Step Out!

We recently had the opportunity to participate in a Step Out and Fight Diabetes Walk at my place of employment. We signed up on Monday (uh, yeah, a little last minute) and walked on Saturday. Not much time! But thankfully our friends and family helped us raise $250 to support the cause.

It was very exciting to see the fifty or so participants gathered to raise money to fight my disease. (Yes, it's personal!) The day was chilly and very windy---but we pressed on, walking the course twice, laughing, and pushing our baby in her stroller. She was quite content, and the last few feet of the race consisted of her "walking" by holding on to our fingers. How exciting! Her first diabetes walk! :)

I've said before that I am not living for a cure. I'm living for today---and that means living with my disease. However, I am hopeful that someday there will be a cure for people like me. Until then, I'll just keep doing what I do: living in this moment.

I'm furious and doing something about it!

See my letter below. I'm ticked! I'm disgusted! And I'm not going to take this nonsense from anyone.


October 28, 2009


Dear Dr. K______ and Staff:

I visited your office for the first time on August 12th, 2009. The office was clean, the staff was pleasant, and I was seen in a timely manner. However, that is where the positive points end for me.

At the end of my exam, Dr. K prescribed a drug called Metanx for me. I took the prescription to my local pharmacy immediately following my visit. I learned that my insurance company would not cover the medication, which is considered by some to be a supplement, but I could have my doctor write a letter of appeal in an attempt to have the medication covered. So I called your office and requested that the doctor take a few minutes to write a letter for me. Without insurance coverage, the medication cost $1 a day. Add that to the costs of my insulin pump supplies, my insulin, my Symlin, my pen needles, syringes, test strips, batteries, and other supplies, and the Metanx cost just isn’t in our budget. I was told over the phone that a letter of appeal would be no problem at all and that the doctor would send it in.

I waited four weeks from the time of my appointment and called my insurance company to see if the drug was going to be covered. They stated that they didn’t have a letter of appeal on file. I figured the insurance company had lost it because all of my diabetes medical team responds quickly to patients’ needs, so I called your office and asked for the letter to be re-sent. The woman on the phone told me that my file was still sitting on the doctor’s desk, in a large stack, and that he was very busy, only working two days a week. She assured me she would bring my file to the doctor’s attention that week and would call me when the letter was completed.

I called back two weeks later, and the file was still on the doctor’s desk. I was told again that Dr. K was very busy and that he had a large stack of files on his desk to respond to. I was also told to expect a phone call that same day letting me know the status of my letter. I was not called.

I called back this week, and I was told the same thing----that the doctor was too busy and that I should expect a phone call soon. Tired of the empty promises and procrastination, I requested a copy of my visit with the doctor so that I could have my GP write the appeal letter. I was then told that my original appointment had still not been transcribed (from two and half months ago!) and probably wouldn’t be for some time. So now not only can I not get a letter from the doctor, but I cannot get a letter from my GP due to lack of proper paperwork.

I’m disappointed in the facility's lack of timeliness and respect regarding patient care. My foot health and my diabetes cannot afford to wait for the doctor to take five minutes to write a letter for me. Furthermore, it’s very disrespectful of the staff to make empty promises to patients. I do not appreciate being lied to. A simple phone call and appropriate, responsible patient care should be standard in your office.

So now I have a few choices that will cost me even more money: visit another doctor to obtain a prescription and letter of appeal or pay the $1 a day cost of the medication. Of course, I could do nothing at all, but I’m sure as a diabetes professionals you realize that option is foolish and dangerous to my health.

I have been patient and vigilant regarding this situation; however, I will not be returning to your facility again. I value my time, money, energy, and health too much to accept disrespect, procrastination, and empty promises.

I expect that my co-pay of $25 will be refunded to me within fourteen business days from the date your receive this letter (which will be October 29th). I will be using my money to see another doctor. Should the money not be returned to me within fourteen business days, I will address the staff in person.



Rachel
(address)

-----

EDITED TO ADD:

So I put this letter in my mailbox today. Around 2:50 my phone rings, and it's the doc office. I don't pick up because I'm just too angry. An employee leaves a message saying the doctor sent the letter in to the insurance company today!

I dash out to my mailbox to retrieve my letter and the mail carrier is at the foot of my driveway and has just put the letter in his truck. He nicely gives it back to me (whew!) along with my mail.

