Archive for the ‘Uncategorized’ category

It’s That Time of Year Again. Boo.

October 6th, 2011

I’m not a big fan of Halloween.  As in, really not a big fan.  I know that makes me a big ole party pooper, but there it is.

For one thing, everybody tries to be somebody else.  Um, I think being myself is plenty hard enough thank you very much and I don’t appreciate people trying hard to fake it as someone or something else.

Totally just me; I get that.  Heck, it weirds me out how many people color their hair.  I’m telling you.

And then there is the fear factor of Halloween, when people dress up as dead people and hide and jump out and dear me are you kidding.

We won’t even DISCUSS the fake spiders or webs.  *shudder*

At my elementary school, we had a parade on Halloween.  That was okay.  Less sitting still in class, more walking around.  Way better!

So for the first ten years of my life, sure, dress me up and put itchy face paint on and make me not touch the makeup all day, fine.  Just pay me in candy and I’ll be juuust peachy.

And then came diabetes.

At the time, candy for a diabetic was a no-no.  My “medical team” aka my pediatrician didn’t ever think about even a sliding scale of insulin to cover carbohydrates, much less carbohydrate counting or whatever the heck a bolus was.

Doesn’t mean I didn’t eat candy, though!

I just had to sneak it. (Tell me how you sneak candy when you take the exact same dose of insulin each day and eat the same food just now with candy.  How?  For me, hide the numbers too.  THIS IS WHY parents need to see the whole 5 second blood check.  In person.  With real blood.  Every time.)

Thankfully, we do things differently now when it comes to life with type one diabetes: carb counting, insulin shots, pens, and pumps.  All foods generally allowed if counted, and if parents say okay.

October means a lot of things (Happy 10th birthday kitten loves Gracie and George! Winter socks! Cranberry-Orange tea!) and Halloween gives me a chance to smile at how far we’ve come in terms of life as a kid with diabetes.

Maybe it isn’t such a crummy holiday after all.

Just get rid of the spiders; I’m begging you.

Walking it Off

October 5th, 2011

I saw a woman who had taken the summer off her regular exercise routine and walked instead.  Yesterday was her first day back at bootcamp and she looked like she was sorry to have taken the time away!  She acknowledged “walking for fitness” isn’t anything like an exercise class.

I know a lot of people walk as exercise.  Are you sweaty by the end?  Are you climbing hills when you’re out there?  Does the weather change your routine?  Do you add in intervals of intense speed to help increase your heart’s capacity to pump blood?

All things to consider.

If you’re in an area of the world that has seasons (unlike me) with snow, walking for exercise probably takes a huge hit during the cold months.  So do you take it indoors?  In front of your television or onto a treadmill?

Running or walking, a treadmill can offer some great benefits but there is also a downside of the treadmill too.  This article discusses benefits of treadmill walking and walking outdoors.  It has some great things to keep in mind for those of us who want to cover some miles several times a week!

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Using a motorized treadmill with no incline, you may burn fewer calories per mile than you do outdoors. The moving tread does some of the work for you, and you have no wind resistance. According to research, you can overcome these by adding a slight incline, as little as 1%.

Holding onto the handrails will reduce calories burned further, and wreck your walking posture. It is best to train yourself to walk a speed you can sustain without holding onto the handrails.

Calories Burned Walking

Work More Muscles Walking Outside

Walking outside has its biggest advantage in challenging your balance and stability with all of the small obstacles, dodges, starts and stops. This will give you an advantage for distance walking as well as overall health as we age — maintaining our stabilizing muscles. Here is what you face walking outside vs. on a treadmill:

  • Up and down curbs, steps, short stairways, and stepping over small obstacles. A little workout for your climbing muscles.
  • Sloped sidewalks and road sides. A challenge to your balance muscles.
  • Dodging people, puddles, and poodles. A challenge to move side-to-side as well as forward.
  • Stops and starts at street crossings. A challenge to the muscles to come to a halt and to start from zero.
  • Treadmills only go uphill or level, only very rare models have downhill incline. Going downhill challenges muscles in a completely different way.
  • On the treadmill, the tread is moving and you may not be giving yourself a good push off with your back foot. Concentrate on doing this correctly on the treadmill.

