Take a short survey and tell me about your success

In my work to help people better manage their diabetes, I’m doing research on how people create and sustain good management. 

I’ve written a short survey (13 questions, many multiple choice) that I’d love for you to fill out. It will take you about 15 minutes. Click on this link to go to the survey: https://www.surveymonkey.com/s/riva_research

At the end of the survey, just click the “submit” button.

I intend to use the results in what I write and in presentations as appropriate to help others better manage their diabetes. I offer you the same opportunity to use the results if you send with your completed survey, your name and email address, and credit the research to me. 
Your name and email address will be anonymous. They will only be used to send you back the survey results and enter you in a random drawing for a prize – a new silver apple ipod shuffle. Your contact information will not be sold, or shared, or used in any way.
Please submit the survey back to me by this Friday, July 30, 3 PM Eastern Standard Time.
My heartfelt thanks for helping me in this endeavor and for sharing what you’ve come up with so others will benefit.

The Power of our health possibility

Screen Shot 2015-02-07 at 9.15.24 PMListen more closely to your body and your thoughts

I’m reading a great book, Ellen Langer’s Counter Clockwise: Mindful Health and the Power of Possibility. It’s about being more mindful in everything we do and how that breaks through many of our assumptions and beliefs and can help us maintain and attain greater health, and happiness. 

It’s about thinking about our health, and aging, differently, turning our own stereotypes on their head, and taking back much of our power.

It’s about how language either empowers or disempowers us, and sets us down a path of expectation, and how we then tend to create what we expect. 

For instance when you go to get a “second opinion” don’t those two words already make you feel it can’t be quite as credible as the first doctor’s diagnosis? After all now you’re going for “second” and it’s only an “opinion.”

Langer, a social psychologist and teacher, has written a book, this is actually her fourth on mindfulness but first on health, that is philosophical in part, and practical throughout. It is based on many of her studies and those conducted with her students. One classic study Langer conducted had senior citizens, some of whom were in nursing type facilities spend a week living as though it was 1959 again, wearing the type of clothes they wore then, doing things like carrying their own suitcases, which they hadn’t done in years, bringing photos of who they were then and “acting as if” they were their younger version, again. A week later, most were actually livelier, stronger and healthier, they expressed more vitality and took more interest in life than they had in years.  

Langer pokes through our routine thinking as in where did these thoughts come from? Do they make sense? And she beseeches us to be mindful, to notice new things. And she reminds us that our routine thinking may indeed be deteriorating our health rather than vitalizing it. 

For instance she proposes that maybe older people are thought to have poor memories not because they lose their faculty to remember but because they’re not much interested in what’s going on in a world geared for younger people. So they don’t pay attention. What looks like memory loss may be a case of older people never having listened to something to begin with because it doesn’t interest them. 

Or maybe older people seem weaker because we’ve been socialized to see them that way, and they’ve been socialized to expect they will become that way. Maybe 80 year olds have trouble getting out of a car not because they’re feeble. Maybe cars just aren’t built for 80 year old bodies.

Langer and her students’ experiments will offer you lots to reconsider that may change how you think which may impact your health more positively. 

Counter clockwise tests many of our assumptions about healthfulness and reading it would be a very healthy choice. 

Writing for the Huffington Post

Screen Shot 2015-02-07 at 9.17.06 PMThe internet newspaper

I’ve never written about what it’s like to write for the Huffington Post, until now. Here’s the story. Actually, it was a fun question to ponder, and you’ll find out more about me than just that single bit of info. 

Amy Tenderich, blogger of the terrifically newsy DiabetesMine.com, posed the question when she asked me to guest post on her blog for today. 

Amy does us all a service posting almost daily about the ongoing news in diabetes. If you haven’t taken a look, roam around the site once you’ve finished my guest post. 


If you want to be happy…

Screen Shot 2015-02-07 at 9.18.25 PMGiving is better than getting

I found this passage that I wrote down months ago on a slip of paper while finally clearing the clutter near my computer. Doesn’t matter, though, because it’s timeless. 

