SCOTUS Hangover…  (a brief aside before we talk Diabetes)

After yesterday’s Historic ruling on Gay Marriage (Read my post: Justice Arrives Like a Thunderbolt!) I must confess that I want the celebration to continue.  It feels weird picking up writing on this blog post on Saturday, where I left off on Wed evening.

Yesterday my Facebook feed exploded with joy and rainbows!  I had to be part of the excitement, so went out last night, saw the rally at Oaklawn & Cedar Springs and hung out with my cousin and a friend I had not seen in approximately 20 years.  The joy, the love, the relief that Marriage Equality is now law, and the energy last night being around my fellow LGBT folk, was just amazing.

Rally / March in Oaklawn, Dallas TX

Rally / March in Oaklawn, Dallas TX

Banner at the Dallas Eagle

Banner at the Dallas Eagle

Banner at the Dallas Eagle

AND when I started writing this post, back on Wed night, the fate of the Affordable Care & Patient Protection Act was not yet announced.  That was upheld on Thursday.  Yay!  So, in less than 48 hours, two of the most important Supreme Court decisions of my lifetime came back to back — both of which directly impact me.  Wow!

I’m now free to marry who I love, assuming I can find a fella!  LOL

And I’m now fairly certain that I will always have access to quality health care.  Yay!

I’m going to do something weird in this post.  The “comments” from Wed night are going to stay, but where I was expressing doubt, I’m going to put an BEFORE label and add an AFTER comment.

Why? Because the ACA law is important.  It is important to me on a very real, very personal, very day-to-day level.  And by doing it this way, anyone who reads my blog may perhaps realize that this is not a philosophical debate.  It is literally about life and death.  Read on faithful readers, read on…

Uhmmm… by the way, we’ll keep the fact that as a newly diagnosed diabetic I should not have been drinking beer last night between thee and me.  Nobody tell my doctor!  Sssssshhhhhhh!

“You Need a Blood Glucose Meter…”

…said my doctor.  And I said “What’s a Glucose and why is it in my blood?

Ok, maybe I didn’t actually say that.  But to me Glucose is something that is related to Gatorade, a distant cousin of Fructose and Sucrose and… well, you get the idea.  It is sugar.  It is all sugar.  And “sugar” is a special kind of carbohydrate.

Standard disclaimer…  I’m not a doctor –  You should verify everything I say and always consult with your doctor on medical decisions.

What I’m sharing with you here is info I’ve learned since being diagnosed with Diabetes and that info has gone into Tony’s head and been mixed around with all the other stuff up there and seasoned with a bit of my patented “Ton-NAY Drama” and is being blurted out here for the enjoyment and befuddlement of you, my loyal readers.

All two of you —  two, or is it thousand?  the whole number thing confuses me.  😉

If you’re diabetic and you need to test your blood daily, what you need is this:

1. A computer widget thing-a-ma-bob called a “Blood Glucose Meter” that ranges in size from an Oreo cookie to the size of a deck of cards. This widget is a specialized electronic testing device to measure the amount of sugar floating around in your blood.
2. You need disposable needle thingies that you stick yourself with to draw blood.  They are called “lancets.” I thought I’d try to use steak knives and save some money but my doctor gave me one of those “Mom Looks” which they hand out to doctors at the same time they get their Medical Degree.  So I quickly and wisely decided that I’d get the lancets and nix the whole cutting myself with knives thing.
3. You need these disposable strips onto which you smear your blood.  Then you stick one end of the strip into the machine and a few seconds to a couple minutes later (depending on the machine) you get a number pop up on the screen on the front.  That’s your blood glucose number.

A Word about the ACA and Insurance

Thank Heaven for President Obama and his allies who pushed through the Patient Protection and Affordable Care Act.  If not for that bill, I’d be uninsured and my goose would be basically cooked.  At present, my only option is to obtain insurance is through the ACA.  Without it I literally would not even know I have diabetes, let alone have the money to treat it.

BEFORE (written Wed night) — If there is any justice in the world, pun deliberately selected, then the Supreme Court will hand down a decision that allows me to continue getting subsidies that allow me to be able to have insurance.

AFTER (written today) — the court has ruled. The ACA is here to stay!  Here is President Obama’s press conference after the Court Ruling:

This law is vital, because medicine is expensive.  Medical treatments are expensive.  And the ACA is worth every penny it costs. Read more on my earlier post on this topic: Where Tony’s been hiding and Thank Heaven for the Affordable Care Act

If you don’t have insurance through your work.  And you don’t qualify for Medicare or Medicaid then check into the ACA at Healthcare.gov

Heaven help anyone without insurance who is diabetic.

