Would you give up your diabetes?

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1971 B.D. – Last photo (before diabetes) with my mother

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2007 A.D – 35 years (after diabetes), with my supportive other half in work and life

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Which part to unplug?  iport, insulin & meter or my work, purpose & contribution? 

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The cold and blue reality…

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…and the work I do: teacher, advocate, writer, speaker 

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A few months ago I interviewed a young woman who had type 1 diabetes, and then she didn’t, and then she did again. She was “cured” of diabetes for a time through two islet cell transplants. She had an infusion of perky insulin-producing islet cells, which meant that after taking insulin for almost twenty years she didn’t have to take it anymore. Unfortunately, after 18 months the cells began to fail and she was back on insulin.

When we spoke she had listed herself on the pancreas transplant list to get back what she called the “freedom” in her life, that of being insulin-free. I thought it extreme to undergo the knife in a risky procedure where you’d have to take auto-immune suppressant drugs the rest of your life and the transplanted pancreas would only be good for about 10-15 years, if lucky. She, on the other hand, had difficulty imagining how I live relatively harmoniously with my diabetes. And, she posed the question to me, “Would you give up your diabetes if you could?”

Before I go there I need to give you a little more background. I interviewed this woman several months ago. Then when I released my new book, The ABCs Of Loving Yourself With Diabetes, thinking she might profit from many of the lessons it contains, I emailed her a note. She sent me this email in return, “FYI – I have taken myself off the transplant list for the time being.  After meeting you – I decided to give it a shot being diabetic again. It is not always easy – ups and downs (as you know) but I am officially diabetic again.”

I was stunned frankly because at the time of our interview she had said, “If a new pancreas gives me only 5 years of insulin-independence I will take it. Five years of reversing complications makes the risk worth it to me, to be free.” Yet now she was telling me she had reversed her decision to get a new pancreas.

Before the islet cell transplants, this woman suffered from severe hypoglycemic unawareness – she couldn’t feel when her blood sugar was dangerously low. She had countless episodes in the last ten years of nearly falling into a coma; it could happen walking to work, driving a car, while in a meeting or lying in bed.

While the islet cell transplants didn’t keep her insulin-free in the end, they did return her warning symptoms of low blood sugar. “Since the islet cell transplants,” she said, “my husband has not had to wake me up in the middle of the night to see if I’m still alive. He used to do that every single night.” So for her, the islet cell transplants created a dramatic increase in her quality of life. Of course I could understand the decision to have that done. But now that she gets the warning symptoms of low blood sugar and is like the rest of us ordinary type 1s on insulin, was a pancreas transplant worth it? There’s the risk, and when you think about it, as of course I began to, who would you be without your diabetes? If you’ve had it a long time, like me it’s probably shaped your habits and become part of your identity. Early on in our talk she was adamant that the freedom of being insulin-free was worth the risk of a pancreas transplant. How giving up diabetes affects identity, we probed a little later.

She got type 1 diabetes as a teen and grew up in a house where she was not fussed over and so became hugely independent, responsible, hard-working, earnest and a perfectionist at a very early age. It serves her now working toward partnership at a prestigious Manhattan law firm. In fact, at thirty she has all the earmarks of a hard-driving, intelligent, ambitious fast-tracker. Sitting in an office high atop Manhattan, I felt utterly out of place in my opposite lay-back researcher and journalist mode, and faintly amused as she checked her blackberry every ten minutes. She was well-thread and somewhat officious. But there was also a little-girl quality, a kindness in her quick apology for checking her emails and an openness I wouldn’t have expected.

She gave me two hours of her time that morning, precious time, and it was toward the end that she told me she’d placed herself on the pancreas transplant list. At that point I asked, “Since you now get symptoms of low blood sugar why go through this surgery?” She said, “At least I could say I did what I could to be free of this disease. There’s something about being free from diabetes that gives you the courage to try again. I also want to be part of the research, to be able to speak about it and show kids that being-insulin free is possible. Since I was 11, when I asked the nurse, “Will I have to take shots for the rest of my life? and she said, “Yes, diabetes is incurable,” I thought, I’m going to prove the doctors wrong someday.”

Then she asked me, “Would you try to become insulin-free if you could?” Interesting question. I don’t suffer from hypoglycemic unawareness so I wouldn’t be a candidate for the islet cell transplant, but if I did I would have made the same choice to do it as she did, that’s a no-brainer. However, if my diabetes then came back as hers did, along with the warning signs of low blood sugar, would I go further to be diabetes-free?  “No,” I said, “I wouldn’t have a pancreas transplant. It’s not worth the risk to me and the short shelf life.” And then I thought further: What would it mean to give up my diabetes?

A fellow A1c Champion told me last year if they could take away her diabetes she would not do it. She gets too much pleasure and sense of worth from her work now helping others with diabetes. Would I give up my diabetes? It’s a fantastic notion to one day not have diabetes anymore. To eat whatever I want, whenever I want or not at all. To not take shots or finger pricks. To not consider if I’m walking today. All kinds of thoughts tumbled into my head. Those were all pluses, but I also thought I would fear gaining weight if I didn’t have a built in reason to watch what I eat and exercise the way I do. My diabetes is now my work, I’d be giving that up. Then there are the friends I’ve made because of it. To be just like everyone else, no longer special from hefting this extra burden and feeling oh, so, virtuous. What would that be like? 

