Post Election Funk, Fear, Pulling Myself Up By My BootStraps & Forging Ahead

Because the past few weeks has been hard on our whole nation - but I'm forging ahead with a vengeance. 
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Post election funk is real and it's scary - it makes focusing hard- writing and blogging even harder. 
I�m scared about the future, my health insurance, the cost of being a person living with a chronic illness, and the ever growing division in our country. 

I know we�re not supposed to talk politics in the DOC - but I can�t explain why its been hard for me to be present in the DOC without mentioning our our presidential election. 
After the election many of us took a break from social media, television and the likes there of - including me - and as much as I hated to do it - I needed too. 
My heart and my head hurt and still do. I�m mad at how the election turned out for many reasons -as a woman, as a person with diabetes, living with a pre-existing condition, as an American who has always voted as an Independent and never straight down party lines, who has always done research on what and who I was voting for. 

I'm scared, angry, and frustrated that fake news is accepted as fact. 
I'm scared of the hate I see others express for those who are different  - and I want it to stop instead of it being encouraged. 
I'm angry that opposing parties demonize one another to the point it's now damaged and fractured our country. 

Instead of feeling empowered - the post election vibe made me feel powerless and scared - two words/feelings I despise. 

As a Diabetes Advocate I�ve learned to use my diabetes voice and become empowered in the process - and now I must take those same DA super powers and develop my voice as a citizen of the United States - and I am. I�ve always been one to reach out to my Reps in Congress and the Senate - and I�ve tripled my efforts now - and I strongly encourage you to do the same!
Financially and health wise, 2017 was the year I was going to sign up for the the Affordable Care Act - and I�m not so sure if I should now.
My current health insurance rates up again in March and my deductible is high. 
Now that the Thanksgiving holiday is behind us - I plan on taking the next week and researching ACA and will keep you posted on my findings. 
Speaking of the ACA, you/we can register our support for the ACA .
Paul Ryan's office is conducting a survey hoping to show a popular mandate to repeal the ACA - but the survey can also be used to register support for the ACA. 
It's automated and quick and here�s what you need to do:
1) Call (202) 225 -0600
2) Wait for awhile (1-2 min) for a recording to start 
3) You will get prompted by the survey
4) Press 2 to participate
5) Press 1 to register your support for the ACA
It only takes a couple minutes and it�s a sure way for our collective voices to be heard!

I�m also mad that the presidential election in the United States had such a negative and powerful impact on the International Diabetes Awareness month - and yet I totally understand it, because I experienced it and talked with others in the DOC who felt the same way. 

Another focus shifter occurred a few weeks ago (the day before election day,) when I scheduled surgery for my right wrist and pointer finger for December 13th. 
My right wrist and finger really hurt to the point of having to ice both daily. 
I�ve met my deductible for 2016 - now�s the time to get it done.
I�ve spent a lot of time (but not nearly enough,) prepping for the time I�ll be off and I wish it was over and done with. 

I spent the past week traveling to be with my family for Thanksgiving. 
For the first time ever, I drove solo and almost 700 miles each way, to spend time with my family - and it worked wonders for my heart and spirit. 
For the first time in what seemed like forever, I laughed until I cried... and I jammed with people who are just as "Kunikal -The_Musical" as I am!  

So as much as I want a �do-over� for the entire month of November - diabetes and politically speaking - I'm working my ass off to pull myself up by my bootstraps and forge ahead with a vengeance - it's really hard and some days are better than others. 
So thanks for your patience and understanding - it means the world to me. 

Speaking of thanks, for as little as $5 you can send a beautiful and straight from the heart thank-you to a loved one/loved ones who makes your life with diabetes easier - and you get to support the Diabetes Hands Foundation in the process! 
Click HERE to learn more.

Also, here's the thank-you that Mr. Mike Lawson sent me - it made my eyes leak in a really great way!  


