Wednesday, September 27, 2006

Not a Sound From the Pavement

Before my wife and I were married, she told me this heroic story about her father, and how while he was serving in Vietnam, he narrowly escaped being blown up at some munitions compound.

Then, sometime later, as we were sitting with her parents talking about whatever we talked about back then, and my wife brought this story up. As it turns out, she had a few itsy-bitsy details messed up, and he didn't narrowly escape. He wasn't even on duty at the time, and no one was hurt.

It seems that our minds like to fill in details to a story to make it more exciting, or at least make us feel more important than we really are.

That would be me. Mr. Important. Or not, as it turned out.

See, here's the thing. I play the piano. I started lessons when I was five, and continued through most of high school. I got to be quite good. Well, at classical pieces, anyhow. So good, in fact, that I went to Festival one year and played a piece by Mozart...Sonata in C I believe it was...and was told by the judge that I had the best grasp of interpretting Mozart he had ever seen.

It was a proud moment. And yes, that part of my memory is quite true.

In the coming year or so, my piano teacher challenged me with new things, until one day she told me that I had learned everything she could teach me, and there was little point in taking lessons from her. I was ecstatic to think I had reached such a stage.

And then, I went to the subsequent Festival playing yet another piece by Mozart, originally picked out by my piano teacher. Fantasia in D minor, or something like that. I loved that song, but was disappointed when, while my performance was excellent, the same judge that I had the previous year told me that I really needed to work on my interpretation of Mozart, because I had taken far too many liberties with it.

And I had. I knew I had. Frankly, the stylistic decisions that Mozart had jotted down for the song weren't right, in my mind. So I spiced it up a bit. While I played every note as written, I had my fun with tempos and interpretation.

No biggie. All that is true, too.

And for years afterwards, even after I had moved, and lost my piano, I would tell people the story about how I had become so good that my piano teacher felt I didn't need her any longer.

Then, a few years ago, my piano teacher came to a program at my church. I forget what it was, but afterwards we had a nice time catching up.

And the truth was revealed. I was never as good as I thought I was. No, it seems my teacher's decision to break our ties had nothing to do with my advanced abilities, and everything to do with the fact that I wasn't listening to her. Sonata in C? Great interpretation because I actually listened to her. Fantasia? Well, I stopped listening. I decided it was time to be "creative" the point that her advice fell on deaf ears.

This was all news to me, and I was devastated. Well, okay, I found it vaguely humorous, though somewhat surprising. All this time I had convinced myself that had I not moved and lost my piano, I could have been the next Horowitz or something.

But no. I was just a schmuck who wouldn't follow directions.

Funny the kinds of things the memory creates...including an inflated ego.

Tuesday, September 26, 2006

It Was My Idea First

About four or five years ago I had an epiphany. A complete story idea sort of plummetted into my skull and couldn't escape. This happens frequently, actually...but in this case, it was an idea for a novel.

At the time, I was busy with other tasks, and so the story sort of simmered in my brain on low, taking form until the day came that I finally sat down to start writing. I wrote about 15,000 words of this story, a science fiction tale set 200 years in the future in a colony on Mars. I won't go into details for this story, as some of the ideas I've since pilferred for other stories and even a young-adult science fiction novel (not set on Mars) I may write some day.

But one itsy bitsy piece of this story was an idea I had. The future of computing. In my mind, there will be a day where individuals don't own their own computers. There is no need. Instead, there are "dumb terminals" everywhere, basically generic computers with all the processing power, but no actual data on them. Instead, each individual carries with them (perhaps as jewelry, or an implant, or something) that contains your personal computer files, operating system, and any other data. You simply walk up to a terminal, and wirelessly the terminal reads the data from your implant and you have your own custom computer system with you at all times.

So, today, I read an article...and it seems there is a company doing just that. Oh, it isn't so advanced as what I envisaged yet, but it is the first step. But let me make this clear: it was my idea first!

I know I have no rights to any monies associated with the product, but I feel I deserve at least a little fame for making this technology plausible in my uncompleted, abandoned novel.

