The twelfth year of my 20-year overnight success: Broadening the bandwidth to Flourishing with illness

Albuquerque 3 - Version 2

I just got back from the Netherlands. I went as a speaker in Novo Nordisk’s 5th DAWN Summit. Doctors, patients, psychologists, policy-makers and researchers gathered from 33 countries for two days of idea-generation and planning how to improve the lives of people with diabetes. I met wonderful people equally committed to help people with diabetes live fuller, healthier, happier lives, including a noted Dutch psychologist, Frans Pouwer, who hearing of my Flourishing Approach now wants to research it.

While in the Netherlands, I was also invited to speak to the leadership team of AstraZeneca, NL. AstraZeneca acquired Bristol-Myers Squibb and now diabetes is one of their largest market sectors. 

For the past few years I’ve been noticing, increasingly, we live in a time I’d call “The Rise of the Patient.” As patients, we are leaders in our own right living with an illness, and many of us have insights and capacities to help transform healthcare delivery for chronic illnesses. My own work toward that is sharing with health professionals how to work from a Flourishing Approach, as opposed to the traditional Coping Approach. And for people with illness, to live from the same orientation. I shared the Approach with Ginger Vieira in this recent post, “From Coping to Flourishing: How a Better Mindset Can Transform Health.”

Every year since I’ve been working in diabetes I’ve said, “I’m in the first year of my 20-year overnight success.” Of course each year it increases by one. Now I am in the twelfth year of my 20-year overnight success – and I feel the traction: of my own success, of the power of the patient and of minds opening to the idea that we have to do chronic illness differently. Actually, I have been sharing the Flourishing Approach over the past several years at various conferences e.g. the American Association of Diabetes Educators’, TCOYD, DiabetesSisters and each time I am met with enthusiasm and respect.

In the past few months I have received many opportunities to share the Flourishing Approach and its tools around the world. In December in Melbourne, Australia at the IDF World Congress, where I addressed 134 Young Leaders in Diabetes on behalf of Novo Nordisk.  A few weeks later, at the Royal Prince Alfred Hospital in Sydney where I addressed the endocrinology department.  

In January I spent 18 days in Bangalore, India where I gave six classes and workshops to health professionals at the Jnana Sanjeevini Medical Center, a diabetes clinic for the poor. I have also addressed more than 200 medical professionals at two premiere hospitals in Singapore. Two years ago I gave a workshop for health  providers of the Pascua Yaqui tribe. It was held over two days and the second day patients joined providers and together barriers dropped, communication opened and both saw a new space open in front of them.  

In March of this year I presented the Flourishing Approach to the Telehealth group of NYC Health and Hospitals Corporation. There a staff of committed nurse/coaches speak weekly to people with diabetes in need of help. They, like all I have spoken to, have been delighted to hear this more positive approach and are interested in applying it in their coaching practice with patients.  

I have written a number of articles on this approach. “A Flourishing Approach to Mental Health in Patients with Diabetes” in last summer’s issue of the peer-reviewed On the Cutting EdgeTwo recent articles on The Huffington Post include, “Chronic Illness’ Opportunity for Patients and Providers” and “The Antidote to Living With Diabetes.” There will shortly be an upcoming article on Sanofi DX. And now I feel fully confident that I have enough research, tested the waters and seen everywhere I present this new framework/lens and way of working and living, providers and patients have only wanted more. 

So this year I will be writing my next and fourth book on flourishing with diabetes. It will provide the understanding of a flourishing framework and how – and why – we need to treat people with chronic illness differently than we do today. Moving from problem- to solution-focused. To look at what’s working instead of what isn’t, work from a trusted partnership, be compassionate, see the whole person and understand the context within which they live, not merely micro-manage the disease. 

We must offer hope and possibilities, knowing the power of both and that there is post-traumatic growth, not only post-traumatic stress. We must explore patients’ strengths and resilience, as we help them move toward a healthy, happy, vigorous, robust and purposeful life.

For twelve years I have said, “You can have a great life, not despite, but because of diabetes.” Because people shared with me this is how they were living. 

We can open a doorway to a new space to be with patients, and a new space for people with illness to be in, where coping is not the target or the answer, but flourishing is. 

It is time.

Healthy habits and focusing on the positive help us manage diabetes

My 1 positive thing


I gave two workshops at the Friends for Life annual conference last week (see post below) and collected feedback from my attendees which I promised to share. 

In my workshop, “Flourishing with Diabetes” I asked everyone to write down ‘1 positive thing diabetes has given me.’ At the end of the workshop each person stood and shared what they had written. Each person – remarkably, or maybe not, no one hesitated or came up empty.

I collected 35 ‘things’ and using the affinity diagram method broke all the comments into 5 categories: Greater Health – 4; Closer Family Ties – 5; New Friends/Community – 9; Empathy/Compassion/Understanding For Others – 9; Self-Resilience – 7.

