This Week in Review

Come see what I've been talking about at The Full Mommy this week.

70th Anniversary Madeline doll and book (enter to win)

PictureItPostage stamps with your own photo (enter to win)

Tuesday DVD Roundup

Cooking Light Magazine subscription for only $5

(Read more product reviews at The Full Mommy and Multi-Minding Mom Reviews.)

Go Big Blue!: It's World Diabetes Day

Today, November 14, 2009 is World Diabetes Day.

Read about our family's struggle with diabetes.

Visit the website, view the YouTube Channel, follow on Twitter, or connect on Facebook (become a fan and join the group) to learn more.

Here is what you can do today:
(From WDDUSA)


FOLLOW TODAY'S ACTIVITIES
Monitor the official World Diabetes Day site.
Check the WDDUSA website.
Search the latest WDD updates on Twitter.
If you have a Twitter account, remember to include #wdd09 and
#bigbluetest in your tweets.
See the latest photos from the WDD Flickr Photo Pool.


PUT ON YOUR DIABETES TWIBBON
Do you have a Twitter or a Facebook account? Set your avatar as a big blue
circle right now. It takes less than 30 seconds using Twibbon.


TAKE THE BIG BLUE TEST
At 2 pm your time, test your blood sugar, do 14 minutes of exercise, test
again and share their results online. (If you are busy at 2 pm, then do it
whenever you are free.)

Here's how to participate:
1. Test your blood sugar.
2. Run, jog, walk the dog or do anything you’d normally do as part of
your exercise routine for 14 minutes.
3. Test your blood sugar again.
4. Post your readings and what physical activity you did. If you have a
camera, you can also add a photo of your reading(s) or you exercising.
5. If you have a Twitter account, you can also post your readings on
Twitter (use the #bigbluetest hashtag) and link back to
http://bigbluetest.org.

Places to report your blood sugars:
TuDiabetes
Diabetes Daily
Diabetic Rockstar
Big Blue Test
... or at your favorite participating social network!

EMBRACE THE COLOR BLUE
Wear blue, light a blue candle, put up a blue light bulb or even paint
your nails blue. Wear enough blue that people will ask: "Why are you
wearing so much blue?" Let them know it's World Diabetes Day and why it
matters to you.

In Good Hands

World Diabetes Day is this Saturday and I wanted to share some videos that I recently watched. If you have a couple of minutes, watch the first video. If you have a few more minutes to spare, meet Manny Hernandez, the founder of TuDiabetes, in the second video.





Read more about parenting a child with diabetes.

Whatever Wednesday: Stomach Reveal

While we were recently reading the original Madeline, two things struck me.

First, the two times my daughter has been hospitalized since her diagnosis, she thought it a vacation of sorts. With everyone doting on her. One-on-one time with parents. The playroom. Breakfast, lunch, and dinner in bed, with the TV on!

It's no wonder Madeline's meilleures amies also wanted their appendixes taken out.

(And no, it wasn't a vacation, the IV's and injections, poking and prodding, peeing in a hat, and more were not fun. But she makes lemonade out of lemons.)


Second, the image of Madeline showing off her scar is a scene I have witnessed again and again over the past few weeks.

Since beginning the insulin pump, my daughter Sophia proudly shows her stomach to any halfway interested party and begins her spiel.

Do you know what it does? It gives me medicine.

(Read more about parenting a child with diabetes. Disclosure: I received the book Madeline as part of a product review written on The Full Mommy.)

T1 Tuesday: Numbers Game

You would think that you need an advanced degree in mathematics to successfully manage diabetes.

Constant counting, weighing, measuring. Estimating, calculating. Even guessing.

Blood glucose levels. Boluses. Basal rates. A1C's.

Mealtimes and snack times. And timing, timing, timing.

But the numbers go beyond the data management that allows for good control of blood glucose levels.

The second set of numbers involves money.

It's definitely not cheap to be diabetic. Of all things to be afflicted with I assume it's one of the more taxing on the wallet. I know for some people it literally breaks the bank.

Some patients cut back on the number of times a day that they check their BG's. And some don't change their lancets often enough, if at all. But we do as we are told. (As a parent, I have to do what is best for my child, setting up good habits that will hopefully stick with her as she begins to care for herself.) We also have decent insurance.

One thing I have learned is that you have to be smart when it comes to filling prescriptions. All, I don't know, ten prescriptions that we regularly fill.

You have to do the math.

Does your insurance company offer the option of getting a 90-day supply? Sometimes this can be a real money saver. But sometimes it is not.

For instance, when we were using the NovoPen Junior* insulin pen, the insulin cartridges came in a box of 5. Based on how much insulin she needed in a month, the insurance copay for a three month supply (two boxes) was $120.

But...if I purchased them one month at a time, I would get one box for $45. Even though we needed less than an entire box to last the month, they can't break a box. So three boxes, purchased one month at a time would cost $135.

