Author Archives: StephenS

Hello… I’m Stephen. I live in Baltimore, Maryland, USA with The Great Spousal Unit, Maureen. I’ve been living with Type 1 Diabetes since January 1991. I’ve been a pump user since April 2010, and I’m currently wearing the Animas Vibe pump. Also wearing the Dexcom G5 continuous glucose monitor.

I found the Diabetes Online Community in the summer/fall of 2011, and that discovery has changed my life. I started this blog in April 2012, and since then, my diabetes advocacy has continued to grow. Among other achievements, I’ve attended and spoken up at FDA workshops and participated in clinical trials.

I’ve been thrilled to serve as a facilitator for the Diabetes UnConference. And I’ve been honored to volunteer for Diabetes Patient Advocacy Coalition. You should Google both of those.

I’m currently serving as a member of the State of Maryland’s Advisory Council on Health and Wellness, where I am co-chair of the Diabetes committee. In addition, I’m part of the 2018 Reader Panel at Diabetes Forecast magazine.

I’m always searching for the perfect balance between the highs and lows of my blood glucose level and my life… always searching for the Happy Medium.

Anything you’d like to share? Please let me know… I’d love to hear from you.

It’s a numbers game anyway.

I was looking at the Baseball Hall of Fame voting from yesterday, and immediately my analytical mind starting crunching the numbers… baseball is a game loved by statisticians, anyway… Since blank ballots submitted count against players being considered, how would the voting change if those blank ballots were not submitted (then they wouldn’t count against the player)? How many more votes do Jack Morris and Craig Biggio need next year to crack the 75 percent threshold for enshrinement?

Then, since my mind has been on D overload the past several months, I started thinking about numbers and how they relate to diabetes. We all know that numbers are important. Hemoglobin A1c, meter readings, carb/insulin ratios, the whole bit.

But let’s look at some of the other stuff for a moment. I was diagnosed nearly 22 years ago. That’s a fair amount of time, and to the best of my calculation (these are approximations only), here are some overall numbers. I’m going with very conservative counts, so the amount of stuff used and the cost of everything is likely higher than this.

– I didn’t always do a great job of checking my blood glucose. So if I calculate only 2.5 times testing on average, per day, for 8,016 days since diagnosis, that’s 20,040 BG checks. At even 50 cents per strip (which is a very conservative number), that’s $10,020 spent on test strips alone.

– I was on multiple daily injections until almost 3 years ago. For most of that, I was on two injections per day. Then I was on one per day (Lantus) for a couple of years, then Lantus plus a bolus fast-acting insulin before each meal and snack. So again, let’s go with 2.5 per day as an average, for 19 years. That’s 17,350 injections! It’s hard to gauge the amount I spent on syringes, but I’ll try: 17,350 injections divided by 100 syringes in a box equals almost 174 boxes. The average cost per 100-count box is probably in the $24.00 per box range (a quick online check reveals it’s about $30.00 a box now). I’m counting the full price here because my various insurance coverages over the years mostly required me to pay 100 percent for them. So 174 boxes at $24.00 per box equals $4,176 spent on syringes.

– I can’t even begin to guess how much insulin I’ve used over the years, so I won’t even try here. But it’s a lot. And there’s no such thing as generic insulin in the U.S., so the cost is probably a lot. Though most of the cost has been covered through prescription plans. So let’s do it this way: My mail-order pharmacy dispenses 90 day supplies of insulin at an average cost to me over the last 22 years of $50.00 per 90 days. That’s 88 quarters of insulin at $50.00 per quarter, which comes to $4,400 dollars worth of life-giving juice.

– I’ve been on pump therapy for almost three years now. I’ve got a pretty good medical insurance plan at work, so the initial start-up cost for my MiniMed Paradigm® Revel™ pump was right around $500. The durable medical supplies portion of my plan helps me pay for infusion sets and reservoirs every 90 days, and my cost is about $90 per quarter. It’s been about 11 quarters since I started on the pump, so at that rate I’m at $990 for infusion sets and reservoirs and other incidentals (the inserter, IV prep, etc). I’m including the cost for the CGM that goes with my pump, even though I don’t use it all the time.

