Month: November 2008

Counting my blessings, large and small

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Of course you’d expect it, but today is the day–although it’s a good practice to do it every day–to take a few moments and think about what we’re thankful for.

So here’s my list:

1. The love, support, friendship and encouragement of my husband (I’m also thankful he works in Holland, particularly since we live in a tiny one-bedroom apt.)

2. That my parents are still living — close enough, and far enough away

3. My friends who truly know me and like me anyway. Some even offer to bring me soup when I’m sick. Hmm, maybe I should reconsider the others…

4. This work that I do that I didn’t even have to go back to school for! In fact it seemed to come out of thin air. (My husband says that’s not true, I did the hard work, but then he’s loving and supportive.)

5. All the people I meet through doing this work: fellow patients and diabetes professionals. There is an immediate bonding, and while I might prefer not to be in this club, at least this club doesn’t have cliques like high school did. Ugh!

6. Peanut butter and yogurt. I discovered it decades ago and still don’t understand why Danon doesn’t have such a flavor.

7. The beauty of where I live: brownstones, trees, sky — 20 minutes from Manhattan, and ah, only 20 minutes home.

8. My health: I’m not missing any body parts, I have all my senses and outside of diabetes, I’m fit as a fiddle.

9. That nobody asked me to create a list of “10 Things I’m thankful for,” so I can stop here.

10. But then, just as I was posting this list a friend (#3) sent me these photos, and I love them. So, there is a #10 after all. I’m thankful for a good laugh and tender moments.

 

 

Counting down to the holidays

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My Omron pedometer

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As I sail from Thanksgiving into the merriment of Christmas, Hanukah, Kwanzaa and New Year’s Eve, counting how many sweet potatoes and marshmallows I just devoured and how many cookies and glasses of champagne await me, I have one eye on threatening extra calories. But I have my other eye on a different set of numbers.

Diabetes comes with so many numbers. Our pre-meal blood sugars should be between 90 and 130, our 1-2 hour post meal blood sugars should be between 120 and 140, our A1cs should be below 7, our HDL over 45, LDL under 100, oops no, for us it’s under 70, our triglycerides under 150… you get the idea. But here’s one measurement I find truly encouraging, rather than discouraging. Counting my steps.

I know how I eat and how I move affect and create all the numbers above, but here’s one value I feel I have immediate, visceral control over; how many times I lift my foot, stretch it forward and put it down again. And, I am rewarded (not just with my blood sugar going down, my insulin sensitivity going up, my calories going away,) but with the instant knowledge and immediate gratification of seeing the results of my labor. 

These 9,183 steps on my pedometer are yesterday’s count from a one hour and 15 minute walk. On this late fall day I was strolling through a nearby neighborhood peering into new restaurants and kicking the leafy foliage underfoot. Since these 9,000 plus steps occurred between 11:30 AM and 1 PM, I know my ambling around my apartment before and after certainly put me over the 10,000 steps a day recommendation for physical activity.

There’s something truly motivating in seeing such immediate results of your efforts. Every time I give a diabetes presentation and show my pedometer someone will ask me where they can get one. Maybe they like the “gadget-ness” of it, but seeing things in black and white makes a big difference — it gives you a feeling of control. And as we all know, diabetes feels pretty uncontrollable a lot of the time.

So while you’re counting how many holiday parties you’re going to, slices of pumpkin pie you just ate, mini hot dogs and mushroom tartlettes you’ll be sidling up to at the buffet tables yet to come, remember, you can always count your steps. Getting them up to 10,000 a day, I guarantee you will put a holiday smile on your tiramisu-stained face.

Blood & Honey sheds new light on diabetes

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I was impressed when I tripped over Jessica Bernstein in an article in DiabetesHealth magazine last month titled, “Blood & Honey: A Documentary.” 

Bernstein is a psychologist making a documentary film that deals with the psychological component of living with diabetes. As a type 1 diabetic herself, she says,  “I wanted to understand how living with the condition for so many years influenced people’s identity development.”

