Diabetes costs ‘Impossible to pay’
Atlantic Canada not on par compared to rest of country, says doctor
When I turned 25, I no longer had coverage. It’s like this magical number they come up with where they think you’re gonna be financially capable ... which is hilarious, because the cost of a new insulin pump is over ten grand. Sarah Woolridge
Sarah Woolridge wasn’t herself.
The 11-year-old from St. John’s, NL was going to the bathroom so often she couldn’t play in a soccer game. Her energy levels were unpredictable. She had lost weight. She could fit in clothes she had outgrown the year before. She was moody, snapping at friends and family, then feeling bad about it later. She was thirsty all the time.
“I did have symptoms for probably a month, and then I started vomiting one day,” remembers Woolridge.
Her father took her to hospital. Woolridge was in profound diabetic ketoacidosis, a condition that can cause death. Her body was not using the sugar available in the blood; there wasn’t enough functional insulin to deliver it to her muscles and organs. Woolridge spent several days in the intensive care unit.
Woolridge was more than sick; she had a disease called diabetes. She’d become one of the estimated 182,000 people affected by diabetes or prediabetes in Newfoundland and Labrador.
'THINGS ARE NEVER GONNA BE THE SAME’
After the ICU, she spent some time in a ward to learn about her diagnosis. One afternoon, someone asked her if she wanted something from the vending machine. Opening her mouth to answer, she realized she couldn’t just eat whatever she wanted anymore.
“I can remember having that moment of realization: things are never gonna be the same,” she says.
While making this choice, and any she would make in the future, she would have to think about her diabetes.
“For some reason, that moment was when everything changed in my mind.”
Soon Woolridge found herself in a world of testing and appointments. Her frequent bathroom breaks were replaced by blood tests and insulin therapy. The young girl was self-conscious of her condition.
“I can remember my mom having clothing tailored so that a pocket was built in, so I could hide my (insulin) pump,” she says.
Swimming, eating, drinking, socializing—every activity was tempered with a mindfulness of the disease. Despite the fact about one in three people from Newfoundland and Labrador have some form of diabetes, some people around her didn’t seem to understand it. They would ask how she could have diabetes even though she wasn’t fat, or why she had it and none of her family members did.
Type 2 diabetes, also known as adult-onset diabetes, is the type brought on by things like poor diet and lack of exercise. Woolridge has Type 1 diabetes, which is caused by an unknown mechanism related to infection. The immune system attacks the cells that make insulin, leaving the body unable to metabolize sugar. Woolridge’s diabetes came from a cold, not from an unhealthy lifestyle.
Still, seeing and hearing how some people reacted, “I carried a lot of shame in having the disease,” she says.
IT TAKES A TEAM
Despite that shame, she had a “really supportive team” to help her with problems that would crop up. She remembers one New Year’s
Eve when her insulin pump crapped out. The nurse practitioner who worked with her “left whatever she was doing and brought me a replacement,” says Woolridge. The pediatric care team, along with Woolridge’s family, was very supportive.
As she grew up, Woolridge started volunteering with Diabetes Canada to advocate for pump coverage so people could have better access. Her experiences motivated her to apply to medical school. She got in. During this time, provincial insulin pump coverage was extended to age 25. Any older, and the person has to pay their own way. Woolridge kept her pump as long as she could.
“When I turned 25, I no longer had coverage. It’s like this magical number they come up with where they think you’re gonna be financially capable,” she says regretfully. “Which is hilarious, because the cost of a new insulin pump is over ten grand.”
That’s only the up-front cost.
“And then the monthly supplies … can be up to $500 a month. And for a student, that’s impossible to pay.”
Woolridge exhausted her student line of credit and had her pump removed while she was in medical school. Now she has to inject herself with needles several times a day. In class, she learned about how insulin pumps reduce the chances of diabetes-related complications and early death.
“That was really tough, knowing that I wasn’t able to receive the best quality of care because of my finances,” she says.
When Woolridge outgrew the pediatric care system and entered the adult system, she found resources were scarce.
“You go from having a care team that is so involved in your care, to really feeling as though you have nothing,” she says.
She feels that her medical education saved her from making life-threatening mistakes.
Sometimes, in the emergency department, she would see other diabetics about her age, in the same state she was at age 11.
“I saw it as a health care provider, the number of young people in that stage who would come into the hospital in diabetic ketoacidosis, who were struggling youth who had just left the pediatric system and had fallen through the cracks in the adult system, and I’d be standing there in the ER thinking, ‘if I didn’t have my medical training, I’d probably be one of those people.’”
ADVOCATE FOR CARE
Woolridge will finish cardiology training in May 2020 and plans to move home when she can. In Alberta, where she studies, the cost of diabetes treatments are covered by the government for life. She says she’d “love to move home” once her training is done and she starts earning an income to pay for treatment.
“It is a deterrent in coming home, the fact that access to diabetes care is so poor. I think that it makes me think twice about coming home,” she says.
“I don’t think we are on par with diabetes care in comparison to the rest of the country.”
Woolridge has become an advocate for diabetes awareness and care. Despite her efforts to live healthy, the disease continues to affect her every day.
“My husband’s an ultramarathon runner, and I train to try and run marathons, but I find it very hard with my diabetes to run that distance and be able to manage blood sugars along the way.”
Her medical training helped her, and now she helps others. As a doctor, she works 80 hours a week - a different kind of marathon.