If you're really interested in what the real-life software can do, go here. Read all about it. Pretty nifty idea, actually (if I do say so myself). I think it is a matter of time before such a technology will grow ubiquitous. Yes, you heard it here first, but I think this is the future of computing.

If you follow the progression of computing, it only makes sense. First, there was the mainframe. Then, someone had the bright idea of making "dumb terminals" that allowed multiple users to access the mainframe computer. Basically all computing power was on the mainframe.

Later, we started to see personal computers enter the market. Quite a shift. But we also started to see "distributed computing", where users could use their personal computers as "dumb terminals" to access a network of workstations. This eventually grew into the internet that we know today. But the PC still remains a mainstay. Still, with all the computer power scattered across the landscape, why not give access to each user's "personal computer" environment no matter where they go? The PDA was one attempt at this, but it wasn't quite right. As much as the PDA was a cool gadget (and still a useful one at that), it still can never fully replace the personal computer (be it a laptop or desktop).

At least not until this new technology is fully developed. It is a start. Kind of cool, though, to think that my idea might actually come to fruition. Too bad I didn't file any patents or anything. Oh well!

Monday, September 25, 2006

Underwear and the Great Clothing Shuffle

It's that time of year again, when plummetting temperatures means the great clothing shuffle is upon us. Every fall (well, and spring), this great event takes place. Pull out the boxes of the fall clothes, throw out the shirts that last year you thought were hip but this year are already out of style (well, okay, so "out of style" applies to my entire let's just say, the shirts that are the most out of style). It also means washing all the shorts and short-sleeves so that they can be packed away, except for a couple standbys in the likely event we get a day or two of warm weather.

Now, this event has grown in complexity over the years, since our family size has also grown. We have three boys and a girl all growing faster than we, as parents, would like (especially when I have to consider that this year, my oldest boy practically needs an entirely new wardrobe). Fortunately, my wife is the master of organization. She sorts the clothes by size, season, and sex, and since we can't very well get rid of anything until the younger siblings have their chance at the same clothes, it all comes down to a huge mess of boxes. Our family is single-handedly keeping Rubbermaid in business.

During this shuffle, I've been putting off doing my own laundry, keeping the washer free for my wife to get the kids clothes sorted. (I leave such work for her since, frankly, I'd be more inclined to toss everything out and start anew each season. All I'm responsible for is retrieving and returning the boxes from the closets without pulling anything.)

Okay, truth be told, it is just an excuse. I hate doing laundry, and so until I'm out of underwear, I make do the best I can.

Well, yesterday, I ran out of underwear. And you'd think I'd just throw in a load. But no, not me. I have to dig through my drawers and see if I can find anything else to get me through another few days.

Sure enough, I have my wife and my kids to thank, because for Father's Day this year, they made me these "matching" hand-painted boxes and undershirt sets perfect for sleeping. Thing is, the boxers are fairly worthless as boxers. They have a fly that won't stay closed no matter what you do, so you still have to wear underwear under them. And then my kids used so much paint that these boxers are actually stiff. After a few washings, you can't really bend them.

But I was desperate, and so right now I'm typing this dressed in boxers that I'd be somewhat embarassed to be found in should I end up in an auto accident. So I guess that means I need to wash my clothes tonight, eh?

Or at least my underwear.

And maybe...just maybe...I'll do my clothing shuffle while I'm at it.

Friday, September 22, 2006

The Great Space Coaster

Anyone remember that show? "The Great Space Coaster"? I used to watch it as a kid. I only started watching it because it had the word "Coaster" in it. I was, and still am to this stay, a huge coaster enthusiast. I love coasters!

Sadly, the show had nothing to do with roller coasters. But, it did have the furry animal who always said, "No Gnus is Good Gnus". Or something to that effect.

But don't worry, this post isn't about that show. It is about news.

