Diaversary: Thirty-Eight Years Of Living With Type 1 Diabetes

Today marks 38 years of living this diabetes life. This day brings up all sorts of emotions - but I try and focus on the positive because that's what works for me. 
I know that living and surviving all that life has to offer - diabetes or not, is a privilege that not everyone gets to have. With that being said, here are 38 things I'm grateful for~
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38 Things That Make Me Happy
  1. I�m still learning  - I love that I�m still learning about life and life with diabetes
  2. I�m still becoming - Yes, certain aspects of my personality are carved in stone - but I love that I�m still evolving and becoming - and that I still want to evolve and become
  3. Cheese - Cheese makes me happy. I LOVE CHEESE
  4. The ocean - it centers me, it makes me feel whole. The ocean calms me and excites me and it welcomes me with open arms
  5. The first cup of coffee in the morning
  6. A cup of tea in the afternoon
  7. Daffodils - I love daffodils so much. They make me feel all sunshiny and they remind me of my mother. Daffodils are resilient and remind me that I am resilient - I embrace the daffodils every chance I get!
  8. Flowers - I love flowers 
  9. Gardening - I�ve been a gardener for a good 15 years - and I come from a long line of women who tended to gardens and made things grow. Gardening relaxes me, gives me a feeling of accomplishment and connects me to the women in my family who came before me - and having that connection gives me great comfort and joy
  10. Dogs - dogs are fucking awesome 
  11. Peanut-butter - Peanut Butter always makes me feel better
  12. Glass Beach at low tide and after storm. I can�t tell you where Glass Beach is - it�s a secret that only select few know about. But I can tell you that Glass Beach reveals its many treasures to those who are patient and weather the storms. Glass beach makes me notice all the little reveals that end up being treasures
  13. Cooking - I love to cook. Cooking relaxes me, gives me a sense of accomplishment and cooking gives me confidence. I love cooking for others and myself - but not a huge fan of the cleanup 
  14. My nieces and nephews - I love every single one of my nieces and nephews. They are 12 magnificent and individual pieces of art and I love them 
  15. My friends children and CWD - They make me smile, they make me laugh and their hugs keep me going
  16. The Diabetes Online Community - Without the DOC, I�d don�t what my life would be like. But I do know it wouldn�t be nearly as wonderful. I LOVE THE DOC
  17. Photography - When I was little I loved having having my picture taken - And I loved sneaking shots on my sister�s camera. As a college student I was always taking pictures of friends and family. As an adult, I reignited my passion for pictures a few years ago, after my mother died. Photography allows me to notice everything around me - and if I�m lucky, capture emotions and beauty in the process
  18. Traveling - I love to travel - I need to travel more
  19. Music - music makes me happy. Some music makes me sad. But music always brings up emotions and that�s a good thing
  20. A really gorgeous coat. Sounds crazy, but I love COAT PORN - and by 'coat porn,� of course I�m referring to gorgeous, tailored, spectacular coats that are unique and beautiful. Yep, I am my mother�s daughter
  21. Gentle Stretch Yoga - give it a try - it will change your life
  22. Movies - I get lost in movies  - I love movies - except for horror movies - they freak me the fuck out
  23. Reese�s Peanut Butter Cups - they are the perfect american chocolate
  24. European and Canadian Chocolate - No additives, creamy, delicious, life changing chocolates 
  25. Red wine
  26. Good Books - Good books take me to a different world and inspire me. Good books are great friends 
  27. Speaking of friends - I love my friends and I am so grateful to have them in my life 
  28. Speaking of friends - I�d be absolutely lost without my sister Cathy  
  29. Prosecco 
  30. Sharing a bottle of prosecco with good friends
  31. Making new friends. As we get older, it gets harder to make friends - I�m glad that I�m still making new friends  - and I will try my best to continue with the new friend trend~
  32. Live theater - Live theater is thrilling and emotional and takes you to a different plane. I love watching live theater and I miss being on the stage
  33. Vodka Martini�s - I love Lemon Drop and Cosmos  
  34. Short acting insulin - I�d be dead without insulin - I am incredibly blessed to have access to insulin - especially short acting  - and I thank the heavens every day for insulin - But I wish it wasn�t so f*cking expensive!
  35. Cupcakes - they are perfect size of delicious contentment in a bolus worthy, desert form
  36. Meeting other people with diabetes in the wild - the �me too� of it all gives all sorts of fuzzy feelings
  37. I appreciate a really good shoe or a kickass pair of boots
  38. Sunsets - Every sunset is beautiful and different  - And at the end of the day when I look up at a sunset sky - it always takes my breath away, makes me appreciate living in the now.
No matter the sunset sky - it always takes my breath away ~
38 years of living with diabetes

Moda will honor health coverage according to current contracts

The announcement this week by Moda Health that it�s withdrawing from the Washington insurance market has understandably raised questions from its current enrollees.

Enrollees should be aware that their current policies will remain in effect according to the terms of the contracts. Moda said it will fulfill its obligations for plans signed on or renewed by Oct. 31, 2015. That includes policies that have already been sold that start on Nov. 1 or Dec. 1, 2015. Policies that start on Jan. 1, 2016 or later will be terminated.