This is from Martin Seligman’s book, Authentic Happiness.

“If you want to be happy 

for an hour, take a nap

for a day, go fishing

for a month, get married

for a year, get an inheritance

for a lifetime, help someone”

What more is there to say?

Food Is Medicine appears on HuffPost


chicken on saladI posted another version of my beef with food – that food is medicine – on The Huffington Post. 

It appears as a lead story today.  

A loyal fan already wrote me,

What an inspiring article to read first thing in the morning – thank you for your latest Huffington Post piece on healthy eating.  

Great tips in there – and makes me glad I have a fridge full of fresh produce waiting for me at home for tonight’s episode of Top Chef (a weakness of mine).”

It also occurs to me maybe I should let you know one of my little secrets for health. 

I not only have a medicine cabinet in my bathroom, but I also have one in my kitchen. 

It doesn’t have a mirror on it, although to be frank that would be a great incentive to eat healthy, wouldn’t it?. But it does have these big shiny silvery doors. 

I’m sure having a medicine cabinet in my kitchen is not particular to New York City. You probably have one too.

And just to show you I’m a woman of my word that food is medicine, I’ve put up a picture of what you’ll find in my kitchen medicine cabinet most days. 

Come to think of it there’s probably more medicine in my kitchen medicine cabinet than in my bathroom medicine cabinet. 

I like to think that’s a good thing.

Food is medicine


For the last several months I’ve really shifted my view about food. I see it as medicine. Not that I don’t enjoy it, but I see what I eat as either making me more healthy, or less. I see what I eat as being almost as important to my health as my insulin.  

Now that doesn’t mean I have a perfect diet. But it does mean I’m more motivated to eat foods that are nourishing me — infusing me with healthy anti-oxidants and strengthening my overall body and fitness, rather than degrading it, or setting me up for the side effects of unhealthy eating – heart disease, overweight, guilt and personal frustration with myself. 

So I wanted to share this great article from Men’s Health magazine giving their take on the 40 Best Age-Erasing Superfoods.  

My healthy eating, and by this I mean smaller portions and eating mostly vegetables, fruit, beans and lean protein, automatically maintains my weight. I’m trimmer these last several years than I’ve ever been, and without trying. Healthy eating also gives my psyche a reason to feel pretty good about myself every day instead of guilty and frustrated. But you got that already, didn’t you? 

And so you know I’m not just blowing smoke, it’s reflected in the blood tests I get twice yearly: A1C 5.7%, LDL (lousy) cholesterol 108, some would say a little high, yes, it’s in the family, but my HDL (good) cholesterol is an astronomical 107, triglycerides 50 mg/dl, blood pressure 90/60 and a heart Al Pacino would say is “Strong like bull.” 

If you’re curious what I typically eat here’s my day food-wise:

Breakfast – a bowl of steel cut oats, I cook, to which I add: flax seeds, sunflower seeds and fruit, and then top with a spoonful of non-fat Greek yogurt, non-fat cottage cheese, and a spoonful or peanut or almond butter. I can’t tell you how much I like this – it’s creamy, crunchy, sweet and delicious. I could eat it for every meal. Maybe having a breakfast I love and knowing I get to eat it every morning, helps me stick to my healthy eating throughout the day; I know a reward is coming tomorrow morning.

Lunch – usually left over veggies from last night’s dinner, or a spinach salad, with some feta cheese or a slice of turkey and some beans. I may add avocado or cooked squash depending upon what’s in the house. If I eat lunch out it’s usually a spinach feta omelette with one slice of whole grain toast. No butter. Olive oil, herbs and mustard are my main taste-boosters. Butter, mayonnaise, bottled salad dressing and such I don’t use anymore. 

Dinner – usually fish or chicken grilled, broiled or sauteed with a mix of veggies and beans. Snacks are usually nuts, particularly walnuts (yes, they have fat, healthy fat which you need, just don’t eat too many), veggies, less sugary fruits like berries, melon, peaches and after dinner usually some dark chocolate.

