Victories in progress

Now that I’ve got the bulk of my medical aid story of my chest, I can give an update on that D-doc appointment I went to on Monday. Overall it wasn’t too shabby...

The last time I went there, it had been such a long since my previous appointment that the nurse/assistant/receptionist lady gave me an evil look and a talking-to about my Diabetes (I guess I deserved it). This time she greeted me with a smile, to my relief. Strange how something small like that can make a difference. And I didn’t mind the two hour wait to see Dr S that much- I took the opportunity to get stuck into the Solzhenitsyn book I found at the flea-market a while back (I have a soft spot for old Russian literature, I’m not sure why).

Just as in my last few appointments, the first thing Dr S asked was if she could put me on a pump yet. It was so good to be able to answer “Yes! At least, I think so, but not yet. I have to wait 2 more months.” 

I told her about switching medical aids and we had a good rant about BM (she’s not much of a fan either. It turns out I’m not the only patient, or doctor, that they mess around).

We worked through all the questions I had. I’ve been struggling with slow absorption and prolonged action of my Humalog, which isn’t all that helpful when the point of being on rapid acting insulin is that it’s meant to in and out of your system in 2-3hours. Working with Dr S’s theory that I may have built up an antibody response to the Humalog from being on it for so long (about 10 years I think), she’s given me a pen of Apidra to try out. So I’ve been rocking Apidra since Wednesday (and by rocking I mean bouncing between highs and lows and more lows as I try to work out the insulin:carb ratios and correction ratios and all that. I know they’re meant to be the same as with Humalog, but I also know that for a lot of people they aren’t) and I think I’m starting to get the hang of it. It definitely works faster, which is what I was looking for. 

My Lantus has been knocking me for a six with night-time lows a lot lately. I can blame my increased exercise levels for that,  but after decreasing the dose by 3 units, I’ve been stuck with what else do to about it. Other than snacking more at night, apparently not much. At least, not until I get a pump and can fine-tune a night-time basal rate. Great :/

On the topic of my increased exercise – it’s worked!! Along with the carb counting and all that I wrote about last week, it’s brought my HbA1c down! Ok, only by 0.6%, but it’s the first time my HbA1C has been below 8% in, well, quite a long time. It’s still needs work, but I’m counting this as a victory in progress J

I’ve saved the best bit (ok, maybe not the best- the A1c drop is pretty darn cool for me- but this is the bit I’m the most excited about) for last. Half way through the rant about BM, Dr S’s eyes lit up. She told me about a patient who had an old pump she hasn’t been using since she’s upgraded last year. This patient had lent the old pump to another patient to use while she was pregnant, but this patient couldn’t keep using it now, because her medical aid (BM. grrr.) wouldn’t pay for the infusion sets. So what this boiled down to was that, if I could get my shiny new medical aid to pay for the infusion sets, I could use this spare pump, while I stick out the last two months of my waiting period. woohoo!

So I left the appointment armed with a prescription for infusion sets. I called DH on Tuesday morning, e-mailed them the prescription, and waited. I got an e-mail bright and early on Wednesday- DH has agreed to pay for the infusion sets! After my experience with BM, this is nearly unbelievable for me. DH has an obligation to cover my insulin and tests strips, as part of Prescribed Minimum Benefits for my diabetes. And from all my prescriptions, they can clearly tell that I’m on MDI and not a pump. So as far as I can work out, they have no obligation to cover infusion sets if I’m not on a pump yet. These supplies aren’t “essential” to me, not at this stage, yet. But they’re paying for them anyway. 

WOW. I have an urge to go get “I heart DH” stickers printed.

So now all I’m waiting for is that other patient to drop of the spare pump at Dr S’s practice, and for the rep who does the pump training to get back from Switzerland, so I can learn how to use it.  Both should be done by the middle of this week. I’m so stoked- I should be on a pump within a week or so!

The spare pump I'll be getting now is the Accu-check Spirit. I’ve got mixed feelings about this detail- I’ve heard less-than-great reviews about it. And, it’s not the pump I ultimately want- I’m super keen on the Medtronic Veo, it seems to be considered more reliable, and it has the option for integrated CGMS. But, seriously, any pump that anyone is willing to give me is better than no pump, so I’m not going to complain. I can get working with the Spirit for now, and if I want to switch to the Veo in a few months, I should be able to do so. And of course, the Spirit can be passed on to whoever else needs it.

I’m super-grateful, and super excited for all this. And constantly amazed at how things seem to just be falling into place now. More victories in progress. 

Soli Deo Gloria.

Because, even if we tend to forget it, ultimately it’s all up to Him.

pre-doctor's appointment... excitement?

I have my appointment with my diabetes doctor tomorrow. I’d call her my endo, but she’s not, she’s a GP with special interest in Diabetes. I guess I should find an endocrinologist at some stage, but they’re in a little short supply in my city. And really, for now, the GP with special interest (lets call her Dr S) works- I like her, she’s got a load of experience, a good rep, and a really well equipped practice. Anyway, I digress.

I’m always nervous before doctor appointments (ok, not for my normal colds-and-fu GP, just all other doctors). Especially with diabetes, I’m nervous about what the doc has to say, if I get good news or bad, if I get a telling off for doing a bad job, or encouragement for trying. And then, there are the blood tests. It’s not the test that scares me (needles aren’t really a thing when you’re sticking one into yourself up to 12 times a day). It’s the results that make me nervous. The waiting for them, and finally getting them forwarded from the doctor.

I haven’t had my HbA1c checked since I last saw Dr S. That was august last year. Yes, I know that that’s way too long ago to have had my check up. The thing is, besides being lazy and broke, when I’m struggling to see any difference in my BG control, I struggle to motivate myself to spend time and money on an appointment where I’ll probably be told the same things, get the same blood test results, and feel even more useless about my diabetes management. Hence, I put off making this appointment until two months ago.

But this time, it feels like it could be different. Even though I’m not sure if there has been much change in my BGs since last year, I have to remind myself that stuff has been falling into place more for me; I have been putting at least a little bit more work into this disease. It still feels like my sugars are all over the place, but maybe, just maybe, I’ll see the effect of my efforts in my HbA1c. Hey, even a little drop would be encouraging.

The bigger thing about this appointment for me is that, for once, I’m actually excited about it. I’m still fostering my recently-acquired raging will to take this stupid diabetes on. The past month, especially, has seen me gathering information about what’s out there in diabetes developments land, and what is actually going on with my own diabetes. I may not have a pattern worked out yet, but I have the data. And a whole lot of questions about it- what can be changed, how to tackle different trends that crop up every so often, and what the heck to do when what should normally work doesn’t seem to work at all.

PLUS, I’m super excited to chat to Dr S about me getting an insulin pump and CGMS. She’s been asking for years if she can put me on a pump yet. For mostly financial reasons (my family doesn’t have much spare cash for such expensive equipment, and there was no chance this side of eternity that my (now old) medical aid was going to cover it), plus a fair amount of hard-headed stupidity for my part, a pump was never really a possibility. That’s changed- my new medical aid was selected specifically because they have a history of paying for these things. This might actually happen, and I’m so super stoked. It’s probably going to take a few months to make this a reality, but at least tomorrow I get to pull Dr S on board with this plan, and hopefully get the ball rolling so this can happen as soon as possible.

Excitement J