August 24, 2021
Recently, long-time Siren Socks user Tim White was featured on the Real Life Diabetes podcast, where host Amber Clour spoke with Tim about how he has managed his diabetes over the last 55 years. Below is a transcript of the conversation. You may also listen to the episode directly by visiting The Real Life Diabetes podcast episode page or accessing it through Apple Podcasts or wherever you listen to podcasts.
Welcome to the Real Life Diabetes Podcast, with today's guest who's lived with type 1 diabetes longer than I have: Tim White. If you're new to the show, welcome, and thanks for stopping by. My name is Amber Clour and I enjoy sharing my story and those of other people living their best life with this disease. And is the very reason I created the diabetes daily grind and host this, the Real Life Diabetes podcast.
It's rare that I meet someone like Tim who's lived with type one diabetes longer than that. That's a long time. The fact that his grandfather smelled his breath to confirm his type 1 diabetes diagnosis is a quick reminder of how far we've come. But before we get started, I have a few quick announcements. Number one, this episode was brought to you by my friends at Real Good Foods.
Right now I'm totally digging the ground chicken enchiladas. Not only are they delicious, but they're also gluten and grain-free because the tortilla is made with chicken instead of processed flour. And I mean, winning on so many diabetes levels, at least in my world, real good foods is now a part of my affiliate page.
So pop over to diabetesdailygrind.com to do a little shopping amongst other reputable brands that are making my life with this disease easier. One number two, the diabetes daily grind is a non-profit organization. Funds raised help keep the website podcast and advocacy efforts afloat. Just click on the donate link in the show notes and finally stay engaged, love, like, share, and comment on all things social media, sign up for the e-newsletter. Leave an iTunes review, subscribe to the DDG YouTube channel. That's so hard to say and click on the Amazon banner on the website before ordering it. Doesn't cost you a thing and throws a little change. All right, let's get started. Welcome to the Real Life Diabetes Podcast.
Tim, tell me where you're calling in from. I'm calling you from El Dorado Hills, California. It's a community of about 50,000 people. We're about 25 miles east of Sacramento, and about 60 miles west of Lake Tahoe. We're sort of right in the middle of a highway system. So I'm sure it's beautiful there with the exception of you guys are in the middle of a heatwave.
It's like a hotspot. It's hot, whatever they call it today. It's going to be 102, and that's not unusual. We get a few days like that each year, but the next two days they're predicting 109. So that is hot. And then, you know, to the extent possible you get up early, do whatever you have to do outside before it gets too hot.
And then you try to stay inside and enjoy the shade in New York. Right? Well, and you know, I, I read all the time about the effects that temperature has on diabetes. And I take extra precautions. We have to take whether that's being well, not being too cold, but our insulin and things like that being too cold or too hot.
So do you feel like with this heatwave, I mean, you've had diabetes for a really long time and we'll get into that here in a second. So it's probably like second nature. You don't think about it, but when you really think about temperatures like that, is there anything else that you're doing with your diabetes management that could be different just watching it, obviously, you know, you go outside, even you go out at eight in the morning and it's already 88 degrees.
It's high and you know what I might do normally and not worry about it, you know, I'm sweating more than usual. You put on sunscreen and a hat and all that, but even so, you can quickly get dehydrated. You can quickly get certain signs of heatstroke. So, you know, you go out quickly to do what you have to do.
Like you said, I've been a diabetic for a long time, so it's somewhat second nature, but I'm certainly always alert as to the warrants. Yeah. And, you know, with an insulin pump, I get, you know, warnings, if I'm going low and stuff like that. So I'm very aware of where I am in the presence and what, and how it affects my diabetes.
Okay. So I want to start to listen to—and I don't know how to word this without it, hopefully not sounding, oh, what's the word, offensive. Maybe parents meet me and know that I've had type one diabetes for 38 years or whatever years. And they've got a child that's newly diagnosed. It's like seeing somebody, it's like, you're a superhero because you've lived this long.
You look healthy and things like that. So it's always nice for me to meet someone who's had type one diabetes longer than I have. So. You don't mind sharing a little bit about your diagnosis story and maybe the year and stuff like that. So everybody has an understanding of how far things are.