Now you’re thinking I must be a monk, or a martyr, keeping to such an austere meal plan. I know you think that, people have said it to me. But neither is true. It’s just that over the years, particularly after reading Bernstein’s book, Diabetes Solution, I’ve rid most of the refined carbs from my diet knowing how much they made my blood sugar swing from high to low; it was awful. Now I have tons more control. And feel better. And, to be honest, while rapid-acting insulin and pumps give us more spontaneity, routine as in eating similarly day to day, makes my blood sugar more predictable.

I’ve also lost my taste for most sweet and fatty foods. It happens when you begin to eat “real food” again. I’m a big fan of Michael Pollans, Food Rules.  I follow his mantra: Eat food, mostly plants, not too much. 

That said, I’m not a vegetarian and I’m not a zealot. Fried calamari, the occasional slice of cheese or flourless chocolate cake, crusty bread and olive oil, anything friends make for dinner and eating everything in my house – everything – those occasional nights when the world tips out of balance also co-exist with my healthy eating. Oh, yes, so does wine with dinner. Another reward. Thank goodness years ago some French marketing guy said it was healthy.

So, check out this list of 40 Superfoods and try to put more of them in your diet. And, if you’ve tried to eat healthy before only to have given up, perhaps this is the day it will take. Here are a few tips that may help:

1. Decide why being healthy is important to you – only to you – and keep that front and center

2. Fill your house with healthy foods and throw out the junk. If when you’re hungry you can reach for a carrot instead of pretzels, you will.

3. The day you fall off the wagon, is only a day. Start new the next day. What you do in a week counts more than what you do in a day.

4. Your history doesn’t have to be your future. Ever.

5. Honor yourself enough to make healthy eating important, and your mission.

6. Know that in a few weeks, your tastebuds will change. You will lose your taste for synthetic food, sweets, salt and grease.

7. Talk yourself through a weak moment. Tell yourself if you’re dying for that piece of cake at 10 PM, you can wait till morning. 

8. Nothing’s off limits. If you need it, eat a little of it. Parcel it out onto a plate, don’t stand over it in the kitchen. You won’t stop.

9. Go slow or cold turkey. Whatever works for you.

10. Remember, you can do it – millions do. It may take time, but depending upon what you do now, next year you’ll either be exactly where you are now, less healthy or healthier.

“T” is for thank you Dex4

UnknownUse positive emotions to better manage diabetes

Every summer in Orlando, Florida, Children With Diabetes, an online community for families with diabetes, runs an amazing conference for families called “Friends for Life.” It’s just winding up today.

Children with diabetes come and play and make new friends (for life). Parents attend lectures to learn more about: managing diabetes, helping their children manage their diabetes, managing the emotions of having a child with diabetes and to bond with other families. There’s also access to a mini-vacation with Minnie and Mickie over at Disneyworld.

Every year since 2007 I’ve attended at least one diabetes conference. Friends for Life was the first diabetes conference I ever attended. It felt instinctive–at 54 I still was, and always will be, a child with diabetes. 

Since 2007, I have wanted to make my book, “The ABC’s Of Loving Yourself With Diabetes” available to families at Friends for Life. This year,Dex4 (manufacturer of glucose products) gave me the opportunity to donate 150 books and distribute them in their welcome gift bags that they handed out to new families attending the conference. 

I sincerely thank Dex4. I also hope as families leave the conference this year, buoyed with new learning, memories and friendships, that when they need a booster shot of strength again, they’ll dip into my book and find their way there. When you live with diabetes from a place of courage, confidence, forgiveness, patience, joy and pride, as my book guides you to, this ride utterly changes for the better. 

Dex4 is working, through both education and products, to help one always be prepared to correct a low blood sugar. I work with Dex4 upon occasion as a patient-expert advisor.

Orlando, a hotbed of diabetes activity


It’s not just the temperature in Orlando that makes it a hotbed of diabetes activity these two weeks, but the enormity of activities going on. 

The American Diabetes Association’s (ADA) 70th annual scientific conference has just drawn to a close. Roche just held its second social summit and Children With Diabetes (CWD) begins today. 

