Dexcom G4 Platinum has landed at our house!

Katie has a new tool which is going to be super helpful in managing her diabetes!  These little devices are NOT cheap.  Our insurance discounted it down to $1600 roughly and $300 a month for supplies.  After we meet our deductible it will be covered 100% though (that is what we are waiting for!)

A continuous glucose monitor (Or CGM) is what Katie is now wearing.  It inserts via a catheter-type needle and stays on her body for 7 days.  Before we got this CGM we were testing her blood via a traditional glucose monitor about 12 times a day or more.  I don't think people realize- but diabetics must test their blood before every meal and bedtime.  In addition to this, because Katie drives she has to test it before she gets in the car also.  Then she needs to test when her numbers seem low or high.  We go through strips (at a $1 a strip) like they are water.  A CGM will enable us to only have to calibrate it every 12 hours and then test the normal 4 times a day.  It's important to note that this will show us trends...but that the device is giving us blood sugar levels from her interstitial tissue- NOT her actual blood.  So it has about a 15-20 min delay.  But it can tell us when she's rapidly increasing, decreasing or hitting lows.  She can then test with a traditional meter and compare levels.

The important thing for Katie is that this device will beep at her incessantly when she's sleeping until she wakes up when she's low or high and deals with it.  This is key for someone who does not recognize her low blood sugar.  She's had a few episodes at work before this CGM where she didn't recognize she was getting low and thank goodness her fellow employees did and got her to sit down and get some carbs into her system.

This device allows her to live more normally.  It checks her blood levels for her every five minutes.
I will say that the set up is clunky.  I can only imagine it will be smaller and easier to insert with every new release.  She has to put this sensor on and it has a sticky pad that sticks to her stomach and then at first it's got this plastic tube on it.  That tube houses the needle.  She needs to push it into her stomach and the needle then stays in place.  The sensor is waterproof and she wears it for 7 days before she makes a change. The receiver itself is good for about a year before you have to replace it and is NOT waterproof but she can keep that nearby.  She currently wears it like a pager almost.  I hope future versions will eventually link it to a cell phone so you don't have to have that big pager thing with you.

When she gets a pump she will have two devices she will need to carry.  I'm so grateful that Humana approved this CGM.  I finally got a good night's sleep knowing that it would beep at us if she had a severe low.  We will post more information as we learn more.  Right now we are working on getting the software on my laptop and then the receiver will download data for us that we can see trends on.  She can enter carbs and insulin units also and the device will calculate what is going on and when.  So priceless..

This is a way for her to check her blood sugar and make corrections while on the go.  She can check when we exercise, she's out running errands, at work, etc.  Priceless!!!

And so we wait

We got the official call that there is no way around their black and white policy.  They didn't care about the reasons why this is important now- we simply have to wait 6 months.  Which is fine.  She's upset but will survive..she's a fighter.  It's just hard to manage with how active she is, etc.  Now to wait and see about the Dexcom G4.  I'm hoping that they approve that.  Please..we can stand some good news.  So fingers and toes crossed..I'll post an update here as soon as we know.

Wonder what they can deny next?  The bright sunny lining on all this?  The pump will be free by then.  Late december is when the six months of starting shots it.  June 26, 2013...so I don't forget.  On December 26, 2013 we can put in a request for it again.  Here's hoping they don't decline a 2nd time.

By then though - Obamacare kicks in and we might be changing up our policies anyway.  She may choose to use Starbucks insurance...it's all a mystery right now....

Denial is a river in Egypt?

Yes we got the "dreaded" denial call. I don't get this.  We have an 8500 deductible.  So if you make us wait 6 mos (the reasoning was that she hasn't been on insulin shots long enough- but wouldn't her endo actually be the better one to make that call insurance company?) - we get the pump FREE...all supplies free, etc because by then we will most likely have maxed out our deductible (we already are 3300 into it!).  But if we get it now and they approve it....we pay $1666 out of pocket.  Well played insurance company- well played......

Is it a tragedy if she doesn't get it?  To Katie yes- so for that reason alone I want it.  But truly her numbers are all over still....we are worrying about that dreaded under 100 blood sugar.  She's now working full time and her numbers are just wildly swinging.  Today she was 70 at one point.  And she's not really thinking clearly then.  She's not wanting to take time to deal with it..because as she says she's FINE...well she's 18 and invincible- but yet she's fragile...super fragile.

Anyway- the next step after denial is a peer-to-peer- her doctor talks to the insurance doctor to explain why they want the pump and so fast.  I don't know what the recourse is after if she's still denied.  I don't  know if because the reasoning is it hasn't been 6 mos that they will just resubmit it again in 6 mos?

And then we found out that the Dexcom Continuous Glucose Monitor (CGM) wasn't approved for sure yet either....we thought that it was since we submitted a payment plan.  So now we wait for that also.  Fingers crossed this one goes through.  With her numbers so all over the place- this device will be crucial in seeing her trends and also for notifying her if she has high or low blood sugar- which means she will sleep better at night.

We are hoping to re-carpet the basement bedroom (where she sleeps- lost carpeting in basement in flood a few months back) to make her room better....but that won't be instantaneously.

I don't get why the insurance company is so obnoxious about things either- why deny us her test strips? I don't get it.  Esp when your discount means I pay $100 over $112 or something stupid.  Why does every step require four steps back?  What do they think we are doing with her test strips?  What do they think will be the problem with us getting a pump??

I'll keep you all posted on how things progress after the peer-to-peer.  Hoping our Dr. Kassar is as persuasive as he seems!