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Who Can Ignore The Economy?

Photo credit:  Fiction, apparently.Anyone who hasn't been storing their brain in a shoebox underneath the bed has probably realized that the economy is tanking.  People are being laid off and positions are being eliminated at companies.  Grocery money doesn't seem to buy as much now as it did even six months ago.  Gas prices, despite the fact that they've fallen a bit in the past few weeks, are still just under $4.00 a gallon. 

But these are issues that are affecting all families across the nation.  For us, diabetes care can also be affected by the crumbling economy.  My brain tends to go into panicked little pockets when I think about the economic situation.  For me, a job means more than just money - it's medical insurance.  Even now, in good health and without any outstanding medical bills, my monthly medical expenses add up.  From co-pays on items like blood pressure medication and birth control pills to the non-prescription items like prenatal vitamins and healthy food, it can get expensive. 

I was thinking about money in my budget that I consider well-spent, like my monthly membership to the gym and our grocery bill.  For some, spending $30 a month to workout and spending an inordinate amount of money on foods like fresh produce, organic products, and other fancy crap that they sell at Whole Foods and Trader Joes may seem like money that could be saved.  But when it comes to diabetes management, "control" is more than just the pump I'm using and the insulin I'm taking - it's about all these other variables, too. 

I remember (let's step into the Wayback Machine again, shall we?) test strips that could be cut in half, or into thirds, and at least the gist of a blood sugar level could be grabbed by comparing the color of the strip pad against the guide on the side of the bottle.  Granted, today's strips are more accurate, but are they really costing manufacturers $0.85 apiece to make?  (Because that's about what they charge us, as consumers.)  Diabetes supplies used to be able to go further.  Now they are indeed more accurate, but they don't go very far at all.  And keeping up with the costs of this maintenance, in addition to making attempts at important, preventative care like a CGM, is starting to make me a little nervous.  I'm finding my mind going back to the desire to wear infusion sets past their three-day shelf life and refilling reservoirs, to help extend the life of my supplies.  Ridiculous?  Yes.  But when I'm thinking about other life expenses - car payment, rent, utility bills, gas prices, and the occasional movie or night out - I find myself cutting corners where I can.

What are you guys doing to get the most bang from your diabetes buck?  Are you streeeeeetching out the life of insulin pump supplies?  Are you trying to gain insurance approval for a CGM as a way of conserving test strips?  Do you find yourself debating between paying for gas or renewing your gym membership?  The decisions are tough now, and I fear that they may be getting tougher in the future.  (And have you seen the Twitter election feed?  Regardless of who you're supporting in this election, this constant streaming commentary is pretty fascinating.)

The price of good diabetes control is high, and the cost of not trying to stay healthy is even higher.  How are you managing the cost of care?

Comments

I understand the fear of loosing a job. We all depend on our health insurance so much.
I have noticed myself stretching my sites out of 4 days at a time. I've been trying to stretch my CGMS sites to 7 or more days (basically until the battery dies).
That constant fear is there, but I deal with the only way I know how: praying.

I'm fortunate in that my health insurance doesn't require me to pay very much on co-pays, but even the little extra, like the $15 on doctor's appointments or the $50 on pump supplies, adds up when you're young like me and don't have much of an income. It hasn't been so much my diabetes that has been draining my already skimpy income as it's been the whole economy. I'm also lucky that I have parents who will pay my airfare to come home, because right now, I'm looking at over $700 to fly across the country. It has half that just last year.

It's so scary, isn't it? I always griped about how much I have to spend on co-pays, but it seems even worse as money gets tighter and tighter. And the thought of trying to do it without insurance is too much to ponder.

I too have been leaving my sites in as long as I can. I also try to trim the grocery budget & still eat well by using coupons and taking advantage of store sales to stock up. Every little bit helps these days.

As a parent of a young (5yo) diabetic -- I'm already losing sleep about keeping her insured. I wound up completely uninsured for a year at the end of grad school because I was too old for my parents' policy (even with the student rider), and it was almost 6 months after graduation before I found a job. How do I keep her from falling into that trap without discouraging advanced education?!

Of course, her being FIVE doesn't make things easier, either. This morning, she dropped her $50 glucose meter into her milk. I'm praying it will turn on after it's had a day or so to dry...

I agree on the strips...I still have an old Chemstrip bottle somewhere, I used to split strips all the time ;)

Mostly I'm trying to stay healthy and out of doctor's offices as much as I can. Fortunately my allergy pill (Zyrtec) is available as a generic now--that saves me $30-40 a month right off the top.

