An Ideal Healthcare World

I know there are certain factors that make our healthcare system play out like it does. And not everyone gets a fair deal. there are many in this country who have horrible care and are constantly frustrated because of it.

Some things may just be ingrained in the way people do things here. Some factors at play in this case may be bigger than we can even see or diagnose. And, no, it's not all because "Big Pharma" is evil and greedy. Big Pharma is the reason I am still alive today.

I am blessed (and work very hard) to have excellent, well-covered health care. To get it, I have made sacrifices. I have kept the same job for 19 years, not because I love it, but because we have excellent health insurance and I won't be fired or passed over or penalized because I am sick.

Sure, I like my job and all, but if I had been healthy, I may have chosen a riskier field that I am truly passionate about. But as a Type 1, I just don't want to take those risks.

But, just because I have good health insurance, does not mean that there isn't room for improvement. So, in my ideal world, here's how it would go...

All of my prescriptions, Dexcom sensors, transmitters, and T:Slim pump supplies would be delivered to my door by drones, on schedule, and without me having to order them.

They drop the insulin in the mini-fridge on my doorstep for safe keeping and slide the others through the prescription slot (think mail slot, but slightly larger) in my front door.

They are covered in full, even the brands my insurance doesn't have a closed door agreement with.

Every three months a nurse comes to my house to draw blood on my schedule, even if that means 9:30 at night.

I meet with my doctor quarterly via Skype to review the results and he always calls right on time. He also calls the diabetic drones to renew any prescriptions needed.

Before our talk he reviews all of my Dexcom data, my Garmin workout data, my adventure plans for the year, and my current training plan to look for any tips he could give me in areas that I may have overlooked. He doesn't find any, so we discuss current diabetes research and its implications on future diabetes care.

He then makes a few nice comments about an adventure pic on my Instagram feed and mentions that he now prescribes my Instagram feed and a few other people's social media accounts to all his patients.

Every now and then, my insurance company sends me a sample of a new non-medical device to see if I can utilize it. Last month they let me beta test the Naked Fit 3D Scanner that scans my body dimensions and weight and sends it to an app to track my body composition to determine if my exercise and food choices are having a positive affect.

This month they are sending me a new Indo Board with a set of balance exercises for Stand Up Paddlers to make sure I am getting stronger and to prevent injury. All of this is, of course, automated and at no cost to me.

At the end of each year, if I have kept my a1C below a certain level that my insurance company and I have both agreed upon, a $2000 bonus will be put in my adventure fund because they would rather spend money up front to send me on an adventure, knowing that my diabetes care is ten times better when I'm planning an adventure, than to spend the money on hospital stays and care for complications from not taking care of myself.

I also get money in that account when I wear my Dexcom and when I consistently change my T:Slim pump site. Data for this is automatically sent through the bluetooth on each pump site, so I don't have to bother recording it.

I also have access to a counselor, well-versed in diabetes care, anytime I need, though I am using that less and less now that I have the budget to go on three adventures a year.

And all of this would continue for the duration of my life, no matter when I retire, or if I have to go on Medicaid when I do.

I know it's just a pie-in-the-sky kind of world, but in a lot of ways, I feel like we're getting closer.

Foul Language

I was raised in an incredibly sarcastic, Irish household. If we were being sarcastic to you, it meant that we loved you. I was lucky enough to marry a man who, not only understood this, he mastered it.

So, it should come as no surprise that around the house we use all sorts of colorful "diabetes" language. From him mocking me when I'm low with his, "I think I'm low" jingle, to his taking and posting Instagram pics as I am crashed out on the dining room floor, stuffing every bit of food I can find into my mouth, our language is far from respectful.

But just as we taught our children, "this is a family joke," I only talk like this in select company.

With all humor, it is best to know your audience. And so, publicly, I have chosen to use language that is least likely to offend, whatever that may be at the moment.

At times that means using language that is not as efficient, using phrases like "person with diabetes" instead of "diabetic." I put a high value of efficiency, especially in language. But I put a higher value on people. And so, I will use an extra few words so that my word choice does not hamper my message. It is far too valuable to help people find a source of motivation to take amazing care of their diabetes to let my efficiency of language get in the way. After all, language is only efficient if I am getting my message across.

We already have enough pain and strife from living with or taking care of someone with diabetes, without my words adding to it.

What Adventure Does to Our Brain

The brain has different areas used for different functions. There is a part for emotions, a part for math, a part for foreign languages, a part that tells you not to curse in church.

Each part does something different. There is even a part of the brain that fires up when we think about ourselves.

Dr. Hal Hershfiled did a study in that looked at the parts of the brain that are active when we think about ourselves now and ourselves in the future and found a funny thing.

When we view ourselves now, we use the medial prefrontal cortex and the rostral anterior cingulate cortex. When we think about our future selves, we use the same parts of our brain we would when thinking about another person.

Our Future Selves feel like someone else to us!

All this brain science is saying is, that making decisions about your behavior today to protect your Future Self forty years down the road is nearly impossible. Your brain sees that Future Diabetic as someone completely distinct from your Present Self.

So why deny yourself another cupcake if “that” person is the one to suffer?

Why workout today, if “he” will be the one to pay later?

There are no consequences to the Present You. Diabetes has some short-term consequences--a low will ruin our day--but those long-term consequences, the really big ones doctor’s try to threaten us with, are decades away.

And it is supremely difficult to always keep those in mind, when the payoffs for splurging are immediate. What you need to do is find a way to bring those long-term consequences into the present so your brain registers them as affect the Present You.

Adventuring does just that.

When I have an adventure on the books just a few months away, all of my decisions are made in light of the success of that adventure.

This cupcake doesn’t have to destroy my kidneys in thirty years, it might add a few ounces to my body for my 100-mile paddle in three months.

And the right decision is easy.

Another helping of dinner doesn’t have to give me heart disease in forty years, it will make my training session tomorrow feel sluggish.

No, thank you.

Getting up in the middle of the night to check my sugars doesn’t have to cause nerve damage in fifty years, it will get in the way of my recovery from a long paddle tonight.

Get out that meter.

All of those decisions become simple. With consequences for the Present Me, I will make the right decision and take excellent care of myself.

I have to.

I have an adventure to get ready for.