Days 15 & 16: The high cost of diabetes

At yet another appointment with a healthcare professional, I was trying to figure out if a different glucose monitor would be more cost-effective. Not the monitor itself, but the test strips that the monitor uses.

The monitors are easy to come by. Manufacturers give them away, even those that cost close to $100, because they know they’ll make up the loss with the sale of test strips. Each strip costs me just over $1, and since I’m supposed to monitor my glucose around five times a day, the cost really adds up.

But that’s just a fraction of the total monthly cost of diabetes maintenance. Here’s an off-the-top-of-my-head list of diabetes-related expenses:

• Healthcare insurance, if you can even get it. Premiums for diabetics are higher than those for people with some other pre-existing conditions, partly because of the many potential complications resulting from diabetes. I am among the millions of Americans without health insurance, and every day I feel as if I’m living on the precipice of financial disaster.
• Equipment, such as glucose monitors and test strips, insulin pumps, disposable insulin needles and so forth. Without insurance or participation in some kind of discount program, the temptation is to let these purchases slide. Diabetics often end up testing less frequently to save on the cost of strips and using insulin needles multiple times, until they’re so blunt that they hurt. Don’t ask me how I know this.
• Doctor visits and labs. Insanely expensive without insurance. Oh, to go back to the days of a $20 co-pay! One doctor’s visit with labs can run $200-plus, and I’m supposed to see my doctor once a month. So I stretch it out to six weeks…two months…three months. At one point recently I went seven months between visits, which isn’t easy to do when doctors insist on in-office visits when all you need is a refill on a life-saving medication.
• Medications. There’s the obvious, like oral diabetes meds and insulin, and the secondary meds, like those that regulate cholesterol and blood pressure. I’m on five meds; I get two from India to save on the cost, but even so my monthly total is several hundred dollars.
• Food. Medical professionals are finally figuring out that all those health-food nuts weren’t so nuts after all. Now I know you can go overboard with the whole natural-foods thing, but I do believe that buying locally grown organic food is the way to go whenever possible. All you have to do is go straight from your local supermarket to a Whole Foods or Wild Oats store and check out the produce section. I want to pitch a tent in my local Whole Foods produce department and graze for a week. Even if you don’t go organic, simply eating unprocessed foods in their unaltered condition is so much healthier—but so much more expensive.
• Supplements. One doctor had me downing so many vitamins and minerals that I barely had time to eat real food. The thing is, he wasn’t a nut job. I believe he was on the right track—my glucose levels did stabilize—and maybe I’ll return to his regimen one day. But the thought of swallowing 30 pills every day in addition to my meds and an abundance of raw fruits vegetables, plus paying the additional price for those pills, just doesn’t cut it right now.

I’m sure I’ve missed an entire category or two of diabetes-related expenses. But this is all so depressing that I’m just going to stop the list now.

How about you? What’s your biggest health-related expense?

Fasting glucose: 175 and 164

Day 14: It’s always something

And tonight it was the challenge of eating out. I had just finished a 2.5 mile, late afternoon walk in the mountains and was craving steak. Seriously. This happens maybe once or twice a year. Bison is the only red meat that holds any appeal for me; beef just doesn’t measure up.

But there I was with this craving, and it would not be ignored. So I corralled my husband and talked him in to having dinner at one of the few restaurants in town that we’d never visited, mainly because the ownership changed so frequently that we weren’t even sure it was still in business.

It was, and on the way there I felt my blood sugar plummet. I immediately told the server I was diabetic and needed bread—fast.

You know what happened next, right? She was in server mode and would not be shaken out of it. Before she could take care of this urgent request, she just had to get our drink orders. And then she had to serve our drinks before she got the bread.

A few minutes later the bread arrived, warm and delicious and all that. But I needed it fast, and cold and stale would have worked just fine.

Several restaurateurs have told me that I should always let the host/hostess and server know that I am diabetic, especially when I’m on a business trip and eating alone or with colleagues who may not be aware of my condition. My husband was with me tonight and would have know what to do had I passed out, but I don’t think the restaurant staff would have wanted it to reach that point.

Of course, I had diabetic gel with me and could have squeezed a few ounces into my mouth. But one of the overriding characteristics of low blood sugar is the inability to think straight, so I didn’t think to do that. And I didn’t think to tell my husband that the situation was worse than it appeared to be. We’ve been together for 30 years, and he knows the symptoms well enough. But I’ve also become a master at hiding them, and this time I had visions of a juicy filet clouding my thinking. Not good.

I survived, satisfied my craving and suffered the consequences—a three-hour “nap.” It’s now almost midnight, and I just woke up.