“When I listen to you,” she said, “I hear that you’re resolved with this disease. You say, “This is what my life is and I have learned to navigate this way. It’s interesting for me to hear your perspective, it makes me happy to hear someone can do this.” I knew she meant it, her voice became softer, slower, and I could see her thinking about a similar possibility for herself.

She also told me toward the end of our talk that diabetes had also given her something, “It’s so funny because I want to get rid of it so badly,” she said, “but it’s who I am too. It’s a hard disease but it’s changed me for the better I think. I wouldn’t be such a good person had I not had it. As much as it’s been an enemy it’s also been a friend. I don’t think I would have accomplished all that I’ve accomplished. I often say diabetics are typically more motivated, capable and amazing, because they have to overcome so much to achieve what they achieve, it makes one a better person. 

“I’m wondering,” she continued, “if you would want to experience being free from the disease or if the disease has become such a part of you that you would miss it in some way? This happened to the first transplant patient at my hospital. He just let the new cells die. It was like he lost himself when the disease was gone. The disease was who he was and he couldn’t deal when he didn’t have it. I wonder,” she continued,  “if in my own life I had made the disease part of me more, maybe I’d be better capable of dealing with it. When I was younger I was embarrassed having diabetes because it meant I wasn’t perfect. I didn’t want to admit it even to myself.  But you probably can’t understand why I feel this way about a transplant.”

I said it was hard for me, and then I gave her my answer to her question, Would I give up my diabetes? “I don’t know,” I said. I suppose if you tied me to the train tracks and made me say “yes” or “no” before the train arrived, I’d give you a better answer, but for now that’s my answer. I don’t think of myself like the young man in the hospital she described who couldn’t let his identity as a diabetic go. I’m just not sure if the choice were really available what I would do. I can imagine my list of pros and cons might be of pretty similar length.

In any case, when this woman’s email crossed my inbox not so long ago and she told me she had taken herself off the pancreas transplant list, I was very moved that she found something in me and how I live inspiring enough for her to re-think her decision. I don’t pretend to know what’s best for her nor flatter myself that I alone was her motivation. I sensed although she presented a firm front that she was struggling with her decision when we spoke. But if I gave her a snapshot of life with diabetes where one can find peace, then I’m grateful.

Would you give up your diabetes? Your knee jerk reaction is likely “yes.” But when you think through it you might find a very intricate web of emotions that reveal just how much a part of you it has become. Anyway, something to think about, as I hope this blog always offers you. It would be nice to find out in a year how she feels about her decision. In the meantime, I’d love to hear what your decision would be and why.

Why am I tripping myself up?

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I haven’t mentioned it before but 5 weeks ago I hurt my ankle. Really hurt it. I either tore a tendon, tore a ligament or have a severe stress fracture. Although I’ve been to my podiatrist twice now, the diagnosis is still unclear. The X-ray showed no break and while the doc didn’t feel I needed an MRI, I figured if my insurance paid for it I did. I want to know we’re doing everything possible to get this fixed as quickly as possible (which already seems impossible after 5 weeks) because not walking is having several unpleasant effects on me. 

1) If I ever needed confirmation that I’m more insulin-sensitive when I exercise I have it. I’ve had to up my Lantus from 12.5 daily units to 14, and add an extra unit or two to most of my boluses. Granted, I use little insulin compared to many, but for me this change is no less significant or upsetting. My blood sugar’s been far less well controlled and predictable. The first week figuring out the new numbers was an exercise in frustration, irritation and downright pissed-off-edness. 

My one hour walk around the park I saw, plain and clear, had been performing blood-sugar control magic. Part of that magic was my numbers were better the whole day, and relatively similar day to day, so fairly easy to predict. There’s the second unpleasant effect – losing that predictability. Once you get your routine down, you know that having it wrecked feels like starting all over again from the day you were diagnosed. Yet I didn’t know just how unprepared I was for retooling again or how much it would bother me. By week two, maybe three, I had made the adjustments, but frankly still resented that I’d had to. Ah, thatpothole again I spoke of many, many posts ago. You’re zipping along and then wham, something unexpected causes you to go on tilt again. 

Unpleasant effect number 3) While I don’t think my one hour walk causes any weight loss, it does keep my weight in check. Now, in contrast, I feel the fat deposits around my stomach and thighs swelling. My resentment of my body’s failure is now on two fronts, foot and fat. Of course that’s on top of the underlying resentment – that I work hard at having good control and being immobile has made my diabetes uglier to manage. My resentment obviously peaked two night’s ago when I ate everything sweet in my house: gingerbread, chocolate, halvah, and washed it down with too much wine. That was me hitting the brick wall. Thank god that’s over, now I can move on. Of course after I tell you the last unpleasant effect – my mood shift.

