I took this photo in front of a Pilates studio in my neighborhood because I thought it was funny. It wasn’t quite as funny when it became true.

At 2:45 am, the morning of Thanksgiving, I awoke with low blood sugar. I was in my mother’s home. I padded out of bed to rummage around the refrigerator looking for juice or fruit or something to raise my blood sugar. Yes, I could have taken a glucose tablet, but when my blood sugar isn’t dangerously low, I’d rather imbibe something nutritious.

No juice to be found, dried fruit would take too long, a jar of raspberry preserves went by unnoticed, I reached for some pomegranate seeds and began munching. Oops, I felt one get stuck in my teeth. Upon closer inspection, there was no seed there, and there was even less of a tooth there. I had cracked my molar and now a piece of it was missing. For the next four days my tongue kept returning to the emptiness where once there was enamel, and getting scraped in the process.

Thanksgiving at my mother’s friend’s home with a broken tooth meant a bit of turkey, roasted sweet potato and something I haven’t eaten in likely three decades for blood sugar reasons, white mashed potatoes. Boy, they were good!

Since it was Thanksgiving weekend, I couldn’t call my dentist until today, and now I’m booked in to see him tomorrow at 9 am. The good news is my tongue has gotten used to the new tooth terrain and is getting scraped far less often. Bad news? That remains to be seen. Still, I’m thankful, there are other teeth in my head standing in for their wounded comrade.

So while my mouth undergoes some redecorating, I am still enjoying my favorite of all seasons, the fall, as the leaves are still golden around here and I smile as the lights begin to come on for Christmas.

I received a mass email this morning from the American Diabetes Association (ADA). In short, the U.S. House of Representatives passed the ‘Build Back Better Act’ that has a national $35 insulin co-pay cap, and allows Medicare to negotiate the price of insulin. This was, in part, aided by the thousands of letters and emails, from us, urging our representatives to support this.

Yet, the bill isn’t a done deal yet, so the ADA is requesting continued support. It’s easy with this form to press this through, it’s mostly written for us.

Let’s keep on them and get insulin down to an affordable price. For the first time I feel it’s within reach.

• 

The husband’s first flight since COVID began was truly memorable. Read on.

Today is World Diabetes Day, the day recognized around the world by a United Nations’ resolution. And this year marks the 100-year celebration of insulin, it was discovered in 1921. You may know it was discovered by Canadian surgeon and medical scientist, Frederick Banting and Charles Best. You may not know Banting and Best sold the patent for insulin to the University of Toronto for US $1.00 – so that no one would ever have to go without insulin. 

Well, we know how that worked out. The last time I walked into a pharmacy to ask how much insulin would cost if I didn’t have insurance, I learned three insulin pens cost $750.

I do have insurance, I have Medicare. Still, the one box of Tresiba pens (five come in a box) that I got a few months ago cost me almost $500 because I had not reached my deductible. That’s $100 per pen. I was told after reaching my deductible, a box would cost around $225. That’s still $45 a pen – with insurance. Plus if you’re on Medicare you cannot take advantage of pharmaceutical patient assistance programs.

Last Wednesday, the husband took his first flight since COVID. Of all places, he went to Toronto, to facilitate a leadership workshop. Having insulin on the brain, I researched how he could purchase insulin for me, while in Canada, knowing it would be cheaper there than here.

I reached out to a few friends and colleagues, they then widened the circle of comrades, and I read numerous articles online. This was a great story. In Canada you don’t need a script to purchase insulin. 

From what I learned, it is legal to order insulin from a Canadian pharmacy and have it shipped to you in the States, but it is illegal to buy it there and bring it home. Grrrr… However, all I talked to who have done it, and each article I read (like the one above) said, if the TSA finds the insulin, they won’t arrest you and they won’t take it away from you. Okay, non-risk-takers that we are, we decided to gamble on this.

The husband’s client for whom he went to Canada is actually in the business of making medicines, so the Chief Medical Officer put the husband in touch with his local pharmacist (thank you, thank you). Yes, the husband could get two boxes of Tresiba from them and they would deliver it to his hotel on ice. For free.

Those two boxes, each with five pens, cost US $218 total. That’s $21.80 a pen! With no insurance! The husband went through US customs on the Canadian side with one box in his vest and one in his carry-on. Both items went through the X-ray machine with no alarms being set off and no police appearing with cuffs. The husband collected his vest and carry-on and walked briskly to the gate whisking his little charges to freedom. 

Of course my two lovely boxes of Tresiba, posing above, were the first thing out of his bag when he walked into the house Friday night. Still, my mind keeps twirling this unbelievable fact/feat around, just like when your tongue can’t stop running over something stuck in between your teeth.

Insulin has always been my drug of choice, but now I have a new dealer, Canada. Thank you Banting, thank you Best, thank you Toronto. Should the husband need to go back again, I might just go with him to thank the nation myself for their sanctity for life – and of course to get some more insulin.

Note of appreciation to Elizabeth, James, Allie, Karlynn, Chris, Michael, Ahmad and, of course, the husband 

• 

Yes, I’m welcoming you a week late, but if you’ve been scrolling around you’re probably aware this is the month dedicated to raising awareness of diabetes. And November 14th is World Diabetes Day. It’s actually a United National resolution put forth by the International Diabetes Federation.

In honor of diabetes month, I’m participating in a Sanofi sales call tomorrow to talk about the importance of helping more people better understand what diabetes is and the toll it takes.

But this is what I want to share, something just between you and me. It’s a message I’ve long wrote about and often speak about. It flies in the face of what doctors will tell you. And yet it is true.

YOU CANNOT CONTROL DIABETES, OR YOUR BLOOD SUGAR. Statement of fact. So let yourself off the hook when you get numbers you don’t expect. When you do everything right and everything goes wrong.

There are just too many factors that impact our blood sugar. Just to name a few – stress, being sick, temperature, menstrual cramps, lack of sleep, counting carbs, meter readings, how much you exercised yesterday, lacking two other hormones that manage blood sugar as well as insulin… If you’re not familiar, take a look at Adam Brown’s 42 Factors chart. And trust me, there are more.

How could you possibly manually do what your body does automatically? I would like every health professional to experience diabetes for a week and tell me I can control my blood sugar and my diabetes.

Okay, enough said. Whew, it felt good to let that out. So let yourself off the hook. Perfectionism doesn’t work here, or anywhere frankly. Instead, learn how different foods and exercise tend to impact your blood sugar, Learn how to respond to any number to nudge your blood sugar back into range. And then acknowledge that that, just that, is success.

That’s my message for diabetes month. Feel free to share it.