Well, my diabetes story started in 1966. I was 13 years old. I'm 68 years old. So I've had type one diabetes for 55 years. I think probably like many teenagers when you get it. You know, I don't think there was as much awareness of diabetes 55 years ago as there is today. You know, as a teenager, you're eating a lot, you're drinking a lot, and I was losing weight, but also shooting up two inches, so that didn't strike me as weird, urinating a lot and getting too. One day, I was heading off to walking off to school and I walked up the block and then I turned around and came back and said, mom, I'm just too tired to go.
So what did your mom do, did she put you to bed?
My mom called my grandfather, who was a retired surgeon. He came over and he smelled my breath, you know, that was sort of the old-fashioned way of telling if something may have gone wrong. And he said, "I think we need to get him to the hospital."
So took me to the hospital. It turned out that I had a blood sugar level in excess of 750. They put me in intensive care for the night. You know, you're 13 years old. You were told you have diabetes. But you don't know, you haven't even learned anything about it. They've got fluids going into you. There's a bunch of much older people who seem to be in a lot worse condition and it was sort of scary, but, you know, I got through it.
And so I've been living with it ever since. So when you were diagnosed and I'm always fascinated by this, like I spent almost two weeks in a children's hospital, I was not in DKA. Like you were saying, you were in the intensive care unit for a night. Did you stay a week? And how did you learn how to manage your day?
I stayed one week, you know, the first thing they tell you is you're going to have to give yourself shots. They told my parents that they would show them how to do it. And my dad said, no, show him how to make sure he's the one who's going to have to do it. So right off the bat, my parents made sure I was independent enough.
So I was old enough to give the shots. Now, I think for a while, young people, you know, early diagnosed when they're ages two to eight or 10, that may be difficult to do. But as soon as you have the independence to give your own shots and start managing some parts of your diabetes, I think it's important that children do that as soon as they're capable of it.
And as soon as their parents are comfortable enough that the child can do that. I agree. Yeah. So I get it. I mean, think about this. 55 years ago, giving a shot was very different. You had to boil stuff, the needle, or actually yes, avoided that. When I was diagnosed just about a year before the BD finally came out with disposable syringes.
But for diabetics before that, yes, you had to use the same needle. You had to boil the needle. You have to sharpen the needle now. You know, disposable needles, we have insulin pumps. The technology is just so much further along and it's so much easier, but yeah, you know, I was never Alessia say I didn't, I never liked particularly light shots.
And then you finally find out you're gonna have to give yourself a shot a day. And then of course over the years went from one shot to two shots, to three shots, and then finally forced you. And then finally I went to an insulin pump, so that sort of reduced the punters to the legs, stomach, and all the rest.
Okay. Last question about your original diagnosis, what type of insulin were you put on? Was it like beef or I don't even know, because it was, it was poor. It was a combination, I think, of pork and beef. And there were always concerns that if enough pork and beef weren't going through the processing plants to get the pancreas out, that you'd run out of insulin.
I mean, I'm not sure how great a concern it was, but it was something about awareness. Obviously, you want to develop things like Humalog and NovoLog that synthetic insulins, if you would, that made a huge difference. I think for diabetic management and also just the safety of the product. Well, absolutely.
I just, that's so crazy to me, especially for somebody like myself, I don't eat pork and I can't imagine having to inject it into my body to stay alive. So let's talk about your current regimen. You mentioned the fact that you're on an insulin pump. Now, you don't have to say what you want if you don't want to, but I want to start with, why did you decide to switch to.
You know, I sort of followed the technology. I went to a diabetic—what do you call it?—convention. It was a get-together at Long Beach, Long Beach auditorium. And, you know, they had all different providers. They are offering diabetic supplies and services and motivational speakers.
And in fact, one of the speakers was I believe Jerry Mathers star of Leave it to Beaver. I believe he is a diabetic. And so I went to a few of the tables and I actually went with the Medtronic pump and I was interested, a coworker had gone onto an insulin pump. And it was something that I thought would help me manage my diabetes.
And the idea that you maybe only had to inject once every three days or every four days as opposed to four times a day was appealing. So I finally got around to it. I won't say I'm a, you know, a, one of the early adopters, but it makes sense to me. So I've been with the Medtronic pumps for 15 years now, since 2006; I'm on my fourth pump. I just got the 780G about three weeks ago. And I'm sort of breaking it in. And do you find, I guess I always feel like, with technology, I'm so thankful for it. You know, I have let my CGM, but it's always kind of like a learning curve and I can't imagine with insulin pumps and I watched my friends obviously deal with it.
