems measly, but it’s still 780,000 people.

 

            Perhaps my anger is misdirected and should be directed at the drug companies themselves for their outrageous prices.  But I feel like if I am paying $3500 a year in premiums for “coverage” then I should be getting a little more in return.  Instead, I am paying more and getting less every year.

 

http://www.pharmalive.com/why-express-scripts-tossed-48-drugs-off-its-formulary-miller-explains

Pic-a-day 13- Awareness

My Dexcom CGM keeps me constantly aware of where my blood sugar is, when I am going low, and how the food I eat effects it.  I feel a certain amount of guilt when I have eaten something I know I shouldn't have and hear that familiar tone.

Pic-a-day 12: Work

For the life of me I could not think of a picture to post for work.  But I will say that, although I am often frustrated and not passionate about the job I have, I am thankful for it.  The job itself can be high stress but it is secure and allows me to do what I need to take care of my family, take time when I need it, and manage my diabetes, even when that means sitting down in the middle of my shift to eat a Snickers

Catching up Pic-a-day 9,10,11: Support, Exercise, Play

Support

In the first months of my diagnosis as Type 2 the ADA website was a priceless resource as were the forums.  They are still soooo helpful when I have Type 1 questions or any diabetes related questions.

Exercise

That shoe is definitely not one that brings exercise to mind, but the amount of walking I do at work (10 miles plus some days) is the bulk of my exercise these days

Play

With the weather getting colder, snowboarding season is almost upon us.  Hopefully I can get to the mountain more this winter than in the past.  I can't wait to teach my son the ropes.

Pic-a-day 7: Blue

Earlier this year a co-worker and I volunteered to work an entire night in drag to raise money for the American Diabetes Association.  This is the result.  The scary, scary result.

Pic-a-day 6: Relationship

Diabetes touches every facet of my life, including my relationships with others, and therefore bleeds over into the lives of those I love as well.  Thinking of diabetes and relationships makes me think of one of my first posts from this blog so I'll be reposting it for today.

This is not just my diabetes- 5/23/2013

You are an amazing wife, mother, and friend.  You hold this family together.  You clean, fix, schedule, reschedule, wipe tears and noses, chauffeur, listen, and worry.  You have to experience every high, low, good day, bad day, bad mood, anti-social moment, short tempered outburst, and burn out I have in your own way.  You do your best to understand what I am going through even if you can't be in my shoes.  On the day I was diagnosed, your life changed as well.  When I become depressed, you have to deal with it too.  When I have a good day, I hope it helps you have a better day, but unfortunately when I have a bad day, I know it makes yours worse as well.  When I was re diagnosed, your life changed again right along with me.  You listened to my fears and had your own.  You were there to listen even if I didn't want to talk.  Every step of the way when this disease effects me it effects you too, so in a way this is your diabetes too.

    You are an amazing young boy.  You are growing up so fast, right before my eyes.  When you learned that I shouldn't have sugar you helped remind me.  You are interested in my medicine and every step I take to manage things.  When I am grumpy, down, irritable, or tired it effects you.  You feel for me on my rough days and help bring me out of the funk.  Sometimes you drive me crazy but I know you don't do it on purpose.  You have an incredible sense of who you are and I am so proud of you.  Even though you don't understand how all of this effects you, this is your diabetes too.

    You are my pretty little angel.  My booger, my stink pot, my cuddle-bug.  You are too little to understand how this effects you but it does.  On the days when I don't have a lot of patience, it effects you.  On the days when I am burned out, tired, and can't motivate myself off the couch, it effects you.  But you effect me as well.  When you poke your head around and the corner and smile, the clouds part a little.  When climb into my lap and cuddle up, the day brightens.  Someday you will see all of this for yourself, this is your diabetes too.

  We are all in this together.  Everything that happens to me, effects all four of us.  This is not MY diabetes, this is OUR diabetes.  Having the three of you to experience this with means more than any of you know.

Pic-a-day 5: Advocate

I have been lucky enough the last two years to be a part of the American Diabetes Association Community Walks program, including the inaugural year in 2012.  After being diagnosed I was trying to find programs in my area to meet other people with diabetes but there was nothing in the area.  As I was searching I found the Community Walks program and because of it I have been fortunate enough to meet other people passionate about diabetes, spread awareness, and raise funds for the American Diabetes Association.

