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Support / Advocate Luncheon – H1N1 Vaccine, Medicare Fraud, Kidney Disease

Every other month I attend a luncheon in Boca Raton at the Bova Cucina. It is a diabetes advocate and support group type meeting.  It is usually comprised of several CDE’s, diabetics, sales reps and a few MD’s.  The support group is put on by Murray Pincus.  Majority of you probably have no clue who Murray is, but if you are diabetic and live in the south Florida area, then you should know his name.  Murray is a great friend of mine and a terrific advocate of diabetes.

Today’s luncheon was comprised of 3 main parts.  Session one was a lecture on diabetes and kidneys by Dr. Frank Lavernia, who is an esteemed endocrinologist in south Florida.  He gave a great lecture on kidney disease being such a silent killer because so many people are living with it right now and have no idea.  Not just diabetics, but people in general.  Diabetics usually find out before non-diabetics because they should be getting tested for it.  Dr. Lavernia’s suggestion for finding out if you are at risk is simple, “Pee in a cup!”  He also explained that it is not just the high blood sugar that will affect your kidney’s, it is multiple things.  Cholesterol problems, high blood pressure, and there are multiple different factors that affect these problems as well.  And of course all of these risks increase with type 1 diabetes.  So to sum it all up, we need to make sure we go to the doctor’s follow the guidelines and be prepared by being ahead of the game and having tests done.

The next part was a talk given on Medicare fraud.  In south Florida, where I live, Medicare fraud is extremely high.  Mainly due to the obvious reasons, people retire to Florida.  There are also the snowbirds (people who come down south for the winter).  Snowbirds may be receiving supplies up north and may switch to a different company when they come down south and the DME can continue to bill for supplies that aren’t even being sent out.  And how can they dothis?  Because they rely on the elderly not paying attention to their statements and being “just old and out of it.”  There are organizations around the country now that do nothing but look at Medicare claims and make sure their are no fraudelent ones.  Unfortunately, there are not enough people doing it.  (Imagine what a national run healthcare reform would look like!)

Finally, it was summed up with a representative from CMS (Medicare).  He was there to talk about the H1N1 vaccine and if it’s covered by Medicare, who should get it, is it safe, etc.  Let’s start with his analogies.  CMS believes that everybody should get not just their seasonal flu shot, but also the H1N1 vaccine.  You can get these at the same time, 2 different shots, but at the same time.  For right now, the H1N1 vaccine requires a second booster shot, however that is beginning to change due to more recent research.  He explained the H1N1 vaccine as a seat belt.  Everybody should wear one.  If you don’t get into an accident, great, at least you were prepared.  However, if you do get into an accident then the person who is wearing a seat belt (the one with the H1N1 vaccine) is more likely to survive.  This was a good analogy.  Someone asked the question, is it safe to take, it hasn’t been around long enough to know the safety of it.  An MD responded, using the same analogy, “Don’t take the mindset that, ‘John Doe died because he was wearing a seat belt, if he wasn’t wearing it he would still be alive.”  As in, you know of one person that got sick from the H1N1 vaccine does not mean that every single person is going to get sick.

Now after all this, I must admit, I have never gotten a flu shot before.  I always think, what’s the point, I’m young, I don’t need a flu shot.  To me, the flu just means I’ll throw up a couple of times one day, have a bad fever, get the sweats, get the chills and then be over it in 2 days, no big deal to me.  As I get older, I understand that’s not going to always be the case.

What are your feelings / thoughts on it?

Diabetes and Feet – Not Enough Effort

Well today had a lot better blood sugars then Sunday did that’s for sure.  I didn’t go over 200 at all today, the closet I came was just right now right before dinner and after 2 hours of coaching football, it was 178.  I just had a pulled chicken sandwich and 1/4 cup of baked beans.  I don’t like eating this late because typically it will lead to higher 3 a.m. blood sugars, but I didn’t over eat, I ate very small.  Today is all about my feet.  First, I want to thank my doctor for taking time to check my feet every single visit.  So far they have been pretty good.  I do have a few calouses but I have always had them from sports.