Advantages of Treadmill vs. Outside Walking

Using a treadmill for your regular workouts is a great way to burn calories and give basic training to your walking muscles and practice your walking form.

  • Workout Programs: You may enjoy the pre-programmed workouts the treadmill offers to give you a controlled workout challenge. The treadmill may also have readouts for heart rate, calories burned, etc. which give you data feedback.
  • More Speed = More Calories Burned: Most people set their treadmill workout for time rather than for distance, and can often go faster on a treadmill due to lack of obstacles. More speed = more distance for the same amount of time = more calories burned than if they walked outside for set distance rather than for time.
  • Safety: If you don’t have access to a safe walking route, a treadmill is a good substitute.
  • Weather: You can usually control the indoors weather, but never the outdoors weather.
  • Easy access to restrooms, water, and changing your gear.
  • Entertainment: Some of us are bored with treadmill walking, while others prefer watching TV or listening to their music indoors to walking outdoors.
  • Fewer excuses: If your treadmill is always available, you can’t use excuses such as the weather, darkness, etc.

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No matter where you go, keeping yourself happy and fit is critical.  Have fun and work hard!

“Bad Knees”

October 4th, 2011

I spoke with a woman this morning who said she couldn’t work out because she “has bad knees.”  This is not the first time I’ve heard this type of sentiment.  (My favorite was when a lady told me her doctor told her to not bend her knees.  I was amazed she could walk to me to say that, much less take care of almost every other movement in her life!)

First of all, if you have seen a doctor for your knees and have had surgery or your doctor has advised you to stop exercising, then you can be excused from reading further.  (Unless you think perhaps you should seek out a second opinion already because what kind of doctor would tell you to stop exercising my word.)

Second of all, you need your knees for almost every movement you make from the waist down.  Every time you stand up, every time you sit down, every time you take a step, every time you reach for that dollar you just dropped.  Every movement.

So it isn’t like you can just remove your knees from the equation.

Thirdly, knees are just like everything else: use it or lose it.

Fourthly: (is “fourthly” a real word?!) your knees were DESIGNED to support your weight and all the impact that entails.

Take a look at the structure of your knee joint as opposed to the structure of your shoulder (side view of the shoulder blade).

One looks like it was built to take a beating, the other looks almost bird-like.

 

It goes a long way toward explaining why we don’t walk on our hands.

So what to do if your knees cause you pain?

  1. Make sure you exercise with proper form.  That means you keep your knees in mind throughout your lower body workouts.  Keep your calves stretched to increase flexion at your ankles so you can keep your heels pressing down as you squat.
  2. Exercise your weak spots.  A lot of back pain and I would argue knee pain as well can be attributed to weak glute muscles, believe it or not.  If you have one part of your body that is too weak to function optimally you are placing excess load and strain on the other portions of your body.  So, keep working on your weaker muscles to bring them up to snuff.  You can find a load of floor exercises like the bridge at the ACE Fitness website under “exercise library”.
  3. Keep yourself balanced.  Working on your balance is a fantastic way to keep your smaller muscles and tendons working to benefit you at all times.  We can all use some of that!

Don’t let laziness or fear get in your way.  Be smart about how you take care of your body and it will in turn be better able to take care of YOU!!

Parents Are People, Too

October 3rd, 2011

Just because you’re in charge of a kid, or even more, a kid with diabetes, you still need to carve out some time to take care of yourself, too.  Why?  Because you teach your children how to care for themselves when you take care of yourself.

It’s super important.

They’ve done studies where they looked at moderately obese children (5-9 year olds) and focused not on the kid at all—they looked at the parents.  By educating the parents and specifically training them in ways to make good, healthy choices their kids lost about 10% of their body weight, and kept it off for two years.

It isn’t just about you, and it isn’t just about your kid.  It’s about making good choices for EVERYONE.