Like me, Bernstein has seen that diabetes researchers are focused almost exclusively on the negative aspects of diabetes. Few talk about how people can develop in positive ways as a result of dealing with diabetes. Bernstein began turning this realization and curiosity about how diabetes can have a positive, developmental affect into a film.

Her film, Blood & Honey is still partially in development and looking forextra funding. At present, the film features interviews with several people who live with chronic illness and explores what we can learn from them. There’s an African medicine man who shares that peple who live with chronic illness for many years in his culture are considered “elders,” the wise ones that communities draw upon in times of crisis. An interesting and far different slant than how seniors who live with diabetes here are regarded and hold it themselves. Here the primary sentiments attached seem to be:  blame, guilt and victimhood rather than wisdom and reverence.

Philosopher, Susan Wendell, who’s lived with chronic fatigue syndrome for 20 years also featured in the film believes people who spend years living with chronic illness learning how to deal with pain and suffering become valuable resources for others. “We don’t talk as much about the experience of illness as we talk about how to get over it, how to stop it, how to prevent it, how to relieve it, how you can be healthy if you really try,” says Wendell. “I think there’s an enormous body of knowledge among people who are suffering that is untapped and if we tapped into it we’d be less afraid and know better how to cope when something happens to us,” she finishes.

As producer Bernstein says,”Coming to see myself as someone with wisdom to share was a revelation.” When Bernstein tells someone she’s lived with diabetes for 36 years, as have I incidentally, they remark, “Oh, I’m so sorry.” Nobody she says has thought to pick her brain and learn what she’s learned about central issues of diabetes and life, like uncertainty, loss, change and mortality. 

Imagine just for a moment how it might change how you feel about yourself and living with diabetes if you regarded yourself as a wise one where every day your strength, courage, humility and dreams are tested, and you learn from such experiences. Would you see yourself differently, your capability and value?

Bernstein’s film has gotten off to an exciting start and is seeking funds. Learn more about the film by checking out her web site, and you can make a tax deductible donation through www.bloodandhoney.org.

Some simple thoughts as Thanksgiving nears

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P1010077 copySimple pleasures: put time aside  to enjoy them

What if we had to purchase happiness and self esteem the way we purchase most things? Would you value it more? Would you feel it more? Would you recognize it as a tangible commodity you owned? Would our lives be happier, easier, more joyful overall? It’s an interesting notion I think.

Somehow it seems negative emotions:  anger, fear, guilt, worry get more of our attention and feel more at home in our lives than positive emotions like happiness, hope, pride and success. Is it just fear of failure or something else at work. I don’t know, but if you had to pay for simple pleasures –  a sunny day and clear blue sky, a field of flowers, to have the loved ones in your life that you do, the satisfaction of a job well done, a fun dinner with friends, coming home after an arduous trip, having your kids put an arm around you – would you enjoy these things more? 

I try these days, as too many of my contemporaries are getting ill and passing away, to recognize how fortunate I am and cherish the day and all it brings. Time passes much faster than it used to, so I’m trying more and more to follow the words of a very wise man, “Be the change you want to see in the world.” These were Ghandi’s words. So, if you want to have love, be love. If you want to enjoy peace, be peace. If you want to find joy, be joy. If you want to see yourself live well with diabetes, live well with diabetes. 

And I think the way to appreciating things more is, while not necessarily easy, pretty much as simple as what Christopher Robin said to Pooh: “You must remember this: You’re braver than you believe, and stronger than you seem, and smarter than you think.” Hmmm…that’s a lot to take in, and yet, some pretty good stuff to live by.

My hat’s off to the diabetes sales reps I meet

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This post comes late in the day on what is today World Diabetes Day, the one day during the year the whole world tries to raise awareness about diabetes. I have just returned from giving an educational diabetes presentation in Burlington VT. 

I often think I gain more than I give–I receive the heartfelt appreciation of patients whom I speak to and equal appreciation from the true soldiers in the field, the diabetes educators and  nurse practitioners. Perhaps it will surprise you to know I also receive great appreciation from the pharmaceutical sales reps of Sanofi-Aventis, the sponsor of the A1C Champions program I deliver and the manufacturer of Lantus and Apidra insulins. 