First, I wanted to follow up on my physical therapy just to say that my physical therapist must be punishing me for some horrible past trauma in her life involving someone who resembles me. Or least, that's how it feels. I've had two appointments so far, and never once has she offered to massage my neck and shoulders. Nope. Instead, she is tugging my leg this way and that, and pressing on my lower abdomen so hard I had to hold in the tears. Very painful. Of course, when I tell her this, she presses on my thigh gently claiming she's only pressing that hard. Impossible, I tell you! But, I can't complain, because the amount of free rotation I had without pain on the second day of physical therapy was already better than before I started, so she seems to be doing something right.

Second, I'm still trying to find an agent. However, I did have a "scare" (literarally) a couple days ago. See, I pulled into the driveway, shut off the engine, and opened the door all set to head inside, when my wife just pops out of nowhere in front of me, thrusting the phone in my face. She scared me so bad that I screamed like a little girl. Into the phone. My first inclination (well, second, if you count the urge to pee my pants) was that my mother had died or something. But she quickly told me it was an agent who had previously expressed interest in my manuscript.

Of course, I'm sure I deafened the agent with my scream, but I took the phone and headed inside, all ready to hear the words, "I'd like to represent you."

It didn't happen. No, instead, she was pleased with the changes I had made to the manuscript, but had a few more "issues". We talked for several minutes, and she explained to me the issues, but the conversation ended without an offer. The good news is that she still wants to see one more revision.

That's great news, actually. But scary news as well, because this next revision is a make or break moment. At least with this agent. If I don't get it right, then we part ways. If I get it right, then she'll take me on. Let the nail biting begin!

So, I'm back to editing my manuscript again. In the meantime, I do have a bit of interest from a couple other agents...but those relationships aren't nearly as far along yet. We'll see.

Anyhow, the fact that I have no real news means that "no gnus is good gnus!" Which is why I mentioned The Great Space Coaster.

Oh the Great Space Coaster!
We'll Explore!
On the Great Space Coaster...

Tuesday, September 19, 2006

Let the Therapy Begin!

Based on the title of this entry, I bet you figured this would be about how I finally faced the realization that I'm totally messed up, and there is no hope for me without professional help, and so now I'm finally giving in and going to see a therapist.

But, I'm afraid you'd be figuring wrong. Because frankly, I haven't faced the realization that I'm totally messed up.

No, instead, I'm talking about physical therapy. Which, in my mind, might very well be a worse realization, because I don't need physical therapy for an injury I obtained while sliding into third, or diving across the sand court and landing on my shoulder while making a save on the volley. No, I'm having physical therapy for a pain in my hip that seems to have happened without any significant event happening whatsoever.

And that, of course, means I'm getting old. At least, my body is. My mind is fine. No problems there. I'm as sharp as...

Sharp as...

Uh...what was I talking about?

Oh, right. Physical therapy.

I don't know what happened, seriously. Near the beginning of the summer, I started feeling pain in my hip (well, the joint between the hip and my leg, in the front). Walking is fine, but various motions where I rotate my leg, such as sitting cross-legged on the floor, have been increasingly painful. I figured it was minor, and so ignored it for most of the summer. But ignoring it didn't seem to actually help, since the pain was getting worse, not better.

I bit the bullet, saw a doctor, who then did an X-ray to rule out arthritis. (Arthritis! I mean, if you want to make a guy feel old, threaten him with arthritis!) But I'm arthritis-free. Instead, I have some tendon problem with a name I can't even tell you because I can't read the doctor's handwriting.

Next stop? Physical therapy. Starts today.

I've never been to physical therapy, and suddenly I realize I have no idea what in the world the protocol is going to be. Do I strip, don a white towel in a steamy room while "Hans" massages my back? I'm pretty sure that's a spa, not therapy.

Do I dress up in sweats, lining up with twenty other folks and go, "Uh-1, uh-2, and lift, and stretch, that's right uh-1, uh-2..."

No, I'm pretty sure that's an aerobics class.

