Saturday, July 21, 2007

Argh!! Insurance company!

I leave on Monday for the BWCA. I am nearly ready.

The food pack is almost ready. I have packed all our meals in individual zip lock gallon bags. Each bag includes all the food and condiments needed for the individual meal, as well as a couple paper towels (for clean up) and handi-wipes. Breakfast is in one sack, lunch in another, and all the dinners in a third stuff sack. Snacks are in their own stuff sack.

The equipment pack is ready. It holds the tent, first aid kit, water filter, and small miscellaneous pieces of equipment. (duct tape, sun shower, rope, etc.)

We will have two personal packs. Two people will share each pack. These packs will include sleeping bags, headlamps, personal gear, clothes, diabetes supplies (in both packs for safe keeping) and entertainment. (Aka: the new Harry Potter book that will be read aloud each day)

I called my doctor for a glucagon refill. I went to pick it up early last week. (I wrote about it in my last entry) The short version is that is wasn’t covered by my insurance company because it is a “diagnostic aid.” My doctor filled out an exemption. I got a letter on Wednesday that said “…your claim is: denied. Reason: other.” I called the insurance company and asked what “other” meant. A rep. told me that glucagon is a diagnostic aid and their company does not cover diagnostic aids. I asked this man if he knew about the BWCA. He said yes. I said that it would be far more costly to have to pay for me having to be airlifted out of the wilderness than to cover the darn glucagon. (I know, I know, it wasn’t very nice to say…but I was really FRUSTRATED by that time) It seems so absurd. I have been getting glucagon prescriptions filled since I was six years old. Suddenly my insurance that covered it last year won’t cover it.

I looked up glucagon on the Eli Lilly site. I guess I never knew that it had another use other than for severe hypoglycemia.

This is listed on their site under indications for glucagon:

For use as a diagnostic aid:
Glucagon is indicated as a diagnostic aid in the radiologic examination of the stomach, duodenum, small bowel, and colon when diminished intestinal motility would be advantageous. Glucagon is as effective for this examination as are the anticholinergic

My doctor is making one more attempt to provide documentation that this prescription will be used for hypoglycemia and NOT as a diagnostic aid. She sent a new form on Thursday. As of today (Saturday) it is not covered.

I’m planning to take my old glucagon that expired in June 2007.

Here’s hoping that I won’t need it. Chances are good since I haven’t needed it for the last 19 years.

I can’t wait to leave.

Monday morning I’ll be off to the great NorthWoods. What a great way to spend your birthday. Mine is that day☺!


Dixie is all packed.

She has her pack full of food (I dehydrated meat patties for her to eat—a mixture of turkey, cooked brown rice, egg, baby food carrots, fish oil, and bone meal) She also has a bag of dehydrated chicken and cookies.

There are aspirin and benadryl in the first aid kit for her.

She will sleep in the tent on an old thermarest pad.

I have her lighted collar and back up leash.

She can’t wait to go.

Thursday, July 12, 2007

Getting Ready

I’ve been busy getting ready for my yearly BWCA trip. It is my big vacation. It is the place where I feel the most powerful and grounded.

For those of you who aren’t from Minnesota and aren’t familiar with it, the Boundary Waters Canoe Area Wilderness (BWCA or BWCAW, sometimes referred to as the bee-dub) is a 1.09 million acre wilderness area within the Superior National Forest in northern Minnesota and is under the administration of the U.S. Forest Service. The BWCA is renowned as a destination for both canoeing and fishing, and is the most visited wilderness in the United States. Motors are not allowed, so the only way around this vast wilderness is paddling in a canoe. (or kayak)

I’ve been going to the BW since I was a kid. My dad introduced me to it, taking my siblings and me as little kids and teaching us how to love that place. I am the only child to continue the adventures as an adult. Every summer for the last 12 years, I have gone with a group of women and spend a week there. The group changes each year. There are three of us that are the “core” group, and we bring another 1, 2, or 3 women each summer. This summer there will be 5 of us going, as well as Dixie.

There are “entry points” on the eastern and western side of the BW. A permit is required to enter at these points during the summer. I apply for our permit in January. As it is a protected wilderness, a limited number of people are allowed to enter at each point every day.

The trip that we take involves moving every day. We pack up our sleeping bags, tents, and equipment each morning, and journey to a new lake and new campsite. Campsites are designated by red dots on the maps, and include a fire grate and a box latrine. Some days our journey is long, other days it is medium. We paddle the length of lakes and then unload our canoes and carry all of our packs and canoes over a portage to another lake. Sometimes we do 8-10 portages/lakes per day. Some portages are quite short—30 feet. Others can be up to a mile or mile and a half long. The paths are primitive and are challenging with elevation changes, rocky and uneven paths, swamps, and/or thick brush and trees.

We drink water from the lakes, sometimes using a water filter, and sometimes just dipping our cups in the middle of large lakes. We eat dehydrated foods, and cook over a stove fueled by tiny propane tanks. We swim, we see animals, and we have peace and quiet.

Having diabetes happens to complicate this adventure.

I pack insulin in Frio pouches to keep it cool. I bring long acting insulin and syringes in case I have a pump malfunction. I require all members of the group to carry GU for me. I test tons. I check my blood sugar every night before we hang our food pack in a tree, just in case I’m low and need to have a quick snack. I’ve gotten low before, when the pack is already up the tree, and it’s a pain to have to untie and get it back down. I pack all the food, and I’m always guilty of packing way more than we need. It’s the diabetic in me—worrying about whether there is enough to keep me safe. I change my pump sites with the aid of friends holding pieces of equipment so I don’t have to put delicate supplies on the ground.