Glucose Meter

• Check with your insurance company.  My company, Blue Cross Blue Shield of Texas, covers the cost of the meter at 100% including free Two-day Shipping to my home.  Yay!
• The true “expense” in using the meter is not the meter itself however.  It is in the monthly supply of testing strips that you have to buy for use with the meter.

So, when I found out I needed a widget like this, I did what any red-blooded-former-librarian would do I went to Consumer Reports to see what they said in their review of the devices.

Consumer Reports reviewed both Blood Pressure Monitors and Blood Glucose Meters in their May 2015 issue on pages 48-49.  Here is the ranking chart for the Blood Glucose Meters:

More about test strips in a moment, but if you look at the Annual strip cost in the column below you’ll see where these companies really make their money.

And you’ll see that for a person like me who lives on a small pension and a few odd jobs to supplement that, there is NO WAY I’d be able to afford those kind of costs.

Which made the choice of machines obvious:  Either get the Up & Up from Target or the ReliOn from Walmart.

So… I check costs, about the same. When I checked last week (around June 15, 2015) the Up & Up was $14.99 on the Target Website.  The Walmart Relion Micro was $14.98.  For those without a store nearby, shipping and handling is extra.

So.. I check store locations:  Walmart by far has more stores than Target.  Which means getting the strips would be easier.  However both Walmart and Target have locations near where I live now and where I’ll probably be living a year from now.

And since, according to consumer reports the test strips are pretty much the same cost on an annual basis it seemed almost a toss of the coin as to which one to get.

I decided to get the Up & Up from Target.  Because I like Target better than Walmart as a store to shop in.  And because red is my favorite color.  And because the rating for the Up & Up is slightly better according to CR than the Relion.

Then Blue Cross Blue Shield Weighed in…

I logged into the customer area of the Blue Cross Blue Shield website and emailed the company for information about Blood Glucose Meters and Testing Strips asking about what BCBS covers.

I got the info back that if I call a special 800 #, that BCBS had set up I could get a FREE Blood Glucose Meter:  Their email said that I am getting the “CONTOUR NEXT EZ System / CONTOUR NEXT System.”

Those are two different version of basically the same device.  The Contour Next is number 3 on the Consumer Reports chart and the only one with “Excellent” in the Accuracy, Repeatability, and Convience categories!  Woo Hoo!

I called on the 23rd.  The very nice lady on the phone said that it would be shipped two-day via UPS so I should get it on the 25th or the 26th.  Woot!

Honestly I was shocked by how easy it all was.  Based on my past experience with Blue Cross Blue Shield I was ready for a fight and prepared to go nuclear on them and report them to the Texas Dept of Insurance if I had ANY issues AT ALL.

I’ve filed a formal complaint on them before and I’m prepared to do it again at the slightest hint that they are not honoring their commitments. But I’ll save all that drama for another day and another post because this post is already too long.

Anyway, everything went off with no issues.  BCBS responded within 36 hours to my request for information.  I called the 800# and only had to wait 10 minutes to speak with someone.  She took my address, name etc and boom. I was done.

So… check with your insurance company.  Because what they cover will determine in large part what you get. The information may be in your Policy Handbook, on their website or you may have to actually call an 800 number or email the company to get an answer to the question “what does my policy cover?”

In my case it worked out, but I was prepared for trouble.  Which brings me to the lancets.

You gotta stick yerself.

Logically lancets are the next bit you need to think about, because without the lancet there is no blood to put on the test strips.

If you have a blood fetish and giant posters of sparkly vampires and Buffy adorn the walls of your house then you might get into the idea of drawing a little bit of blood every single day, one, two or even 3-5 times a day, depending on what your doctor tells you.

But I’m not into blood.  Not into pain.  Not into tiny needles pricking my skin.  shudder

I’m sure I’ll get used to it but for now I’m not looking forward to it.

What I’ve discovered is that there are two kinds of lancets.  (1) A fancy pen like thing kinda like a utility knife that you buy at Lowe’s only thinner, smaller and in pretty pastel colors  But the principle is the same.  You have a holder and you put a disposable needle/blade into the “holder” and there is (2) a completely disposable widget – use it once and throw it away.