I do know I have my own personal "therapist". I think her name is Cassie, or Carrie, or Callie. I just remember it starts with a C and ends in an -ie. Oh, and I found out yesterday that my first appointment will run 45 minutes to an hour. Not exactly sure what I'm going to be doing for that long. But am I going to have to strip and don a white towel? I hope not.

And the weirdest part of all this is that for the past few months, I've been trying to avoid moving my leg...and now I'm going to pay some girl big bucks to purposely cause pain. I don't think they realize that I'm a wimp. A full-fledged, self-diagnosed wimp. I don't like pain. My wife laughs at me when I hurt myself, because I'm the kind of guy who yells, and jumps around howling for five minutes when I stub my toe. Me no like pain!

But, I suppose it is all for the best. Hopefully, after my scheduled six sessions, I'll be able to sit cross-legged again normally. So, let the therapy begin.

Friday, September 15, 2006

The Dish Washer

Once upon a time, a long time ago, in a house far, far away (well, actually, about thirty miles north of here), I had to do the dishes. Actually, not just once, but regularly.

Now, for whatever reason, my mother has always insisted on washing dishes by hand. Oh, we had a dishwasher, but apparently she found the ritualistic dip, scrub, rinse, and dry for each plate, pan, or cup soothing. Uh, yeah. Right.

Me, on the other hand...I was a dishwasher man. And I became a dishwasher-loading expert. Today, I'm one of those people who can't stand it if you don't have the bowls in just the right spot, facing just the right direction. And don't even get me started on how you load the silverware basket!

But never can I say that I actually enjoyed doing the dishes. I suppose I didn't mind it, but soothing? Uh, yeah. Right.

So I was quite pleased when my oldest son was finally old enough to instruct on the ways of doing the dishes. Seven years old is the magic age in our house. You turn seven, and you can scrape and load. So, for an entire year, my boy had the chore of loading dishes.

Then, my second boy turned seven, and so the baton was passed. But, you see, my second son has some issues. He sort of lives in his own little world at times, and you can see, everyday, that his mind isn't on the dishes.

So almost everyday for the past six months I've had to remind him.

"You cannot put dishes in the dishwasher that have food stuck to them."

So, he scrapes off the food. Of course, then he feels the need to rinse off every spec of residue there is before placing the plate in, probably using up about 100 gallons of water in the process. So, I have to remind him.

"You don't have to rinse the dishes that much. Just so there aren't pieces of food."

So, he stops rinsing, and we're back to having food stuck to the plates.

And then there is the fact that he seems in too much of a hurry to actually finish loading. He kind of spreads the dishes around so that it looks like there is no more room, ignoring the fact that we can't see our counters, dumps in the detergent, and rushes off. I check on him and have to remind him.

"You have to fill the dishwaster! If you don't, you'll just end up having to load it twice."

So, he goes back and finishes loading. Well, at least he adds a few more dishes. I think he has a vision problem, though...because he seems incapable of seeing the glasses and silverware strewn across the counter. Once, he even loaded all the bowls (because I reminded him he would need them for breakfast the next morning). But come next morning, there were no spoons.

"Yes, order to have spoons, you have to actually put them in the dishwasher. Now you're gonna have to wash them by hand."

He stares at me blankly, as though I had just asked him to fly.

Of course, when I started my son on the path to responsibility by assigning him dishwasher duty, I expected it to mean I wouldn't have to think about it. But now, I'm beginning to realize that perhaps I should go back to doing it myself. I don't know...I just think it would be more...more...soothing.

Uh, yeah. Right.

Wednesday, September 13, 2006


It is Wednesday, and I haven't written a new blog entry. I don't know why. I'm uninspired I guess. I guess last week's topics zapped me of anything interesting.

Maybe tomorrow folks.

In the meantime, may you have a wonderful day!

Friday, September 08, 2006

The Cover Up

I had considered now tackling the opposite side of the issues I discussed in the last two entries...but I decided against it. Although, the comments have been interesting, including Patti's, with whom I actually agree. But, as I said, I was trying to give a one-sided view on purpose.