Speaking of forging ahead, I have a new article up on Mango Health on Chronic Illness Burnout, so please give it a read by clicking, HERE.  
The topic is timely and it�s straight from my heart - and my beautifully busted pancreas~

Health Care and Senior Wellness

Most senior citizens typically have at least one health care issue that they deal with on a daily basis, whether it�s either physical or mental difficulty. Possibly it is both in many cases. As you age, staying active mentally is just as important as staying physically active. Now more than ever, seniors are leading active lifestyles, traveling, and trying new activities. However, older adults that could use a little support and assistance in their daily lives often are not sure how to accomplish those tasks.

There are many available resources that provide the human connection needed to enhance a senior�s quality of life, also to help reduce loneliness and provide information on available senior support services, including caring volunteers who provide support with errands such as transportation for grocery shopping, short medical appointments, errands and social outings. Seniors in many cases need assistance, depending on age and physical and mental capabilities.

Providing coordinated care with specific attention to most common problems within the senior population is important for a well rounded senior wellness regimen. Some of the more critical areas of care and support should include the following steps:

Basic Physical Assessments:
         Intellectual impairment
         Immobility
         Instability
         Incontinence
         Iatrogenic (inadvertently induced) disorders

Geriatric Assessments
         Clinical history
         Nutritional assessment
         Social evaluation
         Neuropsychiatric evaluation
         Physical examination
         Functional examination

Support services and educational classes:
         Nutrition
         Diabetes
         Independent living
         Memory and healthy brain function
         Fall prevention
         Exercise
         Caregiver support

Both seniors and caregivers should understand the importance of preventive healthcare and be involved withsenior wellness programs that focus on prevention, detection, education and follow-up in order to achieve and maintain productive, high-quality lives.  Whether you live independently at home or in a senior living facility, you may benefit from occasional visits by a registered nurse to ensure you are maintaining a healthy lifestyle. At your first visit, a complete medical assessment should be provided by a registered nurse for the following areas:
  • Physical
  • Emotional
  • Psychosocial
    Another consideration for seniors is prescription adherence. According to the Institute of Medicine, over 1.5 million people each year have adverse reactions due to medication errors or interactions. Caregivers and medical professionals, such as a doctor, nurse or physician assistant, should come to your senior center, group residence, or home and perform a complete medication review, to help you with the following needs:

             Understand what medications you are taking and why
             Learn how to properly take your medication and at what times for optimal results
             Develop a medication chart that is easy to follow
             Separate medication into daily/weekly containers
             Create a telephone list of contact numbers or medication record in the case of an emergency to keep in a convenient location

    For seniors to stay their healthiest and enjoy life to the fullest, it's important to have regular health checkups by a medical professional. Assessments can include:
             Physical
             Emotional
             Psychosocial
             Neurological
             Chronic illness such as diabetes, cholesterol, hypertension and asthma
             Hearing
             Medication review

    An indepth health program for seniors may provide more detailed provision for the following needs for wellness that focus on helping them strengthen and maintain the skills that other workouts often overlook:

    Gross motor skills�including balance and proprioception to keep you on your feet and active. Proprioception is the ability to innately sense your body�s position, movement, and spatial orientation, even when you are not looking. Examples of this are walking up and down steps without looking at each step, catching a fly ball, or closing the eyes and touching the nose.

    Mental processing, motor planning, and motor sequencing�the ability to take information, process it, plan next actions, and implement those actions. The goal is to keep the senior�s mind and body working together.

    Visual motor skills�like peripheral vision and efficient visual information processing�to maintain and enhance the mental connection between what seniors see and how their bodies reacts to it.

    Personal Training--fitness specialists work with seniors one-on-one�at their comfort level�to develop a customized fitness plan that focuses on the areas and skills they wish to target.

    Bone & Joint Health Program--uses state-of-the-art technology to help seniors safely and comfortably build bone, muscle, and joint strength and counteract the effects of osteoporosis and osteopenia.

    Accessible health, nutrition, exercise, and insurance information is increasingly important to older adults, seniors, and members of their families, who are often their part-time caregivers. Yet information about providers, programs, services, resources, and preventive care is overwhelming, confusing, and fairly inaccessible. Because many federal, state, and city programs overlap, older adults and seniors need help understanding what services are available and whether they qualify.