How, how was the transition from the older Medtronic into the new ones? Do you feel like it's an easier fit or more of a learning curve? I think if you. With CGM, which I did have. I think it's just, there's more information available. They have this link, you can link it up to your phone. And so I can get real-time.
I could just look at the Medtronic app and I know I can see what my, how much, how much insulin active insulin I have. What my blood sugar is at the moment based on the CGM, CGMs are pretty good, but we all know that they can have a five to 10% differential from a finger stick, but at least they give you an idea of where you're at. And of course, with the alert function. If you're going high or going low, you can get the alert and take the appropriate action to deal with that. Okay. So here's one of the things that I've learned. And especially as I now in my forties as I've got older, do you still, did you okay. As a kid, did you feel your lows? And what was the feeling for you? What, how did you know that you were going low? It was, yeah, I could get the shakes. I sort of out-of-body a little bit out of the little, even a little weird out-of-body. I know it's hard to describe it, but I could tell. Yeah. You know, back in the day for years, I carried a roll of lifesavers in my pocket because that was sort of a quick and easy way to.
Pre the low eyes you didn't know hygiene didn't know about because you weren't. There was no CGM. There was no A1C. There was no finger sticking glucose meters. You just kind of had to deal with it, but I still carry, I still carry a couple of lifesavers now. No single rep, but again, if they're quick, they're easy. If I feel a low coming in, or I can tell those pop one in my mouth, take a break. And hopefully, that'll get me back to back to within range or at least alert me to go get, get some juice or something if I need more. Okay. So here's the question. So is live on for 15 years. You're retired. How long have you been here?
Let's see, 13 years. Okay. So I don't know if this is well, did you wear your pump to where everyone could see it? Yeah, so I, I wasn't hiding it, but I wasn't, you know, I seen people wear ponder pockets. Like, why are you doing that? But, okay. I wore it on my belt. Many peoples were going to G you know, you're still wearing a pager, you know, pagers and I still.
You have gotten comments on that recently about you're wearing a pager? No, I'm wearing it again. I think it's, I know some people, they don't want to be identified as a diabetic. They maybe they just don't want to be identified as different than others, particularly teenagers, and use that. I understand that.
I certainly didn't go bragging when I was a kid. Well, I'm a diabetic. Wow. Lucky me. I think that diabetes, I don't think should define it. I, yes, I am a type one diabetic. I'm not going to deny that. And I take the appropriate measures to deal with that. But you know, I, wasn't a diabetic attorney. I'm not a diabetic retiring.
I was an attorney who had diabetes. You got people in every profession, every way of life. Who are diabetics? They're not defined by their diabetes. They're defined by what they're doing in their regular career. Whether it's a student, whether it's a gymnast, whether it's a firefighter, they are dealing with it. They have to deal with their diabetes. But first and foremost, they are whatever they're doing. And that's how they, I think they should look at it to me, diabetes, put us on a defensive. We got it. Bad deck of cards. And we, we draw the wrong car, but you know what? You have to deal with it. So you got to put on a defensive, what do you do when you're on the defensive?
You go on the offensive. And that's what I think all the treatment options that are available today, finger sticking. Like I said, when I was growing up, you went to the doctors every three months or those hospital labs. They didn't have Quest and all those other labs, you have to go to the hospital to get it drawn blood.
It did once every three months and you get a blood sugar. There's fasting blood sugar. Usually, it was in the seventies or eighties and they said, okay, good job in three months. But you had no idea what was going on. So, you know, with the A1C then with the finger sticks the glucose meters, the insulin pumps, all different manufacturers.
All these products have made it easier to manage your diabetes. And if it's available to you, take advantage of it and use it because if you could manage your diabetes safely and efficiently, you're going to avoid the hopefully. The consequences of long-term diabetic care. And we can talk about some of those later, but, you know, knock on wood.
I've been able to avoid, I think, many of the most concerning, you know, my eyesight is still good. Yeah. And I got to say because I just had a ton of blood work done last week and just like anybody living with diabetes. You have to have at least once a year X, Y, and Z tests. And I had a moment and I'm saying this for someone who's lived with this for such a long period of time, is when you say, go into the hospital.