Anyhow, today (actually last night) I was thinking about another topic that is aimed at diabetics, and my favorite topic: being self-aware of your symptoms.

But in theming with taking the "other side" of things this week, I wanted to talk about the things that make it more difficult to self-diagnose highs and lows.

What symptoms do you feel when you are high, and at just what point do you feel them? Likewise for when you are low? Symptoms can vary depending on just how high you've been, or how long you've been high, etc. Let me use my symptom of coughing. If my blood sugar is on the rise, generally passing the 200 mark or more, I tend to cough a lot. So, even if I don't have my meter handy, I'll generally take corrective action.

But there is a danger in this if there are other likely causes of the same symptom. And in my case, coughing can also mean a bit too much caffeine.

If I drink, say, two bottles of Diet Mountain Dew in a relatively short period of time, two things happen. First, I have to go to the bathroom, and second, I start coughing. This is because caffeine dehydrates. It runs straight through the body. But if I'm not paying attention, I might confuse my coughing and frequent bathroom trips as a high. I might correct when I don't need to, and end up low instead.

So it is important to not only be aware of your symptoms...but to be aware of anything else that might cause those symptoms, or mask those symptoms.

On the other side of things, I know that when I'm particularly tired, I'm far less aware of being low. That's because one symptom of being low is tiredness or lack of energy. So, when I've been particularly active, having worn myself out, or just tired from a lack of sleep, I'm more prone to end up low. Instead of noticing symptoms at 70 mg/dL, I might not notice them until I reach 50.

It is like a great "cover up"...where something else fools you into thinking you are high or low when you aren't, or fools you into think you aren't high or low when you are!

So what does this mean? It means that despite your best efforts in learning your has to go beyond that. You have to get to the point where you are also aware of when something else could be causing those symptoms. It also emphasizes the point that frequent testing, no matter how good you may be at determining the state of your BGLs, will always be needed.

But now I have a challenge for you. Or, perhaps, homework. I want you all to work on predicting your BGLs. How? Well, randomly, before you perform your usual BGLs, pay attention to how you feel. Note any symptoms you may or may not feel, as well as things you might not think of as symptoms, such as just feeling down, or tired, etc. Then "guess" what your BGL is. I generally say if I'm within 50 mg/dL, I'm pretty accurate. See how well you do. But don't just do it once. Do it for a week, or two weeks. And see if you start noticing any patterns. When you are way off, look at how you feel and figure out why it is. But always keep in mind the "cover ups".

For example, if you say, "Well, I'm really worn out. No energy today. I bet I'm low."
But keep in mind that you also only got four hours of sleep last night. So you test, and you find out you are 423!!! Ah, yes...don't forget that a symptom of extremely high BGLs is a lack of energy as well!

Okay. Let's synchronize our watches...and good luck!

Edit: By the way, I just realized that today marks the 1-year anniversary of the Ryan Bruner blog! Woohoo!

Thursday, September 07, 2006

The Price of Healthcare

A few comments from my post yesterday on whether good Healthcare should be considered a right got me thinking, so I thought I'd just go with it, and tackle another harsh reality of Healthcare: the seemingly never-endingly rising costs.

Now, I'll once again offer warning that I'm tackling one side of the issue here. Clearly there are things that can be done, but lowering healthcare costs can be tricky, and I wanted to cover a few reasons why that is.

Let's start with a common suggestion: that healthcare in America should transform into something similar to what is found in Canada. A government-based national healthcare plan. After all, it works in Canada, why not the U.S.?

But there are several differences. First and foremost is overall population. The U.S. has close to ten times the population of Canada, which would also mean, theoretically, close to ten times the healthcare costs.

That, however, is really only a small part of the picture. The bigger picture, which people seem to forget, is that up until the last few years, most major medical advances have been made in the U.S. While plenty of research happens elsewhere, it is mainly in the U.S. that significant developments and discoveries in new medications and treatments for diseases takes place. The research involved in this progress is expensive. Very expensive. It can take decades for research to result in any usable results...and that research takes money. Lots of it.

