LifeAfterDx--Diabetes Uncensored

A internet journal from one of the first T1 Diabetics to use continuous glucose monitoring. Copyright 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014, 2015, 2016

My Photo
Location: New Mexico, United States

Hi! I’m William “Lee” Dubois (called either Wil or Lee, depending what part of the internet you’re on). I’m a diabetes columnist and the author of four books about diabetes that have collectively won 16 national and international book awards. (Hey, if you can’t brag about yourself on your own blog, where can you??) I have the great good fortune to pen the edgy Dear Abby-style advice column every Saturday at Diabetes Mine; write the Diabetes Simplified column for dLife; and am one of the ShareCare diabetes experts. My work also appears in Diabetic Living and Diabetes Self-Management magazines. In addition to writing, I’ve spent the last half-dozen years running the diabetes education program for a rural non-profit clinic in the mountains of New Mexico. Don’t worry, I’ll get some rest after the cure. LifeAfterDx is my personal home base, where I get to say what and how I feel about diabetes and… you know… life, free from the red pens of editors (all of whom I adore, of course!).

Wednesday, May 09, 2007

Basal Quest

I’m going to bed on target. In the morning I’m 160. Or 170. Or 159.

What the hell, you ask? AhHa! I have technology on my side. I can’t see into the future, but I can damn sure see into the past; and very clearly at that. This morning I hit the ESC key twice to view the 24 hour graph. There my sugar was, stable and coasting down all night until about three am. Then up, up, up climbs my blood sugar. I scroll back for the exact time, using the down arrow key. I park the flashing cursor over the exact moment in time when the graph starts to swing upwards. 2:56 a.m.

I don’t know the cause, but I know the solution. For years my nighttime sugars have been stable. Now my liver is working overtime while I’m snoozing. I’m probably being abducted by aliens in my sleep (they want that tiny little transmitter back!). Well, short of a cure, a good treatment is always the best medicine.

A three a.m. spike means the two a.m. basal needs to go up. I open ParaPal and up the basal steps in the wee hours of the morning. Then I plug the otherwise unused BD Link meter into my computer and beam the new program to the pump.

It is worth mentioning that it is almost impossible to get the CoZmo to talk to a computer. You have to use an infrared reader that doesn’t really work well at all (understatement of the year award). Before you get ready for your 7-10 tries to get it to work you have to peel off the leather case and remove your CozMonitor by unscrewing the battery cap with a nickel. The Monitor uses the same infrared ports the computer needs. CoZmo software is almost as good as the infrared reader. So there you have two more very good reasons to switch to MedT, beyond smaller size and integrated CGM.

The ParaPump, on the other hand, communicates quickly and with no headaches so long as you take their advice and get as far from the computer as you can. They give you enough cable to hang yourself. This last time I left the pump on my belt, set the meter in my lap and gave myself a good push from the desk. My chair rolled back into the middle of the library and I downloaded just fine. Of course, then I couldn’t reach my key board.

Back to the basal quest. In the old days (like two years ago); you would only know that sometime between your bedtime fingerstick and your wakeup fingerstick your basal was off. You’d have no clue when. If you set you alarm to wake yourself up every couple of hours you risk interfering with your own experiment. A three a.m. alarm gives most of us a shot of adrenaline.

With CGM nighttime basal tweaking is a breeze. You can snooze all night uninterrupted and ParaPump is on the case, dutifully recording your blood sugar every five minutes the entire time. You can get a quick look at the night on your pump’s screen, then you can download for advanced study. And you can adjust night after night, until you get it right.


Anonymous Anonymous said...

Hi Will:

Greetings from NC. My wife Cheri and I have enjoyed your blog the first time and the second time around on the new paradigm system. We have been just 3 months behind you with both products. Thanks for taking the time to write such a great blog. It is so helpful in many ways. We discuss it almost every day.

I know that you were discouraged with the costs of this eqipment.

I have learned many of these lessons the hard way and I wanted to write and encourage your readers that persistence does pay off.
My name is Bill Baker and I'm Type 3, which means my wife Cheri is Type 1 and since she fights the disease I fight the insurance companies. It is important to not give up as I really believe after working non stop for 18 months they have a planned set of road blocks simply hoping you will go away and get discouraged. Sadly many must do this. There is reward if you can make it to the final round, but you have to systematically remove each of the road blocks or expectations that they throw at you. They are hoping that you will move on and be someone else's problem.

Particularly with the relatively new continuous glucose monitoring systems they are reluctant to get on board as they are hoping that later when you have compilations you will be insured by someone else. I was able to use Cheri's inability to sense her hypo attacks as a real lever for these products. After nine months I was able to get Lumenos (Medcost) to pay for the Minimed Guardian which I had purchased my self. Untied Health care also through their company Caremark agreed to provide the costly $40 per use sensors. Although on that program I have to be the bank and purchase them and file separately. All because they did not have a code in their system. (See another road block.) In part of my journey I actually called the President of UHC every day for about 45 days. Each day the same receptionist would ask if I had an appointment to call him. (How can you do that by writing?) I would explain that no his company is not moving on my claim and no one can tell me why. Of course he never had enough courage to call me back but finally an arbitrator or assistant to the president finally worked up enough nerve to call me and got my claim moving again.

I just won a 5 month battle for the Paradigm Minimed system. This was very ironic, UHC bought the new pump which had the CGM capability in it. Their sister company Caremark was already reimbursing me for the sensors, but the key piece we needed was the transmitter that moved the data from the sensor to the pump. It was $1000, and I was ready to buy it but decided to appeal UHC decision that it was an un proven system.

After working with Cheri's Physician and getting a letter of necessity, I actually compiled and sent an 87 page fax to the doctor at United Health Care that denied the claim. I slowly and professionally removed every no that he had set up. Of course I also ran his machine out of ink. Again it took 5 months but they finally figured out that I was not going away, and they were going to have to justify their actions. Always keep good records of who you talked to and when.

Get involved with the HR manager where you work. When the insurance companies call on you to get your business we need to ask performance questions on how well the patients get handled. I have shared all my experiences with our VP of HR and these are used in future negotiations.

In the end its all about getting them up to speed on your needs, and holding them to it. Sometimes no is not good enough,

If anyone has any questions I would be happy to share or just offer encouragement.


Bill & Cheri Baker

9:32 PM  
Anonymous Jana said...

I've never had a problem uploading/downloading from the Link even when the meter is right in front of my computer, but I have a laptop, so maybe that makes a difference.

11:17 PM  

Post a Comment

<< Home