So I spent that time and energy writing that letter for nothing....well, except for some mental relief.

Letter writing can be very powerful and if done well, can produce desired results.

But this time, I guess it wasn't necessary.

it's that time again....

Tomorrow I have my labs done. Then next week I go see my endo.

It's far enough away right now that I'm ok. But when that date rolls around, and when I stroll into that doc office, I know I will face dread, fear, and annoyance. Not a good attitude is it?

I've been off my CGM for over a month. It feels good being free of the extra equipment taped to my body AND the DO DO DO (beeping) from my insulin pump if my sugar is too high or too low.

I just want to be normal.

I want to be free.

Mexican Pilaf

I LOVE Mexican food; however, it's all too often full of fat, calories, and sodium. I walk out of Mexican restaurants bloated, thirsty, and nauseated. So why do I keep returning? Um, why do any of us eat the things that we know are harmful and unhealthy? Because it's good in the moment.

When I get the craving for Mexican and know it's best to avoid blood sugar spikes and drops as a result of traditional Mexican food, I make this recipe.

Rachel's Mexican Pilaf

Ingredients:

• 1 pouch of Kashi's Pilaf, prepared as directed



• organic salsa



• 1 can of black beans, drained and rinsed



• 1 can of organic corn (drained and rinsed) or half a bag of organic frozen corn, defrosted



• low-fat cheese



• low-fat sour cream



• tortillas or taco shells (if desired)

Directions:

1. Mix pilaf with desired amount of salsa, beans, and corn.



2. Serve on top of lettuce or in tortillas or taco shells.



3. Top with cheese and sour cream.

Not only is this recipe easy, it can be made in less than a half-hour, requires almost no preparation, is inexpensive, is vegetarian, and my eleven month old baby loves it!

Enjoy!

Teaching Myself

I'm driving home from the library the other day (ha! returning my Gorgeously Green book which was overdue) when I see a man slowly making his way down the sidewalk. This man seemed ageless to me, nothing indicating to a passerby if he was young or old. I'm not sure if he was struggling or if his walk, which was awkward and seemingly labored, was something natural to him. Maybe he has lived with some sort of condition his entire life? Maybe he was recently injured? What was this ailment that was clearly evident in this man's unsteady stride?

Interestingly enough, just the day before I had seen a different man slowly making his way up the side of a very busy street. I ran my errands and about an hour later headed home, taking the same street. The same man was now traveling, slowly and unsteadily, in the opposite direction, this time a grocery bag in his arms. I admired his dedication and persistence.

Today I had an interesting conversation with a friend of mine who has had lupus for four years. She explained her disease to me and said that some mornings it takes her an hour to work out her stiffness; sometimes she feels like she's an old woman. I listened. I am also thinking about another friend, one who has MS. We once had a conversation about the fear of living life in a wheelchair---the loss of ability to do the things that come naturally right now, and we asked one another, "What kind of life is that?" With my own disease, I recognize that there is a risk of amputation or of severe nerve damage to my body, including in my feet and legs.

Nothing is certain with these diseases. They are tricky. They are predatory. They are scary.

And the fear of losing the ability to walk or to walk well is a reality for my two friends and me. Maybe not next year or even within this decade, but we could be like the man I saw, hobbling along, each step a battle.

I wonder if some day I will be forced to slow down. To stop multi-tasking. To cease constantly thinking about "what's next?" Will my disease teach me new lessons, as it always does, about what is really the essence of life?

One day I may not have the option to text while pushing a stroller, to vacuum while holding a twenty-something pound baby, to dart across my university's parking lot in record speed through pouring rain.

Today I have tried to make myself slow down and do one thing at a time. I have shut off the television, avoided the Internet for mindless entertainment, and set my cell phone aside so that I wouldn't be tempted to text. Technology is my best friend and my greatest distraction.

I want to, one day, look back at my life and say that I lived it well. I lived with purpose yet also with spontaneity. I don't want my daughter to remember me as the mom who was always carrying her cell phone, always plugging away at the keyboard, always looking over her head at the television. These things do not bring true fulfillment, joy, or satisfaction.

I hope that I can teach myself to live carpe diem style before my disease decides to teach me. I might someday be that person struggling down the sidewalk, but I hope that perhaps I'm doing so with joy and peace, not with desperation, despair, and disappointment.