Unfortunately my infusions only last about five days max - and less in the summer. But I won't say how long I wear my CGM sensor for. Somehow on that I receive accurate results far past expectations.

I'm very fortunate that my heath coverage is above average - but changing jobs, or just taking a year off to travel more down the road is something that will require a LOT of health care logistics.

I've been doing these two cost cuttings long before the economy tanked - but most Sundays I make all my lunches for the week. When I cook dinner I make more than I need and grill lots of chicken, spiced, marinated or however, then pack it into 4-6 tupperwares with rice, pasta, or whatever. Each day I have a lunch to grab, or a dinner if I don't want to cook or on the go.

And you can use pre-cooked chicken for other dishes throughout the week.

Also my opther half and I share ONE car. I've been biking to work about 9 miles each way 3-5 times a week and love it. Except a few months during the slushy winter its a great ride, I feel refreshed in the morning - and its excellent cardo and only takes about 10-15 minutes more than driving. (Sometimes faster.)

If you live in/near a city and can coordinate your schedules and use transit selling a car and sharing the expense of one is a sure way to skyrocket the savings and extra cash.

all the best- james...

I'm with Cara....there is Someone bigger than the economy. That fact brings me peace in the panicky moments.

As far as having diabetes and paying for it we are thinking outside the box. Unlike some with great insurance, we are self-employed. Our insurance already stinks. Our pump supplies are out of pocket expenses....unless we happen to meet our $3500 deductible...something not likely to happen unless he ends up in the hospital, which we are obviously doing everything we can to avoid. The first thing we noticed when buying through our insurance is how much the price was jacked up. Just last week I needed more ketone strips and the pharmacist tells me that OTC they're in the $6 range, but through my insurance they would cost me in the $8 range. That's just a small example. So with pump supplies we have resorted to not buying anything through our insurance. We buy direct or through discount places online. It has saved us hundreds.

And I'm with James...there's a lot a person can do. As far as food issues....we are a family of 7. Obviously we have noticed how little our dollar goes these days in the grocery store. I am able to feed my family for $700/mo or less....that's about $3.35/person/day. Mainly I accomplish this through LOTS of planning. We rarely buy pre-packaged anything. I cook in quantity ahead of time which helps reduce eating out or eating junk. I make sure the kids are eating what they need for nourishment and health, and not in excess. Instead of buying individual 100 calorie packs of items buy the larger quantity and make up your own 100 cal. pack. Or better yet don't eat those types of items anymore. There's a lot of info out there on saving at the checkout....problem is....most people don't have time.:-(

But it all comes back to my first statement. Praying is so helpful. Also, I think of my great-grandma who survived all the World Wars, The Depression, etc....all 93 years worth of scary stuff. If she made it through, then this present situation seems like a hiccup in comparison.

I pray too. It definitely keeps me calmer when things seem kind of hopeless. Like this economics stuff.

I have found myself stretching sites a bit too long, and I'll admit, I have refilled a few reservoirs. My parents still pay for my meds, and I am still on their insurance, but they're also putting me through college and I don't want to increase their costs more than I have to. And if I knew how to get my insurance company to pay for a CGM and sensors without having to actually buy one first, I would definitely go for it.

Hi, just found your blog via Twitter.

You and your readers (especially those who are pregnant) may find this recorded online seminar interesting. The session is run by Catherine Rietveld who is a midwife who works with diabetic mothers. In the session, Catherine presents background information on breastfeeding and diabetes, and talks about her research in which she is encouraging pregnant diabetic mothers to harvest colostrum for their babies once they are born:
http://sarah-stewart.blogspot.com/2008/09/breastfeeding-and-diabetes.html

I am guilty of streching pump supplies. When I was in grad school and had terrible insurance and no money to my name, I made a typical 3 month supply last 1 year.

I have good insurance now, but there is a low cap on Durable Medical equipment and I am paying about half the cost out of pocket for the new pump and CGM I just got. Worth it? For sure. Expensive? Unfortunately....

I would never admit this to MiniMed, but I use a reservoir over and over again for about a month (the life of a bottle of insulin). I figure, if insulin can sit out for a month and be okay in the bottle, why not use a reservoir over and over again for the same amount of time?

"I'm finding my mind going back to the desire to wear infusion sets past their three-day shelf life and refilling reservoirs, to help extend the life of my supplies. Ridiculous? Yes."

Not ridiculous at all.
I have been without health insurance for well over a year now. I have been extending my infusion sets to 5 days. I have been reusing my reservoirs many times over, which was suggested by the pump salesman and Joslin educator.