So tell me: how do you get a clueless server to take your urgent needs seriously?

Day 12: “Kiss Diabetes Goodbye”

I’d love to kiss my own diabetes goodbye. But even more than that, I’d love to kiss diabetes goodbye for the many children that are diagnosed with Type 1 at an early age. One young girl I know was recently diagnosed with Type 1 and had to start giving herself shots during the time her grandmother was undergoing cancer treatment. This child is growing up in an environment saturated with illness and doctors and hospitals.

Everybody knows someone with diabetes, and many people are actively involved in a diabetic’s treatment and care. And those people are the ones most likely to donate their time, effort, and money to diabetes-related programs. As one of its programs in connection with National Diabetes Month, the American Diabetes Association has launched Kiss Diabetes Goodbye, an effort to raise a million dollars in November for diabetes research.

V8 Brand is contributing $100,000 in matching funds as part of the ADA program. That seemed paltry at first, but then I found out that V8 is also donating 30 million servings of fresh vegetables to local food banks through Feeding America (which used to be America’s Second Harvest). I’ll give them a pass this time.

I know, I know—every disease-oriented foundation has its hand out today begging for donations. But if you’re reading this blog, you have some connection to diabetes, or at least to one diabetic (me). Your donation may not help me—I don’t expect to see a cure for diabetes in my lifetime—but it just may help my young friend and all the other diabetic children who will otherwise face decades of needles, insulin, testing, doctors, hospitals, labs and potential complications, some of them deadly.

You can donate here.

Fasting glucose: 170

Day 11: Fight or flight

One challenge in a personal war on diabetes is the temptation to simply flee (from the program you're on) when you don't see any measurable progress. Your glucose readings aren’t going down, you don’t feel any better, but you also don’t feel any worse.

The problem is that until something goes horribly wrong, we really don’t feel much of anything. If things are getting worse, we can’t tell. Many of our symptoms are hidden, and if we’re not testing regularly or paying close attention to the way we feel before and after meals, we can easily deceive ourselves into thinking we can graze at an all-you-can-eat buffet without suffering any consequences, long-term or short-term.

This is where a support network or support group becomes critical. Right now I’m relying on the support of health-care professionals and a few friends with celiac disease, but I know that’s not enough.

The trick is finding the right group. I attended a few meetings of a diabetes support group where I used to live, but everyone else was Type 1 and had a different set of challenges than I had. I think it would have been okay if there had been even just one or two Type 2 diabetics, because I do believe both types can learn something from each other.

Until I find one, I’ll keep the fight up with the help of professionals and my celiac friends. No way am I going to flee.

If you belong to an online Type 2 support group that you would recommend, let me know about it, okay?

Fasting glucose: 194

Day 10: Are you on a raw food diet?

My nutritionist wants me to consider trying a raw food diet, once I get everything else under control. As every diabetic out there knows, to really take control of your health and well-being requires an enormous commitment of time, energy, money and discipline, and I have enough on my plate as it is. Pun intended.

I did roam around a few raw-food sites last night and discovered what I suspected would be the case: the raw-food community is populated with true believers. I don’t mind that. But just as in the religious world, the nutrition world has its fundamentalists, those all-or-nothing evangelists who insist you go cold turkey (the “cold” part meant literally in this case) and buy thousands of dollars of new kitchen equipment to do so.

I ignored those sites. I’m all for eating raw, organic foods, but please—everything in moderation, you know?

There are also lots of raw-food “cookbooks,” which should be called recipe books for the sake of accuracy. But even here, there’s a lot of nonsense, like one book that apparently includes a “recipe” for chopped parsley: 1. Wash a bunch of parsley. 2. Chop the parsley. It’s impossible for someone who lives in a rural area (as I do) to leaf through a pile of books at a local Barnes & Noble since no such store exists. I rely on reader reviews on Amazon, but they can be wildly inconsistent.

So: Who can recommend a down-to-earth raw food site and/or recipe book that provides genuinely helpful information, recipes that include ingredients that I could find in any decent grocery store, and doesn’t require me to buy a dehydrator and such before I even know if I’m going to like this way of eating?

Suggestions, please! TIA, of course.

Fasting glucose: 202. I’m okay. Honest.

Day 9: Meal planning. Ugh.

Have you had success creating a meal plan and then sticking to it? If so, I’d love to hear from you.

This has proven to be the least successful aspect of my 90-day war on diabetes. I never know what I’m going to have for my next meal, let alone for dinner 28 days in the future.