Greater Health

• A greater awareness of health for the whole family

• Appreciation for the need to take better are of myself: eat better, quit smoking, more exercise

• Health consciousness

• A strong understanding of nutrition and portion control – general good eating habits

Closer Family Ties

• Brought my 17 year old daughter and me much, much closer than what we would be without it

• Stronger relationship with our daughter who has type 1 diabetes

• A close knit family caring, loving, supporting each other

• Made me a more attentive parent

• United my family around a common issue and learning together

New Friends/Community

• Community

• Good friends and the ability to accept their love

• New friends, travels, closeness with my daughter

• New lifelong friendships (more like family) for me and my children

• Lots of great friends who want to stop diabetes!

• New friends for myself and for my daughter

• Friendships that I have made

• FFL, CWD, friends and role models for my daughter

• A community. A voice. A sense of humor

Empathy/Compassion/Understanding For Others

• Compassion for parents dealing with children that have a health challenge

• Understanding

• Patience and a drive to care for and inspire people who need help

• A better understanding of what my sister has dealt with for 25 years (after my son’s diagnosis)

• A chance to be sympathetic with others who go through similar things or difficulties in life

• Wisdom to help my daughter who has a serious chronic mental illness

• Additional empathy and patience

• Empathy & compassion for people who have kids with other chronic conditions

• Greater empathy for parents and children with health issues or disabilities


• Courage to know I can help when my Person with Diabetes needs me

• Insight-single mom of a 9 year old realizing I can do this for my daughter

• Perseverance, ability to deal with and solve problems

• Ability to let go

• Perspective on what is really important in life

• Showing me that I am capable. I can do it

• A good sense of responsibility early in life

And Mine: The opportunity to do this work

In my workshop, “inspired Diabetes Self-Management” we discussed how Healthy Habits help you work smarter managing diabetes. Again, I asked everyone to write down 1 healthy habit they have and share it. I collected 17 healthy habits and they break down into: Food – 7; Exercise – 4; Blood Sugar Monitoring/Site Change – 6


      • Drink water before each meal

      • Keep an accurate carb count @ breakfast

      • Measure everything

      • Eat as healthy as possible

      • Pack a lunch every day

      • Try to be supportive in food choices

      • Choice foods to balance out certain spikes


      • 1 hour of activity a day

      • Run

      • Exercise

      • Variety in exercise

Blood Sugar Monitoring/Site Change

      • When in doubt, check

      • Don’t hesitate to change site

      • Remember, diabetes #s are just data!

      • CGM helps my daughter test more

      • My daughter checks her blood glucose every time immediately before starting the car

      • Set blackberry for every three days for catheter change

You might like to ask what 1 positive thing has diabetes given you, and find it useful to write down your healthy habits, and borrow any of these listed here.

Life is the way we see it – and make it

imagesGinger Viera brightening a corner of the world

Funny that my last post said I was full of woe (well, that happens occasionally.) By the way, I am over it, and here it is another Wednesday, yet I feel on the mend and full of possibility.  I’d like to share a post with you I just read that captures that knowingness of possibility, and my own feelings most of the time. 

It’s written by my fellow diabetes blogger, Ginger Viera, “Contagious, Confidence, Endless Possibilities.”Ginger is a fellow type 1, a weight lifter, personal trainer and health coach. 

She writes honestly about the failings we all feel we have and the will and way not to let them foil us, but to find our strength to carry on and see the best for ourselves whether with diabetes, or just in our lives in general. 

An excerpt

“Don’t let anyone tell you that you can’t do something.” My twin brother, Pete, said this to me several months ago. I wrote it down on an index card and taped it to my bathroom mirror. Funny thing is, it’s never been other people telling me I can or cannot do something. The loudest voice I hear is my own.

When I was diagnosed with Type 1 diabetes in the seventh grade over eleven years ago, the first list that ran through my head was the list of things I probably couldn’t do anymore. I couldn’t eat ice cream without first counting the grams of carbohydrates in the bowl and determining how much insulin I needed. I couldn’t play basketball anymore (at least, that’s what I thought). I couldn’t buy candy and popcorn with my friends when we go to the movies without feeling overwhelmingly guilty about eating such diabetic-off-limits food. The list of foods, activities, dreams and goals I thought were off-limits seemed endless.

With or without diabetes, we allow ourselves to fill our minds with everything we’re sure we cannot do, or cannot have, or cannot ever become. As I grew older, I realized how many things were still within my reach. I used to think I could never become much of an athlete, but today, I’m a health coach, personal trainer, yoga instructor and I’ve set 15 records in drug-tested powerlifting. Clearly, what I needed at my diagnosis, and simply as a young girl growing up in this society, was someone or something to help me learn that my dreams were all still possibilities.”