Amy Tenderich over at DiabetesMine has been following and reporting on some of the ADA highlights, start here with opening day and see the next few posts, as is Kelly Close over at CloseConcerns, look down the left-hand column. 

I attended Roche’s social summit where they invited 37 type 1 and type 2 diabetes bloggers and broadcasters to a day of exchanging ideas about meter accuracy, best practices and an open dialog between us and representatives of  the American Diabetes Association and the American Association of Diabetes Educators

These conversations drew fire, well we are a feisty group, about how the patient seems all but lost amid their constituencies, but the ADA was extremely open about the need and desire to turn their battleship org around to be more representative and serving of patients’ needs, including type 1s – and create more transparency. They also obviously took this seriously sending six representatives including David Kendall, their Chief Scientific & Medical Officer. Kendall talked about the ADA’s “Stop Diabetes” campaign which is one of their first steps in being more patient-centric. 

Unfortunately, the conversation with the AADE was less successful. To be fair, many of us felt it was taking place with the wrong organizational person. She seemed unable to put her finger on our concerns – MAINLY the fact that diabetes educators are a dying breed while patients are an epidemic and need them. 

There are only 15,000 educators nationwide, relatively poorly paid and many suffer burn-out and leave the profession. On top of that, it’s hard to become an educator. There’s no direct route, and, a big catch-22. You need to have 1,000 hours working as a diabetes educator with patients before you can sit for an exam to become certified, but how do you get hired as an educator with no experience? After ricocheting these thoughts around we also voiced that we would like to see the organization advocate to improve the track to become an educator. An interesting point was also raised by my fellow bloggers – why not create a track where patient-experts can also be educators in some recognized fashion?  

In the end, we offered our assistance to help both organizations in any way we can. Specifically with the AADE to link their professional members to more social media. While that idea was warmly received and seen as a benefit to CDEs, allowing them to hook their patients up with us, I hope the AADE also realizes that CDEs can benefit tapping into social media to get inside patients’ heads, and hearts, and follow the trends and news we report on.  

I am impressed by Roche. With their genuineness, commitment and desire to have an open forum with we, who have an open channel to you. And, yes, while we can assume all this will benefit Roche’s sales and marketing, I believe they hope just as much that it will benefit us in getting products we need and want. 

At the 2009 social summit Roche put their toe in the water wanting to learn from us how to enter social media as a “good citizen.” This year’s meeting was heavily weighted on what they believed would be of value to us. Either way you slant it, a pharma better understanding the experience of living with diabetes and doing something with that knowledge can only benefit all concerned. 

To this end, Lisa Huse, Roche Director of Strategic Initiatives, opened the meeting with a recap of the four initiatives Roche has enacted based on what they heard from us last year:

1) “Keep it real” – display the real experience of diabetes, the real blood sugar numbers we get and teach patients what to do with them. I think I heard there’s actually a TV commercial where someone shows a 273 mg/dl on their meter, yea! Then again, I could have been dreaming.

2) Address costs of diabetes – through Accu-check there’s now a 15% prescription discount card and Patient Assistance Program.

3) Advocate for the diabetes community – through their Diabetes Care Project. A coalition of like-minded organizations improving care for those living with diabetes.

4) Help the diabetes community amplify its voice – clearly evident with our exchange with the ADA and AADE. 

Lisa also told us that during this past year of following our blogs and having her ear on the ground with us, she’s come to understand diabetes much more than her first 11 years with the company. As the meeting came to a close I wondered why more companies don’t spend more time, money and attention listening to, and getting to know, their end users. It can only be a win-win.

Personally, for us bloggers in our virtual world, it’s wonderful to get together, to shake a hand, play ping-pong (hope the table’s back next year), give and receive a hug and say to each other, as we hope we say to you, you are not alone

By the way, if you blow up the photo, and notice I’m wearing a lovely blue boot, it’s the result of a freakish accident. Don’t worry, five or so more weeks in my lovely footwear and all will be well. (Thus the hope the ping-pong table reappears next year.)

In full disclosure all expenses were paid for by Roche for this meeting.