It is one of the reps job’s to sell the program to their accounts, the doctors, nurses and educators they service, and it is a win/win. Patients learn how to better care for their diabetes, get inspired and motivated by hearing about it from a fellow patient who knows the experience of living with diabetes, and when they begin to take better care of themselves it can involve using insulin, which benefits Sanofi-Aventis.  But all the reps I have met are incredibly caring people who want to help patients.

So, it seems appropriate this day to share with you an email sent to the organization I do this program through from a Sanofi-Aventis rep about the program I delivered Tuesday in Jersey City, NJ. 

Dear Management Team,

…Today we had an A1C Champion presentation by Riva Greenberg a Type 1 diabetic patient. Riva talked to more than 30 patients and shared with them how easy it is for her to manage her diabetes despite the fact that she takes multiple shots a day, more than 7 (including testing) and yet she has a very fulfilling live. 

We witnessed the increased interest in patients from the last time we supported a similar event by the overwhelming number of patients at today’s presentation, as well as the amount of patients who had one-on-one questions for Riva after her presentation. 

It was very inspiring to me to hear some of the comments she made to encourage patients to take better control of their illness. She also shared with me that ATTITUDE is so important when a patient is diagnosed with diabetes. She added that it becomes a whole different issue when a patient realizes that it is only in “their hands” whether they’ll be present in their children’s future or avoid complications. She said that the change in attitude can come from a simple way of seeing things, switching from a “have to do it” to a “choose to do it” mind frame about their diabetes tasks.  Thanks Riva for all the changes you inspired TODAY!!

Best regards,

Priscila Alvarez, Sanofi-aventis

So today I speak for those much maligned pharma reps whom most people think are only in it for the money. Most I have met are in it because someone close to them had diabetes. Today on World Diabetes Day, I applaud them.

Baboons, diabetes and the power of a tribe to thrive

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I watched a National Geographic special last month about baboons and thought about diabetes. Hmm…I don’t mean we are baboons, or do I?

A researcher had been studying a tribe of baboons for 30 years in the wilds of Africa. After 10 years he noted that they acted like a pretty typical tribe with all kinds of aggressive behaviors, male dominance and female submission– no, that’s not why I’m comparing us to baboons!  

Several of the more aggressive male baboons unknowingly ate toxic garbage one night and died leaving the tribe 2/3 female and the males that remained were the kinder, more socialized, go-along types. Obviously they were preparing dinner while the aggressive males were out stealing food.

Stay with me a little longer. Traditionally, baboons leave their mother after six months of life and roam looking for a tribe to join; the ones that joined this tribe after it lost its aggressive males, the researcher noted on subsequent trips back to Africa, took on the tribe’s new characteristics: the new baboons became interdependent, cooperative, highly socialized and relatively relaxed. The baboons individually, and the tribe, began to “thrive.”

Researchers then correlated the characteristics of the tribe: control, high sociability and low stress with workers in London (it was their call not mine) and discovered when employees felt that they had control in their jobs and were highly social, they experienced much less stress. I began to wonder could we put this equation to diabetes: 

Does Control + High Sociability = lower stress managing diabetes?

Examining this equation against my personal life I mused: I have control over my diabetes because:

1. I have knowledge how to manage my blood sugar and my disease 

2. I have the medicine, supplies and equipment I need to treat it

3. I have control over my emotions realizing they will go up and down, come and go and the best thing to do is learn from my “mistakes” and not berate myself.

I have sociability because I am connected to others with diabetes through participating in a support group and at health events. I can share my woes, diabetes and non, with family members, friends and health providers. I have friends and family to enjoy life with beyond my diabetes life. With control and sociability I feel confident, supported and capable which empowers me to commit to my care.

As my business management husband says this is famed professor and sociologist, Aaron Antonovsky’s famed theory: people do well despite adverse circumstances if they comprehend what is going on, have a sense they can manage it, and they feel it is worth it to do so, which comes from “belonging” to a caring tribe.