But.  How. Do. You. Do. This. Amazingly. Difficult. Job. On. Top. Of. Your. Other. Jobs.

Some suggestions from a recent ACE magazine article:

  1. Take the kids along for the ride. “The best way for me to exercise is to take both kids out in the jogging stroller. Once or twice a week I meet some other moms at the walking trail. Pushing 60-plus pounds of kids and stroller up and down hills for an hour is a pretty good workout!” recommends Danielle Rattray, mother to Owen (4) and Hannah (1).
  2. Ask for help. Lean on a spouse or partner to watch the kids for a few minutes and go for a quick workout. Working parents often want to spend every non-working moment with the kids, but sometimes carving out a few minutes of personal time can make all the difference. “It’s hard not to feel guilty taking time to exercise by yourself when I already feel like I don’t get to spend enough time with [two-year-old] Xavier,” says Amber Curran. “But it keeps me happier and less crazy, so I figure that benefits him as well.” After all, she says, “No one wants a nutty mother!”
  3. Make a game of it. Barb Ruvarac, mother of school-aged children, Samantha and Zach, pushed herself to meet a predefined number of steps each day. If that means staying up late to get the steps in, so be it. “When Samantha went to bed I would finish my steps on the treadmill to reach 10,000 steps. Some days I’d only have to walk for 30 minutes, some days it would take longer. Then, I graduated from walking to running. Then my husband signed us up for the Shamrock Shuffle in 2010—first running event ever! And by May of 2010, I’d lost 20 pounds and two dress sizes!” Barb is now an avid half-marathoner and highly active role model to her highly active children.
  4. Prioritize. In describing her commitment to exercise despite working full-time and raising a nine-month-old, Beth Read uses an analogy that we all can relate to: “Like they tell you in the airplane…put on your oxygen mask first before assisting others.” Whether that means waking up before the children or staying up a little bit later, getting a few minutes of physical activity sets the stage for a more productive day and well-balanced person.
  5. Set goals. Tackling the most challenging health struggles becomes a little bit easier with goal-setting. Try this exercise: Write down three goals—a nutrition goal, a fitness goal and a behavioral goal. Operationalize this goal as much as possible by trying to make sure that the goal is SMART. Specific: What is it exactly that you hope to achieve? Measurable: How will you know if you got there? Attainable: Make sure it is something realistic that you are going to be able to achieve with some moderate amount of effort. Relevant: Choose goals that really are meaningful to you and that will help you feel like you’ve really accomplished something. And Timely: Set a date for when you hope to achieve your goal that is far enough in the future to give you time to meet it, but not so far that you will lose interest before reaching it.
  6. Commit to setting an example. It’s simple: Kids pay attention to what their parents are doing. Despite the many barriers to physical activity, taking the time—even if it’s just a few minutes per day—to engage in physical activity sets a powerful example for children. The repeated opportunities to see how you eat and play make it easy for kids to remember the experiences. And kids are motivated to copy their parents’ actions.

You aren’t alone in thinking this is a big giant task.  It is, and you’re lucky to love your kids enough to find a way to make it work for both of you.

You can do it!!!

Whoomp There It Is

September 30th, 2011

We’ve got new cardiovascular recommendations, Ladies and Gents.  The American Heart Association wants us all, by 2020, to improve our cardiovascular health by 20% and reduce deaths from cardiovascular diseases and stroke by 20%.

That seems like a lot to accomplish in eight years.

(WARNING TO ALL SENSITIVE TO THE GENERIC TERM “DIABETES” THIS ARTICLE USES IT GENERICALLY AND I THINK SOMEWHAT SLOPPILY.)

Taken from the IDEA Health and Fitness Association’s September newsletter, the goals set by the task force assigned to make this all come down to 4 Health Behaviors and 3 Health Factors:

The new Impact Goals document declares that as men and women raise their levels of physical activity by increasing the intensity, frequency and/or duration of that activity, they experience much healthier lives. Moreover, coinciding with the release of the new AHA goals, new evidence suggests that low cardiorespiratory fitness (CRF) is as strong a predictor of cardiovascular disease (CVD) and other health causes of mortality (referred to as all-cause mortality) as are well-established risk factors such as smoking, obesity, hypertension and diabetes (Lee et al. 2010).

