In Pursuit of Quality of Life
I want top-notch Quality of Life, gosh darn it, but where and how do I get it?
with Amy Tenderich
Editor's Note: While this columnist is no longer writing for dLife.com and we have ceased to update the information contained herein, there is much to be read here that is still applicable to the lives of people with diabetes. If you wish to act on anything you learn here, be sure to consult your doctor first. Please enjoy the column!
August 2007 —Being diagnosed with type 1 diabetes in my mid-30's (in 2003) definitely helped me refocus: Why waste time fussing over the bad, the annoying, and the petty, when you can decide to proactively concentrate on all the good things in life?
I want top-notch Quality of Life, gosh darn it, but where and how do I get it? It's a rather elusive concept, I know. Check for it on eBay and you get everything from bass fishing T-shirts to Spiderman novels.
My QOL Challenge
A neighbor of mine whose brother was recently diagnosed with cancer was overheard saying, "You know, you have to enjoy every day of your life. You should live every day like it was your last!"
Naturally, I just had to retort: "Yeah, but if we all followed that principle, nobody would ever work, ‘cause who wants to spend their last day on Earth working??"
So you see my challenge. I'm a cynic at heart. And now I've got this disease that unquestionably takes a bite out of my Quality of Life (QOL). Diabetes robs us of the carefree lifestyle and unquestioning confidence in our own bodies that most people take for granted. It also intrudes in our daily existence by demanding to be continually monitored and fed medicines – otherwise subjecting us to bouts of high and low blood glucose that feel unpleasant, at best.
There's no shortage of talk about Quality of Life in healthcare. Makers of medical devices want us to know that their solution will greatly improve it for patients like us.
On the one hand, this is great, because it helps offset the "noncompliance" concept (blaming the patient for not following doctor's orders). Of course patients are going to slack off – or even actively rebel against – treatments that are inconvenient, painful, and costly. Whoa! That would describe most of the stuff we're expected to do for our diabetes, no?
What it comes down to is that everything in life is a trade-off. Of course I want good BG control as part of my improved Quality of Life. But I also want to have a life. Here are two examples of how some new diabetes devices affected my QOL:
1) Continuous Glucose Monitoring
I used the first-generation DexCom CGM for five months straight last year. This is a short-term sensor that wirelessly transmits glucose readings to a hand-held receiver, providing real-time continuous BG measurements.
I was very excited at first, but soon realized how inconvenient the system was to use: it required four or more calibrations per day, which are possible using only one specific traditional fingerstick meter model (which I happened to hate). It also had extremely loud alarms that cannot be adjusted or disabled, and since the accuracy wasn't all that great, the unit would often beep my husband and I awake all night for no good reason. Finally, this first-generation product was not waterproof, meaning I had to apply a single-use special plastic cover (at about $1 apiece) every time I wanted to shower, bathe, or swim. The shower patches irritated my skin beyond tolerance; the marks sometimes lasted for a week or more. In addition, the sensors cost $125 a pack, and were not yet covered by health insurance.
So thumbs down on QOL for that product, for the time being anyway. (I have just received a next-generation DexCom SEVEN unit that promises to do away with many of the negatives)
2) Wireless Insulin Pump
I became an insulin pumper late last February, using the new OmniPod tubeless insulin delivery system. Moving to a pump not only banished needles from my life, but also all but banished the dreaded math that made insulin dosing so difficult. Before, I had different carb-to-insulin ratios throughout the day. Now the continuous flow of background insulin has evened that out, and the "bolus wizard" feature helps me automatically calculate doses for every meal and snack.
I also schlep less diabetes gear around, since the OmniPod features a built-in glucose monitor. And the insulin pod is waterproof, too, so no need for plastic covers on my body.
In short, this single, cable-free, easy-to-use device has allowed me to eat, swim, sleep, and exercise as I like. It has helped push this disease into the background, so that my energy and time can be spent on more pleasant things. What a gift!
Finally, the system and supplies are covered by insurance, and my co-pays are not much higher than what I was previously paying for injection supplies. Thumbs-up on QOL all around for this one!
No Pain, No Gain?
In pursuit of QOL, the fundamental question is: how much are you willing to compromise? If you suffer from severe hypoglycemic unawareness, then a few calibrations a day and a little unnecessary beeping is a small price to pay for the QOL boost you'll get from wearing a continuous monitor.
Me personally, I'm going for the diabetes devices that genuinely reduce bleeding, itching, schlepping, and the strain on my bank account.
So where can we pick up some more Quality of Life? According to Amazon.com, it's available for 50% off right now at "Total Discount Vitamins." Sigh.
* Amy Tenderich is co-author of the new book, Know Your Numbers, Outlive Your Diabetes.
Read more about Amy Tenderich.
dLife's Viewpoints columnists are not all medical experts, but everyday people living with diabetes and sharing their personal experiences, most often at a set point in time. While their method of diabetes management may work for them, everyone is different. Please consult with your diabetes care team before acting on anything you read here to find out what will work best for you.
As I mentioned in an earlier post, one of the benefits that made it cost-effective for me to go with the real healthcare (HSA) plan rather than the phony (HRA) plan is that my company is now covering "preventative" medicines at $0 copay. The formulary for these, as stated by CVS/Caremark (my pharmacy benefits provider), covers all test strips, lancets, and control solutions. I dutifully get my doctor to write up prescriptions for all of my testing needs, submit...