That�s true for individual, small- and large-group employer plans.

Moda this week notified the Washington Health Benefit Exchange of its decision to quit doing business here. The Exchange is reaching out to its customers to let them know.

You can read that notification here.

In Washington state, Moda has:
  • About 18,000 people enrolled in the individual market inside and outside of the Exchange.
  • About 29,000 people covered through large-group plans.  
  • Another 900 enrolled in small-employer plans. 
Moda said it is withdrawing from Washington to focus on its business in Oregon and Alaska.

By the first week of November, the Oregon-based company is expected to notify all of its enrollees of its withdrawal from Washington.

This Weekend, Don't Forget To Get Your Cher On And 'Turn Back Time.'

This Cher meme has been all over Facebook the past few days & it makes me laugh whenever I see it!
 I tried researching the image and found a link on a Reddit feed from last year.
Not sure if that's where it originated, but here's the link, just in case. 
Daylight Savings Time officially begins on Sunday, November 1, at 2 a.m.
Do yourself a favor and get your Cher on by turning back the time one hour on your diabetes related devices. Items including but not limited to, insulin pumps; cgms, glucose meters, pebbles, apple watches, regular watches, household & car clocks - before you go to bed on Halloween~ 

Do you need flood insurance? Now is the time to do your research

Residents in Eastern Washington are facing increased risk of flooding after extreme wildfires the last two summers destroyed much of the vegetation there that would normally help prevent landslides and mudflows.

Flood damage is not covered by homeowner�s insurance. Consumers who want to protect their property must purchase a policy through the National Flood Insurance Program (NFIP). Most properties qualify for NFIP, as long as it is located in a community that participates in the NFIP.

NFIP has told to us that Okanogan County and most towns within the county will be able to purchase flood insurance.

Typically, there is a 30-day waiting period before your flood insurance policy takes effect. Here is information on how to find an agent near you who sells flood insurance policies through NFIP.

Read more about flood insurance: Are you protected against flood damage?

Eastern Washington fires burned down much of the vegetation that prevents flooding.
Photo courtesy Washington Military Department. 

OIC partners with the American Indian Health Commission on Medicare training

 Terri Osborne, SHIBA, right, speaks with 
AIHC Executive Director Vickie Lowe. 
Earlier this year, Insurance Commissioner Mike Kreidler signed a contract with the American Indian Health Commission (AIHC) to support providing Medicare and other related training to tribal staff throughout the state.

The Commissioner's State Health Insurance Benefits Advisors (SHIBA) held its first quarterly training on Oct. 21 at Port Gamble S�Klallam tribal facilities in Kitsap County to 35 staff from several Western Washington tribes.

SHIBA will provide training throughout the year to tribes all over the state. Next up is a training in Spokane for tribes in the region.

The goal of the training to provide tribal assisters with information about Medicare eligibility, benefits and coordination with Medicaid for tribal elders and tribal members who need health care.
Dale Ensign with SHIBA provides
training to tribal staff about Medicare.
























Mold, mildew, rot typically not covered by homeowner�s insurance

Living in the Northwest, it is not unusual for homeowners to discover mold, mildew or rot damage to their homes as a result of things like a leaking pipe, a hole in the roof, a failing window seal or improper venting.

Such damage is considered wear and tear and is typically not covered by homeowner's insurance. Insurance is designed to cover sudden and accidental damage caused by specific perils, such as a windstorm, fire or explosion. Some policies may cover mold or mildew damage discovered and reported within two weeks of the leak that caused the damage and some insurers offer limited mold coverage. Consumers should check their policies to find out what is covered.  

We do hear from consumers who are unhappy to find out this type of damage is not covered by their insurance. If the policy specifically excludes such damage, we can't compel the company to pay for the repairs. 

Here are some perils that homeowner's insurance policies typically do not cover:
  • Earthquakes
  • Floods
  • Mold damage
  • Damage due to animals or rodents
  • Foundation settling 

Questions? You can contact our consumer advocates online or at 1-800-562-6900.

Diabetes Bonding At The Spa & Over Medicare & CGM Coverage

So every fall I treat myself to a really good facial, because after a summer of outdoor fun in the sun (complete with lots of salt water, massive doses of sunscreen, and big straw hat,) my skin always needs a little extra attention. 
And when one of my favorite spas has a special on facials, you know I�m all over it! 

I could write about how I gave myself a correction bolus after I parked my car (and before I ventured into the spa,) because of a 240 blood sugar from a miscalculation of carbs at lunch. 
I could discuss checking into the spa early because I wanted to to take a steam and sauna, and needed to detach from my pump for over an hour in order to do both. 
Or how after reattaching my pump an hour and 10 minutes later, my blood sugar was137, with 1.9 units of insulin on board, requiring me to dial back my temporary bolus to 30%, down a few ounces of fresh guava juice and throw back some almond honey treats before I went in for my actual facial - but I digress. 

It�s what happened in the room where I got my facial that really hit me in my heart.

After introductions with my most excellent esthetician Danni, I quickly explained that I had t1, wore an insulin pump, and showed Danni my micro wristlet with my meter, strips,  glucose tabs inside and a glass of guava juice.... just in case.