    A good senior wellness program engages both English- and Spanish-speaking seniors to help them understand the information, services, benefits, and programs that exist to help them maintain and improve their physical health and emotional well-being. Senior wellness program benefits may also include:

             Insurance counseling, including Medicare and Medicaid
             Benefit Access Program
             Energy assistance
             Senior companion program
             Pet companion service

    Educational classes may include:
             Aging well and diseases related to aging
             Medical management for physical health and mental health
             Crime prevention
             Senior resources, including government benefits and housing information

    Here are a few websites that have senior friendly information: https://www.agingcare.com/Articles/Home-Modification-for-Senior-Friendly-Living-104573.htm ; http://www.everydayhealth.com/bipolar-disorder/bipolar-disorder-in-seniors.aspx ; http://www.assistedlivingct.com/wp-content/uploads/2013/01/RT-Aging-in-Place-Safe-at-Home-Checklist.pdf ; http://www.aplaceformom.com/senior-care-resources/articles/elderly-depression .

    Senior wellness programs can be very basic, such as just providing an exercise program or minimal social services at a local senior daycare center, to as inclusive as providing most of the services described in this story. Depending on the financial capabilities of how seniors can most afford those programs, it is in the best interest of caregivers and those seniors they are assisting to help those senior adults in navigating their pending wellness needs.


    Until next time.

    The CA Law That Never Was? (SB 10)

    Looks like California SB 10 will die on the vine. The bill was passed and signed into law by the Governor last summer. SB 10 would allow undocumented immigrants to enroll their children in Medi-Cal (California Medicaid) and was further expanded to allow adults to enroll (without subsidy) in Covered CA health plans.  

    Although SB 10 was signed into law, it requires a waiver from DC (HHS) in order to be implemented. I recently spoke with Governor Brown's office and was told that no waiver has yet been granted. Given the change in Presidential administration and the stated goal of replacing ObamaCare, I highly doubt that a waiver will be forthcoming from the new director of HHS. 

    www.davefluker.com

    Before you wax your skis, brush up on winter activities and your insurance

    Snow is starting to fall in Washington state's mountains and in some lower elevations. Before you hit the slopes or backcountry, take a moment to consider insurance implications for winter recreation. 
    Snoeshowing at Lake Wenatchee Sno-Park,
    courtesy Washington State Parks


    Ski and snowboard equipment

    Winter sports gear is not cheap, and replacing it in the event of damage or theft can put a crimp in your winter fun. 

    Generally, equipment you own will be covered up to a specific amount by your homeowner or renter policy. Check the limit in your policy and decide if that will be enough to replace damaged or stolen equipment. Remember to factor in your deductible. 

    If you think you need more coverage, ask your insurance agent about a rider that might allow you to increase coverage (and your premium) for specified personal property.

    Snowmobiles

    Snowmobiles may be covered under homeowner policies when they are used for maintenance of your insured property. They likely aren�t covered by a renter or auto insurance policy. If you want to be covered, talk to your insurance agent about a snowmobile policy. If you take your snowmobile off your property, carry proof of insurance.

    If you are traveling and plan to rent a snowmobile, you may consider rental insurance to cover damage to the snowmobile. Your home or renter insurance might provide coverage for your personal liability while operating a rental snowmobile. Read the contract carefully before signing and ask questions of the agent selling you the coverage if you don�t understand the limits or conditions of coverage.

    Travel insurance

    Traveling in the winter can be full of surprises. Even if you�re traveling somewhere warm, bad weather en route to your destination can cause delays or cancellations. Travel sites and airlines offer travel insurance when you book your trip. Travel insurance can cover everything from lost luggage to delays and cancellations, but make sure you closely read any policy you consider. Learn more about travel insurance.

