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The Costs of Obesity and Smoking on Our Bodies

November 9th, 2010

Wow.

I don’t know what to say to this.  Part of me can absolutely believe it, and part of me is just amazed at how important this is.  I feel like we are so far behind I can’t believe it.

Do you know how much energy we have put into educating people about the harmful effects of smoking?  If you haven’t thought about it in a while, take a moment now to remember what life was like only a few decades ago: when “smoking or non?” was the question rather than “paper or plastic?” (In California, even the paper/plastic choice is changing to “donate or take off” for your cloth bag.)

Did you realize that if we continue as we have been going, smoking won’t seem so bad when we compare it to the mass casualty effects of obesity?

Recent U.S. trends in smoking and obesity have moved in opposite directions: over the past 15 years, smoking rates have declined by 20%, whereas obesity rates have increased by 48%.15

This means, of course, that all the work that went into changing public perception of smoking as completely unhealthy won’t matter if we keep eating ourselves to death.

Wow.

Either one is a time bomb: smoking is a major risk factor for cardiovascular disease, chronic lung disease, and several cancers.  Obesity leads to cardiovascular disease, [type 2] diabetes, and joint problems. 

Yuck.

As someone living with type one diabetes I don’t understand stacking the deck against myself with something I can do something about.  I try to eat right to keep my weight in check, and I exercise to combat a possible future of cardiovascular disease.  I don’t smoke and never have.  Having experienced a body attacking itself, I want to do everything in my power to prevent another malfunction.

I do what I can with what I’ve got: I’m all about maximizing my abilities every day.  I think we all should remember our survival instinct and really spend some time every day moving toward HEALTH.

The study also published another amazing prediction: if all U.S. adults became normal-weight nonsmokers, life expectancy could increase by 3.76 years.

What would YOU do with those extra 3.76 years?  Let’s find out.

If you need some help with getting fit but don’t know where to turn, let me know.  We can work together to get you a plan and keep you working at it!

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Posted in I Can't Believe Someone Got Paid to Conduct This Study, Living with Type 1 Diabetes, My Soapbox, Random Musings, Uncategorized

Sweaty Smarties

November 8th, 2010

Cardiovascular fitness is associated with intelligence in young adulthood.  Awesome!

I love that!

Swedish researchers looked at the cardiovascular fitness of men reporting for military duty at the age of 18 as well as their brain power and socioeconomic status and physical capacity.  The men with greater cardiovascular fitness had significantly greater intelligence scores than subjects with decreased cardiovascular fitness.

They were more likely to be more intelligent and experience greater success.  Who doesn’t need some of that?!

The study looked at 1.2 million men born between 1950 and 1976.  MILLION.  I have discussed studies with 6 or 8 subjects before but I think this one takes the cake for the largest group of subjects.

When you can study more than a million people and come up with a fair conclusion, I’d say that conclusion borders on becoming a fact.

So what was the conclusion?  In order for optimal cognitive function/development to take place, regular cardiovascular fitness is needed.

Gee, seems like we keep arriving at the same spot.  Stressed out?  Cardiovascular exercise.  Need help with blood sugars?  Cardiovascular exercise.  Feeling depressed?  Cardiovascular exercise.

Now we get to add one to the list:  Feeling like you’re missing out from competing on Jeopardy?  Cardiovascular exercise.

It isn’t that the researchers could determine that one came before the other (if you have great cardiovascular fitness, you are not automatically smarter) but the relationship alone should be enough to encourage you and the kids and teens you know (who have a difficult few years ahead of them as they face college and/or the workplace) to get out there and get fit.

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Posted in I Can't Believe Someone Got Paid to Conduct This Study, Random Musings, Uncategorized

Complications: the “C” word

November 5th, 2010

I think we are all aware of complications that accompany our diabetes.  Some of us deal with that specter in our future by denying its existence and some of us swing the other way and become obsessed with controlling our blood sugars.

Both extremes cause us to put our disease far ahead of our personalities, our lives, and our loved ones.

