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When Fear of Liability Prevents Diabetes Care

This post is a very personal one. I’d like to share a tale of what happens when an insured diabetic needs medication but can’t get it.

Current estimates show there are over 90 million people in the US who have diabetes or pre-diabetes. That equates to almost 30% of the population. Approximately 8 million people have diabetes but are not aware of it. The end result of this epidemic is that diabetes has become a huge liability for the mainstream medical community. In the midst of trying to help everyone they can, the medical community has developed a fear their efforts will result in someone’s death. (This fear exists for other medical conditions, but nowhere is it stronger than in diabetes.)

Three weeks ago my insulin pump stopped working. The manufacturer replaced the pump, yet 12 hours later the same problem occurred. Still assuming the problem was related to equipment, I insisted the pump manufacturer replace the insertion sets I was using. Insertion sets attach the insulin pump to the body and have a short tube – a “cannula” – which sticks into the skin to a depth of about ¼ – ½”. (See Picture of an infusion set showing the cannulapicture. The cannula is the tiny piece of plastic at the far right.) Unfortunately, the new box of insertion sets had the same problem. After about 12 hours, the insulin pump returned error messages stating it could not deliver the insulin. The area where the cannula entered the skin was always inflamed, a bit itchy and very painful, but had no indicators of infection.

I experimented with multiple locations on my body and always had the same problem. Final conclusion? I had developed an allergy to the plastic used in the insertion set’s cannula. This meant I had to take a “pump holiday” and return to using injections to control my blood sugars while I researched insertion sets with a stainless steel cannula. Not using my insulin pump presented a problem because the only insulin I had a prescription for was fast-acting Humalog, which has a lifespan of about two to four hours, This short duration of effectiveness meant I had to inject insulin every two to three hours. It also meant controlling my sugars while I slept was virtually impossible. I needed a prescription for Lantus, a long-acting insulin with a lifespan of approximately 24 hours. This is where the story gets interesting.

I called my GP, who told me she would not give me a prescription for Lantus because the liability was too high since I had never taken it before. I offered to come in for an appointment, but she refused. She told me to go to an emergency room. I called an emergency room and was told the physicians there would be unwilling to prescribe Lantus for a patient whom they had no history on and for whom they could not follow as an in-patient. I called my endocrinologist, whom I had not seen for almost two years*. I knew they could not prescribe for me without seeing me, and I begged for an appointment. The best they could do was to “squeeze” me in ten days later. They also suggested I go to an emergency room to get the insulin I needed.

*Please note: The fact I had not seen my endocrinologist for over two years does NOT mean I was not receiving care. I adjust my insulin levels as needed, and I was getting necessary blood work such as A1C, thyroid profile, etc. from my GP. I was staying on top of things and consistently maintain A1C’s between 5.7-6.0. I want to clarify that I maintain very strict control over my diabetes and always get the blood work needed to monitor my control. I was recently told my experience was “my fault.” Please know it was not and that I was doing everything necessary to maintain perfect control of my glucose levels.

In the midst of this, my blood sugar control went haywire. I typically awoke with sugars higher than 500, even if I got up at 3 am to take insulin. During the day, I had to inject every one to two hours in order to maintain decent control. I quit eating carbs completely and still had to inject frequently. My energy levels plummeted, and I began to fear my poor control would have a permanent effect. At this point, I had gone almost two weeks without my pump. The early days were spent negotiating with the pump manufacturer; the later days were spent begging providers for a Lantus prescription.

Determined to get what I needed, I went to an immediate care center. The triage nurse told me the doctor would not be willing to prescribe what I needed. I begged and confess I bullied a tiny bit. Luckily, the on-call physician was in the reception area and heard my tale. He asked me a few questions and agreed to prescribe what I needed. He was the first physician who had shown more concern for my health than for his own liability. I am forever grateful to him.

Let’s review: I’m fully insured. My glucose levels were above 500, meaning I was in an emergency situation and desperately needed different medication. I have 45 years of experience controlling diabetes, so I am not a new diabetic who presents a large risk. I’m a Naturopath who speaks nationwide on endocrine disorders and controlling diabetes, so I have knowledge and training most people with diabetes do not.

In spite of all of that, not one of the MD’s I spoke with was willing to prescribe what was obviously a medically-necessary medication. Failure to prescribe this medication could have resulted in my death. Even when I shared that my glucose levels were running above 500, no one was willing to incur the liability of prescribing the medication that was desperately needed. My best option for care would have been to allow myself to go into a diabetic coma, at which point they would have gladly assisted. I instead chose to take matters into my own hands and be my own advocate in a very strong way.