You do what you have to do. And for me, luckily I work from home but it is between a monthly bill or gas money to visit family.

Times are tough. We cannot rely on things or people or organizations like we used to.

I don't take vacations - ever.
I never buy clothes full price.
And, I have a threadbare couch that sags when you sit in the middle.

I try to always use mail order for my prescriptions, now 3 month supply for a 2 month copay.

I always try to stretch my Dexcom and usually get 10-12 days out of a single sensor.

Finally I try to stockpile supplies a little. So I'll re-order pump supplies every 3 months even if I have a box left. That way if I ever lost insurance I'd have a month or two in the closet.

This prospect is so scary I don't like to think about it.

I've been putting more insulin in my cartridge to try and get 4 days instead of just 3, but I'm being reminded why I switched to 3 days from 4 a few years ago - my BG's suck on the 4th day.

It would help us if the pharm industry and the health insurance peeps burned the contracts they made with Satan, but that seems unlikely, and it doesn't seem like we have any control over that at all.

I try to get at least 20+ days out of my guardian sensors. So far so good, I am just now getting ready to order my second box of sensors for the year. I got the first box in FEB.

Of course I have to pay for these out of my own pocket. Even though I have two health insurance companies neither one can see the benifits of CGMS.

Hey, Kerri!

In terms of diabetes costs, I feel like not much can be done. If I want to be healthy, I have to eat healthy. I have to test a lot. I have to visit my doc, get co-payed to death at the pharmacy, and spend money at the gym.

However, we can cut back in other areas so that I can continue good diabetes care.

Some of the things I do:

I learned how to save SERIOUS money with coupons and store loyalty programs. And we eat A LOT of organic foods. Here's great article to get you some starting point info: http://www.moneysavingmom.com/money_saving_mom/2008/10/guest-post-how.html

Yes, I wear my infusion sites longer than recommended and I always RE-fill my cartridges one extra time. I wear my Dexcom 7 sensors as long as humanly possible.

I use the Freestyle Lite meter when I'm not wearing a Dexcom (and I'll use it ALL the time once I get my Open Choice upgrade) because I can get 100 strips for $15 per month with their Freestyle Promise loyalty program, I ususally combine that with a $25 giftcard transfer offer to somewhere whether it be Walgreens, CVS, Target, etc. and I end up MAKING money on them.

That's a few of the things I do. To cut corners.... there's more I'm sure. =)

I'm going to be changing to HORRIBLE insurance this January, so I've been stretching supplies to build up a stockpile for the last year. I wear sure-t sites for 4 days, reuse reservoirs, and have a tupperware of Novolog in my fridge. If my numbers are fine, I don't see the harm in stretching diabetes stuff to save money.

My new insurance will have a prescription maximum of $1000 per year (including test strips), which will make my out-of-pocket burden very high. It's really sad and ironic that health insurance for MEDICAL students is so crumby.

I know this is bad but I have had to quit going to the dr . Since I lost my job I have had to pay for everything out of pocket including drs visits . I know we have had to cut back on groceries . We never go anywhere except my husband to work . I use wal mart to buy my insulin and syringes . Dont even think about a pump at this point . I know cutting out the dr is not a good thing but when you cant pay their office visits and fees and the state healthcare tells you ,your husband makes too much money to get help then you cut back or out of practically everything . Times are hard and they are going to get harder , alot harder I have a feeling . God take care of and bless us all .

I don't have Diabetes, but I do have Chronic Migraines and IBS, and to stay on top of my treatment requires a lot of money.

My boyfriend and I both worked for a large architecture firm and were laid off (on the same day) back in November. My immediate panic was, of course, how can I continue to pay for my medical expenses?

The unemployment checks I get don't quite cover the full cost of COBRA plus my out-of-pocket treatment expenses. We haven't even gotten to the other "essentials" yet, like food, rent and utilities. Fortunately, we were planning to buy a house before the layoff, so we have some savings set aside.

But it's scary, really really scary. My IBS requires I keep a strict (read: expensive) diet. Most of my treatment is non-prescription supplements, not covered by insurance. And I go for weekly acupuncture and massage treatments, just to try to stay ahead of my Migraines.

My Migraines aren't under control yet, and if I let my treatments slip I relapse badly enough I won't be able to work. So we're left seeing a lot of money go out the door and very little coming in. We do have enough of a cushion, between our savings and our families, but it's still really scary.

Be well,
MJ

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