Danni: Oh, I totally get it - my dad has type 1.
Me: Really?? How�s he doing? 

Danni: He�s doing great!
Me: Is he on the pump? 

Danni: No, he�s on shots - it works for him.
Me: That�s all that�s important.

Danni: Actually, his Doctor wrote him an RX for something... I forget what it�s called. 
It�s not an insulin pump, but he would have to wear it all the time and it has something to do with his blood sugars. God, I can�t remember what it�s called.
Me: OH, OK , a CGM - A continuous glucose monitor.

Danni: YES. But medicare wouldn�t cover it - he�s over 65. It�s a shame because he was really excited to get one.  
Me: THAT SUCKS. You know, there are some bills re: diabetes and cgm coverage for medicare coming up in the House. Tell your dad to call his local JDRF chapter to discuss CGM coverage for medicare and help him tack action.  He can also go to JDRF.org and click on the advocacy link - it will take him to a link regarding CGM Medicare Coverage.

Danni: Can I do that, too? 
Me: Of course you can - the more Advocates the better!
Danni: I�m going to check out the website for my dad - and we're going to call! 
THANK YOU.

Me: Great! Also, you need to checkout diabetespac.org - the site will really help you guys navigate through the diabetes legislation - and they make contacting our Reps in DC re: said legislation incredibly easy. 
Danni: I�m all over it!

We talked a little more about diabetes - and then we got down to business regarding the facial. And when we were done, she handed me two pieces of paper. 
The first had the names of the facial products she used on my skin, the second was a blank sheet of paper for me to write down the JDRF and diabetespac info.

I left the spa with my skin glowing, a blood sugar of 147 and feeling relaxed. 
But as I drove home, my thoughts wondered back to Danni and her dad, who like so many of my friends with diabetes who are over the age of 65, was being denied crucial and life saving  diabetes technology.

Nobody should be forced to age out of lifesaving diabetes technology  - NOBODY.

And I thought of how quickly my almost 38 years of living with diabetes had gone by, and how no matter what amazing diabetes technology is on the market or down the pike, if you don�t have the means (insurance,)to pay for the technology, or if you age out of coverage for said diabetes technologies - you can�t get that technology - and that's not right or fair.

And it made me mad... and it made me fear for my diabetes and financial future.  


The laws MUST change and it�s up to to us to spearhead those changes. 
And don't think that because you or your loved one with diabetes aren't seniors, this issue doesn't concern you, because it absolutely does. 
This isn�t a senior issue - It�s an issue that touches every single person living with diabetes, regardless of age, and  for several reasons. 
1. We are in this together  
2. Seniors aren't the only people with diabetes on Medicare
3. Time is a thief and it goes by like that! 

So please guys, click on the following links and let your diabetes voices be heard - your voice is incredibly important - as is your current and future access to diabetes technologies~

http://jdrf.org/take-action/advocacy/cgm-medicare-coverage/

diabetespac.org

Do you have a teen driver? Five tips to cover with your teen

This week is National Teen Driver Safety Week, sponsored by the National Highway Traffic Safety Administration (NHTSA). Motor vehicle crashes are the leading cause of death for 14- to 18-year-olds in the United States. In 2013, 2,614 teen drivers were killed in crashes and an estimated 130,000 teens were injured. Yet, a recent survey shows that only 25% of parents have had a serious talk with their kids about the key components of driving.

The �5 to Drive� campaign addresses the five most dangerous and deadly behaviors for teen drivers. The idea behind the campaign is to give parents the words to use when they talk with their teens about the rules of the road. NHTSA�s website, has detailed information and statistics about the five rules designed to help save the lives of teen drivers.
  1. No drinking and driving: Nearly one out of five (19 percent) of the young drivers 15 to 19 years old involved in fatal crashes had been drinking, even though they were too young to legally buy or possess alcohol. 
  2. Buckle up. Every trip. Every time. Front seat and back: 64 percent of all the young (13- to 19-year-old) passengers of teen (15- to 19-year-old) drivers who died in motor vehicle crashes in 2013 weren�t restrained. 
  3. Put it down. One text or call could wreck it all.: The age group of 15 to 19 years old has the highest percentage of drivers who were distracted by cell phone use and involved in a fatal crash. In 2013, 318 people were killed in crashes that involved a distracted teen driver. 
  4. Stop speeding before it stops you: In 2013, almost one-third (29 percent) of teen drivers involved in a fatal crash were speeding. 
  5. No more than one passenger at a time: The risk of a fatal crash goes up with each additional passenger. 