    Health insurance

    If you are out of town without access to your physician or local health care center, review your emergency medical treatment requirements:
    • Are you required to seek medical treatment at a certain hospital or urgent care center that is in your insurer�s network?
    • Will you have a copay?
    • If you need to fill a prescription, do you have to go to a certain pharmacy?
    • If you are traveling in an area that is out of your network, what is the insurer�s requirements for reimbursing your expenses? 
    Make a list of these details and carry your insurance card with you when you travel.

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

    World Diabetes Day 2016

    I apologize for the radio silence this past week - there was some stuff going on in my country, the United States - I�ll leave it at that. 
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    Today, Monday November 14th, 2016 is Word Diabetes Day - I�ve lived with T1 for 39 years, and I�ve known (and loved,) many people who didn�t survive the diabetes dark ages - or whose lives were severely shortened because of those diabetes dark days. 
    We are so damn lucky and blessed! 
    I/we survived and are surrounded and inspired daily, by a global diabetes online community. A community that has our backs and keeps fighting for every single person living with diabetes on the planet.
    November 14th is also the 125th birthday of Dr. Banting and I keeping thinking of how I wouldn�t be here (and neither would you, or someone you love,)  if Dr. Banting & Company hadn�t discovered insulin. 
    And not just me - most of my immediate family wouldn't be here, because my late father was diagnosed with t1 in the early 1950s. 
    If insulin hadn�t been discovered and if dad hadn�t had access to it- my father would have died as a very young man - and my branch of the Kunik Family tree would have a been a small twig. 
    Same goes for my dad's two younger sister's who were diagnosed in the 1940s - they wouldn't have survived, therefore my cousins never would have been born.

    Last night our friend Renza from Diabetogenic in Australia ,broke the news to those of us in this hemisphere, that Google finally dedicated a Google Doodle to our hero Dr. Banting. 
    As long as I�ve been a member of the Diabetes Online Community - since 2007 to be exact. My blogaversary was on November 9th - lots of things were going down in the U.S. that day and I didn�t write about this year, but I digress. 
    Back to the story, since I became a member of the DOC family in �07,� the DOC has been petitioning for a #WDD Google Doodle - and now we have one!

    Dr. Banting and World Diabetes Day are Google Doodlefied! 
    Today I will be doing my Big Blue Test , participating in the 5th annual, 24 hour World Diabetes Day, twitter chat #WWDchat16 for those of you who only speak in hashtags. HUGE thanks to Cherise over at DCaf - for making this chat happen!
     I will be hosting the 7pm to 8pm hour tonight :) 
    I will make a donation to IDF�s Life For A Child, an d I will do my best to help as many diabetes orgs as I can. 

    Speaking of diabetes orgs, Kerri over at sixuntilme has a wonderful breakdown of ways you can help others living with diabetes this month and every month - and how others living with diabetes can help you - click HERE, now.  

    We are on this together - now and forever! 

    How Will Donald TRUMP ObamaCare?

    With the election of Donald Trump as the next US President, healthcare reform and ObamaCare are on the chopping block.  There is media speculation that a transformation away from the current ObamaCare system will be rather immediate once Donald Trump is sworn into office in January.  


    While changes are certainly coming, I would not expect a wholesale changeover immediately, but rather over the course of 2017.  My hope is to see an open market available at any time during the year (like it used to be) instead of an abbreviated Open Enrollment Period.  

    Below are some key points to a Donald Trump-Care system and a link to his Healthcare Reform Paper which goes into more detail...



     1. Completely repeal Obamacare.
     2. Modify existing law that inhibits the sale of health insurance across state lines.
     3. Allow individuals to fully deduct health insurance premium payments
     4. Allow individuals to use Health Savings Accounts (HSAs).
     5. Require price transparency from all healthcare providers.
    6. Block-grant Medicaid to the states. 
    7. Remove barriers to entry into free markets for drug providers that offer safe, reliable products.

    How swiftly changes will be made remains to be seen.   Trump has indicated that these changes represent one of his highest priorities so I would expect solid information early in 2017.  Donald Trump's Vision for Health Reform are also on his website.