I try to lotion my feet every single night, but I don’t always remember to.  Luckily I have an amazing girlfriend that is willing to do this for me with a special diabetes foot cream.  I use Neoteric primarily, but there are a few others I have tried, but don’t recall their names.  I have also tried the Anastasia foot cream as well, and liked it, but just didn’t want to pay the higher prices for it.  I don’t feel that I pay enough attention to my feet.  How much attention do you pay towards your feet?  I sometimes get the attitude, well I’m only 25, that stuff will only happen when I’m older.  Well I try to smack myself in the face when I say that.

For instance, I just came home from football practice tonight and my feet are soar.  I’m only 25 like I said and still “fresh” out of football so I am very active with the kids and running pass patterns and throwing them passes so I am running around in cleats all night.  Then I come home and my feet kill, my calouses are even bigger and my feet are as dry as can be.  I am about to take a shower shortly, but as soon as I get out, my feet will be extremely dry.

In the industry that I work in, I see a lot of different wound care products and items and sometimes wonder what they are for or how they are used.  Then I see some of the promotional materials or product catalogs for some manufacturers and then I see examples of open wounds, and sores that can come from not taking care of your feet.  This makes me sick to my stomach and do not want to allow myself to get that way.  I know that sometimes it may not be your fault, but if there are things that I can do to prevent it, I want to make sure that I am doing them all.

One of the keys to my health as living a life of a diabetic is that I must keep my feet in great condition and not allow them to crack or get sores on them.

Hope you all have a great day.

Weekend Full of Highs…Went over 500

This weekend involved a lot of highs.  I hit over 250 Friday night, reached 300 on Saturday and was over 500 on Sunday.  Sunday’s was the worst.  It was also the scariest, and also made me feel like crap.  I was coaching a football game Sunday afternoon and I was sweating a lot and felt a little low so I drank some Gatorade.  After the game and when I got home I tested and I was at about 240.  I then ate Arby’s because Sunday is my diet cheat day.  About 2 hours later I started to feel a little crappy, just felt like laying down. No big deal I thought because I was up early and was out in the sun all day.  I tested and I was now up to 300.  I figured it was because I ate fatty food so it will take a while for my levels to get back down.

Then I started to feel really thirsty and my stomach was starting to hurt.  I tested again and now it was over 400.  So I take some more insulin to correct.  About an hour later, or maybe even less then that, I tested again because I was even more dehydrated, and that’s when the meter gave the worst reading, “HI”  HI Blood Sugar

I didn’t panic because I knew I could bring it down, just do everything that I was always taught from my diabetes educator, thank god I’m able to still have a CDE!  I corrected on my pump and took the necessary insulin.  I tested 30 minutes later, still says high, so I changed my site and corrected with insulin in the new site.  I layed down and tried to fall asleep and wake up and hope that it was lowered.  I woke up about 45 minutes later and now finally I got a reading, it was down to 435.

Before I finally went to bed at midnight, it was down to 235.  I woke up at 4:30 this morning with a blood sugar of 65.  Talk about going from one extreme to the other.  I went downstairs and had some OJ and of course a few Skittles.  I went back to sleep and when I woke up and went to Dunkin Donuts for breakfast, I tested and I was at 106.  So luckily I was able to get it down and get it back to where it needed to be.  I ran a little high all day today as well, around 200 all day long.  I just came back from the gym for an hour and I am about 160 right now.  I thought my sugar was running high because I was starting to feel sick, but now I think that I felt sick because my sugars were high.

Well I guess this is part of living the life of a diabetic.

Friday Reflection Part 1

Every Friday from now on is going to be a “Friday Reflection” day in which I will attempt to reflect upon everything that happened during the week and try to make sense of it and move towards the next week.  This week was filled with some good positive things and some not so good things.  Sounds normal right?  Fortunately, my blood sugars this week have landed on the good side, so that is something that I am excited about.  Unfortunately, due to the bad things my blood pressure has been starting to get a little whacky on me.