Even my nutritionist sympathizes. I met with her today, and when I mentioned my doctor’s insistence that I create a 30-day meal plan, she got all bug-eyed. No way could she do that, she said.

Then there’s the whole no gluten, no dairy, no corn, no soy challenge.

So…who can help me out here? The first person to send me a usable 30-day menu plan that I can cut and paste and adopt as my very own will win my undying gratitude.*

Fasting glucose: 180

* So will everyone else who does the same.

Days 7 & 8: Discouragement

My enemy isn’t behaving as it should. I’ve given it a pummeling, but my glucose readings seem to indicate that I’ve lost a couple of skirmishes. I was so discouraged yesterday that I didn’t feel like going public, but I’m okay now.

I realize that this is as much a balancing act as it is a war. I’m balancing a very challenging soy-free, wheat-free, dairy-free, corn-free eating regimen; a high-altitude walking plan; more meds, vitamins and minerals than I can easily digest; chronic sinus and bronchial problems; a 16/7 work life; and a lot more stuff than you need to know about.

Oh, and this is American Diabetes Month. My decision to wage war on the disease right now is entirely coincidental, but fitting.

Fasting glucose readings: 200 on Day 7; 217 on Day 8. Hence the discouragement.

Day 6: Reversing Diabetes

So maybe there’s no cure for diabetes, but both my doctors have convinced me that we can reverse its effects. It helps, too, that I have a friend who was able to stop taking oral meds simply by amping up her diet and exercise regime. I'm very much a believer.

The best book I’ve read so far on this aggressive approach to diabetes treatment is Dr. Julian Whitaker’s Reversing Diabetes. During the spring I followed this program and saw my blood glucose levels drop dramatically. (From late May until a few weeks ago I was on the road a lot promoting my latest book, and I let the program slide.)

I’m back on it now,* and I expect to see the results soon enough. The book contains lots of recipes, most of which I love. But then, I’m accustomed to using whole grains and other natural foods. If you’re not, some of the dishes will take some getting used to. But it’s worth it if you can get a handle on your blood glucose levels.

There’s a companion cookbook titled Reversing Diabetes Cookbook that I imagine is well worth buying.

Fasting glucose: 175 (Yikes! *Don’t blame Dr. Whitaker; I indulged in some late-night snacking.)

Day 5: Flat 14ers

Here in Colorado we have 54 mountain peaks that reach an altitude of 14,000 feet or higher, like Crestone Needle (pictured above). I’m looking out my window at one right now—Pikes Peak, whose summit is 14,110 feet above sea level. Our picture-postcard view of the peak’s north face is what sold us on the house we’re in now. Little else mattered.

I may never summit Pikes Peak in the usual way, though don’t put it past me. But I can walk the number of steps equivalent to the distance to the top, which some helpful person has calculated to be 23,000 steps.

That calculation is part of a program known as the Flat 14ers Club, which gives those of us who aren’t mountain climbers measurable goals to reach for. The distance to the summits of all 54 peaks has been translated into steps, and participants wear pedometers to keep track of the number of steps they take each day. The idea is to select one peak, walk the appropriate number of steps, log your success on a chart and then reset the pedometer and start on another peak.

For diabetics, finding an exercise program that you’ll actually follow is critical to warding off the debilitating effects of the disorder.

This particular program seemed to be custom-made for me. I lost a friend to a mountain-climbing accident over the summer, so now I walk to honor her and her passion for mountain climbing. She had summited all 54 peaks the hard way. When I’m walking on relatively flat land* and start to falter after several miles, I only have to think of Linda, and I’m immediately energized.

I’ve been on the program for a week or so, and I’m already on my second peak. I chose Crestone Needle, where Linda died, for my first peak. It’s located in the beautiful Sangre de Cristo range, and its height of 14,197 feet translates into 16,000 steps.

The peak I’m working on now is Snowmass Mountain, because of its connection with St. Benedict’s Monastery, a Trappist community that is home to contemplative-living author Thomas Keating. It helps me to remain focused and motivated when I can make an association like that. It’s also a 16,000-step mountain.

You can find out more about the Flat 14ers and other walking programs from America on the Move.

Fasting glucose: 111 (!!)

* Trust me, “flat” is a relative term where I live. You only have to look at a topographical map of Teller County to see that there’s precious little flat land up here.

Day 4: Working in working out

Working out is like writing. I love having written, though I don’t always love the process of writing.

Likewise, I love having worked out, though I almost never love the process of working out, especially since I’m still in pain from a bad fall---on granite--back in June. I was so banged up that instead of wearing a sexy little dress to my high school reunion in September, I had to wear an outfit that pretty much covered me from head to toe. Oh, and my friend’s dog bit me the night before, so my leg was bandaged from that, too. Buckets o’ fun.