So are we baboons? I don’t know, but the principles seem worth paying attention to regarding your diabetes management. Just don’t eat too many bananas, you know they’re full of carbs!

Give diabetes a hand

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A friend sent me news of The Global Diabetes Handprint initiative, a fund raising event sponsored by OneTouch® Brand Blood Glucose Monitoring Systems in collaboration with the Diabetes Hands Foundation. They’re raising awareness of diabetes and funding two not-for-profit organizations if you’ll give them a hand.  

Draw a word on your hand, take a photo and submit it to their site, or if you prefer not to walk around all day with streaky fingers, you can create a word on a virtual hand on their site. 

Either way choose a word that expresses what diabetes means to you. OneTouch will donate $5 (up to a maximum of $250,000) toward Taking Control of Your Diabetes or Diabetes Education and Camping Association, your choice.

This initiative is open to anyone of any age with or without diabetes and ends March 31st. So get off your duff and give diabetes education a hand.

 

Reach out and test someone

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What could be better than during diabetes awareness month diagnosing someone? I’m kidding – sort of.

If you have an older family member and a glucometer help them test their fasting blood sugar (over 126 is classified as diabetes; between 100 and 125, pre-diabetes) or do a random blood sugar test. If their blood sugar is 200 or higher they may well have diabetes, 140-199, pre-diabetes. 

Most people left to live to a very ripe age eventually develop diabetes because beta (insulin-producing) cell function becomes compromised. These cells just don’t work as efficiently after years of food insults–refined carbs and junk food. After all, we don’t work as efficiently eating these foods. 

Feel free to get other family members involved, test your spouse, your brother, your sister, aunt, uncle, and children. One third of the 24 million Americans with diabetes don’t know they have it. Most of the 57 million Americans with pre-diabetes don’t know they have it or don’t think it’s anything to bother about. 

This month, you may just save someone from living with undiagnosed diabetes just by asking someone to stick out their finger. If they discover they have diabetes, they may want to give you the finger, that is until they realize the service you just did them.

 

 

Diabetes Awareness Month

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imagesSpreading the word one syringe at a time

Today begins another month-long attempt to make the world more aware of diabetes. I have no idea if Diabetes Awareness Month is successful in this goal or not. There’s still an awful growing epidemic out there. But I do know there’s a few hundred more people in Europe who know about diabetes.

My husband gives week-long business leadership workshops. At the end of his workshop everyone brings something that symbolizes leadership to them. The group of 20 or so executives share their stories of their leadership symbol over their last evening’s dinner. 

My husband brings a syringe as his leadership symbol and talks about the leadership qualities he sees in me managing my diabetes. You can imagine the curiosity of these management executives when he pulls out a syringe. But the story doesn’t end with my counting carbs, walking an hour every day and frequent blood sugar checks. No, it actually begins there, because then he segues into a story our friend, Joe, a diabetes family therapist, told us. 

Joe recalled a scene from a play he’d seen on Broadway some years after he’d gotten type 1 diabetes at the age of 8. James Earl Jones played a man servant to a young white boy in South Africa. They meet again after the boy has grown and James Earl Jones asks the boy, “Do you remember I used to take you down to the beach to fly your kite?” and the boy says, “Yes.” “Do you know why I did that?,” Jones asks. “No,” says the boy, to which Jones says, “Because I wanted to teach you no matter what happens in life to always look up.” 

Joe tells this story to the families he works with who feel as though a truck has run them over having just discovered their child has diabetes. They clearly believe that they will never have a reason to look up again. But Joe tells them they will. They will learn to work with what has happened and re-create a life that will provide many reasons to look up for all of them. By time my husband has finished sharing this story, half his 20 executives are in tears. Several come up to him afterward and ask how I’m doing, but more importantly, they realize inspiring others to be their best is a key attribute of leadership.

I don’t care if you tell anyone anything about diabetes this month. But tell yourself you have reasons to look up, and then do it. Your living example will show others that diabetes is not the end of the world, it is the beginning of a new life where we can learn once again to value who we are, cherish what and who we love, find greater meaning and purpose in life and inspire those around us to look up.