"Back To The Future Day," Makes Me Visit My Diabetes Past

Today is �Back to The Future� Day and the Internet is all a buzz with everyone and their mother, debating what "Back To The Future II," got wrong and got right.   
 USA Today even ran a special edition today that is straight from "Back To The Future II."
People continue to bitch about the lack of hover boards and flying cars  - and I get it. 
I�ll be the first to admit that I�ve always been a fan of the hover-board concept. 
To me it would be like surfing on the land instead of the sea ( and I know it�s a skateboard sans the wheels, but whatever,) I could still really get into that.  
And as of late folks have been losing their shit because Nike has been hinting via teaser press releases re: the Nike Air MAG Self lacing sneakers becoming a reality. 
And that�s great, especially for older people and those who suffer from diseases/injuries that attack muscles and motor skills  - I fully support the idea of Nike Air Mag Self Lacing sneakers - and I love the fact that Nike is sending the first pair of those sneakers to Michael J. Fox, who lives with Parkinson's Disease. 
But when I think of the concept of going "back to the future", I always end up going back to my diabetes past -  I think of my busted pancreas magically staring to producing insulin after a 38 year hiatus and with no anti-rejection drugs. 
I think of my Peds Endo telling my 8 year old self that a diabetes cure was 5 to 10 years down the pike.
10 years became 20 and as of October 31, 2015 I will celebrate 38 years of living with t1 diabetes.
I�m incredibly grateful for the advances of diabetes technology and the advent of fast acting insulins, I'm glad to leave the Diabetes Dark Ages behind - I haven't had a day off from diabetes in over 13,000 days, I'm tired of adulting with diabetes, but am so very grateful for the life I live.  
Also, I feeling like I�m forever saying, �HELLO.... MCFLY,� when it comes to talking/fighting/begging my insurance company to cover me for more infusion sets, more test strips and better prices on the life saving elixir of life called insulin - that I require to walk this earth as part of the living. 
Same goes for dealing with the public and the media's diabetes misconceptions.

Yep, a hover board would be awesome... but a busted pancreas that started to produce insulin without anti-rejection drugs would be better. 

So while I can appreciate the wave of nostalgia regarding �Back to The Future Day,� and the significance of October 21, 2015. I still find myself focusing on the significance of October 31st and what it represents regarding my diabetes past and my/our diabetes future~ 

Health Care and Pseudobulbar Affect

Have you seen those TV commercials lately with actor Danny Glover talking about a neurological disorder that causes people to break out into uncontrollable laughter or crying? This health care issue is known as pseudobulbar affect or PBA, and its debilitating characteristics effects tens of thousands of newly diagnosed cases per year.

Pseudobulbar affect(PBA), emotional lability, labile affect, or emotional incontinence refers to a neurologic disorder characterized by involuntary crying or uncontrollable episodes of crying and/or laughing, or other emotional displays. PBA occurs secondary to a neurologic disease or brain injury. 

Patients may find themselves crying uncontrollably at something that is only moderately sad, being unable to stop themselves for several minutes. Episodes may also be mood-incongruent: a patient might laugh uncontrollably when angry or frustrated, for example.

PBA episodes can be described in two key ways, according to PBAinfo.com:
         PBA outbursts can be inappropriate: The crying or laughing episodes are inappropriate to the situation in which they occur. Sometimes these are spontaneous crying or laughing eruptions that don�t reflect the way a person is actually feeling.

         PBA outbursts can be exaggerated: Another characteristic of PBA episodes is that though the crying or laughing may be appropriate for a given situation, they�re exaggerated � they�re more intense or last longer than the situation calls for.

One of the jobs of the brain is to figure out how we feel in the moment. That information is then sent down to the brainstem, also known as the �bulb.� The brainstem then sends signals to the face and other parts of the body that show emotion.

PBA is believed to be the result of a disruption of these signals. When people have certain neurologic conditions or brain injuries, it can cause damage in the brain tissue that creates a disconnection between the parts of the brain that express emotion and those that control emotion.

The result is the frequent outbursts of involuntary crying or laughing known as pseudobulbar affect. If you break the term down literally, �pseudo� means false, �bulbar� refers to the brainstem and �affect,� describes how the body shows mood or emotion. More details can be found at this website: http://www.pbainfo.org/science.

The side-effects for PBA sufferers include feelings of emotional exhaustion and, frequently, social isolation, according to Psychology Today. Without realizing that they have a medical problem, people with PBA often adapt their lives to avoid things that trigger the response, including interacting with others unless they absolutely have to. With social isolation comes more negative emotion that can over time manifest as depression.  

While all of this may sound like new knowledge about a recently discovered disease, PBA has actually been well-documented in the medical literature for more than 100 years, though it has been labeled at least ten different things during that time. More detailed material is found at this site: https://www.psychologytoday.com/blog/neuronarrative/201110/not-all-crying-is-depression-understanding-pseudobulbar-affect.

According to the National Institutes of Health, although it is most commonly misidentified as a mood disorder, particularly depression or a bipolar disorder, there are characteristic features that can be recognized clinically or assessed by validated scales, resulting in accurate identification of PBA, and thus permitting proper management and treatment. Mechanistically, PBA is a disinhibition syndrome in which pathways involving serotonin and glutamate are disrupted.

This knowledge has permitted effective treatment for many years with antidepressants, particularly tricyclic antidepressants and selective serotonin reuptake inhibitors. A recent therapeutic breakthrough occurred with the approval by the Food and Drug Administration of a dextromethorphan/quinidine combination as being safe and effective for treatment of PBA.

Side effect profiles and contraindications differ for the various treatment options, and the clinician must be familiar with these when choosing the best therapy for an individual, particularly elderly patients and those with multiple comorbidities and concomitant medications. A much more detailed clinical explanation and overview is available at this site: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3849173/.