Pic-a-day 4: Proud

When it come to being proud I have a lot of things to choose from.  I have a growing son who is smart, inquisitive, funny, and sensitive.  I have fireball of a daughter is all smiles and energy.  I am proud that I am able to provide for them and have the means to manager my diabetes properly and I am proud of the numbers I get when see my doctor every 3 months.  But this lady right here is what I am most proud of:

I picked an amazing woman to take this journey with.  She is a great mother, an amazing wife, and an all around wonderful person.  She is patient, forgiving, loving, and understanding.  I could not get through the bad days without her.

Pic-a-day 3: Snack

I should post a picture today that makes me look like a good, healthy eater.  But I am all out of peas (I really do eat a lot of peas) so you get this instead

I am a sucker for ice cream.  When I first received my diagnosis of type 2 diabetes it was one of the hardest things to give up.  I tried several low carb varieties and just couldn't get past the taste.  The Blue Bunny Sweet Freedom flavors, however, are delicious.  I slowly got back into a more controlled habit of ice cream again and after I got my new diagnosis of type 1 and could regulate it with insulin I felt a little better about it.  I never really was able to see the effect it had on me until I got my Dexcom and found it didn't lead to big spikes and my body handles it pretty well.  Yay me!  If I feel so inclined I can even eat a pint of Ben and Jerry's (which I have been known to do) and have no issues as long as I time the insulin right.  You know, for those times when I run out of peas.

Pic-a-day Nov. 2: Check

I was going to post a picture of the check I write to my doctor every 3 month but that didn't really seem like a good topic.

So instead I am going with.  My Dexcom G4 Platinum.  Which I check about 100 times a day it seems.  I am fairly new to using the Dexcom, having started in August, but it is already hard to remember living without it.  I am still contemplating how I am going to afford the sensors after the beginning of the year when my insurance deductible resets, but I know that it will be very difficult to stop using it.  I read a forum post a few days ago regarding CGMs.  Someone commented saying they did not see why anyone would spend money on one when it had to be calibrated with a meter and the manufacturer says not to make any decisions off the reading but to use it for identifying trends.  Even if all I did was use it to identify trends it would prove invaluable.  Being able to recognize that I don't need as many carbs at breakfast as I do at dinner, or see that my blood sugar is rising or falling prior to bed allows me to adjust my treatment to prevent highs and lows without doing finger prick tests 100 times a day.  That to me makes it worth every penny.

 

Also for the word check.  One of my son's favorite bedtime books is a National Geographic book about sharks.  It explains that sharks take a bite out of their food to taste it and see if it is ok to eat.  Occasionally he likes to make up his own words and read the books to us.  Tonight was one of those nights and for this page he said, "Sharks have to check their blood sugar to see if it is ok to eat."  That kid melts my heart.

To bolus or not to bolus...

Had pizza for dinner even though I knew I shouldn't and I've somehow managed to stay under 160 since.  Now the question is, do I take a bolus before bedtime to insure I don't go high tonight or trust that my number will stay steady and come down?  Damn you pizza!  So delicious but so much trouble!

Pic-A-Day Nov.1- Past

This picture was about 1 week prior to my incorrect diagnosis of Type 2 diabetes.  A month after my daughter was born we took a family trip to Colorado to visit my wife's family.  It was a wonderful trip despite having to use the bathroom twice before we boarded our flight, again during the flight, again as soon as we landed, and at every gas station we passed while we were there.  It was during our stay that I became increasingly worried that something was wrong and I did a quick internet search for "frequent urination" which led me to the website for the American Diabetes Association.  I read through the list of symptoms, silently checking them off in my head.  Increased thirst.  Check.  Frequent urination.  Check.  Constant hunger.  Check.  (This one I blamed on my wife's pregnancy.  Sympathy hunger?)  One of the most ironic statements I have ever made came about a week prior to our trip as my brother made the short trip with me to drop my dogs off at our parents house before the we left.  We were discussing his recent change in diet, having to minimize his intake of sodium, to which I said, "If ever I had some sort of health issue where I had to regulate what I ate I would be in trouble.  If I had to stop eating sugar I think I'd just give up and die."  Famous last words anyone?  Upon returning I used my last day of vacation to see the doctor, who then told me that I had diabetes, based on a blood sugar reading over 300.  And so started my journey...