This week started out with another long week of work ahead of me.  No different then any other Monday or week for that matter.  My responsibilities outside of work are what are starting to pick up and that is what’s causing the most stress.  I have football to coach on Tuesday and Thursday’s and we have games coming up soon so I am trying to prepare the kids for this and create a playbook for them to study from, which is taking forever.  There are so many damn blogs to read now a days I can’t seem to find a chance to read them all.  I find myself every night going to Diabetes Daily and just going through the lists of the posts throughout the day and some nights I make it all the way through and some nights I just can’t.  Monday night also included the first week of Monday night football, two games actually.  So that brought the excitement of the NFL back to me.

Tuesday, like I stated earlier was football practice and then home to try and get some work done on a few little side projects.  I’ve also been doing some brainstorming on some cool, fun little activities to try and give back to JDRF locally.  Wednesday and Thursday were just boring ole days, nothing really exciting that went on.  So that comes to tonight.  I just came back from TGI Friday’s and then heading out later tonight to check out the new Jennifer Aniston movie, should be good.  This weekend will be filled with nothing but football.

Looking back on the week I am happy.  I learned a lot this week.  A lot about myself, a lot about diabetes, and about life in general.  I unfortunately learned a lot about some people, that I did not know previously.  My goal every week is to learn more than I did the week before.  And to be able to look back on the week and think, what did I do to make myself better this week.  Whether a better person, a better diabetic, a better worker, better at anything.  As soon as I become complacement, things get back.

Well there you have it a summary of the week for a life of a diabetic.  Nothing too special, all pretty much boring ole life.  Have a great week ya’ll

JDRF vs ADA – What are your thoughts?

First off, if I have anymore computer problems I am going to flip out and throw this thing out the window.  I was getting some sort of script errors and I don’t know what the heck was going on, so I was pretty much computer-less yesterday.  Anyway on a better note, I have my cup of coffee next to me, making Amanda some chocolate chip pancakes as I speak.  Today is going to be a long day, but what day isn’t anymore.  Long day at the office, long night of football, then the gym, then dinner, then work at home and maybe watch some football if I’m lucky.  I wanted to do this post yesterday, but obviously I couldn’t so here I go.  The JDRF vs ADA, what are your thoughts?  Here are mine (if you care)

I mentioned briefly the other day about how most people have their favorite charity or think that theirs is the best so they want the money for theirs because that cause is more important to them.  In my mind there are two large diabetes non-profits, obviously I am talking about the ADA and JDRF.  Everybody may have their own opinions on these 2 organizations, but overall they are good.  If I were able to only donate to one of them and not both, which I do at this time, this is how I break it down.

I see the ADA and JDRF having two different approaches.  ADA being about advocacy and JDRF being bout research.  So there are two different train of thoughts for me here.  I believe that the ADA is doing a decent job with advocacy in Washington.  Could they be doing better, of course!  So when I donate a dollar to them, I am donating a dollar thinking, “Ok, they aren’t going to help me find a cure, so they are going to help me live a better life with demanding certain rights and insurance priveledges for me”  It is almost as if it is accepted to not find a cure and just deal with the fact that you have diabetes, so let them fight for you and be your voice in Washington.

According to the American Diabetes Association, 24% of funds go to research and 23% goes towards advocacy, however, 21% goes to “fundraising.”  What exactly does that mean?  That $0.21 of my $1.00 goes towards creating a new fundraiser to gain another $1.00 from me?  So I have now donated $2.00 and only $0.48 cents has gone to research and $0.46 to advocacy, but meanwhile $0.42 cents goes to fundraising.  I am not arguing with where the money is being spent because like I said, I still donate to the ADA because I think the things they do are excellent, especially the amount of money they spend on information because the more information the better.  This is just the way my mind thinks of describing the two.

Next up, we have JDRF.  JDRF is my non-profit of choice.  If I had to choose any organization to give money to, it would be them.  The way that I view them is that they are here for one thing and only thing only, to find us a cure and get rid of this nasty thing we all live with.  They obviously dabble in advocacy as well, but their #1 goal is research and a cure, and so is mine.  I want to find something so any chances that my first, second born child will have diabetes will be eliminated.  According to JDRF, approximately 85% of every dollar spent is used towards research.  I’m all about doing it for the kids.

