Archive for the ‘health’ Category

Things That Need Doing

January 26, 2010

Stepped on the scale today for the first time in, what, six months? When I was living at my old apt, I was very good at weighing myself once a month and making adjustments accordingly. It kept my weight steady and my clothes fitting and all was well. Now that my house is so damn cold, I’m less inclined to strip and step on a scale. So I’ve avoided it since at least October when the house started getting chilly.

I knew I’d put on 10lbs or so since J. and I moved in together. I actually managed to get that back down to +5 before the holidays. Then came the holidays, and winter, and tax season, and this really great website with low carb coffee cake recipes…

Despite getting up at 5:30 in the morning to do 30 minutes of exercise and another 20-25 minutes 3 times a week when I get home, it just hasn’t been enough to make up for the coffee cake and cold house. They’ve also cut the workout program at work, which means no more twice-weekly strength training sessions and no more gym membership.

What happened is just what I suspected would happen when I ceased being vigilant – I’ve gained a retarded amount of weight since J. and I first met a year and a half ago – most of which I’ve put on in the last 4 months of coffee cakes and cold houses. Nobody believes me when I say this is what happens when I stop paying attention.

What actually moved me to get back on the scale was my crazy sugar numbers. My blood sugar has been a lot harder to control, and far more frustrating. I wanted to know if the weight gain was indeed substantial enough that it may be causing insulin resistance. And oh yes, dear reader – it is.

There are some quick and easy changes I’m making right away: no more low carb cookies and coffee cakes, for one (do you have any idea how many calories are in almond flour?), and sticking to the lunch I bring into work instead of adding snacks from the free salad bar at work. I did manage to eliminate my peanut butter/low carb English muffin fix way back, which is how I curbed the initial weight gain and got things back under control. But now there’s that coffee cake thing…

My 20 minutes pilates/15 min free weights workout each morning is pretty solid. What I need to work on now is getting at least 30 minutes 5x a week of cardio instead of the current 20-25 3x a week. A lot of the problem with getting this in is wonky sugar numbers. Some days I turn my insulin off at 3:45 and I can workout for 50 minutes. Other days, I turn it off at the same time and I can only workout for 20 and then my sugar crashes and I start to tremble and all the energy goes out of me and I have that intense hunger spike and desire to burn the world to the ground. I need to get this timing right if I’m going to workout properly every day after work.

I’m also working toward doing at least 40 more minutes on Sat or Sun to get me to 6 days. 6 days a week of 30-50 min a day is pretty much the only thing that moves me. It’s just a really tough routine to put into place during the best of times, and right now the house is cold and I’ve got a crazy day job and personal deadlines.

But. The alternative is very bad. This is a good reminder of what happens to me when I don’t stay on top of maintaining my weight with monthly weigh-ins. I know some folks thought this was odd – if you’re happy with your weight, why be so vigilant?

Here’s why: because aside from that whole immune disorder thing, I have great genes. I’m very good at packing weight away, and when you have aforementioned immune disorder, this is a very bad habit to get into. I have been displeased with my numbers, and not feeling well to boot. Now I have a better idea of why. I’m still quite pleased with how I look (I spent a long time learning how to like myself, and reorienting how my self worth was measured in a society with weird ways of measuring worth, particularly in women), but my numbers are bad, so I don’t feel as well, and I’m not throwing out my wardrobe because I’d rather eat coffee cake.

So, here’s what we’re going to do to get back to maintenance:

Monday/Weds/Friday

Workout: 20 min pilates. 15 min free weights
Breakfast: 2 eggs w/spinach
Workout: Bike to work (if not snowing, more than 20 degrees out)
Lunch: Leftovers. No more salad bar additionals.
Workout: Bike home (if not snowing, more than 20 degrees out)
Workout: 25-30 minutes elliptical
Dinner: Entree and side. No more tortillas/low carb bread
Dessert: Yogurt and berries