The Curves workout is especially painful right now because of all the upper-body work and the persistent pain in my shoulders. I’m fortunate in that I can walk to Curves, which is great, except for the fact that it’s all downhill on the way there. Meaning, of course, that it’s all uphill on the way home, after I’ve already pushed my body to the limit.

And then there’s the wind. At 8,500 feet, we get more than our share of wind. The uphill walk is in a westward direction, straight into the winds that routinely pound the Rockies at this time of year. Otherwise, walking is great. I did four miles the other day and actually lived to blog about it.

My biggest problem is time. Walking to Curves, working out, and walking back is an hour and a half commitment. Taking a walk that lasts less than an hour doesn’t feel challenging at all. I realize that simply walking, even for a half hour, is better than nothing at all, but somehow I can’t wrap my head around that. Working a workout into my already overloaded schedule is the real challenge.

But this is war. I can’t forget that. So I’m off to Curves, wind or no wind. No matter how winded I get.

Fasting glucose: 145 (on the way down!)

Day 3: Celiac diet

My friend Eryn, whose husband has celiac disease, graciously lent me several gluten-free cookbooks and sent me these links to celiac- and gluten-free sites:

• http://www.celiac.com/. Not surprsingly, the go-to site for all things celia. Very helpful.


• http://glutenfreegirl.blogspot.com/. Fun, personal blog from one who has been and is still there.


• http://www.celiacsite.com/index.php3. Lots of celiac news here.


• http://www.outsidethebreadbox.com/. A gluten-free bakery in neighboring Colorado Springs (Old Colorado City area). They ship via UPS.


• http://www.cereskitchenco.com/. Gluten-free baked goods, sauces, full meals and so forth. Located in the Briargate area of Colorado Springs.

A Google search turned up lots of other sites, of course, as well as numerous gluten-free stores and bakeries around the country and online sources for specialty products. If you have any other recommendations, send them along, okay? I need to create a 30-day menu plan, so I'd appreciate any help I can get.

Just to be clear, I don't have celiac disease; my doctor wants me on this diet to see if this helps the myriad health issues I do have. I don't need to worry all that much about cross-contamination the way other people might.

Fasting glucose: 156

Day 2: My Battle Plan

Well, it’s actually my doctors’s battle plan. He passed it along to me, and I signed on. Here are the basics

• Keep a food diary. (I’ve never been good at this, but this is war.)
• 30 minutes of exercise every day without fail. (Living in Colorado makes this one easy. We have hiking trails everywhere.)
• Get outside every day, regardless of the weather. (See above.)
• Plan menus 30 days in advance. (I really don’t like this one, but I’ll do it. I’ve already had several false starts, but maybe tomorrow…)
• Follow a dairy-free, soy-free, corn-free, gluten-free diet. (I only have a problem with the soy-free stipulation, since I eat little meat and rely on soy for protein. But beans and rice work for me, so I can do this.)
• Get enough sleep. (Always a problem for me. I don’t sleep well and never have.)
• Supplements: a bunch of stuff I already take, including fish oil, Vitamin D, B-complex and lots of other vitamins and minerals, and a new one, Probiotic.

My doctor did make one mistake: he underestimated me. He told me to spend the next two months planning all this out and then get started on the program after the holidays. I’m sure he thought that made sense, but not to me. Hey, if this is war, it starts now.

Today’s fasting glucose reading: 155

I've declared war!

If, like me, you have Type 2 diabetes, it's likely that you've resigned yourself to a lifetime of challenges that either become the focus of your life or become so daunting that you want to give up. I've faced those challenges in both ways and pretty much every way in between.

But then a mini miracle occurred. The rural area where I live received a grant to provide medical care and guidance to people at high risk for heart problems. As every diabetic should know, that includes all of us. Because I have neither health insurance nor a predictable income, I hadn't been seeing my doctor or getting tested as often as I should have. This program was a godsend.

What astonished me most was that the doctor affiliated with this program was every bit as holistically oriented as my previous doctor had been. Considering that I live in a small mountain town with few doctors, to find two that took a body, mind and spirit approach to diabetes was so unexpected.

Dr. James told me I needed to declare a 90-day war on diabetes. So this is Day 1. I'll post more tomorrow about the specifics of the program I'm on.

I decided to go public with this as a means of accountability and to offer hope to other Type 2 diabetics. To do the latter, I really have to work the program and not give up. If you're doing something similar, let me know so we can encourage each other, okay?

Fasting glucose level: 180