4) I’ve basically been a very unpleasant person around my husband, whiny and petulant. Good soul that he is he hasn’t filed any papers, instead he just left for Holland. Of course, he works there so I don’t think the two are related. But being housebound and not being able to scoot from here to there, having lost an enormous sense of freedom and spontaneity, not being able to clear my head outside my immediate environs, see endless sky and be a part of life all around me, has deadened something in my spirit. We are social animals, after all, and my social life is largely apartment-bound.

So, what’s the message? I don’t really know. Am I just verbally vomiting? Maybe. Interesting though that I picked the day I’m actually feeling better to write this. Maybe this little patch of light creeping into my head today is offering such relief and hope that I dare to look at how poorly I’ve been feeling, and get back on track. 

You should know, while I preach looking for the good in things, which I absolutely believe is the way to go, I am like you a student and a work in progress. So putting my own, look for the good, words into practice I could say from this little experience: 1) I have more compassion for people who are struggling with their weight or are incapacitated in some way. I really, really do. 2) I am reminded (seems to be one of my life lessons) that I don’t have to overachieve to feel I’ve achieved something.  My ankle debacle came from taking my daily walk too aggressively – not missing a day – walking faster than usual – walking another hour most days as well – and then this overloaded ankle twisted in a pothole on a city street. All that effort I put into my walking to more aggressively keep my weight in check, all that speeding up has brought me to a standstill. That concern with weight comes from having been a heavy teen. My, my, such old programming still exists! That concern with overachieving is just more of the same entrenched, old programming. Seems my head needs to be re-booted. Well isn’t my current condition delivering the perfect symbolic message!? (See photo)

Then too, maybe I caused this because in the world of Louise Hay, spiritual teacher, my world is shifting rapidly and I am a little frightened of all the new things I’m taking on and all the new places I’m going. Did I slow myself down so that I could control it all, because I am an uber-controller? Not of others, just myself. “What I know for sure,” as Oprah would say, is when I’m faced with big, new things that feel overwhelming, my first impulse is to freeze and fear. But then what gets me through is to chunk it down into small steps. To take one small step at a time and create a small success. One step, one success builds me a road to the next step and the next success. Just writing that is soothing.  So I could say tallying my accumulated good the last one is, 3) I have been reminded that this small-step approach is what I need to do with all that’s in front of me. 

After all, the only race I’m in is the one I’ve created in my head. I guess my deeper wisdom knew that I needed to remember that. And like the tortoise and the hare, sure and steady wins the race. I just wish all this knowing had come to me in a dream, while slumbering peacefully in my space-age tempur-pedic bed, not in a pothole on 81st street. Then again, I could choose to see this whole affair as a symbolic, celebratory “kick-off” of all the many good things yet to come this year. 

Are your systems helping or hurting you?

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In my last post I touched briefly on the importance of the systems in your life to support your diabetes management.

Systems-talk is generally heard relative to companies seeking ways to improve  processes in order to increase profits and save time and waste. But doesn’t it make perfect sense that the same holds true for managing diabetes? Our systems either make us successful with less cost in time and energy, or foil us. Back to the company analogy, no matter how dedicated employees may be, if they’re working within a system that doesn’t support their intentions and efforts, they won’t accomplish their aim. Similarly, no matter how good your intentions, if your systems do not support your best efforts, success will evade you.

What does this really mean? We all have some kind of system we work within for the daily or weekly tasks we perform regarding our diabetes management. For instance, you have a system for feeding yourself – it may be skipping breakfast, eating a yogurt for lunch, then a candy bar in the mid-afternoon, and having dinner at fast food drive-ins half the week and pulling frozen entrees out of your freezer the other half. This system doesn’t support having your best health, let alone a desire to lose 10 pounds. A better system would be having a healthy breakfast, a larger healthy lunch and skipping the candy bar, and, going to the supermarket once a week to bring home nourishing foods. You might cook a week’s worth of dinners on the weekend, freeze them, and one day a week greet the loud speaker at Burger King, McDonalds, KFC or your fast food joint of preference.

Trust me, you have a system for everything. Take refilling your meds. It may be you open your pill bottle and you notice it’s empty, you grumble or shriek and then go to the pharmacy or call your doctor. Here’s another system that might be less stressful: when a new bottle of pills come into the house, if it’s for a 90-day supply for instance, write on a calendar 75 days from that day, “Reorder meds.”

Think about how diabetes fits into your day, or doesn’t? Is it the last thing you always seem to contend with? If so, your systems are not very efficient or supportive for managing your diabetes. How about your emotional system? Do you let loved ones help you in some way or shoo them away? Do you do enough of what you love to replenish your energy and positivity? If not, can you schedule that into your week?

The good news is you designed your systems, consciously or unconsciously, and can change them with a keen eye, some creative thinking and practice. Look specifically at what you’re having trouble with and then look at the system behind it. For example, if you forget to take your pill before lunch because you’re always stressed at work, or running into a meeting, how can you remedy this? Can you put a note where you’ll always see it just before lunch? Dan you keep an extra pill in your wallet if you carry your wallet or  purse into meetings? f you’ve been trying hard and not doing terribly well, don’t blame yourself, blame your system and then revise it.

