Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Latest Posts

Diabetes: An Expensive Disease

Back when I was a young bird with type 1 diabetes, insulin cost about $70 dollars per bottle.  (And I had to walk uphill both ways to the endocrinologist’s office.)  I had no concept of this cost, or how it played into my family’s finances, at the time.  I would just open the fridge door, grab the bottle, uncap the orange top to a 1cc syringe, and take the units my mom would yell to me from the kitchen sink.

“Two. Two of Regular should do it.  Rotate to your right arm this time, okay?”

“Okay!”  (And then I’d proceed to jab it into my left arm because I’m right-handed and also stubborn.)

Now, twenty-five years later, insulin has taken a bit of a price hike.  I just ordered a three month supply of Humalog from Medco and the total for the insulin came to six hundred and ninety-seven dollars.  For six bottles of Humalog that will be all gobbled up by early March.  (And thanks to a high, but manageable-on-paper deductible, we’re responsible for the full cost this round.)  Almost seven hundred dollars worth of insulin.

We’re lucky that we’re able to pay for that cost without panicking, but knowing what these bottles cost without the assistance of insurance makes me look at everything through a diabetes lens.  When three days are up on my insulin pump site, I am very aware of Read more »

*This blog post was originally published at Six Until Me.*

Extraordinary Growth Predicted In Health And Fitness Apps

Post image for Health and fitness apps expected to grow to $400 million, according to ABI research

A recent report by ABI Research, providing a broad overview of the mHealth industry, predicts extraordinary grown in health and fitness apps over the next five years.

The report, Mobile Devices and mHealth, includes forecasts for the next five years on factors such as regional smartphone adoption rates, app downloads, and wearable device usage among others. One major conclusion from the report is that the sports and health mobile application market will grow to over $400 million in 2016 – up from just $120 million in 2010.

Mobile health devices recently received a major boost with the incorporation of Bluetooth 4.0, which is expected to spur the development and launch of devices that will take advantage of the lower energy consumption. While much interest is focused on blood glucose monitors, remote monitoring of cardiac rhythms, and other similar parameters, one conclusion of this report is that some of the most impressive growth will be in health and fitness apps that are more directly consumer-oriented.

The report itself, for a rather hefty price, also addresses other questions like Read more »

*This blog post was originally published at iMedicalApps*

A Day In The Life Of Type 1 Diabetes: Glucose Control Burn Out

Diabetes?  Isn't any of this unicorn bullshit.Two weeks ago, I was in the emergency room for some severe stomach pain, down on the lower right hand side of my abdomen.  After consulting with Dr. Google (bastard), I realized that it could be appendicitis.  Knowing I was heading to Toronto the next afternoon, I didn’t want to take any chances with this pain.  So I headed off to the ER to check things out.

Looooong story made Twitter-esque short, I didn’t have appendicitis.  I just had some rogue stomach pain.  However, while I was at the hospital, I asked to have my A1C run.  I figured I was there, they were already drawing blood, so what’s one more vial?

“Can you guys grab an A1C while you’re at it?” I asked.

“Is your diabetes under control?”  asked the doctor.

“Um … define control?  I wear a pump, I wear a CGM, and I’m very aware of my disease.  But I’ve been having a hard time juggling things lately, on just about every level, so I’m pretty sure my A1C is crap.”

The doctor shot me a very rude, very judgmental look.  I shot one back at him.

“I’m asking you to run an A1C because I’m trying to regain control.  I don’t have this nailed down and perfected, but I’m trying.  Is that the wrong thing, in your opinion?” Read more »

*This blog post was originally published at Six Until Me.*

When Diabetes Requires Mad Scientist Experimentation To Get Blood Sugars In Target Range

Hoping I hit a balance as lovely and even as depicted in this here clip art from 1994.I do not enjoy basal testing.  Even though I sometimes go six hour clips without having a snack (thanks, Birdy and your busy ways), something about knowing I can’t eat or exercise makes me want to do a 5K while simultaneously chomping down on some soft serve.

But when I noticed that I was going to bed at a completely normal blood sugar, but waking up in the 180 – 220 mg/dl range for three days in a row, I knew I needed to do some basal tweaking.

Making adjustments to my overnight basal rates always skeeves me out.  I’m a very deep sleeper (as evidenced by the fact that Siah prowling around on the bed all night doesn’t wake me in the slightest, but makes Chris say “We’re sleeping with the door SHUT tonight,” in the morning), and I have a very healthy fear of overnight low blood sugars.  My symptoms of a low on the overnights used to be this body-drenching sweat, but since the birth of my daughter, that symptom has all but disappeared.  Now, I don’t have any symptoms at all.  Blood sugars of 60, 50, and lower don’t even register until I prick my finger and go, “Oh.  I guess I’m low?” Read more »

*This blog post was originally published at Six Until Me.*

The Improving Outcome For People Living With Type 1 Diabetes

During the Joslin medalist meeting last week, I didn’t say anything.  I wasn’t presenting or doing any kind of networking.  I was invited as “media” (totally in quotes) but I attended as a grown-up child with diabetes, hoping to continue on that path of growing up.

I sat next to a woman named Eleanor (my beloved grandmother’s name) and she had been living with type 1 for 58 years.  She asked to see pictures of my daughter.  She offered me a cough drop after I spent a few minutes trying to clear my throat, and she stuck her hand out to take the wrapper, spying my pump tubing jutting out from my pocket.  “I don’t wear a pump,” she said.  “I do just fine with my needles.  And you appear to be doing just fine with your pump.  Do you need another cough drop?”  I almost hugged her.

As Dr. George King, director of research at the Joslin Clinic, gave his opening remarks, quotes from the medalists were flashing up on the screen behind him.  “I have learned to understand that perfection is not possible.”  “Tomorrow is another chance to do better.”  “Say YES to every opportunity.”

These people were incredible because of what they’ve accomplished with type 1 diabetes.  Hilary Keenan, PhD and pat of the Joslin biostatistics team, stunned me with the stats on this group. Read more »

*This blog post was originally published at Six Until Me.*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

Read more »

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

Read more »

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

Read more »

Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

Read more »

See all book reviews »