Confronted with how to define and measure ideal cardiovascular health, the task force identified four health behaviors and three health factors:

4 Health Behaviors

  • nonsmoking
  • body mass index < 25 kg/m2
  • physical activity (150 minutes per week of moderate-intensity exercise or 75 minutes per week of vigorous-intensity exercise, or a combination of these two)
  • consumption of a diet that promotes cardiovascular health (emphasis on a low glycemic load, high fiber, high marine omega-3 fatty acids, high polyunsaturated to saturated fat ratio, and low trans fat content)

3 Health Factors

  • total cholesterol < 200 milligrams per deciliter (mg/dL)
  • fasting blood glucose < 100 mg/dL
  • blood pressure < 120/80 mm Hg

Clearly those of us with diabetes have missed the Avoid Diabetes Boat (some of us by a long shot).  However, we still can do so much to reach fantastic levels of cardiorespiratory fitness we are missing another bigger boat if we don’t do our best to keep up with the other recommendations.

Let’s get after it.

Whoomp.

On Your Own (?)

September 29th, 2011

It’s sometimes the things someone says when they don’t even realize they’ve said something.  I met a woman at my recent talk on Diabetes and Exercise, and she said something in a way that made me instantly know I will never ever forget her.

She probably didn’t even hear what she said, but it struck me and has been on the edge of my consciousness ever since.

She said she has to do her diabetes all by herself.

(Realistically, I understand that I just got a bunch of readers who said in their heads something along the line of “of course!” or in some way agreed with that.  And, depending on how your day is going, you may feel various ways about that, and there are probably about three hundred different ways to say “of course!” But keep reading because this is important.)

But here’s the thing.  I think she’s wrong.  I don’t think she has to do her diabetes all by herself.

For one thing, her boyfriend was attached by her side the entire two hours she was at the event.

For another thing, I think she is pretty damn brave for showing up when she’s feeling like her diabetes life is not where she wants it.  She was in a room full of people who know E.X.A.C.T.L.Y. how that feels.  I’m proud of her for getting herself to that chair.  I’m proud of her for speaking to me when I plopped myself down next to her because I hadn’t seen her say a thing to anyone in the entire room and felt compelled to introduce myself.  (Seriously; what IS that?! I find myself do irritating sometimes.  But, in all, it was important and I’m glad I elbowed my way into her world for that brief time.)

I’m thrilled she knew enough to ask for help.  I’m honored she felt I could be a good resource for her.

I was thinking later about other people I have known whose actions tell me they feel the same as this woman: doing diabetes all alone.

One person hid her diabetes from everyone and didn’t let anyone else have a chance to share the burden.

One person kept his diabetes to himself but went low often enough that his entire office knew what to do for his lows, and they called in a nearby doctor when it was necessary.

That doesn’t sound to me like he was alone with his diabetes.

One person asked for help from some smart people, received it, and has since spent most days speaking, explaining, educating, and venting to friends, acquaintances, and maybe the entire internet about diabetes and how it is to live with the disease.

Oh, wait; that’s me.

Life with diabetes is not meant to be a solo enterprise.  It simply doesn’t work in any significant, long-term way to keep it that way.  But you do have to recognize that you are responsible for sharing your diabetes burden if you want to feel not alone.  You do have a responsibility to yourself to check your blood glucose levels, and deal with them however best you and your doctor have decided, and to keep living your life.

You have a responsibility to speak to the people you share your life with.  You aren’t getting rid of your diabetes any time soon, and like it or not, your diabetes is a huge part of that life.  So share some of your diabetes.

Teach your best friend to count carbs.  Teach your girlfriend how to deal with you when your blood glucose is 50 and getting to the fridge for juice on your own is too much.  Teach your kids what you’re doing and why it matters.  Invite your boyfriend with you to your next visit with your CDE.  Show up at a diabetes event.