$135 is more than $12o, right?

No, it isn't.

Purchasing one month at a time, I would get three boxes for $135 ($45 per box).
Purchasing a three month supply, I would get two boxes for $120 ($60 per box).

The three boxes would actually last a little more than three months, another savings.

Some companies want to help keep money in your pocket.

Not until almost a year after diagnosis did I find out about a program run by Abbott*, who makes our blood glucose meters and test strips.

Abbott's FreeStyle Promise Program is completely free to join and has saved me so much money. When you sign up you are sent a card that you present to the pharmacist for additional savings on test strips. People always complain (rightfully so) about the price of test strips. But they are cheaper when you use the Promise card in conjunction with your own insurance.

You can save up to $50 a month on test strips for a total of $600 a year. Abbott will pay up to $50 each month after you pay $15 out-of-pocket. So if your prescription is $65 after your normal insurance pays, you pay only $15.

Yesterday I filled our test strips. Our prescription is for testing 10 times a day, which means 900 test strips for a 90 day supply.

Cost before insurance: $1,034.91 ($1.15 per strip)
Health insurance copay: $66 ($0.07 per strip)
Promise discount: $50
Our out of pocket: $16
Net cost per strip: (less than $0.02)

Through their free program, Abbott will also send you control solution, batteries, and meter upgrades.

Do the math, again.

No matter what medical condition you have, it really does pay to look into programs that might help ease the pain in the wallet and to do a little math once in a while to make sure you are still getting the biggest bang for your pharmacy buck.

Do you know of any programs that discount prescriptions or medical supplies? How do you save money on prescriptions?

(This post is part of my Type 1 Tuesday series, sharing with you how I parent a child with diabetes. Brought to you on Tuesdays...sometimes.)

*These are not advertisements nor endorsements for these products, brands, or companies. They are simply what our particular doctor has prescribed.

Diabetes and Vaccinating Against H1N1

(November 9 is D-blog day. I normally write about diabetes on what I call "Type 1 Tuesday." Though this post is about vaccinations, diabetes permeates our daily lives and many of the decisions we make for our family.)

I tend to stay out of the whole vaccination debate. I know some parents choose not to vaccinate their children for various reasons or beliefs. We have decided to vaccinate our children as scheduled and as advised by our doctors and by the American Academy of Pediatrics.

As a parent of a child with an underlying health condition, I have been asked by several parents what I personally think about vaccinating against H1N1 and what I would suggest for them. And while I am about to give you my reasoning as well as some information from the CDC, which I consider a reliable source, you can make your own decision for yourself and your family and I encourage you to go the the following websites (www.cdc.gov/flu, www.cdc.gov/h1n1flu, www.flu.gov) as well as speak with your own physicians for advice.

Our First Sick Day

You already know that my daughter Sophia was diagnosed with Type 1 diabetes in the spring of 2008. Although we had her condition under control, a simple illness last fall wreaked havoc on her health. She got whatever was going around her preschool. An illness that might make most healthy children down for the count for a few days, but back playing in no time.

She was home from school when her blood sugar levels began sky rocketing. Illness, any illness can make blood sugar levels rise, even with insulin boluses to try to bring them down. I had left messages both with the endocrinologist in St. Louis and with our local pediatrician as this was our first real "sick day" since diagnosis. While waiting on return calls, my daughter sat down to eat her mid-morning snack. Sitting at her usual spot, she turned to me and before a word came out of her mouth she vomited on the floor.

The scary thing for a diabetic is that vomiting can mess with blood sugars, especially when you've recently given insulin to cover food that is no longer in your stomach, but on the floor.

But, was the vomit because her blood sugars were so high that she was developing ketoacidosis? Or was it from her illness?

I was frantic at this point. I was able to check her urine for ketones and it was positive. Her blood sugars were in the 300 or 400's. I finally talked to the nurse in St. Louis and she said to take her to the emergency room. As I was getting our things together, the local nurse called and advised the same.

Of course my parents were out of town and my husband was unreachable at work, which only added to the panic as I could not take the little guy with us. Eventually we made it to the emergency room where an inept nurse made three attempts to get an IV in her. (I was not happy about that!) We were told that the only doctor who would see a diabetic child himself was sick and that if her blood sugar levels and ketones didn't decrease that they would have to transport her to St. Louis.

In the end she ended up staying over night to get extra insulin under their watch and lots of fluid and she returned home the next evening. Of course after our hefty deductible (I will pay whatever it takes to make sure my kids are healthy, but it still hurt to fork out that money).

Our first sick day was quite traumatic for me as her caretaker because I didn't know what to do or how bad it would become.

(Care teams always tell newly diagnosed patients to get in contact with them on their first sick day for exactly this reason.)

Sick Day This Fall

Sophia began kindergarten this year and week after week notes were sent home saying that someone in her class presented with flu-like symptoms. At the first chance we had, the entire family went to the flu shot clinic and got the vaccine for seasonal flu.