So when I compare the two I see that it only takes me $1.00 spent to get $0.85 worth of research with JDRF.  On the other hand it is going to take me $4.00 spent with ADA to get that same amount of research funded.  This is why I have come to view these two organizations in the way that I do.  I know there are skeptics out there that believe we will not have a cure so we may as well have somebody fighting for us to give us everything we possibly need.  And then there are positive thinkers that just know there will be a cure and do everything in their power to get to that cure, and that’s the boat I am in.  Not to say that one side is better then the other.  In fact, I also think that they should both work together a little closer.

For example, every year for the ADA walk their is a JDRF event the same morning.  Every year at the JDRF walk, there is an ADA event at the same time.  What are your thoughts, do you agree, disagree, am I just crazy?  I will continue to donate to both because I think they are both extremely important.  I know putting up ads and links on your blog is somewhat frowned upon in the dblog world, however if you have noticed that any ad that is on my site, I donate that money to JDRF.  I think this is a great way to easily donate funds to a non-profit of your choice.

Well, I must get going, like I said it is going to be a long day in this life of a diabetic.  So have a great day ya’ll

Where Would You Be Without Diabetes Education?

So where would you be without diabetes education?  I can tell you where I’d be, and it wouldn’t be here, that’s for sure.  I am willing to bet that majority of you would say the same thing.  To me, diabetes education is the most important part of diabetes in general.  You can’t accept it if you don’t understand it.  You can’t manage it if you don’t know about it.  But there is always something more to learn about diabetes.  As soon as you think you know all there is, something else pops up.

I recently did a post on the old blog starting to get into this subject of diabetes education and that all the programs that are closing down.  Just locally here in south Florida where I live in the last year I have personally seen the JFK Medical Center diabetes center go down, along with the North Broward Hospital diabetes program go down.

I use Google Alerts for the keyword “diabetes education program” and it seems that almost everyday I receive another alert with a local newspaper writing about another program closing down.  I will admit that there are also some that talk about new ones starting up, which is amazing.  But when you read into it, the program is opening with minimal funds and sharing an office with the whole hopsital education system.  Now as someone with diabetes, I know how important it is for diabetes education programs.  I understand that this will lower my chances of any complications that may come in the future.

Now why do hospitals not think this way?  Oh I know, because this doesn’t allow their wallets to get fat.  It is very clear, there is no money in diabetes education, none!  The re-imbursment rates are minimal.  I see all the time in these articles that a reason the hospital will close the center down is because the amount of people coming to certain diabetes education classes or programs are decreasing.  The reasons they may be decreasing are because less people have health insurance, can’t afford to go to the classes, gas prices are getting better now, but during the gas spike of recent times people just couldn’t afford to drive to their local hospital to get the education they need.

So how do we solve this issue?  How do we get the education that we all need to the people that need it most.  One way I am personally trying to resolve this is to raise funds for diabetes education.  Raising funds in these times is a difficult thing to do.  There is a million charities out there and everybody thinks that theirs is the best and their cause is better.  Especially when you have a discussion about the ADA and JDRF, (tomorrow’s post).  Anyway, time to get back on subject.

Please let me know of any projects that you may be working on or that you have heard of or any local events.  I would love to help out and be as active as possible in fighting for the education that we need.  I continue to fight and do what I can to help find a cure, but until that day comes the best I can do is to help people get the same education that I received and still receive today that has helped me stay healthy.

I want everybody to be able to enjoy their lives and share their own stories of living a life of a diabetic.

Have a great night ya’ll

A Relaxing Weekend with Diabetes

This weekend was filled with a lot of excitement, well at least I think so.  What I mean by exciting is a relaxing weekend with diabetes.  I don’t even know where to begin, but I guess I will just start on Friday.  Friday night may have been boring for most people, but to me it was great because I had a chance to relax and catch up on some reading and reviewing certain things, mainly healthcare reform debates, and not have to worry about being anywhere in the morning or at night.  The night started out a little rocky because at football practice my infusion set had fallen out.  No big deal though because there was only about 20 minutes left of practice and when it fell out I checked my sugar and it was 75, so I didn’t need any insulin for a while anyway.