Despite the constant bathroom breaks and life changing diagnosis at the end of it, this was still one of my most memorable trips with my family.  In fact I still contemplate a move to Colorado pretty frequently.

Pic-a-day

I'll be getting a late start because I never got around to digging up pictures today, but I am taking this from Kerri at sixuntilme.com and posting a picture everyday in November for Diabetes Awareness Month.  Stay tuned tomorrow, the topic is "Past".

Curveballs

Until recently I have been working a 12 hour graveyard shift 4 nights a week, with 4 nights off a week.  Because I also have two young kids and the Pretty Lady in My Life also works a full time job that means on my off nights my schedule was flip flopping from sleeping in the day time to sleeping at night.  I have been doing this since before my diagnosis was changed from Type 2 to Type 1 and the entire time I have been using insulin.  I had things tuned in pretty well.  About three weeks ago I moved to working the day shift, 3 12 hour shifts followed by 3 days off.  I was expecting a change in the way I managed my diabetes but I got more than I bargained for.

My first day on my new schedule I was fighting off lows all day. I adjusted my insulin to carb ratio each day and each day fought the same battle.  I had an epiphany a few days ago and realized I probably needed to adjust my basal insulin and tried that.  Still not much of a change.  Somewhere in there I started encountering highs in the early morning.  I tried to treat these which led to more daytime lows.  I discovered that as soon as I got out of bed my numbers immediately started to plummet.  Then I started splitting my dose between morning and night.  No change.  Now I am taking the whole dose at bedtime.  It's too early to tell if this is really helping.  I miscalculated a high card dinner two nights ago and went scary low that night. Last night I went to the movies which means lots of popcorn, things peaked a little bit at night but stayed within reasonable ranges.

I think diabetes time is different than real time.  It feels like I have been counting carbs and calculating insulin for a decade. Sometimes I have to stop and remind myself that I'm still young in my diabetes life, only having been on insulin for about 8 months and counting carbs for a couple of years.  Even tiny changes can make big impacts on blood sugar management and I have to be patient as learn what adjustments I need to make (and I need to avoid pints of Ben and Jerry's Half Baked while I'm making those adjustments).  I'm still taking things in stride and learning as I go.  And usually resisting the urge to chuck my Dexcom across the bedroom when it wakes me up 3 times a night

Giving Back

     About 5 years ago I started feeling the desire to give back to my community.  There were always people around me who were willing to help out others when there was a need.  I just couldn't find a way that worked for me.  My job offers me a lot of opportunities to donate money and I take advantage of those but I was looking for more.  After being diagnosed with diabetes in 2011 I spent a lot of time on the American Diabetes Association website and came across the Step Out program.  I really wanted to participate but the closest event was too far away to be feasible.  I began asking about the possibility of starting a Step Out walk in the Boise area and was introduced to the Community Walk program.  I brand new program, Community Walks were designed for smaller cities too far away from Step Out walks to participate.  It is entirely volunteer driven and has no monetary support from the ADA.  2012 was the inaugural year for Community Walks and I was contacted in July about the new program.  We set a date in September, leaving a small amount of time to plan our walk.  In the end it was a less stellar turnout than envisioned but still a very good experience for me.  I had a lot of family attend but not many people beyond that.  Thanks to a lot of help from my Father-in-law we raised over $1000.  Which brings me to today...

     This past Saturday was our Second Annual Walk to Stop Diabetes.  There was a much larger turnout, around 25 people, and raised around $1300.  We should be getting another $1000 from a volunteer program through my employer and $550 from my father-in-laws employer.  That is huge!  All those funds go to the American Diabetes Association and is used for research towards a cure, funding community outreach and education programs and keeping PWDs from being discriminated against because of their diabetes.  I am so thankful for the support of local, businesses, our community, the people I work with, and my family.  This event would not have happened without them. I am grateful to be able to do something to give back to an orgonanization that is striving to help all of us who battle diabetes everyday.

Thanks to all of you who donated, walked, and showed your support.  We'll see you all next year!