I emailed my doctor earlier this week asking her to call in a refill for my glucagon and levemir prescriptions. (and directions of how on earth to dose levemir) For safety, I always bring two glucagon kits. Being 20 miles by canoe from the car, and another 30 miles from a town requires preparations like that. I went to pick up the meds, and the pharmacy tech said “that will be $172.67.” What!?! My copay is $14. That can’t be right. The pharmacist came over to tell me that it wasn’t covered because it was deemed a “diagnostic test.” What?!? I told them that I didn’t want it if I had to pay full price. I called the insurance company today. The lady on the other end said that my insurance wouldn’t cover “formularies.” (meaning “name brand”) I asked her what the generic equivalent was. She said that there wasn’t one. Hmmm, then why wouldn’t it be covered. She told me that I needed to call my doctor to get a “formulary exemption.” Seriously. What a joke. Needless to say I sent another email to the doc today asking for that exemption. I’m going to be in the wilderness, for crying out loud. Far away from medical care. It’s not a luxury item.


The good news is that I leave for the trip on my birthday. What a great way to celebrate.


Dixie will be coming on the trip. She likes riding in the canoe and sleeping in a tent. Let's be honest... a dog living in the wilderness for a week. It probably can't get any better for her.

Last summer, on the sixth day of our adventure, Dixie ran off (she wasn’t on a leash) midway through a portage. When we realized that she was missing, it started storming like crazy. We called and called for her. We ripped through the woods trying to find her. She didn’t come.

It got late and my friends told me that I had to go to a campsite and continue the search the next day. I don’t really even remember how I paddled away from that portage. I layed awake that night, praying that I would find Dixie, praying that I wouldn’t have to leave her to die alone.

The next morning four of us went back to the portage and continued looking. Two other women paddled their canoe around the big lake looking for her. A couple hours later, their canoe pulled to the portage where I stood, and Dixie was in the middle of the canoe. She was exhausted and covered in scratches. She had traveled over six miles and was found by a counselor working with Voyageur Outward Bound campers. It was a miracle.

Dixie will be on a leash the entire time.

But, as you can probably expect, I am nervous about it.

(The picture above is Dixie and me finishing a portage last year. She has her pack on that she carries her food in, and I have a canoe above my head with a pack on my back.)

Tuesday, July 3, 2007

A bunch of firsts

Dixie and I had a safe journey to and from Atlanta.

It was a pretty smooth trip. Dixie did great on her first airplane trip. On the way to Atlanta I sat next to a nice fellow. He was really kind. Helped me get my stuff in the overhead compartment. I asked if he knew that there would be a dog next to him and he said no. I asked if he was o.k. with that and he said “Yes.” Dixie was very mellow. She was most anxious during the taxi on the runway part of the flight. She put her front paws on my lap and hit her snout in my armpit. There were two men behind me who were very kind. They asked if I would let Dixie back to visit them. She was as interested as they were, so I let her go back to them. The two men took turns petting her. Then she crawled under the seat and layed on my feet the rest of the trip.

I have to say that flying first class is nice. It’s like going to a spa and being pampered. I had a lovely salmon and field greens salad, along with a tiny container of Ben and Jerry’s ice cream for dessert. (Yes, it had the carb value on it. And yes, I ate it.) The photo above is of Dixie in seat 1-A. She had hoped to sit in the seat during the trip. I snapped the photo before she moved to the floor.

We arrived in Atlanta, picked up my luggage and went outside to the shuttle. The shuttle driver wouldn’t let us ride because she said, “dogs have to be in cages.” Two managers later we hopped aboard.

Dixie had her first plane ride, first shuttle ride, first taxi ride, first major league baseball game, (Atlanta vs. Washington) and first bus ride. I’m so proud of her. She was a trooper.

I appreciate Minnesota nice so much now. I had so many people in Atlanta scream in fear of Dixie, refuse to ride elevators that we were in, and restaurant owners tell me that I couldn’t come in their restaurant with a dog. (again, several managers later and I eventually was able to enter) It was a pain. Kids came up to me several times and asked if Dixie bites. I’ve never been asked that before.

I left Atlanta on Thursday. I went through security, and Dixie set off the alarm. (like she had in MN. There, they escorted us aside and patted her down) A man asked me to step into a “waiting area.” This was like a glass hallway with a locked door. I waited about 10 minutes. Finally a woman came over and opened the door and grabbed me by the arm to lead me to a chair. She told me to sit. She said “raise your left arm.” I did. Another guy came over and started to pat down Dixie. I asked the woman if she could wait a minute so that I could focus on Dixie while she was being patted. The woman said “NO!” The process took another 5-10 minutes. (it felt longer) It was humiliating.

We boarded the plane back to MN. The pilots asked if she could stay with them during the flight. The man next to us was really nice and said that he had a couple labs at home. Dixie was more anxious during the return flight. I wasn’t feeling particularly well, so I thought maybe that was why. We both slept most of the trip. The flight attendant brought Dixie a pillow. ☺ Nice people.

I got into the MN airport and a friend picked me up. I was feeling pretty horrible. Got home and took my temperature. 101.7. No wonder I felt so bad. I had a cold, and spent the entire weekend resting. I’m still not over it yet. When Dayquil is on board, I can keep my temp around 99. Ugh. Aren’t colds supposed to happen during winter? A summer cold?! What the heck. Fortunately it hasn't caused much havoc with my blood sugars.

It's good to be home.