I knew that I went, when we went to the children's hospital, every three or four months, we were going to walk down the aisle and we hadn't followed one color of the pathway. It was orange. And I knew that I was going to get labs done. So the fear of having blood taken was, has always been such a big. But my mom knew that it was such a big deal that we usually went shopping afterward.
So my shoe addiction was born through having to have blood work done. So I always give myself a little bit of a gift. And when you have the work done and I even sent a day, cause I got my results in and I'm very happy with everything. And my mom asked about it and I was like, Number one, number two, you know, and she was like, I don't understand why you're so defensive about it.
And I was like, I've been judged by a number of my whole life. And you know, when you ask, how did it go? It's just, it was, it was a poor decision on my part to talk to her like that. But it's one of those reminders. You know, my friends that don't ever get blood work done, unless they're sick and there's a problem.
And so it was just a reminder this week about, yeah, we're just a little bit different and the offensive, you gotta step up, you got to do whatever it takes to hopefully avoid the complications. And so you had a very successful career as an attorney, and I'm saying that right. Even the college years are difficult diabetes or not.
So do you feel like you had any difficulties and I don't like that. We're trying to deliver things at any point in your professional career because of your diabetes management. Now, I feel like I have a pretty disciplined personality because of my diabetes, which has helped. Areas in my life. So anything that comes to mind with that type of weird question, I agree with you.
I think that in order to manage your diabetes correctly, you do have to be disciplined. And I think that discipline does carry over into the other facets of your day. You know, as an attorney, I was, I was busy, you know, I worked for the same company for 26 years. And for the last 10, 12 years, I was doing international finance and heading up a team of attorneys across the world, literally.
So, you know, it was long hours. I'd be. Because I was based on the east coast at the time, I'd be on calls with Europe, you know, five hours ahead of us at six in the morning. And then the calls from Australia and China would come in at 10 or 11 o'clock at night. So it was a lot of long hours, but other than not getting enough sleep.
But I think that's indicative of a big table and many careers. I don't think diabetes affected what I did that, whatever traveling I had to do, I was able to manage. Diet beauties. Well, again, I think the things like the insulin pump just made that a lot easier in terms of recalibrating it to local time when you get there.
I think that again, I was just very aware of my diabetes and, you know, in those days, I would be looking at testing maybe eight or 10 times a day, particularly for travel because things can go up and down. You may, you're not on your normal, probably not on your normal diet. The hours may be different on a business trip to Argentina.
You know, there, the culture is you don't eat dinner. Nine o'clock is early dinner, eating dinner at 10 or 11. So that was an adjustment because I wasn't going to say no, I can't eat or I'm not going to eat, or I'm going to go eat at the hotel room while everyone else goes out. No, you gotta be part of the group.
So you make the adjustments necessary. Yeah. And we're going to talk about, you've got an upcoming big drip, but we're definitely going to touch on that here in a little bit. I don't want to talk about it. No, I've looked at a couple of complications in the square interface, and I'm thankful to say that I don't have any long-term obligations.
I've had a retinopathy scare twice and worked through blood pressure medication meditation. And just knowing that I was in a too stressful situation. So there were a lot of factors there. And so I know you've had a couple of things and I think I bring, I'm bringing this up. I guess you talked about frozen shoulder whenever we connected a few weeks ago.
And so do you want to share any complications that you've had? And I say that because I want to talk about possible complications and then some of the other resources that we post found that once you come across these things, you know what action you take in order to see it again? Yeah. I mean, I was an active tennis player for a long time.
I mean, not particularly good, but I enjoyed playing and at some point, it got to the point where, when I was going to work, I couldn't even list my elbow or my hand or shoulder up high enough to put the slot to get into the garage, the card. Yeah. Right. And so I was diagnosed with frozen shoulder, and then it got into the other side and it turned out that frozen shoulder is a complication of diabetes.
For some reason, I had arthroscopic surgery on both shoulders now, almost 30 years. But that ruined my tennis career because I just couldn't serve anymore. But again, I had the surgery, I've got probably 95% rotation back and all that. It's just my 2% I didn't get back in my right shoulder, which prevented me from serving a tennis ball.
I switched. Did you, you went from tennis golf, right? But then I try, I tried golf again. Not particularly I enjoyed playing. It's nothing worse, nothing better than going out on the golf course for four hours and you know, and walking around and swinging at it and occasionally get lucky and the ball goes where you want it to go.