So while going to a government-subsidized healthcare system may sound appealing, it also means that research, in general, would grind to a horrific standstill. So, if you thought that cure to diabetes was just a few more years away, under government-sponsored healthcare, that would grow to several decades away. (Although, as I've mentioned, I personally see a cure as several decades away anyhow.)

Anyhow, this brings me to the seemingly high costs of medical supplies and medicines. Scott mentioned the cost of test strips at $1 a piece. Does seem exorbitant, doesn't it? But these are commercial companies we're talking about. Companies who are not only trying to make a profit (as that is the goal of any company, and the driving force behind our capitalistic society), but they must always be on the cutting edge, developing new technologies. That takes research. Research is the ultimate money pit. There is absolutely no profit from research unless that research leads somewhere. And so, companies must come up with a stream of income that allows them to finance the research which will ultimately lead to the next level in diabetes treatment (or cancer treatment, or heart disease, etc.).

Think of it this way. When you pay that $1 per test strip, you aren't just paying for the materials and production costs of the strip itself, but you are paying for the company to develop, perhaps, the next continuous glucose monitoring system. Or perhaps the money isn't going into developing anything related to diabetes at all, but some other area of research the company is heavily invested in.

The reason why "generic" versions of medications and medical supplies are so cheap is because those companies don't need to spend money on research. All they are doing is taking the research another company did and copying it (once patents expire). But the company who did the research to begin with can't afford to make such a price cut. They need a source of income to move forward.

Now, granted, these companies are, as I mentioned, looking for a profit. A great many of them have shareholders, etc. But profit is, and always will be, a driving force behind research. I mean, frankly, I wouldn't be working where I do if I wasn't getting a paycheck. And I'm always interested in a larger paycheck. Okay, so perhaps the people at the top of the companies seem to be paid excessively. But is it really that excessive? Think about it. Those companies need experienced people who can ensure the longterm survival of a company. To keep such people at a company (be in medical or any other field), they need to be rewarded greatly, or else they'll go someplace else, and you'll end up with a mediocre company president or chairman who might drive the company into bankruptcy. Where I work, the president of the company made, last year, more in bonuses than I'll make in a lifetime. Yet, that president is always driving our company to profitabiliy in a very unstable time.

Okay. Next up, waste. Minnesota Nice's post about throwing on a once-used vial of insulin brings up another reality of healthcare in this country: the lawsuit. Or, rather the pursuit to avoid one. While it seems ridiculous to throw away that much insulin, hospitals are looking to avoid any possible source of infection, etc., that could jeopardize patients and result in a lawsuit. And while tossing out a vial of insulin after one use does seem excessive, from a cost perspective, do you have a better alternative? Because what would it take to avoid cross contamination with absolute certainty? There is a nursing shortage in this country. Medical staff work long hours, and are underpaid. So, medical errors can happen. Hospitals need to do what is necessary to minimize those errors.

So, why not implement a system which will prevent the contamination without the waste? Well, because it would mean hiring even more people throughout the hospital, investigating and implementing more checks and balances, leading to greater inefficiencies, which ultimately drive up costs. So, while throwing away a $100 bottle of insulin may seem like a waste, it would likely cost more to have a system in place that would eliminate the need to throw away that $100 bottle of insulin.

One solution, of course, would be for the insulin companies to produce hospital-sized vials, so that far less insulin is being thrown away. Okay, fine. But what financial incentive do the insulin companies have? It means that there is less waste, and therefore less profit for them.

I could go on and on here, but I think the point is made...despite our frustrations with the expense of healthcare, much of it cannot be avoided. Or, if it were avoided, we might not be very happy with the results. It is going to take a huge overhaul of the healthcare system that involves every level, from the consumer, to the doctors and hospitals, to the drug and research companies, and yes, even the government. Getting everyone to talk together in the same room and come to an agreement on how to solve the problem is likely a near-impossible task.