To distinguish PBA from depression or other causes, doctors may administer a questionnaire rating episode frequency, duration, voluntary control and appropriateness to context and inner feelings. Additional details can be found at this website: http://alsn.mda.org/article/pba-symptoms-no-laughing-matter.

According to the American Stroke Association, in January 2011, the FDA approved a new drug called Nuedexta� (dextromethorphan quinidine) specifically for PBA. In clinical trials, it proved effective against placebo, but it has not been compared directly to antidepressants. Analyzing data across studies, it appears to be faster acting than the anti-depressants with few side effects. Nuedexta� is not recommended for patients with certain arrhythmias: prolonged Q-T interval, complete heart block, history of torsades de point (a type of ventricular tachycardia) or heart failure.

As with any new drug, there is a considerable cost difference when compared to older, off-patent medications. Nuedexta� is manufactured by Avanir Pharmaceuticals and costs $200�300 for a month�s supply. The SSRIs mentioned in the article are $10�$12/month. Though off-patent antidepressants are often used in treating PBA, Nuedexta� is the only prescription drug currently indicated specifically for PBA by the FDA. Avanir, like many pharmaceutical companies, does have a Patient Assistance Program. More detail on this medication and PBA is available at this website: http://www.strokeassociation.org/STROKEORG/LifeAfterStroke/RegainingIndependence/EmotionalBehavioralChallenges/Pseudobulbar-Affect-PBA_UCM_467457_Article.jsp

One of the best ways to deal with PBA is to tell your friends, co-workers, and family that you have it. Explain what PBA is and what causes it. Let the people around you know that you may have uncontrolled emotional outbursts. That way, when you suddenly burst into tears or start laughing they won�t be surprised or shocked. And you won�t have to always worry about losing control at the wrong moments, according to HealthLine.com.

You can gain some control over your symptoms with a few simple tricks. When you start feeling the urge to laugh or cry, try to distract yourself. Think about something different. If you�re crying, try to focus on something upbeat or funny. For example, you could think about a funny movie you saw recently. Take slow, deep breaths. And relax the muscles that start to tense up whenever you have an episode. More info is located at this site: http://www.healthline.com/health/multiple-sclerosis/pseudobulbar-affect#Medicines8.

PBA can have an enormous impact on a person's social life. Emotional episodes caused by the disease can be embarrassing and can damage interpersonal relationships. The Brain Injury Association of America study indicates that 60% of people with brain injuries feel that PBA and its accompanying outbursts make it hard for them to initiate and maintain friendships. The disease was also the cited culprit in being housebound for 40% of people in the survey.

For caregivers of people with PBA, it can be difficult trying to deal with a person who feels isolated and alone because of their disease.  PBAinfo.org offers a few tips for caregivers to help them interact positively with emotionally explosive loved ones:

         Let them know that you support them and they are not alone. Reassure them that many people suffer from the symptoms of PBA.
         Remind them that their outbursts are caused by a physical disease, not a mental condition.
         Indicate your willingness to listen to their frustrations and concerns.
         Keep an "episode diary." By recording PBA episodes, you can ensure better communication with your doctor and help him or her make an accurate diagnosis.

According to the American Stroke Association, these episodes can strike a person up to 100 times a day. They can be a few seconds to a few minutes long. More information about this topic for seniors and others is available at this website: https://www.agingcare.com/Articles/crying-is-not-always-depression-148580.htm.

Psuedobulbar Affect has been identified in several million patients, both men and women. It is a disease that can be managed, but not readily identified unless the doctor knows what to look for and how to treat it. More people suffer every day from PBA. The good news is that there are therapies to help overcome PBA and its impact on the lives of those who have it. If you think you may be symptomatic, or know someone whom you may suspect exhibits the symptoms, see your healthcare provider to get a proper diagnosis.


Until next time.

New Medicare pages on OIC's website, including new Advantage plans


SHIBA is happy to announce today's launch of the new and improved Medicare webpages on the OICs website. Last spring, SHIBA staff and OIC's Web Services team conducted a usability study on the agency's Medicare webpages. After several months of research, and writing and editing content, the new section should provide content that is more user-friendly and easier to navigate for consumers.

In addition, the 2016 Medicare Advantage and Special Needs plans by county are now available on the OIC's website. Medicare open enrollment started today and ends Dec. 7. Read more about Medicare open enrollment.

My Insulin Pump Gives Me Comfort

Diabetes technology helps to save our lives and improves our quality of life. 
But diabetes technology also gives us comfort. And I swear to God, sometimes I reach for my insulin pump like a child reaches for their favorite blanket or stuffed animal and I'm not even aware I'm doing it... And that's cool because it is comforting. 
######
My insulin pump has become a part of me - an extension of myself - so much so, that when I'm not wearing it for an extended period of time, either by choice or by force - I'll still reach for it out of both comfort and security.