Broken

I love my Dexcom CGM.  There is no way around that.  There is just one problem.  That little sensor attached to my stomach has become another reminder.  Everytime I lift my shirt and look down I see the sensor, I see the bruises from the injections, and I remember that I will be in this same routine for the rest of my life.  And it is depressing.  I keep a pretty positive outlook most of the time.  I love the opportunities I get to educate others about the disease.  I few days ago I got to show of my CGM to some co-workers and excitedly tell them the ins and outs and how it is a great tool to spot trends and tweak insulin dosage.  I totally geeked out on them.  I also got to express my passion and some of the startling numbers about diabetes to a group of workers while I tried to rally support for this years Community Walk.  Times like that make me realize that this disease has had it's blessings come with it.  I feel hopeful and love that I have this part of me that fuels a passion to spread the word and help others.  And then I look down... 

Cyborg Glucose Monitoring!

A week ago I entered the world of CGM (continuous glucose monitoring not cyborg glucose monitoring as the title suggests).  For those who don't know how this works, I'll explain.

I attach a sensor to my body, either on my belly, butt, thigh, or arm, which has a filament that is deposited under my skin by a very small needle.  This filament determines blood glucose readings by monitoring sugar levels in interstitial fluid (the fluid I between cells).  This information is sent via a small grey transmitter to a receiver that displays a blood glucose reading every 5 minutes.  The sensor is calibrated by periodic checks with a finger prick from a standard glucose monitor.

In the last 6 days (I'm excluding the first day because apparently the pain killer I took confused the sensor which in turn confused me) this information has already proven invaluable.  I simple vibration from my pocket tells me "Hey Craig, you should probably take a break and eat something", or "Hey stupid, that handful of Snickers fun size you ate should have been accompanied by some insulin."  

But the information goes beyond a simple number and alert now and then.  While a finger stick will give me a number that tells me if I'm high or low, my CGM will tell me where I've been for the past 12 hours, if I'm headed up or down, and how fast. That is really good information when I'm deciding how to treat. If I know that I'm at 200 and falling I'll use less insulin than if I'm at 200 and rising.  Same goes for treating lows.

Yesterday reaffirmed my thoughts that this was a great choice for me.  I left work and took The Bug to the urgent care.  After dropping her off at daycare I stopped at the gas station to get a donut.  I injected what I thought was the correct amount for the donut and enough  to cover my planned breakfast after I got home.  Having worked a 12 hour shift on an hours sleep I was exhausted when I got home and collapsed on the couch, forgetting the breakfast and taken insulin to cover.  An hour or so later I snapped awake, not sure if the Dexcom was beeping or if something else woke me.  I was in a stupor and shaking badly.  My mind was in a fog and I took a second to remind myself where I was.  I reached for the receiver to my Dexcomand it simply read LOW.  Looking at the graph it appeared I was in the low 50's.  This was the worst low I had ever experienced.  Had I spent the time looking for my meter in my already confused state and then tried to pour myself some cereal which already ended up on the floor before reaching for a handful of gummy bears I very well may have been found in a crumpled heap on the floor.  But the Dexcom allowed me to act fast without searching for anything extra or taking extra steps.  

My experience so far has been full of positives and I've loved being able to explain to people that my new toy is not an MP3 player.  Hopefully it continues that way as I continue to pay more for this equipment than simple test strips but reap greater rewards.

The Facts of Life

Well, it's official.  My body hates itself.  It has taken to attacking itself not just in one form but now two.

After a promising doctors appointment two weeks ago during which I found out my A1c has dropped down to 6.4 (Yay! Go me!) I found out the results of a blood test they did the same day.  The test came back positive for auto-antibodies indicating that I have Rheumatoid Arthritis.  So my body first said " Scree you pancreas, we don't want you here anymore," and is now saying the same to my joints.  

While part of me is relieved to know what the constant worsening pain in my pinkie is, part of me is, of course, saddened and partly afraid.  I waited two weeks to hear the results of the blood test, will wait at least the weekend and most likely part of next week for a referral to a rheumatologist, and then it sounds like a 3 to 6 month wait to actually see said doctor.  My biggest concern for the wait is that during that time I will do my best to self educate, learn about all the possible downfalls of yet another chronic illness, and worry myself about them.  

So thank you immune system.  But I guess that's the way it is.  If Nick at Nite taught me anything it's that you take the good.  You take the bad.  And there you have.  The facts of life.  (Thanks Mrs. Garrett.) end shameless 80's sitcom reference

Everyday

Wake up.