My Systems

My system for taking my blood sugar approximately 5xday includes keeping my meter always in the same place, on my kitchen counter, my test strips always in my meter case, my lancing device  always on my kitchen counter. I work at home and this works for me. If I’m out of the house, I take my smallest meter with me so I can always test.

My system for eating is to buy mostly fresh vegetables, fruits, chicken and fish and do most of my own cooking. Every morning I make a bowl of steel cut oatmeal. Almost every lunch I have a spinach salad with an assortment of veggies, beans and some feta cheese. I mostly steam vegetables and broil or saute meats and fish for dinner. I eat beans in replacement of higher carbs, for instance, rice, pasta, potatoes. The few freezer products I use don’t have any added butter, cream, etc. I use vegetables a lot as foods to fill up on, and crunch on, when I need something crunchy. I like nuts for this too, and yes, I have to be careful not to sit down with the whole jar. I notice when I run out of healthy foods, I begin to reach for less healthy foods (my husband’s stock of crackers, licorice, etc) so part of my system is to always try as I can, keep an adequate supply of healthy foods in the house. I make sure I have 85% dark chocolate in the house and cocoa powder so when I need a sweet I can satisfy my sweet tooth and not go crazy. If I don’t do this, I’ll eat everything in my house and still feel unsatisfied.

My system for exercise is to every morning take a one hour walk around my local park typically from 9:30-10:30 A.M. Just after checking my email and before getting into any major project. If I miss my walk because I have an appointment, I try to fit it into the late afternoon. If my appointment is in the city, I’ll walk 40 or 60 blocks when I get out of my appointment to a subway station so I fit my walk in that way.

My system for emotional health includes doing lots of things I really enjoy that make me feel purposeful, and I get the rich reward of serotonin, the feel good brain chemicals from helping others. I spend time with friends who nourish me. I love reading and movies and indulge in both. When times are tough, I reach out to my partner who always listens and then see how much good I still have in my life. If all else fails I do something guaranteed to bring a smile, look at the pictures in my wedding album, call a dear friend across the country or just leave my house and go somewhere else from where life looks different.

I’m only telling you about my systems to give you an idea of how systems work. Admittedly, I have a lot of lattitude working for myself and working at home. I don’t want you to compare what you to what I do. I want you to look at your systems and your life and see if your systems support your best efforts and if not what can you do to improve them?

Here are some questions to stimulate your systems-thinking:

Q: Where are my supplies? Are they handy? As I said my meter is always on my kitchen counter making it easy to find and grab, no searching that might lead me to say, “oh what the heck, I’ll test later.”

Q: Am I always running out of my meds or test strips? Why? Can I guesstimate when it would be time to order more and work out a system for this? Is my husband or wife always at me about this and so do I put off reordering my meds just to bug him or her? Can I remedy this by having a heart to heart talk with my loved one and then do better for myself?

Q: How can I avoid all the tempting foods always at work from parties and meetings? Can I keep a healthier replacement treat at my desk, or give myself a reward when I pass up temptation like a movie or little trinket?

Q: I only seem to be getting to the gym a third of the time I’d planned because work or family obligations get in the way. Can my family help pick up some of the load by taking over some simple chores?

Looking at your systems, start with the assumption that it’s possible to refine them. And remember, to improve you can’t do what you’ve always done and expect different results. Sounds like common sense, but many people will often spend their energy trying harder in a failing system than change their system.

The emerging trend in chronic illness

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Screen Shot 2015-02-08 at 2.58.07 PMFind the balance where you manage your illness well, and, really enjoy your life  

There is a slowly emerging trend in chronic illness, very slowly emerging, but you can see elements of it here and there. I have referred to it before in books I’ve read like Richard Cohen’sBlindsided about his multiple sclerosis and his newest book, Strong at the Broken Places, that profiles people with a variety of chronic conditions. There’s Jill Sklar’s book, The Five Gifts of Illness about living with Crohn’s disease, and now my own book, The ABCs of Loving Yourself with Diabetes, featuring a new approach to living with diabetes.

The emerging trend in chronic illness has various components. Here are some of them in no specific order:

1.To live with illness from a different perspective – that of using your illness as a catalyst to find greater joy, purpose and meaning in your life.

2. To see the patient as the central figure in managing his or her illness, rather than the health care provider (hcp), although hcps are essential for information, education, direction and advice.

3. The hcp acts as a coach to collaboratively, with the patient, create a  treatment plan that really works for the patient.

4. Hcp and patient together examine the patient’s “life systems,” ie cultural mores, food preferences, family structure, support network, neighborhood advantages or limitations, work etc. in order to design a treatment plan that will work in that individual’s unique life.

There’s an interesting article on a management blog that speaks to these points  titled, “Why patients have to be doctors today” It’s worth a read. The article looks at diabetes in particular not so much as a medical condition, but from the point of a chronic condition that need to be managed by the patient. It is a bit lengthy, but don’t let that scare you, nor some of its “management-speak.” You will get an insightful view regarding what supports good diabetes management and what patients and the medical community are coming up with.