Be brave.  YOU CAN DO IT. Diabetes gets a hell of a lot lighter off your back when you share it.  If you aren’t getting the response you want or need, try again.  If the people still aren’t willing to help, ask someone else.  Ask your CDE.  Ask your counselor.  Ask me.  Ask someone you met at that diabetes thing you went to three years ago.  Whomever you share something with will then be helping you do your diabetes.  Not alone.

YOU DESERVE THIS.  

You Either Do, or You Don’t

September 28th, 2011

Some of these studies have just such goofy titles I have to blame the editors.  I mean, you have to think about the researchers who came up with the study idea in the first place: they probably already suspected the answer, but wanted proof so they came up with the study to prove/disprove the theory.

In any case, the study that brought this up for me is called: Does Blood Glucose Monitoring Increase Prior to Clinic Visits in Children With Type 1 Diabetes?

If you have ever BEEN a child with type one diabetes, you probably have already answered the question.  Assuming you are anything like me, the answer is most assuredly Y.E.S. (with a twist)

I sort of think that’s why they make us come in every 3 months, and why my endo in high school made me come in more often than that.  (She is an entirely different story and one not quite appropriate for me to discuss here.)

But this study is I’d say completely accurate when it says, essentially, that those who already checked a lot increased the checks the month before the visit but those who didn’t check in the first place weren’t likely to check any more often just because a visit loomed.

I can just hear the thoughts of those unlikely to check: “I’m not afraid of you, doc.”

I can hear them because I’ve said and thought them.

(The twist comes in when I say that downloadable meters haven’t always been available so I used to have a pending visit and drag out a couple different pens and pencils and make up a “realistic-looking” blood sugar log book before the visit.  So in that way, I did increase my activity related to BG checks… they just weren’t in any way BG checks.)

The goal, of course, is to use the doctor as a tool just like any other we have at our disposal for managing our disease.  If you’re smart, you write down your questions in the weeks before you go in, and check often so that you can discuss periods of your day or specific issues you’re dealing with.  (They are supposed to be great at that kind of detective work.)

If you have a funky chirping or whirring noise when you drive your car, you try and see how you can replicate the noise for the mechanic.  I don’t see checking blood glucose much differently than that.  If it’s an issue with something that only happens when your car is cold, write down when it happens and leave it with the mechanic overnight so they can hear it, too, and then trouble shoot and hopefully fix whatever is weird in your car.

Same here, in my world.  If you’re smart about it.

Having been on the other side of things, I agree with the results as they seem realistic.  If you aren’t responsible enough to check your blood glucose levels on your own for yourself, you aren’t likely to check them for a doctor visit either.

Growing up with diabetes is tough stuff.

Really tough.

‘Fess Up

September 27th, 2011

How many of you have already gotten sick since school started back up?

Did you know that people who exercise five or more days a week spend 46% fewer days laid up with a cold or respiratory virus compared to those who work out only once a week or not at all?

I am starting to think we should get UNSICK pay. Sheesh.

The study found that aerobic exercise was best to fight the common cold because it activates the immune system and increases the activity of white blood cells and antibodies whose job it is to fight off infection.

How great is this information?!

The boost in immunity lasted for a while after the aerobic exercise ended… much like an elevated heart rate, I imagine.  You stay armed and ready for the next bout.

Of course, too much can be a bad thing and if you’re overtraining you end up having the opposite effect.  My rule of thumb when it comes to overtraining?  If you wonder “am I overtraining?” the answer is YES. 

We sometimes don’t do a very good job at listening to ourselves.  If something someplace happened in your body and you thought, even hours or days later, that you might be overtraining, what’s the harm in taking it easy for an extra day?

This is the type of place I think those of us with diabetes can excel over our non-glucose-checking counterparts.  Listening and respecting and responding to our bodies’ little teensy questions and signals and tweaks and blips really comes into play when it comes to taking care of ourselves.

Diabetes mandates that attention and respect.  We are trained for it already.