    Stay tuned as updates come in and visit us at www.davefluker.com 


    Health Care and Sleep Apnea

    One of the most challenging aspects of sleeping soundly is a health issue known as sleep apnea. It is a common disorder that causes interruptions in breathing during sleep, preventing oxygen from reaching the brain. Sufferers wake hundreds of times per night, each time normal breathing is interrupted and the brain is depleted of oxygen.

    As a result, they never feel rested and experience excessive daytime grogginess. It is not a disease but increases risks of contracting other diseases and conditions. There are three types: obstructive, central and complex, which is a combination of the first two, according to SimpleSleepSolutions.com.

    Central Sleep Apneais caused when the brain fails to properly signal the muscles to breath. It is very uncommon and snoring is generally not a symptom.

    Obstructive sleep apnea (OSA) is the most common form of sleep apnea, with some estimates at 1 in 7 people in the U.S being afflicted with some form of OSA. In OSA, the muscles around the throat and airway relax, causing the airway to collapse. Sometimes the tongue falls back and obstructs the airway. The brain can no longer receive oxygen and sends a signal to the muscles to open, often causing the person to wake up with a gasp or a snort. Most of the time, sufferers do not recall waking up during these episodes.

    More than 18 million adults have sleep apnea, according to the National Sleep Foundation. It is very difficult at present to estimate the prevalence of childhood OSA because of widely varying monitoring techniques, but a minimum prevalence of 2 to 3% is likely, with prevalence as high as 10 to 20% in habitually snoring children. More information is located at this website: https://sleepfoundation.org/sleep-disorders-problems/sleep-apnea/page/0/1.

    Sleep apnea can make you wake up in the morning feeling tired or unrefreshed even though you have had a full night of sleep, according to the American Academy of Sleep Medicine. During the day, you may feel fatigued, have difficulty concentrating or you may even unintentionally fall asleep. This is because your body is waking up numerous times throughout the night, even though you might not be conscious of each awakening.

    The lack of oxygen your body receives can have negative long-term consequences for your health. This includes:
             High blood pressure
             Heart disease
             Stroke
             Pre-diabetes and diabetes
             Depression

    If you sleep on your back, gravity can cause the tongue to fall back. This narrows the airway, which reduces the amount of air that can reach your lungs. The narrowed airway causes snoring by making the tissue in back of the throat vibrate as you breathe. Obstructive sleep apnea in adults is considered a sleep-related breathing disorder. Causes and symptoms differ for obstructive sleep apnea in children and central sleep apnea. More info is available at this site: http://www.sleepeducation.org/essentials-in-sleep/sleep-apnea.

    Anyone can develop it, regardless of gender or age, and even children can be afflicted, according to Simple Sleep Solutions. The most common risk factors include:
             Excess weight, especially obesity � about half of all OSA sufferers are overweight
             Male, although recent research has indicated that women�s risk increases to about the same level as men once they reach post-menopausal age
             Over the age of 60
             Smoking
             Enlarged tonsils and adenoids, one of the most common factors for children with OSA, particularly overweight children
             Having certain anatomical features such as a thick neck, narrowed airway, deviated spectrum or a receding chin
             Using alcohol, sedatives and tranquilizers, all of which relax the muscles in the airway
             Having asthma, in adults and children, particularly if they are overweight
             Race and ethnicity can play a part as well � some studies have indicated African Americans, Hispanics and other races have a slightly higher risk
             Allergies and chronic nasal congestion

    Only a doctor or sleep specialist can confirm if you or a loved one is suffering from sleep apnea. More information is available at this website: http://www.simplesleepservices.com/what-is-sleep-apnea/.

    According to the National Institutes for Health (NIH), Doctors diagnose sleep apnea based on medical and family histories, a physical exam, and sleep study results. Your primary care doctor may evaluate your symptoms first, and will then decide whether you need to see a sleep specialist. Sleep specialists are doctors who diagnose and treat people who have sleep problems. Examples of such doctors include lung and nerve specialists and ear, nose, and throat specialists. Other types of doctors also can be sleep specialists.