I wonder what has tipped our gaze now to look at chronic illness through this prism of patient management and what can be gained from illness. I would imagine it’s because we have new medicines and procedures that allow us to live longer with illnesses that would have killed us decades ago. With someone getting diabetes every 10 seconds around the world there will only be many, many more individuals, and by virtue of that, also families living with chronic illness.

What we need now is for our medical professionals to be trained in chronic care so that they can help patients better, and I’d want to say best, their quality of life within the parameters of their illness.

Since doctors are trained in curable illness – diagnosing, medicating, cutting and curing, there is little in their toolbox to help those of us with life-long conditions. But I see some headway and as “Why patients have to be doctors today” points out, it is a movement starting on the ground with patients supporting and counseling each other as many from the inside report peer-coaching will be the next wave in chronic care. We see it evidenced already on the health and community web sites popping up every day, and programs like my own A1c Champion program, where I, merely as a fellow patient, deliver motivational diabetes presentations to diabetes patients.   

It is my hope that my contribution in diabetes will be to help people see that if you look at diabetes through a different lens, you can use it to create a bigger, more fulfilling, more meaningful and healthier life than you may even have had before. It would be nice to think the medical community is not too far behind me.

Why insulin can contribute to making you fat

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UnknownA good rag for news & reflection

I write a monthly column for DiabetesHealth Magazine. It’s my personal opinions and experiences about living with diabetes. Of course Scott King, the publisher, likes to say it’s my, “rants and raves.” My articles also appear on their regular web site blasts. 

Yesterday their web blast featured an extremely understandable and easy reading article about the carb/fat debate, The “Fat-Free Fallacy:” Is It Obesity’s Great Enabler? 

I could condense the article here, but it’s better you read the whole thing. Don’t let the length of the article scare you, it reads fast. 

I will give you, however, my 3-bullet take away: 1) Glucose not used by the body is turned into fat by insulin, so unused carbs make you fatter than fat 2) Never skip your insulin, instead lower your carb intake. And, since you have to have three things in a list 3) The food pyramid will likely make you fatter since carbs form its foundation. 

You can take all this with a grain of salt, but I’d say pay more attention to the results you’re getting from your diet and then draw your own conclusions.

Be your own Valentine, you deserve to love yourself

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DSC00111_2

Last night I celebrated Valentine’s Day with 26 women and sent my husband away for two hours. I was the guest speaker, as the author of my new book,The ABCs Of Loving Yourself With Diabetes,at a Divabetic support group meeting. Max Szadek, showman extraordinare and founder ofDivabetics, the group that’s quickly growing from a grass roots movement to a national phenomena, chided me that the evening was my book launch. Looking around the somewhat disheveled room at the McBurney YMCA I chided back, “So where’s the champagne?” But it was my launch. I was launching my philosophy about viewing our diabetes differently, positively, to a real-live group of people with diabetes.

Divabetic, in its support group meetings, and now its national Divabetic “Makeover Your Diabetes”events sponsored by Novo Nordisk, brings diabetes education and empowerment to women, attracting them through things that make women feel good about themselves like make-up and hair styling, pedicures and tea tastings, with diabetes educators and coaches at the ready to answer their questions. You may think it crazy, but it gets women out, talking about their diabetes and smiling. Of course I took empowerment on a slightly different trajectory last night – we were going within.  

The ABCs Of Loving Yourself With Diabetes is about using your positive emotions to create a healthier and happier life. It’s pretty simple, really, if you focus on what you want and “rev up” your self-love, joy, courage and confidence, you’ll take the actions that will bring what you want into being, including greater health and happiness. Having greater health and happiness, you’ll perform your diabetes management tasks more easily, more regularly and more competently and confidently, with appreciation for how livable diabetes is, rather than being overwhelmed by anger and resentment.

Conversely, traditional diabetes strategies try to motivate better management through negative emotions – we are meant to fear complications and feel guilty when our management is not very responsible. Focusing on the negative, however, does not create sustainable positive actions. It doesn’t make you feel very good either. So I’m saying focus on what you love – about yourself, about your life, be grateful for the things you have and the people you care about, appreciate your courage and all you do living with diabetes, see yourself as a “warrior” not a “worrier” and be kind, patient and forgiving with yourself when you’re not on your game. Know you’ll do better tomorrow. Here’s something else, if you look, you can also find deeper meaning and purpose in your life through diabetes, and life can turn out to be even more rewarding, fuller, richer, healthier and happier than it was before you got diabetes. Don’t get me wrong – I didn’t say I’d ask to have diabetes, I’m just saying since we’ve got it, better to find something good about it and get on with life.

Sound crazy? I wondered before I presented this idea to my 26 Valentinas last night. In Divabetic tradition, we began by passing a pink boa around the circle and each person gets to glam a little while introducing herself. I asked everyone to say their name, how long they’ve had diabetes, something they love about themselves and one positive thing diabetes has given them.

Half the women said, “appreciation or humility.” One woman having trouble seeing, as her eyes are faltering now from her diabetes, said she has so much more compassion for people who have no sight or have a disability. Another said humility knowing she could have something much worse than diabetes. Women who got diabetes young said it helped them learn to be strong and responsible.  Many women said diabetes has helped them eat healthier or get regular exercise, and they were grateful for that. Some talked about the friendships they’d formed from the group. Many said they are helping family members with diabetes, which makes them feel worthy and valuable. Others said it just makes them more aware of life and not to take things for granted. It has heightened their senses.