There are several dozen different brands of lancets and more models of lancet holders than there are models of cars.  Let your insurance be your guide.  Get whichever one they will pay for.

My insurance has several brands that it will pay partially – I end up paying a copay of $10 per month for the lancets.  Since I’m getting the Bayer Contour, I figured I’d make all the bits match so I’m getting the Bayer Microlet lancets.  These lancets are tiny cartridges which click into the Lancet holder.  A hundred comes in each box which depending on your testing schedule means it will last 1-2, perhaps 2 1/2 months.

Bottom line:  you have to do your homework to get the lowest cost.  Read your policy manual carefully.  Again, thank heaven for the ACA aka “Obamacare”  without it I’m up a creek with no lancets.

The Testing Strips / How often should you test?

They have to match your testing device.  So, since I’m getting the Bayer Contour Next, that means I have to have the Bayer Contour System Testing Strips.  To get the insurance to cover it, I had to have my doctor write a prescription, just like a drug and send it to Walgreens.

How often you need to test depends.  Ask your doctor.

I have an appointment with my Doctor on July 7th and I’l talk to her then about it.  Until then I’m going to take the advice of the Pharmacist at Walgreens.  Yes, the actual pharmacist, not the very nice clerks who ring up things.  The trained professional person.

She said that I should (1) Test as soon as I wake up in the morning, before eating or drinking anything and before taking my meds.  Then after eating breakfast and taking all my meds, (2) I should take a second test about 2 hours later.

She said it is important to be consistent in when the second test is done.

My doctor wants me to record everything and show her the numbers when I see her each month.

The Insurance and their love of fine print.

Ok, here’s the deal.  My doctor wrote my prescription for the test strips for me to test two times per day.  100 per box / 2 per day = 50 days.   Which is 10 days short of two months.  But because it is greater than a 30 day supply my insurance is insisting that I pay $20 in copay because they view a 100 count box as a two month supply and my insurance will only cover a 30 day supply at the $10 copay level.

BUT… the 100 count box is as small a box as they sell!

So, I’m faced with a choice, either ask my doctor to tell me to test 3 times a day (and write a prescription to match) or just accept that I’m going to be paying for two months but not getting enough lancets and strips to last for two months!

Especially since I’m new at this and I end up messing up both lancets and test strips.  Yesterday, the vampire that is disquising as a blood testing meter kept beeping for “more blood” because I was messing it up.  I went through FIVE strips and three jabbed fingers before I finally got a good reading.  Hey it is a skill like any other skill.  It will take me time to get it right.

This morning I was able to do it in a single try!  Woot!

So, take a deep breath and do your homework.  You may have to work with your pharmacy, your doctor, and your insurance company to get things set up so that you can do the testing on your budget.

After talking to the benefits department at BCBS, and translating their legalese into normal human communication, I thought, “I’ll call Walgreens” and talk to the pharmacist and see if there is anything they can do on their end.”  I don’t know exactly what she did to the Rx but when we were finished speaking on the phone, my first box of strips will now cost me $10 not $20.

She cautioned me to check the price next month and if it switches back to $10, she recommended talking to my doctor and getting the prescription changed to be “test 3 times a day.”

And frankly I have no issue with that.  It will give a better data set for her to determine if the drugs are working or not.  And if it turns out that I only need to do 2 times a day at some point, well it isn’t like I plan on stockpiling these strips.  I will only re-order the Rx when I’m getting close to needing more.  If that works out to be every 30 days or every 50 days then it doesn’t matter to me. What matters is that I’m paying $10 not $20.

My prescription for the lancets has not yet been sent over by my doctor.  I think that there will be no problem with that one however because, according to Blue Cross Blue Shield, the negotiated price on the lancets is 9.88 which means that since my copay is $10, then I’ll pay full retail for the lancets.  Not sure how or why that is the case and I won’t believe it until I’m standing at the Walgreens counter with the Rx in my hot little hands, but hey, if that’s how it turns out then awesome.

Sticking it to yourself and feeding the electronic leech / vampire:

YouTube is an awesome resource.  Lots of people have loaded “how to” tutorials for doing the testing.  And reviews of different products.  The two that actually ended up being the most helpful actually came from the Bayer Company itself:

and

Check on YouTube for videos about the device you use.

I hope that sharing my own learning experiences with all you guys has been entertaining and helpful.  Fell free to comment, share etc.

See ya on the dance floor!