If I had any other condition, physicians would have prescribed what I needed without question. ALL medications have side effects. ALL medications can result in death if not taken correctly. Only a diabetic would be denied care due to physician’s fears of liability. Physicians regularly prescribe narcotic pain medication to patients, often without providing adequate instruction. Those narcotics could just as easily cause death from overdose as insulin could, yet getting them is incredibly easy.

There’s something wrong with this picture.

The current medical system has put so many shackles on physicians that a patient in desperate need of care cannot receive it. When an insured patient is refused care by an emergency room, solely based on fears of liability, there is a desperate need for change. Based on current trends, I predict things are going to get worse, not better.

What are your thoughts?

Updates on Where to Find Me

Hello! I’m getting so many questions about where I see clients that I decided it was time to share some updates. I’ve had many big changes in the last few months and want to let everyone know!

As always, I provide consultations in person or via telephone or Skype. Please don’t let location stop you from contacting me. I also travel frequently and am often able to set up consultations during my travel dates.

Contact Information

Please feel free to contact me via telephone at 317.489.0909 or via email. Feel free to contact me with any questions you have about me or my services.

Please note I cannot answer personal health questions via email due to liability issues. I can only answer personal medical questions for established clients.

Information on the Website

  • If you are interested in scheduling a consultation and want to learn more about what to expect, the Consultations page is a great place to start.
  • If you are curious about what will occur during your consultation, please visit the What to Expect page.
  • If you would like to learn more about me and the journey I traveled to reach the point I’m at today, please visit the Meet Pamela page.

Office Locations

I currently see clients on the west side of Indianapolis, near the Eagle Creek Airport. 

West Side Office

Located inside of the offices of Dr. Michael Gossweiler Periodontics:

7537 West 38th Street
Indianapolis, IN 46254


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How I’m Different from Other Practitioners

The words, “Naturopathic Medicine” evoke a wide variety of different perceptions and misconceptions in people’s minds. Because of that, and because no natural practitioner is exactly the same, I thought it might be wise to share more details about my practice and about my philosophies of healing. As you read, please feel free to ask if you have any questions.

As I said, every natural practitioner is wonderfully unique. That’s part of what I love about my profession. Because we are very unique, we can each help a very different set of people. The points that follow provide information that will help distinguish me from other practitioners. Please don’t hesitate to ask if you have any questions!

  1. Not opposed to mainstream medicine: Many people incorrectly believe I am opposed to all forms of mainstream medicine and pharmaceuticals. That is not true. There are many situations where mainstream treatments are necessary. What I am opposed to are violations of the first tenet of the Hippocratic Oath: “Do no harm.” I see the results of serious damage caused by medical doctors and/or pharmaceutical medications every day in my office. THAT is what I’m opposed to. There are many situations where mainstream treatments are needed and are a huge blessing. It’s the times they are used incorrectly or in ways that harm the patient that I’m opposed to. I embrace an approach where mainstream treatments are seamlessly combined with holistic approaches. I am happy to consult with my clients’ doctors to request blood work, recommend medication alternatives, provide information on non-invasive test procedures, etc. Many of my clients bring their test results and blood work results with them to every appointment so that I can review their results in a holistic fashion, explain the potential causes of abnormal results, and explain what the results mean in a way that’s easily understood. I myself am alive due to insulin, so I recognize the need for mainstream intervention when needed. Clients in my office will never be made to feel inadequate for choosing to use pharmaceutical medications.
     
  2. Belief in the body’s ability to heal itself: I am a firm believer that the body will heal itself if given the support it requires. However, healing of extreme, chronic, long-term issues does not occur rapidly. Most chronic conditions require extreme dedication and commitment to changing lifestyle, food choices and negative thought patterns. My belief is that healing requires the removal of any toxins or issues preventing healing, and the identification of systemic weaknesses or nutritional deficiencies. If you remove the blockages that are preventing healing, your body will often heal. The “trick” is to dig deep enough to find all the issues preventing healing. I have had diabetes for almost 50 years, but still believe I can support my body so that it can heal itself. So far I’ve gone from taking 80+ units of insulin daily to needing less than 20. My pancreas has gone from not producing any insulin to producing insulin in small amounts. I’m not there … yet … but I’m on my way. The bottom line is that if you believe you cannot heal, you can’t. Reversing the emotional scars that make us cling to illness is essential for healing. My job is to help identify nutritional deficiencies, cellular damage, systemic weaknesses, toxic overloads, and negative thought patterns that are preventing the body from healing itself. I then work with you to create a plan to slowly but surely reverse those issues.
     