You’ll want to read the full article at the link above. Thanks Ginger.

What if we change the question?

Raw foods for 30 days


Now that Labor Day weekend is over and the cool fall breeze is bringing me to life, my thoughts raced back to something that happened earlier this year. (Yes, there’s a video here, but I’ll get to that later.)

I was giving a talk at Time Inc as part of their employee wellness program in June. About 20 employees were there, some with diabetes, some who have family members with diabetes and a few who have pre-diabetes. 

What I remember most about the talk was a very open, overweight man who asked a lot of questions. He had pre-diabetes, was already taking pills for diabetes-related conditions and wanted to know more about pre-diabetes and its link to type 2 diabetes. 

I told him that most people with pre-diabetes get type 2 diabetes within 5 to 10 years. That there’s a reason why they call it “pre-diabetes.” I also told him you may prevent this by losing some weight and getting active. Both of which he needed to do. 

Not unusually, he gave me many reasons why losing weight and getting active were nearly impossible for him. And then my mouth got the best of me. “So, you’re telling me,” I said, “that it’s almost impossible for you to lose weight and get some exercise?” “Yes, he agreed.” “What if the only choice you had was to lose some weight and get active or die?” He looked at me. Intensely. I could see I had shocked him. I could also see he was thinking. “What would you do?” I asked.

“Well, when you put it that way,” he laughed, “I’d lose some weight and exercise.”  

If you have pre-diabetes or type 2 diabetes and have wanted to lose weight and get more active, ask yourself the same question, “What if there were no pills for you to take and the only choice you had was to lose some weight and get active or die?” What would you do? It may just help you see that you do have some power over your health, and your choices. 

In the Diabetes Prevention Program in 1992, 3,000 participants with pre-diabetes proved that moderate weight loss (5-10%) and exercise reduced the risk of getting type 2 diabetes by 58! A higher percentage than the control group taking Metformin (brand name Glucophage.)

On another note, back to the video up there, here’s one choice I can’t say I subscribe to, but I do find interesting. Eating raw foods. Some swear by it. 

Join me for the TCOYD event Rhode Island, September 11th


Join me in Providence, RI

TCOYD, which stands for Taking Control of Your Diabetes, is a non-profit organization that provides one day health fairs all across the country to help people better manage their diabetes. The organization alsobroadcast in-depth discussions with renowned health professionals and patients.

Next month, September 11, if you’re anywhere near Rhode Island, you should attend because I’ll be there presenting. Of course, it’s not the only reason you should come. You’ll hear lectures on facets of diabetes care from your feet to your heart, learn and get some exercise, bond with many others and attend interactive workshops where the learning is personal. It’s a full day affair of fine tuning your diabetes management provided to you by many respected people in the field. All for only $30. Register here.

Joining you will be top physicians, psychologists, educators, foot specialists, exercise physiologists and there’s much to see and do in the exhibition hall including many new devices, products and foods. 

TCOYD was the first diabetes health event I attended way back in the early part of this decade. There I attended, among others, psychologist’s Bill Polonsky’s workshop where I learned something crucial — that diabetes is not the leading cause of heart attack, blindness and amputation but poorly-controlled diabetes is. It made a huge difference to me: 30 years of fear slid down my shoulders and the resolve to master my self-care led me to the healthy regimen I have today. 

I also met a lovely gentleman in the exhibition hall who answered all my questions and then guided me to the peer-mentoring programs I deliver today around the country speaking to fellow patients. 

TCOYD is the labor of love of Dr. Steven Edelman who founded it almost 15 years ago. Dr. Edelman was recognized last year with the ‘Outstanding Educator’ award from the American Diabetes Association.  Edelman himself has lived with type 1 diabetes since the age of 15, and has dedicated his life and work to helping as many people with diabetes as possible to live healthier, happier lives.

My workshop by the way is titled: The ABCs of loving yourself with diabetes and I’m on at 3:30 PM. You’ll discover how to live a life with diabetes where you don’t just cope with diabetes, but actually flourish. If you come, do let me know. I’ll want to say hello. 

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:

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.

A diabetes fable


Once upon a time a scientist who was enthralled with the exotic emperor moth, (because their wings are as beautiful as butterflies), found a caterpillar ready to spin its cocoon. He gently cupped the caterpillar and took it back to his laboratory. He placed the caterpillar in a glass container and watched as the caterpillar built his cocoon. The caterpillar then fell into a deep sleep. Soon this fuzzy little crawling caterpillar would become an amazingly exotic emperor moth floating in the sky.

Some months later the day came when the moth was ready to leave the cocoon. The scientist watched anxiously as the new tiny head of the moth chewed its way into the light of the laboratory. The moth struggled and struggled to escape its cocoon seemingly getting nowhere. Its body was simply too large to fit through the tiny hole it had made. The moth finally tired and laid its small head on the shell of the cocoon where it had poked out.