Total cost of everything above: $20,086

That’s just the big stuff. I could go on and on about doctor visits every 90 days, cost going to and fro seeing doctors and specialists and gathering stuff that I need, and that ill-timed emergency room visit in Dayton, Ohio a couple of years back.

What does all of this make you think about? How much everything costs over time? How about diabetes burnout? Does it make you want to do some number crunching of your own? Is there something I’ve left out? Feel free to add to the conversation by leaving a comment below.
 
 
 

Like these links.

It’s Wednesday, and I realized that it’s been a while since I’ve done one of these posts. So when you have a moment, check these out:
 
 
Kelly Kunik at Diabetesaliciousness reminds us that January is the start of tax season here in the USA, and that means it’s Time To Collect And Organize All Your 2012 Medical Expenses!!
I’ve collected… Now I just have to do the organizing.
 
 
Over at Diatribe, Kerri Sparling of Six Until Me fame has a follow up and some great points to make after her December interview on National Public Radio. Find out why Kerri says the Proof Is In The People.
 
 
Finally, Alexis at Chronicles of D-Boy and Ribbon has some great Advice. You’ll want to share this with every newly diagnosed person or parent. I know I want to.
 
 
Happy Hump Day!
 
 
 

When I love to swim, and when I don’t love to swim.

I started to get back to the gym Sunday. This year, I’m starting my overall training in the pool.

Yesterday was the first time in over six months that I swam laps in a pool. I’ve been dealing with some painful issues in both shoulders that I don’t understand completely. But after trying to work through them unsuccessfully early last year, I finally decided to let them rest as much as possible and I hadn’t swum laps since early June. I waited, and waited, and waited, until both shoulders finally felt something like normal when I stretched them or threw a ball for the dog to retrieve.

So I swam laps for the first time in a long time Sunday, and I loved it. I actually missed doing that. This is the time when I absolutely love to swim. Even after all this time, I can still feel the power (even though it might not really be there anymore) as I put each hand in the water, draw it along side my body, then kick hard before dropping the next hand in. To flip, then kick off the wall hard and get as aerodynamic as possible under the water before I come up to the surface.

I feel good at this time, like I’m discovering my love of swimming all over again. In the next few weeks, as I get stronger and faster, I’ll feel even better. I’m looking forward to that.

The part that I won’t like will be a couple of months from now, when it starts to become routine. At that point, it becomes boring, and I start to dread stretching, getting to the gym early, changing, and jumping into a cold pool. Then doing a hundred or more laps.

That happens at some point nearly every year. It used to happen even when I competed back in high school. When I cross the line between doing something that’s fun and doing what I feel like I need to do.

This year, I’m going to try to avoid that feeling. I’m really swimming this year to train for a triathlon, and it won’t be a long swim at that. So I won’t have to train 4 or 5 times per week for months on end. Once I get my swim stamina back, I’ll probably only need to do laps once a week.

In addition to that, I’m going to try to find a place to swim, just swim, no laps, once it warms up in late spring. Or maybe take a vacation to a warm locale with a pool. In those moments, like in Florida last October, I swim because it’s fun and I love the water. At any rate, I’ll be looking for a way to break up the monotony… keep things fresh, if you know what I mean.

By the way, a day later, I can report no bad repercussions from either of my shoulders. And just before I climbed into the pool Sunday, my BG was 158 mg/dL. After swimming and a quick shower, I was at 84 mg/dL (don’t forget that I can’t wear my pump in the pool). That’s something to feel good about too.
 
 
 

Really?

Okay, first rant of the new year coming up…

I’m beyond needing to order test strips. I’ve resorted to using my old meter because I knew they would be expensive right now. To explain this would take a month of blog posts, so I won’t bore you with it here. The situation is this: I have a pretty great prescription plan at work, but there’s this time, usually in the middle of my plan year (which is now), when I have to pay for everything out of pocket for a period of time. And that time is now.