Prick the finger, test the blood.

High.  Dial up the pen, poke, inject.

Dial up 28 units from the grey pen, poke, inject.

Take a pill to make me "happy."

Cook breakfast. 

Count carbs.

Dialing up the pen, poke, inject.

Prick the finger, test the blood.

Too much or too little?

Make lunch.

Count carbs.

Dial up the pen, poke, inject.

Take a pill to stop the headache.

Make dinner.

Count carbs.

Dial up the pen, poke, inject.

Go to bed.

Try to sleep.  

Repeat.

Happy Birthday again!

Yesterday, just two weeks after her brother turned 5, Hadley had her 2nd birthday (that was going to say celebrated her birthday but then I realized we aren't celebrating until tomorrow). I have feeling that some day this two week stretch is going to be difficult and depressing for their mother.  Watching a first child grow up and reach all the milestones was such an awesome experience and feel so blessed to be able to do it a second time.  Blessed and exhausted, but mostly blessed.  My experience with Hadley has been quite different than the first time because I have a little experience behind me and because she is so different.  I love the way she can entertain herself and I get as much enjoyment out of watching her do her thing as she gets out of doing it.  She melts my heart every time she runs to me and wraps her arms around my neck and puts her head on my shoulder.  I'm not sure how a 2 year old does it but somehow she knows exactly what mornings I need a pick me up the most and those are the mornings she gives me the biggest smile when I walk through the door.  There are days when I just don't think I can handle another second.  But those moments are quickly replaced with joy because my family makes me extremely happy.  Hadley has such a happy soul and I can tell already that she is going to take great joy in spreading that happiness around.  She does it so well already.  I can't wait to see the changes that come and to see her grow up, as long as that stops at 12 because she is not allowed to be a teenager or date.  Sorry, Badley, Dad's rules

Going Home

Yesterday marked the beginning of my first departure from home since being diagnosed as insulin dependent.  I am back in my hometown to celebrate my parents 50th wedding anniversary with my family and will be here for 5 days.  I have been slightly stressing over the packing process for about a week now.  How much insulin am I going to need?  Should I pack some back up pens?  What will I do if I have an emergency and need to get more insulin.  In the end I calculate how much basal insulin I will be using and came to the conclusion that the current pen I am using has enough in it; and then packed one more as well as an additional pen for bolus insulin.  In the end I think I spent more time worrying about what to pack than actually packing it and arrived last night with everything I needed.  Well almost everything.  I seem to have forgotten my razor and shaving cream but I'd rather be conscious and hairy than clean shaven and unconscious.

My buddy

I remember the commercials for the "My Buddy" dolls from when I was a kid (side note: who was ballsy enough to take the idea of marketing a doll for boys to their boss?). The image of the little boy taking his buddy all over with him, a constant companion.  I never had a My Buddy doll but now that I'm grown I have a buddy of my own, a constant companion that goes everywhere with me in the form of my Accu-Check Aviva blood glucose monitor.  Not necessarily because I want the 3x5 reminder of my disease by my side wherever I go, but because I have to.  We're I to buy a glucose monitor today I'm sure I would look into every feature, check other people's reviews and opinions, and drastically over analyze the whole thing.  But when I got my meter it was amidst a whirlwind of emotions after being newly diagnosed and it was one of two options covered by my insurance.  I wasn't worried about features or functionality.  I was worried about how much strips were going to cost and being able to figure out the mess I felt I was in.  Today I have 6 meters (my new doctor felt the need to unload one of everything she had onto me at my first visit.  And I have one at work from an emergency last Thanksgiving). One of them sits unopened, one is only opened for the sake of robbing it of its battery for my other meter, and one because it had 10 strips in it and I was waiting on a refill.  One of these newer ones probably has benefits that make it better than my current meter and at least on of them would save me $20 a month on strips, but I stick with the Accu-Chek (I suddenly feel the need to name my meter now).  It has been there with me from the start.  I learned about Type 2 diabetes and the effects of carbs on my body with it, I adjusted to my new diagnosis of Type 1 and figured out my insulin to carb ratios with it.  There is icing caked into the zipper of the case on one side from the cake we had at work for some ones retirement.  Sadly I remember the cake more than who retired.  It's dirty and worn, but it's my buddy.  We have been through a lot together in the last 2 years and even though there are probably newer, better, more accurate, and flashier models out there, I'll stick with old reliable because, hey, she's gotten me this far right?