One Monday I got a call saying that my daughter's blood sugar was in the 300's at lunch. I drove over and she was negative for ketones. She seemed fine otherwise and was in a hurry to get out to recess.

The thing is that often her blood sugar levels rise before there is any physical manifestation of illness. By the time I picked her up at 2:45 she was feverish and lethargic.

Tuesday morning I talked with our pediatrician's office securing an appointment for that afternoon with the on-call doctor. Between the morning and afternoon, my daughter did develop ketones. I was fearful that we were heading in the same direction as before and would end up in the hospital.

Her symptoms other than fever included a sore throat and fatigue. She was tested first for strep throat and then for the flu. (Neither test was joyful and I had to talk her down from near hysteria when they threatened to hold her down and do the tests against her will.)

Though the rapid tests were negative, a few hours later the doctor told me that she should be started on Tamiflu just in case it was the flu. If you test positive for flu, you definitely have it, but a negative result does not mean you don't. A trip to Walgreen's at 9:00 PM and we began treament.

Her fever subsided the next day, but her blood sugars and ketones remained high. Any other child would have been able to return to school 24 hours after being fever-free. But she needed her blood sugar levels and ketones closely monitored, should she be headed toward ketoacidosis.

The H1N1 Vaccine

Before her bout with illness, I was undecided on the H1N1 vaccine not having given it much thought since it wasn't available in our area yet. I saw a story on 60 minutes showing kids and teenagers in perfect health who were fighting for their lives. I listened to how the H1N1 vaccine is made and why it affects the young so severely. I was sold. When the school district sent home a form asking if I would like my child vaccinated, I signed on the dotted line.

A couple of days later the public health district announced that it was having a clinic to immunize those children 6 months to 5 years. My husband took our son.

Not knowing exactly when they would be vaccinating in school, I called public health the next day and asked if I could bring my daughter to the clinic since she's five. I took her that afternoon. When they said that they were also offering it to caretakers of high risk children, I decided to get the vaccine myself.

Both children still need their second dose and vaccination in the school doesn't occur until mid-November. Since immunity doesn't begin immediately, I am glad that my children received the vaccination at the earliest time for our area. None of us have had side effects except for sore arms. We all got the injection rather than the mist. (Children and adults in high risk categories should not receive the flu mist which contains live virus.)

Why Diabetics Need Protection

It's not the flu that is necessarily going to adversely affect your diabetic child, but what the illness does to the diabetes. As you learned from our story from last fall, an otherwise perfectly healthy diabetic child can quickly go from bad to worse and need immediate emergency care from exposure to even the mildest of illness.

I wouldn't want my own child to suffer the complications from the seasonal flu or H1N1 if there was a prevention available.

Advice from the CDC

Although my children have already received the first vaccination, I participated in a conference call last week with CDC pediatrician Dr. Georgina Peacock to learn more about H1N1 and the vaccine. Because I have been asked my opinion so many times, I wanted to hear first hand what the experts are saying and ask questions of my own to confirm my thinking.

The doctor reiterated what I already knew:

• That the vaccine is made the same as the seasonal flu vaccine which has a history of being safe.
• The H1N1 vaccine is only separate from the seasonal flu vaccine because the strain was introduced too late to be included in the regular vaccine.
• H1N1 can cause complications for diabetics because blood glucose levels can be elevated during illness.

(From the CDC website:) Complications of flu can include bacterial pneumonia, ear infections, sinus infections, dehydration, and worsening of chronic medical conditions, such as congestive heart failure, asthma, or diabetes.

CDC resources about the flu:

• www.cdc.gov/flu
• www.cdc.gov/h1n1flu
• www.flu.gov

More CDC resources for people with diabetes or other health conditions:

• People With Health Conditions
• Diabetes and the Flu
• If You Have Diabetes, A Flu Shot Can Save Your Life
• General Questions and Answers on 2009 H1N1 Influenza Vaccine Safety

***

Read more about parenting a child with diabetes. I am not a trained medical professional, dietitian, or nutritionist. The information provided here is for entertainment purposes only. If you have or suspect diabetes, please consult a medical professional. If you have questions about vaccinations, please consult your family physician.

This Week in Review

Come see what I've been talking about at The Full Mommy this week.

MADD's Power of Parents: Learn how to speak to your children about drinking and driving.

Cheerios Spoonfuls of Stories: Score in the cereal aisle (and enter to win a prize package).

Holiday DVD's That are Sure to be a HIT: Yes, my kids are already watching winter-themed DVD's.

2009 Holiday Shopping Guide

The Full Mommy is looking for products and companies to feature for the 2009 holiday shopping season. Find out how your product can be submitted for inclusion.

(Read more product reviews at The Full Mommy and Multi-Minding Mom Reviews.)