I was surprised how easily most of the women reported something positive they’ve gained from diabetes. A few were stumped to come up with something, but no one was argumentative or thought I was full of sh_t – something I had wondered about before I began.

Then I read aloud the text from the letter A in my book, A is for Appreciating All the Special Things You Are and Have. The group was quiet for a moment after I finished reading and then they applauded and murmured heart-felt messages of solidarity. Then I read my personal message from the book, “To My Fellow Travelers” and several women, including me, were brimming with tears. A diabetes educator seated to my right and a health coach seated to my left both told me how wonderful, delightful and right-on the book is and how this message needs to get out there. A diabetes nurse came up to me at the end of the meeting asking if I will come and speak to her diabetes class about this.

For decades many pharmas have been selling their products through fear, entrenched in the belief that that’s the best way to get patients motivated to take care of themselves, and use their meters and meds. Much of the medical profession has also been under the delusion that fear and guilt is motivational. How long have we heard, “You have to take care of your diabetes or you’ll lose a leg, go blind, have a heart attack!” But this focus on doom and gloom many doctors and pharmas have used has not inspired better management, we know that statistically, but it has increased denial and depression among the diabetic population. 

Now instead, imagine the approach to diabetes management was to have you focus on a picture of the life you want to live and believe you could have it. Imagine hearing that you should treat yourself with kindness and forgiveness when you have an off day, and that you are strong and capable enough to do better as you learn and practice. Imagine that you are encouraged to live the biggest life you can dream, that you deserve it and that you can have it with proper care. Wouldn’t you move heaven and earth to stay healthy?! You bet you would! 

The belief that patients can live a happy and healthy life is far more motivating and would sell far more meters and meds than the fear of complications, because we’d do everything to bring our desired life into creation. Moving toward what you want has proven to yield more success and be more empowering than avoiding what you don’t want. Excited, hopeful patients would actually use their meters and meds. Hmmm..that means companies would be selling more meters and meds. Sounds like a win/win to me. You can see a modified version of this attitude is actually being adopted by Bayer and Novo Nordisk. Bayer’s latest round of TV commercials has a more upbeat tone. Novo Nordisk, the world leader in diabetes care, launched an initiative in 2005 called, “changing diabetes,” where they’re bringing together innovators in diabetes education, treatment, reimbursement and policy to shift attitudes and change the way patients and health care professionals think about diabetes. Hallelujah! A beginning.

It’s time to take that message to every medical professional’s office and every patient: focus on the best vision of your life, energize your positive emotions and you will create more health and happiness – and better diabetes management. Why? Simple, you will see better management as the foundation that supports that fantastic life. And here’s a second message: Sometimes diabetes is a pain in the neck, frustrating as heck and you wish you didn’t have it. I know. But here’s what’s also true, if you really look, you can likely find something positive you’ve gotten from diabetes. The two are not mutually exclusive. Both can co-exist. So doesn’t it make sense to find something positive about having diabetes since it’s not going away anytime soon?

I have also never forgotten what the actor Jim Carrey did when he first got to Hollywood. He drove up into the Hollywood Hills and looked out over the blazing lights of Hollywood and visualized a check made out to him for $20,000,000 for making a movie. Ten years later it happened. I believe last night was a mini demonstration of what’s to come. And it will start where diabetes lives, in us, not in the white coated offices or pristine HQ campuses. So business and healthcare think the way they think, but on the ground, those of us living with diabetes are ready for change. Hmm… sounds like my political stump speech.

Last night, on Valentine’s Day, I celebrated loving yourself with 26 women. It was one of the best Valentine’s Day presents I’ve ever been given. Thank you Max.

Is Cleanliness next to Godliness?

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Every so often I look at my house, well my one bedroom apartment, and see red. No, not in anger that I’m tripping over my husband’s books and piles, but fine streaks and blotches of red. It’s particularly noticeable in my kitchen that has light yellow walls and white cabinets. Oh, yes, and I see it occasionally on bits of food I’m preparing, like the edge of a broccoli floret or cauliflower segment. You guessed it, my kitchen is where I test my blood sugar. Admittedly, I am anal about many things, but apparently not about where I leave trails of blood after a blood sugar test. Or would some poet say I am just trying to find my way home?

I know there are many ways to clean up residual blood left after a meter test. No, I don’t mean Fantastic the walls, I mean remove the left over blood from my finger. Many people I interviewed about their experience living with diabetes told me they lick their finger. Somehow that is about as appealing to me as the article I just read about bugs being good protein and chefs trying to put them on the menu. Myself, I pull the used test strip out of the meter and use it to wipe away the blood left on my finger. Guess it’s not a fool-proof system.

Also tending to be an amateur shrink, I found it most interesting when my husband, worried that he is having blood sugar problems, spent yesterday testing his blood sugar. I told him to do it 7 times; the ritual before breakfast, lunch, dinner and bed and 2 hours after a meal. Each time he tested (after complaining about how much it hurt and his poor fingers!!!) he tore a new sheet of paper towel – a whole sheet — off the roll to blot the miniscule drop of blood left on his finger. Hmph!

