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.

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.

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. 

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

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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.

To the garden state and back

One of the most surprising elements in the book, “How Doctors Think” by Jerome Groopman, M.D. is right at the start when Groopman says most doctors interrupt their patients within the first 18 seconds. 

A few days ago I went to New Jersey to present diabetes materials at a minor league baseball stadium that was also featuring a small health fair. Funny to see our little table against a backdrop of every unhealthy fast food available, but let’s not go there.

While I talked with a number of people I remember one particular woman who stopped by the table. She was hesitant at first, tentatively looking over what was on the table. Her hesitation and Pacific Islander look immediately made me think she probably wasn’t that educated about diabetes. Yet when I began to ask her about her blood sugar and A1c, wow, she knew her stuff. She told me about her 6.4% A1c and how she want’s to get it a little lower, she told me what she eats and where she can do better and she told me about her last conversation with her doctor, turning her shy smile downward. Hearing her A1c, without thinking I stuck out my arm and shook her hand saying, “Congratulations! You’re doing a wonderful job!” She grinned, she glowed, her smile lifted and spread from ear to ear going right up into her eyes. “Keep up the good work!” I said as she walked away waving and smiling, smiling and waving and thanking me. 

Right before my eyes I saw the affect of congratulating a patient on her hard work. Something I fear not nearly enough doctors do. And I know damn well she’s going to work even harder to get that A1c where she wants it because someone acknowledged her and her efforts. More and more I am convinced patients will do better if we acknowledge and praise, congratulate, encourage and inspire them.

In a Wall Street Journal article, “The Importance of Trying to Be a Good Patient” by Laura Landro, Landro cites medical educator and physician groups that are training doctors to conduct more sensitive interviews, recommending doctors find ways to praise patients for their competencies and express sympathy with how frustrated patients may feel. John Prescott, chief academic officer at the Association of American Medical Colleges, reports more and more communication training programs are trying to get doctors to step back and say, “What’s going wrong with this discussion and how can I change that?” And, the authors of “Breaking the Cycle”recommend doctors let patients speak uninterrupted for three minutes and ask open-ended questions. We hark back to where I began.

As my sojourn out to New Jersey came to an end, the driver of my ride turned to me as we approached my neighborhood saying, “I heard you talking about diabetes…” (I had been on the phone in the car). I explained to him what I do and he began to tell me about his father who died of diabetes and his brother who is having a terrible time with it. And how he and his wife are concerned because they’re both overweight. 

I listened, answered his questions, encouraged him and spent an extra five minutes in the car in front of my building to give him information and a soft place to speak. When I reached for the car door handle to let myself out he reached for my hand, shook it and thanked me, wishing me the best day anyone ever has. I feel now as though it was kismet that I met the two people whom I know I impacted. I imagine they feel the same about meeting me.

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.