Tuesday/Thursday

Workout: 20 min pilates. 15 min free weights
Breakfast: 2 eggs w/spinach
Workout: Bike to work (if not snowing, more than 20 degrees out)
Lunch: Leftovers. No more salad bar additionals.
Workout: Bike home (if not snowing, more than 20 degrees out)
Workout: 25-30 minutes elliptical. 25 minutes circuit training.
Dinner: Entree and side. No more tortillas/low carb bread
Dessert: Yogurt and berries

Saturday

Breakfast: Low carb pancakes (no almond flour makes a big difference)
Workout: 40 min circuit training
Lunch: Soup/sandwich/leftovers. No more “it’s a special occasion” carbs
Dinner: Entree and side. No more tortillas/low carb bread
Dessert: Yogurt and berries

Sunday

Breakfast: Low carb pancakes
Workout: 15-20 minutes elliptical
Lunch: Soup/sandwich/leftovers. Ditto above carb curb.
Dinner: Entree and side. No more tortillas/low carb bread
Dessert: Yogurt and berries

This eliminates the low carb bread/tortillas I’ve been snacking on and low carb/high calorie coffee cakes and cookies I’ve been making. I think this alone will make a big difference. I’m telling you, I could live on low carb coffee cake forever.

I’m not terribly happy with this, but I’m less happy with my sugar numbers right now. If I’m going to do some of the things I’d like to do this year, it’s also very important that I get into some semblance of fighting shape. And all this happy-happy-joy-joy stuff has aided me in becoming a bit doughier than I’d like.

Thing is, you want to be a certain kind of person, you have to start living like that kind of person, no matter how frustrating it may be. And there’s a certain type of person I’d like to be. And she works out a lot more than I’ve been able to the last few months. It’s too bad she doesn’t eat as much coffee cake as I’d like, either, but them’s the breaks.

Back At It

December 7, 2009

Up at 5:30 this morning to add 20 min of pilates onto my 15 min morning free weights routine. *Damn* I am out of shape.

This thing with having a chronic illness is that you just notice more when you’re lazy about taking care of yourself. During the last couple of weeks of sporadic workouts and weird food, I’ve been experiencing some mysterious aches and pains – especially in my core – and inflammation. There is likely also weight gain tied to this, as my clothes aren’t feeling so hot on me, either. I just can’t get away with letting things slide for a few weeks. I just feel it too much now.

Not that there’s been complete fail, mind. I still bike to work 5 days a week, do my morning weight routine 5 days a week, and even during last week’s laziness, I still worked out for 20 min on the elliptical twice that week. It’s just that… well, it’s not enough for somebody with a sendentary job and wonky immune system.

A couple of weeks of pilates and getting back on track with my after-work workouts on the elliptical should help. 5 days a week pilates, 4 days on the elliptical – in addition to weights and bike riding commute – should do the trick.

I’ve also been combating some hunger issues. I’d been getting wacky-hungry at work between 9-10am and vainly searching for food. Some of this is just stress eating, but it’s stress eating triggered by mild hunger. I went ahead and added a little more protein to breakfast – two scrambled eggs w/spinach in the morning instead of just one egg – and that seems to have done the trick (an extra 70 calorie egg in the morning beats a 350 calorie english muffin with peanut butter at 10am).

As we head toward the holidays, I’m being more mindful of what I eat. One of the drawbacks to getting the pump is that it made me a lot less careful with what I ate – and my #s and my body are paying for that. It’s time to stop. I’m a carb addict, which means it’s incredibly hard to change my habits when I get used to indulging again. Too much “well, it’s the holidays!” means shitty sugar numbers, shitty health, and shitty mood.

And you know, I’d like to stick around those extra 15 years.

What I’m Up To

December 1, 2009

Drowning in Day Jobbe work. This will be the state of things until the end of January or thereabouts. Hard push for the next 6 weeks.

I’m also working on cobbling back together a good workout routine. Regular workouts are great, buy my sugar numbers have suffered. Lots of lows this week as I work hard to recover my sugar from Thanksgiving excess. It’s certainly “allowed” to relax my restraint for a day or two, but man, I pay for it later. I’m starting to think the occasional slice of apple pie and sedentary days just isn’t worth the resulting 3-4 days of achiness, inflammation, depression, and rocky sugar numbers.