    If you think you have a sleep problem, consider keeping a sleep diary for 1 to 2 weeks. Bring the diary with you to your next medical appointment. Write down when you go to sleep, wake up, and take naps. Also write down how much you sleep each night, how alert and rested you feel in the morning, and how sleepy you feel at various times during the day. This information can help your doctor figure out whether you have a sleep disorder.

    Sleep studies are tests that measure how well you sleep and how your body responds to sleep problems. These tests can help your doctor find out whether you have a sleep disorder and how severe it is. Sleep studies are the most accurate tests for diagnosing sleep apnea. There are different kinds of sleep studies.

    If your doctor thinks you have sleep apnea, he or she may recommend a polysomnogram (also called a PSG) or a home-based portable monitor. Testing can show patterns and symptoms that can help lead to a diagnosis and treatment options. More information is available at this site: https://www.nhlbi.nih.gov/health/health-topics/topics/sleepapnea.

    According to HelpGuide.org, if your sleep apnea is moderate to severe, or you�ve tried self-help strategies and lifestyle changes without success, a sleep doctor may help you find an effective treatment. Treatment for sleep apnea has come a long way in recent times, so even if you were unhappy with sleep apnea treatment in the past, you may now find something that works for you.

    Treatments for central and complex sleep apnea usually include treating any underlying medical condition causing the apnea, such as a heart or neuromuscular disorder, and using supplemental oxygen and breathing devices while you sleep. Treatment options for obstructive sleep apnea include:
             CPAP
             Other breathing devices
             Dental devices
             Implants
             Surgery

    Medications are only available to treat the sleepiness associated with sleep apnea, not the sleep apnea itself. Much more material on this health care issue can be found at this website: http://www.helpguide.org/articles/sleep/sleep-apnea.htm.

    According to this website: http://vjpillow.com/sleep-health-benefits-science/, there are at least 8 reasons why sleep is important to you. Check out how you benefit from getting good sleep; it's important to your health.  

    Since so many people suffer from sleep apnea, it is perceived as a very common problem, but not that many take steps to deal with the problem. As sleep apnea can result in long term more severe health issues, it is advisable to see your doctor for a solution that is to your benefit. If you have it, or think you do, get help. You�ll sleep better for it.


    Until next time. 

    CA Small Group Special Enrollment Coming Up

    One of the provisions of Obamacare is an annual one month guaranteed issue  "Special Enrollment" window for small employer groups.


    The Guaranteed Issue Special Open Enrollment period runs from November 15th to December 15th each year for a January 1st effective date.
    Carriers are required to offer a special open enrollment window to Small Employers that do not meet carrier participation and/or contribution requirements. These groups must meet all other Underwriting Guidelines. Small Employers that have struggled to attain coverage due to participation or contribution requirements can obtain coverage during this special open enrollment window.  

    Small  employers who have not been able to establish a group plan due to low participation among employees and/or wishing for lower contribution requirements can use this special enrollment window to establish a plan.

    With all of the havoc in the individual health markets (particularly tiny networks and ever-changing drug benefits/formularies), now might be a good time to take a look at setting up and employer-sponsored program.  

    Dave
    www.davefluker.com

    November Is National Diabetes Awareness Month - Here's My T1D Footprint - What's Yours?

    November is National Diabetes Awareness Month, (#NDAM, for those who only speak in hashtags) - a month where where we "bust diabetes myths and perpetuate diabetes realities," to those sans diabetes. 

    And JDRF has created a very cool tool that calculates your t1D footprint. http://www.jdrf.org/t1dlookslikeme/

    We spend so much time dealing with our diabetes - now we have an easy way to get our own personal breakdown of our D numbers to help us educate others - and to remind us of how hard we work!
    What's your T1D diabetes footprint look like? 

    Also, if you live with LADA1.5 or t2, you work damn hard, get your D stats, too! 
    I haven't had a day off from my #T1D ind 14,246 days! 

    New Medicare cards are coming starting in April

    The Centers for Medicare & Medicaid Services (CMS) will start mailing redesigned Medicare cards to beneficiaries in Washington state aft...