So, for now, I live with my $1 per strip expense. It is the price of healthcare, after all.

Wednesday, September 06, 2006

Is Good Heathcare a "Right"?

Let's face it. Having diabetes is expensive. If not for the individual, then for the individual's insurance company who foots the bill for test strips, insulin, syringes and/or pump supplies, quarterly doctor's visits, A1c tests, urine analysis, cholesterol screenings, annual eye exams, and if it should progress, treatment for complications such as retinopathy, neuropathy, heart disease, kidney problems, etc.


But I'll admit I'm split on the issue of the "right" to health care people tend to have. And, while I can argue either side very well, I wanted to focus on the more controversial side today, if only for the purpose of causing us to think. (I know, I know. Thinking makes my head hurt, too.)

There seems to be a lot of effort fighting for the "right" for everyone to have good health care. And, not surprisingly, most of the voices calling for such a fight are the very people either without health care, or with maladies that require it.

But I have to wonder just where the line is. At what point does the "right" end? The way many talk, you'd think we have a "right" to not be sick, that we have a "right" to not come down with colds, or the flu, or AIDS, or cancer...or diabetes.

The fact is, illness is a part of life. It is a part of this world. It isn't going away. Every time we make progress against some life-threatening disease, another one pops up. And treatment for existing diseases is growing more and more expensive.

So, where does my right to live as a healthy individual begin and end? And just what level of responsibility do I have in this?

Let's focus solely on diabetes. As the list above indicates, there is a lot of stuff that costs a lot of money to keep me healthy. And while it is all fine and well to say that my life is worth more than whatever the associated costs are, the fact is our country is bleeding, financially, when it comes to health care. Health insurance companies can't afford to treat everyone, nor can the government. So there must exist a give and take.

Unfortunately, everyone always wants to be on the taking side. But such mentality has to change.

I have a responsibility not only to my own life, and my own family, but also to my company which provides health insurance, as well as to the health insurance company itself (yes, I know...don't have a heart attack) to limit my health care expenses as much as possible.

There are many ways to do that. The first and foremost is taking care of myself. I've met many people who make no effort to take care of themselves, but then expect everyone to jump in and save their lives when their lack of responsibility for their own health catches up to them. I'm not suggesting any level of "enforcement" of this, of course. There is no effective means to judge who is taking advantage of the system in such a way. But the point is to encourage everyone to do everything possible to take care of themselves.

Of course, no matter how well I take care of myself, the fact is I'm still a diabetic. That isn't going away. (Sorry, but I'm not holding out much hope for a cure in my lifetime.) So, then, taking care of myself is confined to the hand I was dealt. As a diabetic, it means constant monitoring, for example.

But here is where things get tricky. If I want to stay healthy my whole life, just how much is reasonable for my health insurance to cover? Let's say they only pay for a box of 50 test strips a month. Am I willing to foot the bill to pay for more if I need them, knowing that it is my own life at stake, not the guy's writing checks at Blue Cross Blue Shield? And if not, why? Why would I expect BCBS to pay for something if I'm not? I've drawn a line in the sand, saying my own life isn't worth that much, so some insurance company should pay it instead.

Now, as I said, I'm being one-sided in this, because I realize many just can't afford the strips...or other care. But stay with me. I'm only trying to promote some discretion in how one determines their "rights".

Let's look at another expense. In my case, I have an insulin pump. Fact is, I don't need an insulin pump. I lived most of my life without one. Sure, I had to give myself four, five, sometimes six shots a day, and sure, I couldn't get quite as good of control as with the pump...but I was managing decent control. Staying under an A1c of 8, at least. The motive for getting the pump, aside from the fact that it is just cool and would help get a tad better control, was because I was having frequent lows on injections.

So, my insurance company foot the bill for a $6000 medical device, not to mention the additional cost of infusion sets and reservoirs. Now, in theory, the better control it offers should result in fewer complications and ultimately cost the insurance company far less money in the long run.