My first thought was if I did that each of the times I’ve tested, hmmm…let’s see, on average I test myself 5x/day, that’s over 30 years, well I wasn’t as diligent in the beginning so let’s just say I’ve pricked myself somewhere between 54,812 times and 93,907 times … the point being I would have spent approximately $5,000,002 just on paper towels.  

My other thought was when we move and I redo the kitchen, maybe I should paint the walls a deep, burnished tuscan red. Yup, I don’t expect my blood testing habit to change. There is no great wisdom to take away from all this, just an observation and maybe a mutual smile. Of course if you have a fool-proof system for getting the residual blood off your finger, do let this fool know.

 

Diabetes can awaken you to your life’s purpose

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Screen Shot 2015-02-08 at 3.45.51 PMUse diabetes to create a greater life and a new earth

March 3rd Oprah’s launching the biggest book club ever on her web site – it’s global and they’ll be reading a book I read two years ago and was so taken with when I lifted it up off my friend’s coffee table in Scottdale, that she had to gift it to me. Which she did.  Since the world is beginning to pick it up, I dipped in again last night. The book is  A New Earth- Awakening to Your Life’s Purpose by Eckhart Tolle.

A new earth is about detaching from your ego and waking up to your inner consciousness. When you come from your inner spirit, not your ego, you will be an instrument for positive change in the world, so says Tolle. This is the act of leaving your identification of yourself as your ego behind; residing in the consciousness that you truly are, whose purpose is to create good, both in your life and the world, and can do so supremely better than our small, defensive, judgmental egos.

The passage I read last night struck me in relation to this journey we’re on living with diabetes. Talking about loss Tolle says, “there are many accounts of people who experienced an emerging new dimension of consciousness as a result of tragic loss at some point in their lives. Some lost all their possessions, others their children or spouse, their social position, reputation or physical abilities. Whatever they had identified with, whatever gave them their sense of self, had been taken away. Then suddenly and inexplicably, the anguish or intense fear they initially felt, gave way to a sacred sense of Presence, a deep peace and serenity and complete freedom from fear.”

Paraphrasing what Tolle goes on to say here’s the message — When there is nothing to identity with anymore, who are you? Your sense of  “I am” is freed from being tangled up with concrete forms. You realize your essential being, your true self, is consciousness itself.

Not everyone reacts to loss with this realization. Some create a strong mental image (thought form) seeing themselves as a victim, whether of circumstances other people or fate. This thought form of themselves creates anger, resentment, self-pity, and they strongly identify with it. The ego then identifies with this new form. The fact that this form is a deeply unhappy one, doesn’t concern the ego much. As long as the ego has an identity it is happy.

Whenever tragic loss occurs, you either resist it or you yield to it. Some people become bitter and deeply resentful, others become compassionate, wise and loving. Yielding means you are accepting what is and you are open to life.

If you take action from resistance and negativity you will create more resistance and negativity in your life; life will not be helpful. When the shutters are closed the sunlight cannot come in so to speak. However, when you yield, when you surrender, a new dimension of consciousness opens. If action is necessary, yours will be in alignment with the greater good and supported by creative intelligence. Circumstances and people become helpful and cooperative. Positive coincidences happen. If no action is necessary, you rest in peace and inner stillness. You rest in God.

Tolle is a great spiritual teacher and I am an avid believer. It’s always been my message that we should try to see our diabetes as a loss that can lead to greater positive determination, empathy, compassion, appreciation and quality of life. Yield and find your strength, power and ability to transform yourself, your life and the world for greater good. I’m with you Tolle. I’m with you Oprah.

Diabetes Resolutions – is it time to get fired up again?

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O.K., time to take stock. As for New Year’s resolutions, if you’ve already given up on your resolutions you’re among the greater 64% who have too. How about your diabetes resolutions? Did you make any? If so, you may well have given up on those too, or nearly. Change is hard!

I don’t make resolutions of any sort because if I’m really committed to doing something, I don’t have to make a declaration about it, and if I’m not committed it won’t get done whether I say it will or not. So what gets in the way? The experts say stress, mood swings and boredom are largely what dash our resolutions into the snow or the sand depending on your geographic clime, weeks after we make them and throw us off our well intentioned paths. Sounds about right.

Resolutions typically require changing your behavior – doing things differently on a steady basis. This means forming new habits. Did you know it takes at least 3 to 4 weeks to form a new habit? And, it’s not a straight road to success, you’ll stumble on your way. Whether you get back up and continue toward your goal depends on you – your commitment, how important the goal is to you and how compelling your motivation is. So each resolution is deeply personal and each resolutioner has his or her very individual level of commitment and impediments. But here are two rules of thumb that apply across the board. 1) Don’t put excess pressure on yourself when forming a new habit to do it quickly or do it perfectly. These expectations will defeat you before you barely begin. 2) Appreciate any and every step you take in the right direction. If you see success as moving in the right direction rather than goal completion, you’ll gain new steam from your improvement alone.