So when it comes to warding off an attack of a tuffy node, do yourself a favor in advance: Get out there and move yourself.

Ahh and Omm

September 26th, 2011

“Yoga: It’s not just for Sissies” was my other title.  But then I started to think about who I’ve ever met who actually thought yoga was for sissies.  And I can’t come up with anyone.

So why does yoga sometimes get a bad rap?

Yoga is actually pretty difficult, and you get some nice strength benefits and some crazy great flexibility benefits and different types can improve your cardiovascular fitness as well.  That right there is the fitness trifecta: cardiovascular training, strength and muscle work, and flexibility.  Woop; there it is!

Not to mention improvements in your physical balance and for some, mental balance as well. (Bonus!)

Researchers (love those researchers) in India took a look at a group of 123 type 2 patients.  They divided the 123 into four groups, according to those with microvascuar complications, with macrovascular complications, with peripheral neuropathy and without complications.  They then subdivided the groups into those who received standard care and those who received standard care plus yoga for three months.  They then compared the health of those in the care + yoga group with the standard care group. (Not sure what “standard care” is for type 2s in India but I’ll assume it isn’t much different than in the US.)

The point they were trying to study was whether or not performing yoga reduced oxidative stress on the body in type 2 individuals.  (I looked for a good definition of “oxidative stress” and found: Oxidative stress is the total burden placed on organisms by the constant production of free radicals in the normal course of metabolism plus whatever other pressures the environment brings to bear (natural and artificial radiation, toxins in air, food and water; and miscellaneous sources of oxidizing activity, such as tobacco smoke). I like it.)

Since oxidative stress is in a lot of ways how damage occurs in our bodies, it’s good to see that we have options to fight it! Of course, eating well and not smoking are key here, but so is exercise.

Back to the study: they found that the groups performing yoga for three months in addition to receiving standard care for their type 2 diabetes had a significant reduction in their BMI (they lost weight), glycemic control was better (exercise=better BG management), and they had increases in vitamin C and other critical antioxidants that typically decrease with age.

So if you’re struggling with your diabetes, I would say be it type 2 or type 1 or any one of the other types, give some yoga a try.  You just might like it, and you’re sure to love the side effects!

Here’s How I Figure It

September 20th, 2011

Being a fitness professional, I know more than the average bear about what aging can do to a body.  Being a type one professional (in training and education for longer than any other professional schooling, I see myself as a type one professional… aren’t you?) I know more than the average bear about what my diabetes can do to my body.

So here’s how I see it.

  1. We need cardiovascular health.
  2. We need muscular strength and endurance.
  3. We need great management of our blood glucose levels.
  4. We need to be happy and healthy as many days as we can, for as long as possible.

I think only #3 on that list makes me different than any non-diabetic.

I think it’s critical for my cardiovascular system that I engage in challenging
regular cardiovascular workouts
.  I want to increase my body’s ability to handle stress and one of the best ways I can do that is to train it to work under some extreme conditions.  Every time I do, my body reacts by building a few more bone cells or making a few more mitochondria.  Thank you, Body; I will need those!

I think it’s essential for my skeleton and my muscles and my wellbeing overall to challenge myself with resistance training a few times a week, every week.  We all begin losing muscle mass by the age of 30—and the only way to fight that is to pick up something heavyHeavier.  And heavier still, as our muscles grow and we get stronger.  You need to lift  something heavier than you thought you could lift last week, or hold it longer, or move it  faster or slower to always work against a challenge.

If you’re bored, you aren’t challenged.

My blood glucose levels are always going to be a challenge for me, and I need to keep my head on straight about those.  I need to work with all sorts of health care professionals who are my allies on this.  Life is too short to be stressed out when I see a doctor or dietician.  I don’t want to carry anxiety about working with someone around with me.  I want to check as often as necessary and not have any part of me afraid to see that little screen.

Life just has so much more crammed into it that is so much more important than spending time afraid or anxious.

And on that note, if I can manage those items #1-3 I think that #4 will kind of take care of itself.  Work hard, work smart, and keep everything in perspective.

Go to it!