Yeah. I’ll be skipping the excess at Christmas, I think.

Also, I’m reading a damn bloody book, which I’ll be blogging about soon.

HealthCare Concerns

November 20, 2009

Is anyone else really concerned that the latest “health screening reversals” have targeted women? See mammograms, and pelvic exams. I have yet to see the “let’s stop screening men for prostate cancer” and “forget the colonoscopies” announcement.

Insurance is Officially Back Up

October 30, 2009

And not a fucking moment too soon. I have $2500 worth of pods that should have been in the mail last week.

The delay means I’ll be on shots from tonight until at least tomorrow when/if the shipment arrives. They’ve been holding it since Monday, likely waiting for the fucking payment to process. Not looking forward to a whole weekend of shots, so let’s hope the shipment arrives tomorrow, shall we?

Light At the End of the Tunnel

October 27, 2009

There appears to be some light at the end of the health insurance tunnel, which is good cause today was the day I was going to drop $1154 on health care premiums through Sinclair.

I was able to place my pod order without a problem (!! really !!), and tho our account still shows up as “inactive,” I’m told that doctors are taking and processing the claims, which will be back up to date by the time anything we do this week actually gets processed, so at least we don’t have to pay out of pocket at the hospital or get turned away.

Still paying out of pocket for prescriptions, but that wasn’t my urgent concern. The terror and sleepless nights were in trying to figure out how to come up with $1100 for my pump supplies and $3,000 for J’s twice-yearly post-cancer scan (which he was due to have last week).

We are both a lot less hysterical now, and should hopefully be sleeping a lot better. Man, what a nightmare. It’s not quite over, but it’s a fuck of a lot less urgent. It’s like the difference between wondering how you’ll survive and just wondering how many nights a week you’ll be eating ramen.

Oh, there was some other good news today, too.

As J said, “IT’S LIKE CHRISTMAS!”

Batten Down the Hatches

October 22, 2009

I’ve spent some time tightening up our budget this week, which is rough to say the least. Monday morning I’ll be sending J. in to Sinclair community college with a credit card authorization giving UHC $1145 to cover the two of us through J’s account since they’re no longer honoring my work account.

As noted elsewhere, I can’t go more than 60 days without coverage, and tho once this whole debacle is sorted out they’ll retroactively cover me for the gap… well, let’s just say I don’t want any paperwork in exsitence anywhere that says I went more than 60 days without coverage. I have to live my whole life as a t1, and trust me – insurance companies will find every crazy way possible to shunt the most expensive folks from their ranks. And I’m one of them. And tho I could fight them when they pulled out that “no coverage since Sep 1st” letter… it would take 6 months to sort out, and I would be fighting it my whole life. Every time I changed insurance providers or J. or I had a big medical bill, they’d root through our account. We’d never escape it.

So Monday morning we’re out $1154. It’s an 80/20 plan, so we’ve started stuffing money toward paying for expenses. He’s got an MRI every 6 months that runs $3,000. My drugs, if I drop my pump and get real lean, may “only” run $350 if I’m careful. Add that to regular endo appointments for me and port flushes for him (J.’s a cancer survivor. There’s another year of follow-up before he’s insurable again outside a major employer-sponsored group plan), and we’re looking at about $11-12,000 a year in bare bones medical expenses. You figure we’ll need to come up with, what, $2400-3000 of that out of pocket in addition to the $1145.

Hopefully we’ll only be out coverage for 3-6 months. So let’s say $1500 out of pocket over the next 3 months in addition to the $1145.

That’s an extra $500 a month we need to pull from thin air (not counting the $1145, which is going on the credit card I had nearly paid off).

Sorry this has become the “all shitty health insurance, all the time blog,” the last couple of weeks, but these issues weigh pretty heavily on me, and getting all the facts and numbers down on paper actually helps me cope and process the whole thing.