But today, I face a choice. My insulin pump just went out of warranty. It has been four years on the pump, and I'm happy to say I've kept my A1c levels at or below 7 for most of that time. I've had fewer lows. But my pump still works, and even though there are newer, better versions of the pump out there, and my insurance company would cover a replacement (being mine is out of warranty), the fact is I'm going to wait.

Why have the insurance company pay for something new when what I have today works just fine? And then, what about the fact that now I could get Minimed's Paradign REAL-time pump system with continuous glucose monitoring? Insurance companies won't pay for the CGMS part...and rightly so. Perhaps it would provide better control, and greater convenience. But do I have a "right" to that? Again, there is a line in the sand...and truth is, I don't think insurance companies should cover such an expense...not until it is cost effective for them.

So, here I am, living with an out of date pump. Boo hoo. Truth is, I'm so incredibly thankful and blessed to have it, I just can't see taking advantage of a "right" I have to a replacement pump unless something goes wrong with this one.

Anyhow, I suppose I'll stop now. I can imagine some of you rolling your eyes, going, "Yeah, easy for him to say. He's got health insurance." Or whatever. And I agree. It is easy for me to say. My tune would be very different if I didn't, I'm sure. Still, I think each of us can do anything we can to help out the health system in this country. And perhaps one day I'll write up why I think big business is good for health care, while at the same time it is bankrupting health care. But not today.

Tuesday, September 05, 2006

The Impossible Dream

I had this dream last night about my book.

Okay, actually I didn't. Rather, I had this daydream about a dream I had about my book. And it didn't happen last night at all. (Sorry, I just have this tendency to want to tells these horrific lies, like the time I was out with J. K. Rowling and I told her that it was because of her that I wanted to become a writer...)

So, back to the daydream of the dream. See, there I was walking through Barnes and Noble children's section when I happen upon my book. There it was, all shining as though rays of sunshine were streaming in through the ceiling (or maybe it was just one of those really expensive sun lamps) overhead. It was a truly angelic sight. Mindburst, by Ryan Bruner.

Thing is, there was only the one copy. And it seemed as though no one else in the store was aware of the bright light proclaiming the wonders of my book, because not a single soul made a second glance.

Then I realized that I was standing in the way, so of course no one would take a look. So, I hid around the corner, crouched down next to the Star Wars section, which was no small chore because it meant fighting off four different boys desperate to find the next book in the Jedi Apprentice series.

"No," I told them. "They aren't here. Go look over there, in that shiny light. Maybe you'll find something you like."

Eventually one of the kids managed to beat me up and get his Star Wars book. And still no one glanced at my book.

So I found an employee, who found the manager, and I offered to sign the book.

He hemmed and hawed and then said, "Well, I'm sorry, I can't let you do that."

"Why not?"

"Well, we've had the book on the shelf for three years now, but not a single person wants it, so we were going to ship it back to the publisher."

"But I only started writing it two years ago."

He shrugged. "Nevertheless, if you sign it I can't return it."

"Well, what if I buy it."

Looking me up and down, he said, "You're going to buy your own book?"


So, I go back, sign my own copy of my own book and take it to the cashier to pay.

"What a great find," I said (another of my great lies). "An autographed copy, even!"

She nodded and handed me a flyer. "You can save 10% if you sign up for our book club."

"Do you have any kids? They'd love it, I'm sure."

"Will that be cash or charge?"

I pulled out my card. "Charge."

Then she handed me my credit card slip to sign, checking that my signature matches the one on my card. Glancing at the book cover, she smirked, and my face went white. She handed back my card and said, "Thanks, Mr. Bruner. Enjoy your book."

Drat. Foiled again. I'm going to have to remember to pay cash next time. And the last part of my dream involves going out to my card and tossing my own book in the back end of my car, where another several hundred copies haphazardly sit.

Of course, not a bit of this is the least bit true. Just me daydreaming. And you'd think that if I'm the one in control of my daydreams, they could be a bit more upbeat. I'll have to talk to Dr. Phil about that the next time we do lunch together.