Tag Archives: medicare

Diabetes, expenses, family, government, Juvenile Diabetes, medicare

Private Insurance

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our daughter has a pump – an insulin pump delivers a steady amount of insulin via a needle that stays in place for 3 days and then is moved to a new site. At present it is the closest thing to an artificial pancreas available and it allows her to live a much more ‘normal’ life. She can sleep in, she can skip meals and she can eat a big meal (like Thanksgiving).

On regular injections it is necessary to balance meals, have snacks available and to get up in the morning by 7:00 in order to have the first needle of the day and eat breakfast. Sure, this doesn’t sound like such a tough deal and in the scheme of things, it isn’t. We tend to coddle our kids, I know that, but after coming so close to losing her, we have damn good reasons for going out of our way to spoil her now and then.

The real benefit of the pump is that when kids go on them they don’t have as many dangerous lows and it’s easier to keep blood sugars down at a decent level. Okay, in our little sugar plum’s case, she hasn’t been doing so good at keeping the levels down but that’s another issue – the good thing is she isn’t having lows and we haven’t had to phone the ambulance or break out the emergency glucose once since she strapped on the pump.

Breaking out the emergency glucose is one of those things you do when you notice she isn’t responding to questions or making any sense. Her eyes are starting to roll around and it is only a matter of seconds before she’ll be unconscious – so find candy or honey or glucose and fight to get it into her mouth. … And plan on spending the next few hours or the whole day just napping with her and getting her back on track because brain cells have died and she won’t be able to focus clearly on much for the next little while.

It is one of those things that shorten lives, leads to amputations and all the other delightful complications of diabetes. And, to get to the point here, some insurance companies providing extended medical benefits cover pumps and some don’t.

My husband’s company switched extended medical insurers recently. Guess which one we have now.Well, not exactly…they said they would cover whatever the previous company covered. When the claim went in for our daughter’s new pump it was denied. We appealed based on the fact that they are supposed to cover whatever the previous company covered. Well, it seems, in the opinion of the current company, the previous one shouldn’t have covered it, it was a mistake and therefore this one isn’t going to.

There’s an old joke from the days of the Jim Crow laws in the southern United States.  An old black man is told he has the right to vote in the election and appears at the polling station. A good old boy is the returning officer there and smiles at the black man holding out his id.

“Well, boy, if y’all wanna vote, y’all gotta pass a litteracccy test. Here, read me a bit outta this newspaper.”

And he holds out a chinese language daily to the old man who takes it and looks it over for a minute.

“Well, boy, can you pass this here litteracccy test or not? … go on, tell me what it says….”

The man takes a long look at the paper and then at the returning officer, “Why sure I ken read it, suh”

The good old boy sat bolt upright and snarled “Whaddya mean you ken read it, you aint no more Chinee then I am..”

“Why look it this, see, it say right here, ‘This n-r ain’t gonna get no vote.”

I’m thinking of taking chinese lessons ’cause something tells me, we’re gonna need it for the next round with the insurance company.

Pumps and pump supplies are part of the medicare system in other provinces…that’s the difference between private medical insurance and public…Unfortunately we live in a province that is trying, by hook or crook, to move us to a privatized system.

Lots of us are gonna have to learn to read between the lines soon.

government, health, Juvenile Diabetes, medicare

It hurts other places too

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direct costs for aproximately 1 month:

Pump supplies – infusion sets – $318

– syringes – $118.

test strips $ 75.00

insulin $135.00

Pharmacare is an interesting system. It covers some things but not others, lancets but not test strips, for instance or one type of insulin but not another. It was also ‘improved’ so that it doesn’t start covering drugs until a you’ve paid out a certain amount on your drugs. At that point it starts at a scaled percentage of the cost, gradually increasing the amount it covers.

It resets every January 1 and despite paying in over $1,200 a month with all our different prescriptions, we still haven’t hit the pharmacare threshold and it is the end of March.

A good extended medical plan helps a whole bunch, fer sure and I can’t imagine how families without one manage to cope with all the costs. Yes, it is evenutally, tax deductible but between refund time and the next year, most folk like to eat and maybe pay the rent and, believe it or not, go to the odd movie. Yes, poor folk deserve a movie now and then too.

If it wasn’t for our socialized health care system, we’d have gone under a long time ago. That is why, next to Dr. Banting, my big hero is

Tommy Douglas

But more about him later.

family, health, Juvenile Diabetes

Good night nurse

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I learned of Trudeau’s death when taking a few minutes to grab a coffee in the parents’ lounge on the Pediatric Ward. It was my third day there – I’d been sleeping on the floor by R.’s bed each night until, finally, one of the nurses suggested I see if a bed was available in the parents’ quarters just down the hall. I suppose they’d hoped I’d go home each night but that wasn’t going to happen until I was sure she was out of the woods.

It was something I had to do. The thought of her waking up in the night – and she was being woken up two or three times a night for blood work at this point – surrounded by strangers was not a good one. After all she’d been through, the least I could do was be there when the nurse came around to take a little blood.

Once R stabilized on the insulin and her fluids were back up, they took out the IV. It had been very handy for all the blood tests needed to keep up on her metabolic state of affairs but IV sites are notorious for infections. So, for some blood work they could get enough by warming up her fingers and using a large lancet, milking the blood into small vials. For most of it, though, the quantity needed really called for getting it from the arm. The inside of her elbows were getting pretty chewed up from all the needles the blood work required.

On the third night it was a new nurse who came around with the tray. She seemed a bit put out at having to come to the ward – maybe she’d planned a nice quiest night, maybe she’d been held over on her shift, I don’t know but there was an attitude I hadn’t seen in any of the other blood-letters.

She grabbed R.’s arm, looked at it, snuffed. Went to the other side and grabbed that arm, snuffed again. With a heavy sigh she took up her needle and started the tie-off. She inserted the needle, muttered – she’d missed, pulled it back a bit and pushed again, muttered, pulled it back and angled another way. By now R was getting distinctly uncomfortable and was whimpering. I was appalled at what I was seeing and gripped the bed rail to keep from leaping across the bed to grab the woman by her throat.

She clumped over to the other arm and started again. Same thing, pulling back and angling another way, pulling back, angling. R was in tears now. The nurse just tossed her gear on the tray and said someone else would have to give it a try, she wasn’t getting anywhere and off she went. I was shaking by this point, followed her out and went to the nurse station.

“I don’t ever want that woman to touch my child again.” The nurses looked up in total surprise. They had grown used to my being there, sleepy at times, encouraging always and making little humorous comments to keep spirits up but this time I was white. “If she comes near R., I will put her through the wall.” One of the nurses came with me and took a look at my dear’s little arms which were actually swollen to the point she couldn’t bend them anymore. I described what I had seen. The nurse said that I could have told her to stop at anytime and that protocol is if the needle misses on the first try, it is to be removed completely and the other arm used.

She called up another phlebotomist – a sweet, obviously gay male nurse. He took a look and was shaking his head. They’d have to use finger vials because there was no way any of her arm veins could be used with all the swelling there. He apologized profusely and said he would make sure to take care of R. himself from now on for any night time blood work.

The ward nurse confided to me that the other leech, the night butcher, as I took to calling her, had a reputation for being impatient with children. She wasn’t usually called out to the ped’s ward. All I knew is she wasn’t going to be allowed within sight of me for a very long time.