Caloric Intake Formula

Dr. Oz stated this simple caloric intake formula on his show the other day. Here goes:

200 + your weight x 8 = your caloric intake.

I believe Dr. Oz said this was the amount of calories you can take in to maintain your weight without any exercise.

I came up with 1360 calories a day for me.

Now, it's great to know the number....but then there's the fact that you have to count your calories if you actually want to maintain or lose weight. And I have kept food diaries here and there. No doubt the diet gurus have it right---it does work! But what a pain! There's tools like online calorie tracking, paper tracking, cell phone tracking, etc. But still, a pain.

I hope you have found a successful way to manage your caloric intake and achieve the goals you have set up for yourself!

Green, Lean, Fighting Machine!

(photo from bn.com)


I recently picked up a copy of The Gorgeously Green Diet by Sophie Uliano at my local library. The cover is so enticing! This is a book you can judge by its cover.

I have long been resistant to the "going green" movement. Honestly, I don't care that much about nature, and "the planet," and farming practices. I don't like animals. I do recycle (two points for me!), but I use way to many tissues, paper towels, and napkins. We use regular-fill-up-the-landfill diapers for our daughter.

But having a child has made me realize that being wasteful isn't a habit I want my daughter to form. I want her to respect the things we (as a family and as part of a greater population) have. I also, as always, am looking for ways to improve our dietary habits and overall health. And, I'm finally coming around to realizing that how animals are treated (what goes on at those farms?) affects me.

I didn't pick up Uliano's book in order to overhaul my diet. I believe there is no magic diet, and I also believe there is no way one person has all the answers that will solve our obesity (and diabetes) crisis. However, if I can take a few things from here and there and apply them to my life, perhaps we will continue to learn and grow and make positive changed.

Here are some highlights from the book which I loved:

• Chapter 21 is entitled "Skin Food." There are recipes to make your own face masks (think bananas and honey and yogurt----oh my!) and hair care (scalp treatment and hair shine formulas). I think I'd rather eat the recipes than apply them to my face....
• Chapter 22 is dedicated to the truths about buying and consuming organic foods. She spends some time focusing on children and why organic foods are so important for them. She outlines the top ten foods that should be bought organic. She also talks about pesticides and notes, "If they can destroy the nervous system of an insect, they can do the same to us." Hmmm. Good point.
• About one-third of the book is dedicated to "the diet" which includes a pledge. This was way too Hallmark for me, and as I said before, I'm all about eating healthfully but also normally. Make changes where you can, adapt while you can't, and for sanity's sake, please eat dessert! One concept I do support is that the author offers three variants on the diet plan---one for "light green" folks, one for "bright green," and one for "deep green." I find myself being a "bright green." Even though I'm not changing my diet to fit the author's plans, it was still interesting to see which description fit me.
• Recipes. The last part of the diet section is full of recipes. I always love trying new recipes if they fit into my diet standards. Ten points for the author because there are dessert recipes! Ok, now I know I can trust her. :)
• I agree with the idea of the "pantry purge" (chapter 9). What crap is lurking in your kitchen just begging you to screw up your health? Additionally, the author lists fourteen additives and explains why they are unhealthy. I know HFCS and hydrogenated oils should be off limits, but I always forget why. AND DID YOU KNOW (DIABETES ALERT!) that 75% of the complaints made to the FDA are based on the consumption and side effects of artificial sweeteners?!? (See page 133). I'm trying very hard to not give in to the marketing aimed at people with diabetes. Those fake sugars may not raise your blood glucose, but they might give you cancer (oh yeah---another health issue) in ten years or totally destroy your digestive system. :(

My favorite part of the book was the section entitled "YOUR HEALTH IS REFLECTED IN YOUR GROCERY CART." I'm constantly evaluating what customers in the grocery store are putting in their carts, pushing around in their carts, and moving from their carts to the belt that moves the groceries to the final leg of the grocery store race---the checkout.

The author writes, "I have never seen a bright-eyed, slim woman with fantastic energy pushing a cart full of processed foods. Conversely, I have seen hundreds of sad and gray-looking men and women standing in line with their carts overflowing with chips, crackers, sodas, and frozen meals. Minimally processed foods puts a spring in your step and a sparkle in your eye." (p. 137).

I suggest you read as much as you can about diet, nutrition, exercise, and healthy living. Oh, and some "green" stuff too---like how to save money, save the planet, and save your own health by going more green.