Since I wear my insulin pump almost 24X7, I find myself myself reaching for my insulin pump automatically, without thinking, and for no reason at all except... well, it�s comforting - and subconsciously, reaching out for my insulin pump comforts me.

sometimes place my hand on my pump while watching television and I�m not even aware that I�m doing it. Other times I purposely check to see if my pump is clipped to my hip while walking from the start of my driveway to the car... just in case. 
There are moments when I�ll hold a small piece of insulin pump tubing between my thumb and pointer finger while chatting on the phone and twirl it gently and mindlessly, like some people twirl their hair.  And there are times when I unintentionally feel for the infusion site lump under my shirt and feel for a bit of the tubing with a slight quick of hand - and no one at the dinner table is the wiser. 
On occasion I find my pump tubing still connected, but I find my actual insulin pump in places I don�t even remember putting it, because dealing with diabetes and my pump has become part of my cadence. 
There have been instances when I�m down right surprised to find my electronic pancreas bungee pumping from my lap to the floor when I get up from the couch/desk, because I�d checked my IOB (insulin on board,) and didn�t re-clip i because l was lost in a really good movie, book, or DSMA chat.  


It�s funny the how we have diabetes idiosyncrasies that give us comfort, even when we aren�t aware that we need it. 

OIC joins Great ShakeOut drill � are you prepared for an earthquake?

The OIC is joining the Great Washington ShakeOut drill tomorrow, along with more than 1 million other participants in Washington state. 

In addition to practicing drop, cover and hold, in what other ways are you prepared for an earthquake? Here are some tips from the OIC to help you think about ways you can protect yourself and your home in the event of an earthquake:
Questions? You can contact our consumer advocates online or at 1-800-562-6900.

Health Care and Hypertension

Hypertension, or high blood pressure as it is commonly called, is a dangerous health care issue, and can be a killer. Tens of millions of men and women, as well as some children, suffer from this malady on a daily basis; and for some, hypertension is a lifelong struggle.

Hypertension (HTN or HT), also known as high blood pressure or arterial hypertension, is a chronic medical condition in which the blood pressure in the arteries is persistently elevated. Blood pressure is expressed by two measurements, the systolic and diastolic pressures, which are the maximum and minimum pressures, respectively, in the arterial system.

The systolic pressure occurs when the left ventricle is most contracted; the diastolic pressure occurs when the left ventricle is most relaxed prior to the next contraction, according to JAMA, the Journal of the American Medical Association. The publication has a lot of info about this medical topic, and you can locate it at this site: http://jama.jamanetwork.com/journal.aspx .

According to the American Society of Hypertension, hypertension--the most prevalent cause of stroke and kidney failure--is part of a bigger disease conglomerate almost always accompanied by obesity, diabetes, kidney disease or many other co-existing problems involving lifestyle and/or genetics. More details are located at this site: http://www.ash-us.org/About-Hypertension/Hypertension-Information.aspx

Here are some statistics provided by the Centers for Disease Control at this site http://www.cdc.gov/nchs/fastats/hypertension.htm :

         Percent of adults ages 20 and over with hypertension (measured high blood pressure and/or taking antihypertensive medication): 32.5% (2011-2012).
         Number of visits to physician offices with essential hypertension as primary diagnosis: 38.9 million.
         Number of visits to hospital outpatient departments with essential hypertension as primary diagnosis: 3.7 million.
         Number of deaths from essential hypertension and hypertensive renal disease: 30,770.
         Deaths per 100,000 population from essential hypertension and hypertensive renal disease: 9.7.

One in three Americans are at risk for hypertension, according to the American Heart Association. Science has identified several factors that can increase your risk of developing hypertension, or high blood pressure. One big contributor is that it may be in your genes. Family history has a lot to do with your risk of hypertension. Height, hair and eye color runs in families --- so can high blood pressure. If your parents or close blood relatives have had hypertension, you are more likely to develop it, too.

You might also pass that risk factor on to your children. That's why it's important for children as well as adults to have regular blood pressure checks. You can't control heredity, but you can take steps to live a healthy life and lower your other risk factors. Lifestyle choices have allowed many people with a strong family history of HBP (hypertension/high blood pressure) to avoid it themselves.  Much more detail can be found at this site: http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/UnderstandYourRiskforHighBloodPressure/Understand-Your-Risk-for-High-Blood-Pressure_UCM_002052_Article.jsp .

You'll likely have your blood pressure taken as part of a routine doctor's appointment. Ask your doctor for a blood pressure reading at least every two years starting at age 18, according to the Mayo Clinic. Blood pressure generally should be checked in both arms to determine if there is a difference. Your doctor will likely recommend more frequent readings if you've already been diagnosed with high blood pressure or other risk factors for cardiovascular disease. Children age 3 and older will usually have blood pressure measured as a part of their yearly checkups.

If you don't regularly see your doctor, you may be able to get a free blood pressure screening at a health resource fair or other locations in your community. You can also find machines in some stores that will measure your blood pressure for free. Public blood pressure machines, such as those found in pharmacies, may provide helpful information about your blood pressure, but they may have some limitations.

The accuracy of these machines depends on several factors, such as a correct cuff size and proper use of the machines. More information about hypertension can be found at this website: http://www.mayoclinic.org/diseases-conditions/high-blood-pressure/basics/definition/con-20019580 .