But I think I enjoy golf and I played that for a number of years. And then when we moved back to San Francisco, it's just sort of dropped off because of a different reason, Right. But, and then the other thing, you know, the major thing and the major negative side effect with diabetes with some foot surgery I had, I had real problems with my left foot.
One person said I had gout. Okay. Gout. Okay. The next person said, let's take a look at this. It wasn't gout. I think I was just a wrong diagnosis by that, that I trust. But new year's Eve 2000. 11 or 12, my foot swells up. It was huge. Alright, I said, let's go to the ER, go to the emergency room and check it out.
Well, it was a major thing. I apparently had Charcot foot, the bone, it started to dissolve and collapsing my foot. Three times normal. I spent New Year's Eve in the hospital. The next day, New Year's day, the hospital was the surgical wards were closed, but there were three emergency surgeries. I was one of them.
They drained a lot of fluid out of my put a four-inch scar on my left foot heel, heel to toe or so drained. They didn't sew up the whole foot. It was still too swollen. So they left it open and then five days later they went back up and were able to sew it together. It's healed well, but you know, it was misdiagnosed initially.
But once I got the right treatment, it was terrific. Three years ago, my new podiatrist up here in El Dorado Hills area told me about a company called Siren. And he says, I think this company might be something you would be interested in. This company produces special socks that have six temperature sensors in them and they measure the temperatures in the right and left foot in the corresponding areas.
It's been showing that they can alert you to problems with your feet, because if you're having a, if you have a potential foot ulcer or cutters, if you're not aware, The temperature in your foot where you have, that will be higher than the corresponding other foot, because it's inspiration, right? Like the inflammation-fighting infection or something.
Yeah. And it, and, and again, I checked my feet and you may not notice it, but they noticed it first. So earlier this year, starting February and March, I was getting a lot of red alerts saying, Hey, there's a big, different temporary temperature difference. Between your left foot and your right foot, the differential was in my right foot was, was a non-Charcot foot.
And so I talked to my podiatrist, I talked to the Siren Socks folks. They had not seen us. They said, you know, let's look at your feet. As I looked at my feet, I had my wife look at my foot to make sure there was nothing I didn't see or feel there was nothing there. But I was getting again, I had, you know, 20 days of red alerts, which is unusual.
So the early diagnosis from Siren Socks told them: get off your feet rest as much as you can. I know you have to do some stuff, but you know, don't garden as much, or just cut back. So I sat there, rested, read books, watched some TV, and it cleared up by itself. But I'm convinced that without the sock warnings I might've, I would not have known because there was no external evidence that anything was wrong, and who knows where it would've gone.
You know, one of the things I say. I mean all the tools, you know, I use a number of tools every single day to manage my diabetes and whether that's compression socks, or the siren socks, which are giving you alerts the CGM, you know, as a matter of a finding the tools, thankfully your podiatrist or your GP knew about the tool.
That's one of our jobs. As people living with diabetes to say to our medical community, I need this, I want this, I'm interested in this. And to be honest, too, Hey something's not right here and because you don't see, it doesn't mean that it's not there. So I'm telling the people out there with diabetes as a patient advocate, you need to be able to start guiding that conversation.
Siren Socks sound awesome. I've never worn them, but I've heard great things. And I'm very happy that you're able to share that because would you say that it was totally preventative? I mean yes, absolutely. They are something brand new that came out three, four years ago. There wasn't something like this before that they'd built on, they came out with a new product that addresses a specific concern. I think the podiatrists out there if they listen to this, should check it out to see if it's something that they should advocate for their patients. Again, it's a pair of socks. They're not difficult to wear, they come in black and white, you know, if you're not a sock person and that might be an issue, but again, you get early warnings. And again, that's what you're trying to do. You're trying to prevent a good early warning about a foot ulcer. So you can deal with it before it becomes a major issue in your, in the hospital.
Yeah. Well, and the good thing is you listen to your physicians and you got off your feet. You took some time to rest, which is hard for a lot of us, especially as an active person like yourself. So if I remember correctly, A master gardener. Yes. And a master gardener here in Alvarado county. And I'm, you know, we have a relatively small vegetable garden, but a lot of raised beds and we're right now we're actively growing.