I’ve shaved about $150 from the budget right now by tossing out netflix and severely cutting our “misc./fun” budget from $200 a month to $100 a month (we already live pretty lean. You don’t go from having $17,000 in credit card debt to $2,800 in 3 years if you aren’t already living lean). We’ll be making up the rest by paying a little less toward that fucking credit card bill (did I mention I was just $2,800 and 5 months away from paying it off completely?), and relying on J’s new part-time job. I’m also working on hunting down a few freelance gigs. One of the roughest things going on right now is that my student loans have come due this month. That was fine when the credit card was going to be paid off. Now I have to juggle those with the CC payments and medical costs.

We’ll make it through this. But it doesn’t make me any happier about it. The most frustrating part is that it’s totally out of my hands. At least when UHC was only fucking *me* over, I had some control over it. I could spend hours and hours yelling at them and get the issue resolved. Now I’m totally powerless to do anything but pay for a second policy. That’s incredibly, brutally frustrating. Because ya’ll know me: I’m a fighter. I fight to the end. Being on the passive end of this whole fiasco drives me crazy.

So, I’m doing what I can. Cutting back, paying bills, eating a lot of soup and beanless chili… Recipes to come! Because when it looks like everything is crap, it’s good to remember that you can still afford to eat. And with how rough it is out there right now, that’s nothing to sniff at.

What Would…

October 18, 2009

Welcome Back to the Ranks of the Uninsured

October 17, 2009

Last Saturday, I was alerted that UHC had dropped my insurance coverage due to an “administrative” error. I had been completely uninsured since October 1st.

Now, I have dealt with a lot of “administrative” errors at United Healthcare. Every three months, I spend about 6 hours over three days on the phone screaming at customer service reps, their supervisors, rapid resolution managers, *their* supervisors, customer care coordinators, benefit coordinators, and (when you finally reach somebody with any weight in the hierarchy), the actual medical “advisors” who approve and deny my actual claims.

You learn the buzzwords. “Attorney general.” “Lawyer.” “Sue.” “Medical necessity.” “Death.” And, “Gross negligence.”

And in about three days, you get shipped the medical hardware they approved for you a year before.

Yes, I go through this every time I need my medical hardware. But it does get covered. You know, eventually.

Folks who have yet to experience a major medical issue are often ignorant of how insurance companies actually work. They are also largely ignorant of what happens when you get a major illness like any form of cancer, diabetes (including juvenile, the immune disorder that I’ve got),lupus, CFS, or any of the long list of over 30 “uninsurable” medical conditions that – as my shorthand name implies – means that you are completely uninsurable outside a major employer group plan… for life.

Let me say that again:

If you get a chronic illness and/or cancer, any form of cancer, you are TOTALLY UNINSURABLE for at least 24 months. And in the case of certain cancers like leukemia, you are uninsured FOR LIFE outside of an large employer-sponsored plan (so long as you go less than 60 days without coverage. More about that later).

If your employer drops you for any reason – because you’re laid off, because they don’t pay their bill, because of an “administrative” error – you have just 60 days to find major medical coverage through another company, or you will be totally uninsurable for 12-24 months EVEN UNDER AN EMPLOYER SPONSORED PLAN. That’s right: 60 days without coverage and I will have to wait 12-24 months to get insurance covered for the insulin that keeps me breathing. After 60 days, insulin becomes part of me “pre-existing condition” and will not be covered – EVEN UNDER A MAJOR EMPLOYER SPONSORED PLAN – for 12-24 months.

If I bare bones my medical costs, I’m out about $300-$500 a month. Right now, I’m out about $8,000 a year in medical costs with the pump. If I go back to shots and get a cheaper, crappy testing meter (testing strips alone run me $180-$250 a month), I can winnow that down to that $300-$500 range.

And that’s JUST TO STAY ALIVE.

That doesn’t include any preventative care. I’d have to drop my 4x yearly endocrinologist visits, gyno care, urgency care visits for antibiotics, etc. That $300-$500 covers the costs of keeping me breathing.

That’s why I include health insurance benefits in my salary negotiations. If I have a comprehensive plan, I can put up with being paid a little bit less.

But when you drop my insurance… you’ve effectively cut my monthly salary by over $500.

And when you drop my insurance… the clock starts ticking.

I have been uninsured for 17 days.