According to the Cleveland Clinic, approximately 1% of Americans with hypertension are estimated to be affected by hypertensive crises. Hypertensive crisis broadly covers both hypertensive urgency and emergency. Hypertensive emergencies are more common in patients with essential hypertension (20%-30% in Caucasians and 80% in African Americans). Factors such as renal failure, heart failure, cerebrovascular accidents, and nonadherence to antihypertensive therapy are associated with hypertensive crisis. Illicit drug use is an important cause for hypertensive crisis.

One in 3 Americans over the age of 18 years suffers from hypertension. The prevalence is higher among older individuals, women and non-Hispanic blacks. The prevalence of hypertension increases progressively with age. Significant clinical data is available for review at this site: http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/nephrology/arterial-hypertension/

About 72 million Americans are estimated to have high blood pressure. High blood pressure occurs more often in blacks�in 41% of black adults compared with 28% of whites and 28% of Mexican Americans. It also occurs with high frequency in people whose ancestors are from China, Japan, and other East Asian or Pacific areas (such as Koreans, Thais, Polynesians, Micronesians, Filipinos, and Maori), according to Merck.

The consequences of high blood pressure are worse for blacks. High blood pressure occurs more often in older people�in about two thirds of people aged 65 or older, compared with only about one fourth of people aged 20 to 74. People who have normal blood pressure at age 55 have a 90% risk of developing high blood pressure at some point in their life. High blood pressure is twice as common among people who are obese as among those who are not. 

In the United States, only an estimated 81% of people with high blood pressure have been diagnosed. Of people with a diagnosis of high blood pressure, about 73% receive treatment, and of the people receiving treatment, about 51% have adequately controlled blood pressure. Although many have a solution, a significant number still do not.

To many people, the word hypertension suggests excessive tension, nervousness, or stress. In medical terms, hypertension refers to high blood pressure, regardless of the cause. This site has a substantial amount of info about hypertension: http://www.merckmanuals.com/home/heart-and-blood-vessel-disorders/high-blood-pressure/high-blood-pressure.  Because it usually does not cause symptoms for many years�until a vital organ is damaged�hypertension has been called "the silent killer." Here is the high level overview of hypertension as a summary:

         Often no cause for high blood pressure can be identified, but sometimes it occurs as a result of an underlying disorder of the kidneys or a hormonal disorder.
         Obesity, a sedentary lifestyle, stress, smoking, and excessive amounts of alcohol or salt in the diet all can play a role in the development of high blood pressure in people who have an inherited tendency to develop it.
         In most people, high blood pressure causes no symptoms.
         Doctors make the diagnosis after measuring blood pressure on two or more occasions.
         People are advised to lose weight, stop smoking, and decrease the amounts of salt and fats in their diets.
         Antihypertensive drugs are given.

Hypertension, or high blood pressure, should not be ignored. If you feel that you may be suffering from symptoms, then see your doctor. If you have hypertension, follow your physician�s directions on how to treat it or how you can get rid of it if possible. Each person needs to have a diagnosis specific to him/her, but hypertension can kill you if you�re not careful. Don�t be another statistic.


Until next time. 

Use extra caution when driving in areas near wildlife

October and November are the months with the most collisions between vehicles and deer, which is compounded by fewer daylight hours and animal mating seasons and migrations. The National Highway Safety Administration (NHSA) reports there are about 1.5 million deer-related auto accidents each year. In Washington, more than 1,100 collisions with deer and other wildlife are reported to State Patrol each year, and result in an average of nearly 1,200 human injuries. 

Hitting a deer or other large animal at highway speeds can, at best, damage your vehicle and at worst, injure or kill drivers and their passengers. The Washington state Department of Transportation (WSDOT) reports it removes nearly 3,500 deer and elk carcasses from state highways each year.

Our consumer advocates recommend that consumers check their insurance policies or contact their agents or brokers to find out if wildlife collisions are covered by the insurer. Most auto insurance policies cover such damag�e under the optional comprehensive portion of the policy. If you only have collision coverage or liability coverage, your insurer may not cover damage to your vehicle resulting from a collision with an animal. Comprehensive auto insurance also includes coverage for fire, theft, vandalism or malicious damage, riot, flood, earthquake or explosion, hail, windstorm and falling or flying objects. Filing a claim for an accident covered by your comprehensive coverage means you'll still need to pay a deductible. After that, your insurer will cover the costs of the claim up to your policy limits.