Let's see. What's out there. Squash, peppers, tomatoes, cucumber. Asparagus season has done. Let's see, artichokes season is done, but you know, and then we'll get the winter crops in September, October, we're putting out lettuce and kale and stuff like that. So this is you're the second person I've interviewed since addressing two questions.
And I feel like you kind of addressed them without me asking them is that you worked for a particular company for 26 years. So I'm willing to bet you've had good insurance. So access to devices, insulin, and things like that. Would you say that, that you had access to things easily? I would say yes. Yes.
Absolutely. Like you said, it was a good company with a good health program and you know, things were available through the medical insurance provided well and good on you. That's nothing to be ashamed of it. I, you know, some people are, I'm not going to get into that because I'll be around a whole. But I think that one of the other things that other question I would ask is, do you have access to healthy foods in your area?
Well, you do because you're growing them. So that's it. In addition to that, you're living in the heart of the country that probably has, so the closest grocery store is probably not far and I'm willing to bet it has a lot of fresh names. Is that right? That is correct. Yeah. And there's, you know, there are several local farmer's markets, you know, Wednesdays, Saturdays, or Sundays.
So if you're not growing something, you know, you can go to those and they have a much greater variety of anything that we could up. Well, I think I'm saying this out loud to you because I love to garden and I have friends that do tomatoes. I've got other friends that do peppers. So we kind of all share with that.
I'm saying to the listeners, if you do not have access to fresh vegetables, I'll gladly send you some seeds, then you can learn how to garden a little bit. That's a great life. Check out the community garden because a lot of community, if you don't, if you're living in an apartment building and you don't really have a garden checkout to see if your city or the park department has a community garden, where you can get a four by four, four by eight space and you can plant your own things and you'll be with the community of Cielo guard.
Who can certainly advise you of what works here and are in your neighborhood or in your weather area and what doesn't work. So, you know, it's not that hard, really to grow it to me. I know. And I don't know if it's the summer weather, it's been weird here and really writing out some of you not too hot, we have more tomatoes.
It's like, it's crazy. I'm very thankful for that. And you can't, you can't be the fresh tomato. And so I'm glad that we talked about all that. Cause I'm going to put this in the show notes. I'm going to look for some community gardens. The resources, excuse me. If you're interested in starting a community garden or how to find a community garden, I will see what I can find and put it in there.
So you can get involved because gardening, I don't care who you are. If you put your hands in the dirt, whether that's the flowers or tomatoes, would you say that? I mean, it's therapeutic for me. Yeah. I mean, it's, you know, it takes a while obviously, but you start with a little plant like this and suddenly it's you know, those tomato plants can go four or five feet high in four or five feet wide and yeah.
And then you're sort of digging through the leaves and finding that, you know, right. Or we have some of the yellow, gold cherry tomatoes, which are bright yellow, but they're, they're wonderful. You mix them in with some bread, cherry tomatoes, you have a beautiful-looking salad. Well, okay. So I want to kind of wrap things up with the fact that you are an active person.
And even though you force yourself every once in a while to take it down a notch and relax your legs, you are training. I say that loosely for an upcoming trip to Egypt. Let's talk about that. That's not until next year, right? And you booked this trip during the pandemic, just knowing that everything would hopefully come back to normal and you'd be ready.
We booked it about three months ago through alumni association travel. And yeah, the hope was that we were we're anxious to get out again. Like I think everyone is, you know, we were all, we were all sort of in our houses or apartments, not going out. Luckily we had the garden to get into so that, you know, it was easier for us, but we've always enjoyed traveling.
You know, now that we're retired, we can take some maybe longer trips we could have otherwise. So yeah, we booked this trip to Egypt which is 15 days. There's I think three or four days in Cairo, then we're going to be sailing up th
About Siren SocksSiren Socks are innovative smart socks that detect potential issues with your feet. Siren Socks are an FDA-registered Class I medical device and are for people with neuropathy.The socks measure your foot temperature. Temperature monitoring has been shown to help prevent diabetic foot ulcers in multiple clinical studies clinical studies over the past 20 years and is considered the gold standard in diabetic foot care.The information from the socks is monitored by licensed nurses who contact you regularly to check on your health and the status of your feet. Your doctor review any issues that arise and determine if a clinic visit is necessary.Siren Socks are covered by Medicare, Medicare Advantage, and many private insurance plans.Interested patients can find a Siren-Certified Provider near them and begin the enrollment process by clickinghere.