8.16.2013

Appeal

Well we are being forced to appeal.  Our insurance declined Katie for the pump.  Which was fine....but she's been on the insulin injections now for almost two months and in that time she has not stabilized even a little.  Granted I don't mean stabilize like how most people think.  I expect there to be some highs and lows...but what I don't expect with her blood sugar is for Katie to go from the 200s and rising fast to then falling fast to the 100s and lower.  It's wreaking havoc on her system and making her too sick to want to do anything.  This is an active woman.  She's always on the go.  It makes me so sad to see her SO sick and not wanting to dress up, wear makeup, go out with friends or do anything.  And it's not depression- it's simply the damn numbers.  She's sick of the first thing her family asks - "What does the dexcom say" or "what are your numbers?"  And I don't blame her at all!

Needless to say- after seeing the endo in the last few weeks....they've changed her insulin again.  The lantus was doing the job but it was causing her bleeding and burns and they switched her to Levemir.  Some idea but not as flat or long lasting as Lantus.  Which works better (aka no burning or bleeding) BUT doesn't control the blood sugars as well.  In addition to this- her Humalog was changed from the kwik pen to cartridges.  This was to help her do smaller increments of insulin.  They adjusted her insulin to carb ratio too.  (More on calculating that in another post!).  All of this wordiness to say that I basically wrote with Tenney's help (Thanks Tenney!  You are a DOLL!).  I used a few sample letters I found online but entered in a bunch of information on my own.  Referenced the American Endocrinologist's Association and their recommendations.  Then if that wasn't enough I decided to look up some journals and directed them to actual tables and data that I read.  I am hoping all this plus the Dexcom data is enough to convince them that Multiple Daily Injections (MDI) therapy is not the answer for Katie and insulin therapy is.

I want a world where an artificial pancreas is available and there is a cure for Type 1 Diabetes.  An artificial pancreas is the insulin pump and CGM all rolled into one and it talks to your phone on an app.  In addition to this..it is able to calculate how much insulin automatically that your body needs based on the concentration of sugar in your blood.  That's a pretty awesome device.  It's in trials now and I hope it gets through quickly.  I really do!

Keep us in your thoughts.  I'll update here when I can.  I'm about to be in the field next week so won't be posting as much and classes start again for me in two weeks on Monday.

I'll post our appeal letter here after all is said and done for those that might want a template to use. Right now I don't want to do anything to hurt her process.  In six months we can get it and for free but to see your child so sick from highs and lows- you are willing to do anything for her.  Fingers crossed!  (Toes too!)

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