WSDOT reports the following areas of the state have the highest number of collisions with wildlife:
  • Spokane and surrounding areas, where highways intersect with white-tailed deer wintering grounds.
  • Methow River Valley, which is home to one of the state�s largest mule deer herds.
  • Wenatchee and vicinity, also home to a large number of mule deer.
  • Interstate 90 near Easton/Cle Elum has the highest number of collisions with elk.
  • Whidbey Island has a high number of deer collisions
  • Packwood/Randle off Highway 12 and North Bend off Interstate 90 have a high number of elk collisions.
Here are some tips to avoid hitting a deer or other wildlife:
  • Deer tend to travel in herds, so if you see one, watch for more. 
  • Keep an eye out for deer signs, which are placed at known deer-crossing areas. Reduce your speed when you see a sign. 
  • Animals tend to be active during dawn and dusk, so be extra-aware during those times and watch your speed. 
  • Make sure your headlights are in working order to ensure you see well at night. Using high beams can help you spot wildlife, but be considerate of other drivers when using them. 
  • Stay focused while driving. Do not text, talk on your phone or allow passengers to distract you. 
  • Always wear your seat belt. This won't prevent a collision, but it can save your life depending upon the severity of the accident. 
If you are involved in a collision with wildlife:
  • If you can, move your vehicle to a safe place and turn on your hazard lights. This may mean pulling over to the shoulder of the highway. 
  • Stay away from the animal. A frightened or wounded animal can hurt you. 
  • If you can't move your car, or the animal carcass is blocking traffic, call 9-1-1 so emergency responders can clear the roadway. 
  • Document the collision by taking photos of your vehicle damage, the roadway and any injuries. 
  • Check to see if your vehicle is safe to operate. Check for leaking fluid, damaged lights, loose parts or other safety hazards. When in doubt, call a tow truck. 
  • Report the collision to your insurance as soon as you safely can.
Read more about auto insurance on our website. Questions? You can contact our consumer advocates online or at 1-800-562-6900.

Homeowners, insurers have responsibilities in repair claims

We often hear from consumers who are concerned about their home repair or rebuild insurance claims and have questions about their insurer's role in overseeing the contractors' work.  

Your insurance company is responsible for paying the claim, as laid out in your homeowner policy. Typically, it is your responsibility to oversee the project with your contractor, and when applicable, your lender. The exception would be if your insurance company has given you assurances or if your policy contains a provision that obligates the insurer to manage a covered home repair or rebuild.

However, if you are using an insurer�s recommended (sometimes called �preferred�) contractor, you should expect assistance from the insurer in answering your questions about the contractor�s actions and performance. 

Many insurers also require the homeowner to stop the damage from getting worse--this is called loss mitigation in your policy. If you don�t mitigate the loss, you could be on the hook for paying for any resulting additional damage. For example, if you have water damage in your home, you must control it as soon as you discover it. If you let it go until you get around to calling your insurance company, you will be responsible for any resulting damage, including rot, mildew or mold. Even if you use an insurer's preferred contractor, you are still responsible for mitigating the loss prior to the contractor showing up and starting the repairs. 

More information:
Questions? You can contact our consumer advocates online or at 1-800-562-6900.

Dear Congressional Members: #HearingDiabetesVoices In November & Beyond

Dear Congressional Members: 
My name is Kelly Kunik, and I'm asking as your constituent, your countrywoman, and a person who has lived with t1 diabetes for roughly 13,870 consecutive days, (38 years,) to hear not only my voice, but the voices of every single person living with diabetes in the Unites States and regardless of the type. 
Also, I also lost my 31 year old sister, Debbie to t1 diabetes complications in 1991. 
Back then, diabetes technology was in its infancy - analog insulins weren't available and our diabetes treatment options were limited. 
Debbie's death was painful and horrific and the emotional toll it took on our family is still being felt today. 
Thankfully, much has changed in the diabetes arena - diabetes technology and medications including insulin, are not only saving lives - they are assisting us to live healthy and long lives. 
With that being said, people with diabetes need your help - We need access across the board to life saving diabetes treatments, D technology, Certified Diabetes Education for all and regardless of the PWD  type and or medicare status.
We need our elected officials to understand the diabetes facts, instead of relying on the diabetes myths when it comes to diabetes legislation that will cross your desk come November.

We are asking that you schedule a Diabetes hearing in Congress this November, National Diabetes Month. 

And we, your constituents living with diabetes and all those who love them, need you to vote YES on diabetes legislation that will come across your desk this November. Including: 
  1. The National Diabetes Clinical Care Commission Act (H.R.1192) 
  2. Medicare Diabetes Prevention Act (H.R. 2102)
  3. Preventing Diabetes In Medicare Act (H.R. 1686)
  4. Access To Quality Diabetes Education Act (H.R. 1726) 
  5. Medicare CGM Access ACT ( H.R. 1427) 
  6. **Checkout this article from the folks over at Healthline/Diabetesmine for a simple to understand breakdown of these important bills
Our future good health depends on these Diabetes Bills becoming laws.  
These Bills will allow PWDs better access to diabetes medications and diabetes technologies, quality diabetes education, not only insuring a better quality of life, but a more healthy life!
99 percent of our diabetes care is in our hands and these Bills will help us to take better care of ourselves.

Lastly, PWD (People with Diabetes) vote - and we educate ourselves on the laws that will benefit or hurt people living with diabetes.  
When legislators vote on legislation that helps people living with diabetes - we will return the favor in the voting booths. 


When legislators vote against laws that help people living with diabetes, we will absolutely return the favor in the voting booths. 

#hearingdiabetesvoices is crucial for every single person living with diabetes, for every single person who loves someone with diabetes, and for every single person caring for someone one with diabetes. 

And #hearingdiabetesvoices is crucial for every single member of Congress and The House who is running for re-election. 

Sincerely, 
Kelly Kunik
PWD, daughter, sister, aunt, cousin,and niece to family members who are currently living with diabetes or who have died because of diabetes. 
Diabetes Advocate
Registered Voter  

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