After I got home and showered, I sat down and reviewed President Obama’s speech from last week again, but this time with a little more detail and not just taking it all in like I did the first time.  But more on that later on in the week.  The rest of Friday night was spent researching the options in creating a business in the state of Florida.  A lot of paperwork and dumb fees, that’s what I concluded!  Finally the night ended with a refresher course on basic HTML.  I know how boring this night sounds, but it was so damn relaxing for me.  And the whole time my blood sugars were at great numbers.  Just to stress this point, a Friday night life of a diabetic is not much any different than a Friday night of someone who isn’t, so take that diabetes!

Saturday morning did not start off too well however.  I volunteered to help out with the local JDRF at a sidewalk sale where all profits went directly to JDRF.  I drove down to Boca and when I got there, I was getting out of the car and riipppp.  My infusion set tubing got caught on the door and it pulled my infusion set out.  Two infusion sets gone in 2 days, not a bad pace.  I had to go back home and by the time I did all of that, there was really no point in going back down to the fundraiser, so I had to miss out on this one.  Saturday night came and it was a little like the night before.  I didn’t do as much work because I decided to just relax and watch the USC-OSU game all night.  I did very little work.

Sunday came which means my Philadelphia Eagles.  I made myself a promise that I would not allow myself to get all worked up and make my blood pressure and blood sugars go crazy anymore. I would not allow these 5 reasons to affect me this week.  The game was pretty much wrapped up after the first or second quarter, so I was not on edge like I normally would be, but my blood sugars were perfect.  I tested before I went into the sports bar and then again 3 hours later after I left.  It was 175 when I entered and 106 when I left, and that was after French Onion soup and a chicken quesadilla.

So, that was my exciting weekend.  Not much to it, but just a normal day living with diabetes.  Now it is time to enjoy some Monday Night Football (Brady, Moss, Pats Defense all on my fantasy team) and watching this incredible match between Federer and Del Potro.

Have a great day and night everybody.

Need to Wear CGM More Often

In a previous post that I had after my doctors visit I discussed that I promised not just my endo but myself that I would wear my CGM more often.  And I started to, but then I haven’t put it back on in a few days.  And why may you ask?  Because I am lazy, and since there are only certain times during the day that I can put it on, I usually decide not to do it.  They say to not put it on during a time that your blood sugars are fluxuating or not stable.  Well that eliminates the morning time and also night time.  So that leaves when I am at work.  Well, it’s not the most comfortable thing to do at work.  So then that leaves me doing it on the weekend, which allows me to have the CGM on from Saturday – Tuesday (unless it falls off during golfing.)

I know all the good things about the CGM.  That it is going to help me conquer my morning lows by knowing more of a minute by minute analysis of what my blood sugars are doing.  There are article out like this one from Science Daily, that states, which we all pretty much know by now anyway, “…patients averaging at least six days per week of CGM use had substantially greater improvements in HbA1c compared with those who used the device less often.”  Hmm, so do I need any more proof or any more of a fire lit under my butt?

I vow to wear my CGM for 7 straight days.  Then 14.  Then 21.  If I start with a goal of 30 days in a row, I have a problem reaching long goals without setting smaller ones in the short term.  This is my promise.

What is the longest that you have worn a CGM in a row?  I don’t mean, did you sneak 4 or 5 days out of a 3 day sensor from Medtronic.  But as in, you inserted a new sensor the same day you took an old one out, etc.

This all makes me think about my mindset.  I am usually so good about doing things the right way.  I have done things the right way my whole entire life.  I worked my butt off to be the best basketball and football player I could possibly be.  Of course there were times that I was lazy, but I would make up for it the next day or next week by working even harder.  Or if you have one of those days and you are a little slower at work, you can catch up on work the next day.  But diabetes is completely different.  If I want to take a day off, or be lazy, I can’t just make that time up or just work harder the next day.  This post could potentially become the change of my life and how I see things and act with my diabetes.  I have had A1c right around 7.0 or below for over 2 years,  but it’s time to stop being complacent with those numbers and continue to work harder.

I am committed to making this life of a diabetic a better one and in turn a longer one!