The scientist felt so badly he took it upon himself to help the tiny creature. “How could I stand here for so many hours watching this beautiful moth go through such agony and pain?” he questioned. “Where is my mercy?” So he took a pair of tweezers and his scissors and began to cut away the cocoon. As soon as the cocoon was opened, the moth fell from the cocoon. But he did not fall upwards into the sky. No, he was badly deformed and fell on the floor where he died within minutes.

Soon after the scientist discovered that it was precisely the moth’s struggle to escape from the cocoon that allows him to do so. His struggle forces the fluids down into the body of the emperor moth that give it its ability to fly. Furthermore, the struggle perfectly proportions the moth as it works to free itself from the cocoon. Cutting away the cocoon, as the scientist had done in an effort to help, had actually killed the moth and interrupted its natural life-cycle.

The moral of the story: Struggle is not necessarily a bad thing and often it is what helps us grow. Sometimes when you seem to be caught in a struggle, you are actually in a germination stage, like the moth transforming into something even greater.

Food for thought: What happens if you relax into the struggle? 

The day of thanks

Screen Shot 2015-02-08 at 5.29.07 PM

We’ve tried it once, I think, instigated by my sister-in-law’s sister a few years back when she was pregnant with her first child at 40. We went around the table of 12 each saying what we’re thankful for. We got through about three and a half people before it all caved in and other conversations looped us elsewhere so that we never returned to the affair. 

So, in this space, I will say what I’m thankful for before anyone has a chance to divert me: 

The fact that each day I wake up to another day

My beloved husband, who has to remind me that rather than take a picture of something on a piece of paper and then drop it digitally onto my computer, that I can just scan it

My immediate family who still allow me to feel protected in the world

My dear friends who send me those annoying, trite emails because they care

My work which leaves me to never question what to do with my life – the single question that haunted me for years and years

My little home, that while I bemoan its size, I have one – and I love the leafy neighborhood it occupies

Seeing the world from Cleveland to Copenhagen, meeting new people who feel like old friends, and escaping New York City and coming home again

Great nights out discussing the world over good food and great wine

Books that take me away and films that bring me home, and vice versa

Adventures and surprises that show up now on a regular basis since I’m never quite sure where this life is taking me

That I still look relatively OK at 56 due to moderate living and my parents’ gene pool

My health, which outside of a few nicks and dents is pretty good

My ability to stay positive in a negative world

That I could come up with another bunch of stuff if I spent more time thinking about it…

and all of you who make what I do possible.

Can You Be In This Moment?


I am trying to be more conscious to “be in the moment.” Sitting on the subway yesterday, staring out the window (there are a rare few moments where the subway is overground) I was thinking that what happened yesterday, last week, a moment ago is over and what will happen in the next moment isn’t here yet. So let me see if I can just be present now, in my body, looking at what I’m looking at, smelling what I’m smelling…well, maybe not on a New York City subway, but you get the idea. Of course the exercise was not in the analysis, but what followed, to “just be.” 

In all honesty, I’m not sure I completely believe that there is only this moment. Part of me thinks whatever has already occurred still exists energetically in the minds, memory and maybe even cells of our body. But I do believe that if I can be more present in this moment, that my moments will be fuller, richer, calmer, more content, and that like threading a necklace of beads, if each bead is high quality the end product will be beautiful. For I do unequivocally believe that the quality of each moment creates the quality of our lives. 

So today I’m going to try to be more present when washing the dishes – to feel the soap suds slime over my hands, enjoy how clean the dishes are becoming (and not worry about the next post I have to write). And I will truly listen to whomever is speaking to me and quiet my own thoughts racing to and fro in the background. And I will attempt to do this throughout the day.

So now I’m going off to the Motor Vehicles office to renew my license. Yes, I’m going to spend my precious moments marveling at the ancient, dilapidated room I’m sitting in, chuckling at the 3,000 people in energetic discourse with the ten civil servants behind protective glass, savor the sweetness of the peach I’ll be biting into to bring my blood sugar back up, and smile when I emerge five hours later into the predicted rainstorm for this afternoon that my license is good for another eight years.


Post from the park

While taking my walk around the park this morning I was playing a game in my head. Trying to think what I could come up with that would be useful to better our diabetes management using the letters ‘d i a b e t e s’. Well, sometimes I have to look for entertainment hoofing an hour around the same route. 

So here’s what I came up with. Not poetry, but something to think about. Ask yourself:

D – Do

I – I

A – Aim (for)

B – Better (Management)

E – Expecting

T – Trouble (or)

E – Expecting

S – Success?

What we expect is generally what we create. If you typically expect you’re going to fail somehow, you probably do. Just today expect success. See if it makes a difference. I promise I won’t know, but you will.