  3. Dedication to finding the cause instead of masking the symptoms: I was in the corporate world during a time when performing a “root cause analysis” of every business problem was the craze. These exercises were developed based on the belief that finding the cause of a problem was essential to correcting it. I apply this same approach to wellness. Instead of trying to solely minimize your symptoms, I use a variety of assessment techniques to find the CAUSE of your issues. I then work with you to create a plan to address and reverse the cause, thereby eliminating or diminishing the issue. Although I try to focus more on the cause than the symptoms, I will also recommend supplements and therapies to alleviate any symptoms which are negatively affecting your daily life and ability to function. For example, in the case of someone having daily headaches, I will recommend ways to alleviate the pain so that the client does not suffer while we perform the necessary assessments to identify what is causing the headaches.
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  4. Compassion – I’ve been there: I can honestly give thanks that I spent ten years almost bedridden due to illness because it helps me relate to a very wide variety of symptoms and health conditions. It also provided exposure to a wide range of medical specialties and procedures. During my illness, I dealt with diabetes, hypo- and hyperthyroidism, depression, adrenal fatigue, chronic sinus problems, extreme food allergies, multiple autoimmune disorders, severe neurological disorders, cardiac abnormalities, Chronic Fatigue Syndrome, debilitating anemia requiring IV therapy, malnourishment caused by malabsorption, environmental sensitivities, liver disease, poor kidney function, hormonal imbalances, GERD, hypertension, and more. I was incorrectly diagnosed with MS three times and cancer once. When a patient or client sits across from me and breaks down crying because he or she is frustrated and discouraged beyond the breaking point, I often cry with them because I’ve been there. I understand. I KNOW what it’s like to be sick and tired of being sick and tired, to do all the right things and get no results, to be too ill to function yet have “normal” test results, and to deal with doctors who refuse to listen to your insight and and imply your physical issues are all in your head. I know what that’s like because I lived it. But … I also know what it’s like to heal. Of all the issues I listed above, I now only deal with a few very minor ones. Healing happens. My goal during a consultation is to listen more than I talk, to address every single concern or symptom you have, and to provide encouragement and support. In the midst of that, my goal is to empower you with the knowledge you need to achieve wellness and the support you need to be successful in pursuing your goals. (I cover more about this in my post, Why I Do What I Do.)
     
  5. Truly holistic approach: I work with my clients to address any and all imbalances in body, mind and spirit. Wellness is not solely a physical issue, and most physical issues have a spiritual and/or emotional component. Solely addressing the physical side of an issue is similar to chopping off two legs of a three-legged stool and expecting it to stand better than it did before. True balance cannot occur unless all three legs of the stool are healthy and whole. I use a variety of non-invasive but very effective techniques to help identify and address any issues that may be impeding healing.
     
  6. Comprehensive remedies: After assessing the issues affecting you, I will work with you to create a holistic plan to address them. One of the things I believe sets me apart from others is that I work with you to create a plan instead of dictating a long list of do’s and don’ts and then sending you on your way to do them. You are responsible for helping your body to heal, I’m merely a support tool. I will meet you where you are and will not ask you to make huge changes overnight. I will not overwhelm you with changes but will create a plan that allows you to make changes at your own pace. I will also provide support and encouragement every step of the way. YOU are the only person responsible for your health. My job is to educate and empower you to make the right choices to improve your health on a daily basis. The remedies I recommend will be comprehensive and may include any (but not all) of the following: lifestyle changes, modifications to eating habits, supplements, hypnosis or EFT to address harmful habits, gentle exercise, lymphatic therapies to boost immunity and speed healing, massage, acupuncture, Jin Shin Jyutsu (a Japanese art used to bring balance to body and mind), detoxification, aromatherapy, Bach Flower Remedies, or specific protocols for health conditions that I customize to fit your needs. I NEVER use a “cookie cutter” approach. If you want an allopathic approach where the exact same supplement protocol is always used to treat specific conditions, I will not be a good fit. I will work with you to create a very customized, very personal plan. What is right for you may not be right for anyone else, and that’s ok. We are each wonderfully unique and each need a very personalized program to achieve the maximum wellness possible. I also don’t believe there is one, single dietary approach that is correct for everyone, nor do I believe extreme dietary habits are good. Again, I will work with you to develop a realistic eating plan that allows you to get the nutrition you need while providing your body with the building blocks it needs to heal itself. (For the record, I’m not raw or vegan. I support those lifestyles but typically encourage a more balanced approach.) On what may be an unrelated side note, I want to express to my Christian readers that I have no concern with the therapies I use being occult or satanic. Please ask me if you have any concerns with the origins or spiritual connections of any therapy. I’m happy to share the research I did that led me to accept the therapies.
      