Weekly Weight loss update

Some computer problems prevented me from posting yesterday. My computer still isn’t up to par so I am trying to create a whole post from my WP IPhone app. Ouch my finger is getting tired already.

I wanted to give an update on my diet today. This weekend I slacked off just a bit because of the long weekend but that should not be an excuse at all. I am still right around 240. It seems that no matter what I do I can’t knock this weight off. I look skinnier I feel thinner and my clothes fit better so why does the scale say the damething.

Amy from DiabetesMine had a great post about this and a TIME front cover magazine article a few days ago which sums this whole thing up.

The number one reason that I am not losing the weight is because I am being lazy and not working out like I should. I will go to the gym for 20 minutes and then leave like that is enough time to do what I have to do. My eating habits have become better however still not the best. For instance, today I brought a Lean Cuisine meal with me for lunch that is only 250 calories but I decided to go with the group to Firehouse and eat a 400 calorie sandwich. Right there is 200 less calories that I could have had in my diet. Over 15 days of that 200 calories would be one pound.

Well that is it for today hopefully I can have my computer back up and running by tomorrow night.

Have a great night everybody.

Hollywood and Diabetes, Another Failure

I saw a few posts over the last few weeks about diabetes and Hollywood and how Hollywood gets diabetes wrong a lot.  Well over the weekend I saw another movie that they just got it wrong, another failure.  This movie was “Panic Room.”  I saw this movie when it first came out years ago and remembered the little girl having some sort of problem that was making her blood sugar go low, but at that time I didn’t know it was her blood sugar or what her problem was.

For those that haven’t seen this movie a mother and daughter are locked inside of a panic room when 3 men are attempting to rob the new house they live in.  The little girl has diabetes and her blood sugar is dropping throughout the whole movie.  Good thought and plot for a movie, but not the best at the details.

The first thing that bugged me was when they first moved in they were eating dinner downstairs and the girl with diabetes was drinking a regular soda.  I don’t know about you, but I sure don’t enjoy a regular soda for dinner, actually don’t think I have had one for pleasure in about close to 10 years.  How could the director or whoever is in charge of this let this little moment make the cut?  Failure number 1.

Second thing was the CGM, or futuristic CGM she was wearing.  I had heard of this thing and saw it online, the GlucoWatch, but I haven’t seen anybody actually wear it.  Basically it was just a watch she was wearing that was giving her blood sugar readings to her.  We all know that it’s not that easy.  How about showing her inserting the sensor into her skin and allowing people to see what actually goes on behind the scenes.  People are already ignorant to diabetes and don’t know what we go through on a daily basis, so why give them the thought that, all you have to do is look at a watch to see what your blood sugar is?  Failure # 2.

Using diabetes in a movie plot can be a great tool and make the movie extremely interesting, but only if it is done in the right way.  Add some educational aspects to it.  Explain how this person’s diabetes is going to affect them later on in the movie, give hints, just like you do with the rest of the plot.  I remember seeing a sci-fi movie, (wait I’m sorry, now it’s Sy-Fy) about a year or so ago that involved these alien looking creatures who lived off of sugar.  Without sugar they would die.  Of course there was a group of teenagers that were somehow being attacked by these aliens, but there was one girl in particular they really wanted and nobody knew why.  Well it turns out she was diabetic and had really high blood sugar and they were looking for some insulin so the aliens would stop trying to attack them.  If I remember correctly, the insulin ended up being the killing formula to the aliens.

Although the movie was cheesy, it explained diabetes.  The girl explained to her friends that without insulin her blood sugar will continue to get higher and she will not be able to runaway from the aliens because her body will slowly start to shut down on her and cramp up.  She also explained what the insulin did and how it lowered your blood sugar.  She used the PacMan analogy by saying the insulin eats up the sugar like PacMan.  Maybe not the most scientific explanation, but it works in my book.

So today I dare somebody in Hollywood to make a movie that explains diabetes.  Put a character on tv that explains diabetes, and no not Brett Michaels.  I mean somebody respectful, not washed up, a has been and does diabetes the right way and not keep their blood sugar higher so they can enjoy sex.  Hollywood, you have been challenged!

Somebody make this life of a diabetic a happy one and have a great day.