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.*

Making Discoveries About Type 1 Diabetes From Long-Term Survivors

It’s hard to imagine what it was like to live with type 1 diabetes 80 years ago. Insulin was a brand new and relatively untested drug, the only way to check blood sugar levels was by testing boiled urine, syringes had to be sterilized, and needles sharpened by hand. Couple those challenges with the common complications of diabetes—heart disease, kidney failure, nerve damage, blindness, and more—and life expectancy for someone with type 1 diabetes wasn’t that long.

Spencer M. Wallace, Jr., was diagnosed with type 1 diabetes in 1931, at age 7. He’s now an active 87-year-old who plays golf several times a week. He isn’t alone as a long-term survivor. Since 1970, almost 3,500 men and women who have lived with the disease for a half century have been recognized by the Joslin Diabetes Center in Boston with bronze 50-year medals. Forty-five of them Read more »

*This blog post was originally published at Harvard Health Blog*

Researchers Compile Surprising List Of Most Risky Drugs For Older Americans

Some medications are well known for being risky, especially for older people. Certain antihistamines, barbiturates, muscle relaxants—take too much of them, or take them with certain other medications, and you can wind up in serious trouble (and possibly in the back of ambulance).

But researchers from the federal Centers for Disease Control and Prevention (CDC) and Emory University reported in this week’s New England Journal of Medicine that those high-risk medications are not the ones that most commonly put older Americans (ages 65 and older) in the hospital.

Warfarin is #1

Instead, they found that warfarin is the most common culprit. Warfarin (the brand-name version is called Coumadin) reduces the blood’s tendency to clot. Many older people take it to lower their risk of getting a stroke.

After warfarin, different Read more »

*This blog post was originally published at Harvard Health Blog*

Researchers Explore New Methods Of Testing Blood Sugar

My fingers hate diabetes. Several times a day they get poked with a sharp, needle-like lancet. The drops of blood they give up tell me how my blood sugar roller coaster is doing. That’s really important information I need to determine whether to eat, exercise, or give myself some insulin.

It would be such a treat to check my blood sugar (glucose) without pricking a finger, squeezing out a drop of blood, and placing it on a small test strip attached to a meter. Help may be on the way—though I’m not expecting any big breakthroughs for another few years—as researchers across the country explore prick-free ways to measure blood sugar.

Here are three interesting approaches. Read more »

*This blog post was originally published at Harvard Health Blog*

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.*

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 »