I have just 43 days to get comprehensive coverage, or I become uninsurable EVEN UNDER AN EMPLOYER SPONSORED GROUP PLAN.

I have been here before. When I was diagnosed three years ago, I had very cheap health insurance with a very high deductible. But I was “insured.” And I was about to find out just how incredibly “lucky” that was.

What “insurance” means is that I was out ONLY $6,500 out of pocket for my 3 days in the ICU instead of $30,000.

That’s what being “insured” means. It means you get forcibly fucked, but not gang raped.

Over the next few months (again, as an insured person), I was still spending $300 a month out of pocket for medical expenses. I had a $2500 deductible and 80/20 plan. I was shelling out a lot of hard earned cash to stay alive. But hey, we all need to pay to stay alive, right?

And I was INSURED.

Six months after being diagnosed, I was laid off.

COBRA was nearly $400 a month. Rent was $550. Utilities were $200. Unemployment was $328 a week.

You do the math.

I was forced to either cash out my 401(k) or become uninsured completely.

I cashed out my 401(k).

I started living on expired insulin and reused my needles. I saw my endo half as much as recommended. I did the bare minimum I had to to stay alive.

When money ran out, I moved in with friends in Dayton. I lived in their spare bedroom rent free. I continued to live on expired insulin. I had trouble paying for food. I went almost 30 days without insurance.

I signed up with my temp company’s health insurance plan. It was cheap, and nearly worthless. It covered NO pre-existing conditions for 12 months. It was completely useless to pay for any of my diabetes drugs or appointments or any hospital stays I may incur that had anything to do with my illness.

But by signing up for it, it insured I didn’t go more than 60 days without coverage and become totally uninsurable under a “real” insurance plan.

By the time I got employed at my current job, I had over $17,000 in credit card debt. Over half of that was related to medical expenses. The other half was composed primarily of moving, traveling, and grocery expenses.

At my new job, I got day one health insurance coverage. I paid $20 for insulin and nothing for syringes. Co-pays were minimal. Costs were suddenly manageable. I could start living on non-expired insulin again. I had fewer crazy lows and started seeing an endocrinologist again. Life improved remarkably.

When we switched plans to a no-deductible plan, my health insurance costs went down to basically nothing. I now pay just $50 a month for coverage for J. and I.
It sounds too good to be true…

And, of course, that’s because it sometimes… is.

I spent the first 6 months of the new plan arguing with UHC because my account had some kind of “administrative” error that required me to pay the $1,000 deductible out of pocket instead of through the company HRA. Six months this went on. Six months. After six months, they finally “reimbursed” me for the $1,000 out of pocket.

OK. Fine.

Then came the whole fiasco with trying to get my insulin pump approved. It took a year of Insulet fighting with my insurance company before they got approval. Then once they had approval, the paperwork was filed incorrectly. We fought for weeks over that to get Insulet paid. But every three months, UHC found some reason or another not to send my shipment. The shipment they’d APPROVED a year before.

They couldn’t find my paperwork. Or my paperwork was automatically denied because it wasn’t processed correctly. Or there was now an in-network provider for my pump… but no one had the actual phone number of the in-network provider (it took me three days and six hours of screaming and threats to get… a… phone number. I’m serious).

And now… now I’m 12 days from needing my next shipment, and here we go again.

UHC once again dropped coverage. Not just for me, but for everybody at the company. Just dropped it. “Oops.” Just like that.

And just like that, I’m completely uninsured.

I have $186 worth of testing strips that I need to come up with the cash for next week. I have $90 worth of insulin I need to get the week after that.

And I have 43 days to find insurance again. Or J. and I will be turning off our heat completely and living primarily on rice, hot dogs, and expired insulin.

Welcome to America. We have the best healthcare system in the world.

And this is how it works.

Support of Public Services Health Insurance

October 4, 2009

Apparently, John Boehner hasn’t “met one American” who supports a public health insurance option (you know, like our public postal option, public library option, and public security [police] option). I think our current public services have improved the public good and kept private costs down for the same services, and I believe it will do the same for health insurance.

If you think so too, you can sign the petition here.