Happy Birthday!

      5 years ago I was given the best gift I could ever ask for.  A gift that keeps on giving (and taking if you ask my bank account).  At 5:12 pm today Camden will be 5 years old and, while it is early on, it has been a great ride so far.  He is the smartest, most stubborn, and funniest kid I know.  He is learning what life is, what is and isn't OK, what he can get away with, and just how far he can push his mother.  And I am learning when to say no and when to let it slide, that I can't say certain words in front of him, and how to explain the hard things (why is the grass green, why is the sky blue, what does respect mean, where do babies come from).  So we are learning together and we both screw up now and then.  I love so much about being a dad and everything that this undersized ball of energy (seriously, he's like 40 lbs of go in a 10 lb sack) brings to me, but it is just one more reminder that diabetes effects every part of my life.  There are days that I can't get myself out of bed because I feel so run down.  I lose my cool because the highs make me irritable.  I have to stop in the middle of a game of soccer to eat some candy and hold off a low.  And then there is the nagging feeling in the back of my head that someday, because he has inherited my genes, he could very well end up fighting the same battles, and that's the hardest thought of all to deal with.  But if that day comes and I am so glad that I have experienced this first so I can help him through it.  And right now, we are both still learning.  I teach him what I can, and he teaches me more than I ever thought he could.  No matter what happens I know I'll treasure every second of it.

This is not just my diabetes...

    You are an amazing wife, mother, and friend.  You hold this family together.  You clean, fix, schedule, reschedule, wipe tears and noses, chauffeur, listen, and worry.  You have to experience every high, low, good day, bad day, bad mood, anti-social moment, short tempered outburst, and burn out I have in your own way.  You do your best to understand what I am going through even if you can't be in my shoes.  On the day I was diagnosed, your life changed as well.  When I become depressed, you have to deal with it too.  When I have a good day, I hope it helps you have a better day, but unfortunately when I have a bad day, I know it makes yours worse as well.  When I was re diagnosed, your life changed again right along with me.  You listened to my fears and had your own.  You were there to listen even if I didn't want to talk.  Every step of the way when this disease effects me it effects you too, so in a way this is your diabetes too.

    You are an amazing young boy.  You are growing up so fast, right before my eyes.  When you learned that I shouldn't have sugar you helped remind me.  You are interested in my medicine and every step I take to manage things.  When I am grumpy, down, irritable, or tired it effects you.  You feel for me on my rough days and help bring me out of the funk.  Sometimes you drive me crazy but I know you don't do it on purpose.  You have an incredible sense of who you are and I am so proud of you.  Even though you don't understand how all of this effects you, this is your diabetes too.

    You are my pretty little angel.  My booger, my stink pot, my cuddle-bug.  You are too little to understand how this effects you but it does.  On the days when I don't have a lot of patience, it effects you.  On the days when I am burned out, tired, and can't motivate myself off the couch, it effects you.  But you effect me as well.  When you poke your head around and the corner and smile, the clouds part a little.  When climb into my lap and cuddle up, the day brightens.  Someday you will see all of this for yourself, this is your diabetes too.

  We are all in this together.  Everything that happens to me, effects all four of us.  This is not MY diabetes, this is OUR diabetes.  Having the three of you to experience this with means more than any of you know.

An Introduction

My name is Craig Le Fevre and I am a person with diabetes.  On July 19, 2011, after discovering several issues I was having while on vacation were symptoms of diabetes, I was diagnosed as a Type 2 diabetic by my general practitioner.  I remember that day before my appointment my wife and I were talking and while in the back of my mind I think I knew what the final diagnosis was going to be, we told each other that it was probably something else that was no big deal.  The appointment was pretty quick; a urine test that showed high levels of sugar in my urine, a finger prick, and a few minutes of waiting followed by the big news.  "Craig, your blood sugar levels are much higher than normal, about 350.  You are very likely diabetic."  I left that appointment with a prescription, directions to not eat too many carbs (like it's that easy right? and how many is not too many?), a followup appointment a few days later, and a head full of questions.  I spent the next several days scouring the internet for anything I could find about diabetes, trying to ease my mind and answer my many questions.  I tried to choose my meals wisely, avoided the candy that I loved so dearly, drank lots and lots of water, stocked up on veggies and cheese, and took my medicine religiously.  At my next appointment the finger prick was repeated and my blood glucose had decreased.  For the doctor this confirmed his suspicion and he officially diagnosed me with Type 2 diabetes.  We both found this strange because I am thin, 140 lbs at the time, and have no family history.  I fit the bill for a Type 1 diabetic but because the medicine lowered by blood glucose he was confident I was Type 2.  My A1c was 10.7, a bought a meter, and began to adjust to this new life. 

