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Happy Anniversary, MedWatch!

Anniv

MedWatch, the USA Food and Drug Administration’s self-billed “premier safety reporting system” is celebrating its 20th anniversary.

MedWatch is also using the occasion to tout a new web-based learning tool called MedWatchLearn, including a nifty video that gives a lot of information about how to report issues to the FDA. Also, they’re rolling out a new reporting form that supposedly has less technical jargon than the previous form did. I didn’t see the previous form, so I can’t compare. The new one is more “consumer friendly”, but it’s still five pages long.

I know we like to beat up the FDA sometimes, but it’s important to remember that MedWatch has helped inform People With Diabetes about problems with blood glucose meters, the drugs Avandia and Actos, and insulin pump infusion sets. Those issues were reported by someone, and someone at the FDA listened. And then reported on it.
 
 
Here’s a link to the official announcement and the new reporting form:
Announcement: http://www.fda.gov/Safety/MedWatch/ucm353999.htm?source=govdelivery

Form: http://www.fda.gov/downloads/AboutFDA/ReportsManualsForms/Forms/UCM349464.pdf?source=govdelivery

And of course, you can always reach the Food and Drug Administration at www.fda.gov/medwatch, or by calling 1-800-FDA-1088 (1-800-332-1088).

Happy Anniversary MedWatch… here’s hoping all our drugs and devices work perfectly and we never need to talk to each other again.
 
 
 

You might be interested in this.

There’s something I left out in Wednesday’s Like These Links post, and I want to include it here today. Plus a couple of extra things you might want to know about.

First, the thing I left out on Wednesday: Lee Ann Thill of The Butter Compartment has started a new project. If you’re a veteran of Diabetes Art Day, you know that Lee Ann has a special gift for inspiring people connected with diabetes to create art as therapy. I’m not particularly gifted (and that’s an understatement), but she even inspired me to do something this past year.

Anyway, Lee Ann’s new thing is related to her Doctoral studies, and it’s called VIAL Project (Voice – Insulin – Art – Life). According to the official website, “The purpose of this research is to explore the experience of having type 1 diabetes and food and body issues, and the experience of using arts-based expression on a social media platform.”

To get a detailed explanation of this very cool project from Lee Ann’s point of view, check out her post from earlier in the week: http://www.thebuttercompartment.com/?p=6863

To read more and sign up to participate, visit the VIAL Project website: http://vialproject.ning.com
 
 
 
Also, the International Diabetes Federation is sponsoring a giveaway of one of their “Show Your Outrage” T-shirts plus some extra blue circle swag. But hurry… the giveaway ends January 14. It’s easy to enter.
Just go to: http://www.idf.org//international-diabetes-federation-giveaway-0

Consider your message shared, IDF.
 
 
 
Finally, if you’re close to Washington, D.C. the first weekend in February, you’ll have the opportunity to attend the Children With Diabetes Focus on Technology Conference in Arlington, Virginia, right across the Potomac river from our nation’s capital. Tom Karlya will be there. And I just found out that Kerri Sparling and Scott Johnson will be there too. Okay, now I’m kinda jazzed about going. There will be lots of talk about diabetes and technology, and a closing keynote from Sebastien Sasseville, Team Type 1 athlete and the first Canadian with Type 1 diabetes to summit Mount Everest. The Great Spousal Unit needs to hear from this guy that I can do anything I set my mind to.
To find out more, register for the conference, and even book your hotel, start here: www.childrenwithdiabetes.com/activities/DC2013/
 
 
 
Enjoy your weekend!
 
 
 

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.
 
 
 

A Name for Hypos.

The Great Spousal Unit talks about how, sometimes when I have those low blood sugar moments, I turn into someone she doesn’t know (unlike the Snickers commercials, where you turn into someone you do know). She says that I go to a different place. She doesn’t know where I’ve gone, she just wants me to come back.

So now when I think of going hypo, I think of going to that place on the other side of the tracks, where I don’t always visit. And since “hypoglycemia”, or “hypoglycemic episodes”, is way too sanitary to describe what happens in those moments, I’ve been thinking that a geographical reference might describe it better.

For instance, I live in Baltimore, so I might say that I “Dundalked” last weekend while I was working in the yard (sorry everyone from Dundalk– I really love your little hamlet… but I don’t visit often). When I lived in Cincinnati, I could’ve said that I “Newported” yesterday, and man, did it suck. If I still lived in Columbus, Georgia, I could’ve apologized for being late… but that early morning trip to “Phenix City” really knocked me down.

If we wanted to be a little more generic, we could simply say that we crossed the state line. “I crossed the state line last night, and it took me a long time to get back. Wow, I am so tired this morning”.

Maybe if we add a directional point of view, we could come up with something that could be descriptive for both hypoglycemia and hyperglycemia. Imagine this exchange between a patient and their endocrinologist:

Endo: “So, have you experienced any bad south of the border incidents in the last 90 days?”

Patient: “No, but I went north of the border a couple of weeks back. Bent the cannula during a set change. After some failed rage bolusing, I knew something had to be wrong, so I changed the set again. Took me most of the day to come back in-state.”

You know, I kinda like that south/north of the border idea. That Endo question is so sexy, it almost makes you want to say yes, no? If you were to break away from the clinical definition of hypo- or hyper-glycemia, how would you describe it?
 
 
 

Our second dog is a cat.

I’m not the first person to write about this. But here goes:

Myself, The Great Spousal Unit, and The Live-In Niece share our house with a dog and a cat. The dog(Boomer) is a big, loving Golden Retriever who’s a lot of fun but not very smart. The cat(Max) is the first cat any of us have ever lived with. Both are rescues. Boomer spent almost all of his first two years in a cage before we found him. Max was a stray who never left. They both get along famously. Maureen likes to say “Who would’ve thought that our second dog would be a cat?”.

Over the course of the last year and a half that Max has been here, I’ve become increasingly aware of his ability to recognize low glucose moments. Sometimes he bugs me in bed while I’m sleeping. Other times, like last weekend, he walks across my lap while I’m watching TV. Then, he goes into the kitchen, climbs on the refrigerator, and starts knocking things off the top onto the floor until I get up. Then he looks at me, and looks at the fridge. Back and forth, looking at me then the fridge. A quick check with the meter, and it looks like he’s right. I need a BG boost. Once I open the fridge, he hops on the counter and looks at me with those cat eyes until I drink all the juice. And if it’s not enough, he bugs me some more.

Okay, maybe I’m overdoing it a bit. But this cat has a knack. And you’re hearing that from someone who’s definitely a dog person. I’m allergic to cats. Never been a fan. But this guy can stay with us as long as he wants. Unless someone wants to borrow him for a while.