  7. Education, education, education: My role is to teach and equip you to help your body heal itself. I do that by working one-on-one with you, providing hand outs and resources you can refer to after our appointment, and by always being available to answer questions. I also hold frequent classes and seminars to provide education on specific topics. If needed, I will schedule a grocery shopping consultation with you and will go grocery shopping with you to help educate you on label reading and how to make good choices while shopping. If you leave a consultation without having learned anything new or gained new insight into an issue, I’ve failed. I also assume I’ve failed if you leave without feeling encouraged and uplifted. I feel so strongly about the value of education that I travel nationwide speaking on natural health topics. I also speak locally and lead corporate wellness programs. If I can teach you enough about wellness to ensure you never need to schedule another appointment with me, I’ve succeeded. I may be in the only profession in the world whose primary goal is to put myself out of business. I’m ok with that. (Please feel free to contact me if you’d like more information on scheduling me to speak.)
      
  8. Unique assessment techniques: I use a variety of unique assessment techniques to identify and assess systemic weaknesses, nutritional deficiencies, and blockages that prevent nerve flow and physiological energy from freely circulating. In addition to reviewing blood work and test results from your MD, I use any or all of the following to identify other issues:
  • Bio-Impedance Analysis (BIA) Testing: To assess metabolic function and cellular hydration
  • ElectroDermal Scan (EDS): EDS measures nerve flow through acupuncture points in the body to identify systemic weaknesses, nutritional deficiencies and more. I can also use the EDS unit to assess your current supplements to determine if they are right for you or not.
  • Fingernail and tongue analysis
  • Iridology
  • Saliva hormone testing (more accurate than blood tests)
  • Food allergy testing

If you would like to receive additional information about scheduling a consultation in person or via Skype, please feel free to call me at 317.489.0909 or email me. Please also feel free to sign up to receive my newsletter. Thanks so much!

Lessons Learned at my First Indy Food Swap (It was a blast!)

Last Saturday I had the extreme pleasure of participating in Indy’s first Indy Food Swap. I want to start this post by complimenting and thanking Suzanne Krowiak, whose vision and hard work made the event a huge success. Thanks, too, to Sacha Brady (@Zigged), who volunteered to make everything run smoothly. You can learn more about the Indy Food Swappers on their Facebook page: Indy Food Swappers and on Twitter at: Indy Food Swap.

It was so much fun to chat with everyone who participated and to view the amazing diversity of handmade foods shared. I highly recommend attending the next event in October! I failed to take pictures of the items I took with me to trade, but the pic in this post shows the delicious items I traded for. Every one of the unique, handmade items is truly delicious!!

As with most things in life, I made mistakes at this first swap and learned valuable lessons as a result. Here are my tips based on the lessons I learned the hard way:

1) Take small servings so you have more to trade. I wasn’t sure what the typical serving size would be, so I took large portions. For instance, I took homegrown, organic herbs and packed large amounts into quart-size bags. In retrospect, I should have packed the herbs into sandwich size bags. Doing so would have given me four items to trade instead of just one. Most people brought sample sizes to share. Quantities traded did vary, though … everything from 4-ounce jars to 16-ounce jars of liquid items, and everything from plates of four cookies to a plate filled with six cake balls. Obviously, anything goes, but packaging items in smaller quantities will allow you to trade for more items.

2) Don’t be afraid to bargain: Because there is such a diversity of sizes and quantities being traded, be ready to get creative and flexible about what you’re trading. If someone wants to make a trade you don’t think is fair, don’t be afraid to offer to trade a different quantity or to ask for two of the item being offered. Most people are more than willing to bargain with you.

3) Niche items may not be popular: I took a jar of kefir grains and coconut water kefir and found that most of the people at this swap didn’t know what they were. That gave me a great chance to educate people, but meant that very few swappers showed an interest in trading for them. Obviously each swap will have different attendees with different interests, so it’s hard to say what will or will not be popular at each event. I’m such a firm believer in the health benefits of kefir that I’ll probably continue to take a jar, but am prepared to take them home if no one wants to trade for them.

4) Is it better to bring single servings of many items or many servings of a single item? I’m still not sure what the best answer is to this question. Please share your thoughts. Is it better to bring one serving of several different items, or multiple servings of a single item? I took single portions of four different things, but wound up wishing I had multiple (smaller) servings of some of them. Most people had a single item with multiple portions to trade. A few folks had two different food items with multiple portions. The bottom line is that you can potentially take home one new item for each item you bring to trade, so having multiple portions allows you to try far more items.

I can’t wait for the next Indy Food Swap! Did you go to the most recent one? What lessons did you learn? If you’ve never been to a food swap, what questions do you have?