Psychologists also talk about a “change muscle.” Figuratively, it’s a place in your body that has captured a memory of you having successfully made a change before. Connecting with this place and drawing upon this memory and energy can help you; your remembrance of change and success can inspire you to move forward with more conviction when things get tough.

Also, a support team is helpful when you’re trying to make a change. Whether it’s your spouse, a friend, neighbor or community resources, reach out, it’s easier if you’re not going it alone. Sometimes you just need a cheerleading squad, especially when your mind, as punishment for self-assessed failure, has placed you in front of your own personal firing squad.

Thinking about where I draw support from in addition to my family and friends, I remembered a poem I read long ago. It talks about a higher spirit always being there to help us. It gives me comfort. You will probably remember having read it before too:

Footprints in the Sand Copyright © 1984 Mary Stevenson

One night I dreamed I was walking along the beach with the Lord.

Many scenes from my life flashed across the sky.

In each scene I noticed footprints in the sand.

Sometimes there were two sets of footprints,

other times there was one only.

This bothered me because I noticed that during the low periods of my life,

when I was suffering from anguish, sorrow or defeat,

I could see only one set of footprints, so I said to the Lord,

“You promised me Lord, that if I followed you,

you would walk with me always.

But I have noticed that during the most trying periods of my life

there has only been one set of footprints in the sand.

Why, when I needed you most, have you not been there for me?”

The Lord replied, “The years when you have seen only one set of footprints,

my child, is when I carried you.”

Even if you’ve given up your resolutions, nothing says you can’t start again right now. There’s no need to wait another 330 days.

Try telling yourself you’re going to “practice” your change this year. It will take the pressure off and chances are it will actually become real when you’re not even looking.

When quitting is a good thing

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This is something I was going to post over the weekend until Saturday night I exited my friend’s car and walking down her block, where a lot of construction was going on, twisted my ankle. I twisted it so badly that an hour later I felt like my foot had been run over by a truck. Since it was Saturday night and I was not at home, my friend went out to a neighborhood drug store to buy pain relievers. I spent the next two days basically with my foot up and being waited on. Alas, all dreams must come to an end, and I returned home last night to fare for myself.  

The ankle still needs rest, the pain relievers continue although at a lower dose, and I’m still wondering if my 2-day blood sugar rise was my body’s reaction to the stress or the excess unbelievably delicious whole wheat peasant bread I was gorging on all weekend at my friend’s house. Guess I’ll know soon enough now that I’m back in my bread-less house.  Proof positive, 35 years after getting diabetes every day comes with episodes and more questions. 

O.K. that out of my system, this is what I wanted to post if there’d been no drama this weekend. I was watching Oprah last week and she had on Dr. Oz, heart surgeon and one of her resident experts. He was talking about quitting smoking. While I don’t smoke, I was intrigued to see if Dr. Oz would offer any advice that would be applicable to diabetes. I was not disappointed. Here are a few transferable actions you can take to improve diabetes management.

1) Pick a quit date –  that might be the date you will chuck the junk food out of your house or quit eating as much refined carbohydrates like white rice, white potatoes, pasta, white bread. But what’s important is to pick a date.

2) Prepare yourself mentally, physically and socially – In other words decide how you’re going to handle it when you go out to eat with friends and they’re ordering desert and you’re in conflict. Know ahead of time you’ll just have two bites, for instance. If you’re starting an exercise program, what will you do if the weather’s bad and that curtails your walk? Have a back up plan.

3) Make 2 lists – Write down all the reasons why you want to improve your management, what will you gain? Then write all the reasons you don’t want to improve your management, what do you get to keep? Compare lists. What conclusions do you draw? Write them down and review them when your motivation flags.

Above all, Oz advised to take it one day at a time, one hour at a time. He went on to say, phrases like “Don’t Smoke!” just make you think about smoking. Like don’t think about a pink elephant. Like “don’t eat cake.” Instead tell yourself  the advantage of not smoking like “Breathe Free.” It keeps your mind focused on what you want. So I think phrases like “Don’t have that incredible, chocolate cheese-cake covered with lip-smacking raspberry sauce” is probably not helpful. If you replace that with, “I’m going to look fabulous at my friend’s wedding next month!”I think there’s a much better chance you will. 

Lastly, I admired Dr. Oz for an admission he made. He summed up with, “We are a society that’s not comfortable being uncomfortable. (Thus the miracle diets, 5 steps to anything, drugs for everything, addictions that momentarily seem to relieve our pain – my thoughts). Yet discomfort is the best way to grow in life. I don’t feel great every day, and it’s OK. It’s life. Some days you just don’t, accept it, it’s life.” 

I think Dr. Oz’s smoking advice makes sense for any behavior change you want to make and his admission that we don’t feel on top every day takes the pressure off. Normally I’d be really pissed off that I can’t take my daily power walk because of my ankle. But I’ll accept that some days are just not as good as others. Moreover, if I feel really sorry for myself by tonight, Ill only have one bite of my beloved gingerbread and put the rest away remembering that I’d rather have another year on the planet than another piece of gingerbread.