Well, I decided that I really do need to order new strips for my current meter, so I told myself I would bite the bullet and order the strips. Then I found out how much it would cost:

TestStrips

That’s nearly $1.00 USD per strip, people. I guess I should be happy they only want to give me an 88 day supply this time (in case you’re wondering, 7 50-strip packages equals 350 strips, divided by 88 days = 3.98 strips per day).

I’m all for companies making a profit on their product. But I also believe in a little fair play. I know it makes me sound like a “free market capitalist”, but if you’re going to produce a product that’s so expensive, shouldn’t I have the ability to shop around for the same product elsewhere? Either from another prescription provider or another manufacturer? Or both?

I know that the manufacturers will say that their product is proprietary, and they shouldn’t have to share it, and they’re doing everything they can to “create efficiencies” and keep costs to consumers as low as possible. It’s still a test strip, manufacturers. You’ve been making and marketing test strips for 25 years or more here in the USA. I grant that accuracy is an issue, and I’m glad you’re all working on it. But can’t you just make the strips you’re already making more accurate? And can’t all of you make the same test strip, and work on making that more accurate? Sounds like that alone could “create efficiencies”.

My take: Profit away, test strip manufacturers and prescription providers. But if it’s going to cost so much for something I really need, you should be willing to show me how much of a profit there is in 88 days worth of test strips. And I should be able to search for the same product elsewhere, from multiple vendors. Trust me… I’m going to be a loyal customer for the foreseeable future. I just think that when push comes to shove, diabetes necessity should trump profit (and accessibility should too). Is that too much to ask?
 
 
 

It’s January. Start the resolutions!

Happy New Year! This is the time when many people make resolutions that we do our best to keep as we go through the year.

I’m not one of those people.

There are a number of reasons for that. To begin with, I’m not very good at thinking up good resolutions. What good is a resolution that isn’t great to begin with? Second, I’m not very good at keeping resolutions when I make them. It’s not that I don’t make headway toward my promise to lose weight, exercise more, etc. In fact, even if I do make headway, I’m not good at closure. I always think that there’s more to do, so I can’t even let myself feel good about keeping my resolution. And that’s when I’m really good at keeping my resolutions.

Instead, I’ve tried to come up with a few simple ideals at the beginning of the year. Then I try to remember them throughout the year, and review how I did at the end of the year. Does that make sense? I guess you could still call them resolutions, but that wouldn’t feel right to me.

So here are a few defining ideals that I hope to remember throughout 2013:

– Be a better person
That’s a pretty big umbrella to stand under. It means a lot of things to me. It means remembering birthdays and anniversaries. It means asking people how they’re doing. It means smiling more and groaning less and opening myself up to new ideas. I love new ideas, so that part’s easy. It means looking for the good in people instead of remaining a cynic searching for the dark side of someone’s personality. I’ve gotta keep reminding myself of that last part, but I think I can do it.

– Do good things for people who need something
No matter how little we have, it always seems like there is someone who has less. I want to help that person. With a meal, with a handshake. By shoveling snow or mowing the grass or raking leaves for a neighbor who’s under the weather. By supporting worthy causes, like JDRF and ADA and others (some of you know who I mean). By participating in walks and rides and runs that benefit some of these causes and bring together like-minded individuals who also want to make a difference. By giving ‘til it hurts, but in a completely unnoticed way because giving is most meaningful when it’s anonymous.

– Be as healthy and as active as possible
This is a more recent ideal for me. Simply put, I can’t help others as well as I would like if I’m always worried about how much getting older sucks. So I’m going to be as active as I can. I have four athletic goals in mind—more on that at another time. And I really mean it this time when I say I’m going to check in with my eye doctor and my podiatrist, who haven’t seen me in almost two years.

So mostly, my goals are the same as every year: To feel good and do good. And to never stop. What does your ideal 2013 self look like?