Over the next several months I continued to learn as much as I could, improved my diet, tested religiously, and documented as much as I could.  I joined several online communities and asked questions as often as I could.  The message boards on the American Diabetes Association website became a daily visit if not more often.  In December my A1c had dropped to 6.3.  I was so excited to see my hard work paying off.  I made it through Halloween and Thanksgiving without getting too far off track and my blood glucose readings had stayed within the normal range.  The Christmas came, I relaxed a little, and things changed...

As diabetes became more of a routine thing I tested a little less often, cheated on my diet a little more often, and stopped paying as close attention.  In March I received news that I would be changing my schedule to the night shift.  I noticed that I wasn't feeling as well, and my fasting numbers were getting higher when I remembered to test.  My next routine exam was coming up and I was a little nervous.  I shared my concerns with the doctor.  I was worried that my glucose readings were climbing but suspected it was because of my indiscretions with my diet.  I was also concerned how my new schedule would effect things.  An A1c of 8.5 confirmed what I really already knew.  I wasn't managing things as tight as I should.  I renewed my commitment and wanted to get things back in good standing and did a pretty good job of it.  My fasting numbers continued to be a little higher than I liked but in June my A1c was down to 7.2.  I thought I had things figured out.  7.2 wasn't exactly what I wanted but it was moving in the right direction.  Once again I thought I had figured things out, but I was wrong again.

In the following months I kept pretty close to the same diet I had for the previous 3.  I didn't check my blood glucose everyday but when I did it was on the high side and slowly increasing.  My mood had changed, I was down a lot of the time, my temper was short, I just wanted to sleep, and I didn't enjoy things the same as I once did.  My next appointment wasn't scheduled until December but I got it moved up to November because I was very concerned.  I was shocked to see my A1c up to 14.4!  My doctor was not convinced that I was taking my medicine everyday.  His first thought was to add more medication but I could not afford this and I was already suspecting there was something else at work.  It took some convincing but we finally agreed that taking a basal insulin would be the best choice.  This seemed to move the needle in the right direction, but I still had concerns.  I brought up the possibility of LADA (Latent Autoimmune Diabetes) or delayed onset type 1 but the Doctor was convinced that my original meds would not have had an effect if I was Type 1.  I finally convinced him to send for some lab tests and as soon as I got home I started searching for a new doctor.  I felt like my current doctor only wanted to prescribe the latest and most expensive drugs that he had samples of and got perks for selling.  He didn't want to listen to my concerns and was unwilling to stray from his original diagnosis.  My blood test results showed signs of antibodies, and while I knew that because I had been using insulin this would have been the case either way I let the doctor use this to convince himself I was indeed Type 1.  He told he his office would set up a referral to an enocrinologist.  I probably would have felt abandoned and pawned off if I hadn't already set up an appointment with a new doctor. 

I continued to take oral meds and basal insulin until my January appointment with the new doctor.  At my appointment I explained what was going on and within 5 minutes she said she believe I was Type 1 all along.  Thank You!!!  Finally someone who seems to understand!  She told me she was sorry I had to deal with this and gave me time to be upset and talk about it.  She took time to explain the ins and outs and started me on rapid-acting insulin as well.  In that first appointment I spent more time and got more answers than in all my previous appointments combined.  At that time my A1c was in the 10's and within 3 months back into the 8 range.  I felt relieve but also scared.  That's pretty much where I sit now.  After over a year as a Type 2 diabetic and having adjusted to a new way of living I was back at square one and adjusting once again.  And once again I feel like I'm getting this figured out and moving in the right direction.  But if there is one thing I have learned in my short post-diagnosis life, it's that you shouldn't get too comfortable because you never know when things are going to change.