So what to do?  The Mayo Clinic’s experts blogged this week about ways to stop worrying about complications of diabetes.  Their suggestions included recognizing the tools we have now are far superior to anything in the past when it comes to management of our disease, and they reminded readers that the Diabetes Control and Complications Trial demonstrated the complications are not inevitable.

Well, that’s good.

However, I’m not sure that is very helpful on a day in, day out basis when we read our meters and see numbers we know aren’t in range. 

I need a plan instead of what seem like blithe assurances from someone who doesn’t share my same fears.

So how do we deal with knowing our future may well hold complications we don’t want to deal with, but we have to deal with them in order to avoid them?  (Yes, it’s confusing to think about.  Reminds me of Back to the Future when the kids start becoming transparent because it looks like their parents won’t get together in the past… or is it the future…)

I think a way to approach the topic is to, as always, look it right in the eye.  (This is the kind of thing I do when I run; I’m quiet, I’m alone; I’m almost in a meditative trance, and feel relaxed and safe enough to approach an incredibly difficult subject.)

So what am I most afraid of?  Is there a particular complication I want to specifically avoid? 

How likely is it that that specific complication is realistically in my future?

How likely is it that by changing something right now I can avoid the complication?

How likely is it that I can actually make that change and stay myself (and not become obsessed)?

I am always asking myself: Is it worth it?

I ask myself if the specific complication is worth the worry, fear, and anxiety I have already spent on it and am likely to spend on it in the future.

They rarely have been, when I’ve thought about them.

I know this isn’t something we can think about very often or for very long.  Complications are scary to think about.  None of us want to face getting older or having our disease impact our bodies any more than it already has.  For me, though, I think it’s worth it to take whatever time we can to really think about it for ourselves and our lives. 

I know that a lot of the energy we spend trying to avoid thinking about complications can be put to a much better use.

Take care of not just your body, but your mind as well.  Know that you aren’t alone. 

We’re all doing the best we can!

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Posted in Living with Type 1 Diabetes, Random Musings, Uncategorized

What would you do for a T-shirt?

November 4th, 2010

For some people, myself included, running is all about the shirt.  When I run an event and the shirt I get with my entry doesn’t fit, or is of poor quality, or I don’t like the design, I’m disappointed.  I have run crazy events in the past for the sole reason “it’s a technical tee!” (Technical = sweat wicking, not cotton)

My recent marathon shirt is a great one.  I’m very excited to wear it, and try to do so as often as possible. 

BUT NOW WE ALL HAVE THE CHANCE to earn a shirt for ourselves!! 

Sunday is World Run Day.  I like World Run Day because it’s a worldwide event that anyone can participate in.  Anyone willing to run a block, I mean.

Check it out:

What is World Run Day?

For the past decade, World Run Day is a running event held annually in November to celebrate running and charitable giving. It is recognized as both the International Day of Running and the International Day of Charity. Your support will help it grow into the largest running event on earth.

Why did World Run Day decide to organize this event?

World Run Day is a celebration of running. Runners can participate anywhere: a road, a treadmill, in a park, on a beach… anywhere they can run! Group events form randomly and are organized by passionate runners in cities both large and small. Our goal is to connect with other runners worldwide and make charitable donations to local causes.

What is the main goal of the event?

The main goal for the event is to celebrate running and also highlight the health benefits of running to the local media. In a time where obesity and other health concerns plague areas throughout the world, running is one of the best remedies towards a healthy lifestyle.

So maybe this weekend you’ll be inspired to set out for a little jaunt with friends or family.  It’s your call when, where, and how much you do.  Celebrate your health and your ability to move your body and celebrate your achievements in your life on a day everyone is celebrating worldwide and running by your side.

Go for it!

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Posted in Living with Type 1 Diabetes, My Workouts, Random Musings, Uncategorized

True/False: INSULIN INJECTIONS DON’T HURT.

November 3rd, 2010

Ut oh.  Gotta climb up on my bitterness high horse again and blog about this silly online survey.

It isn’t that I don’t have better things to do than take online quizzes.  I have plenty of other things to do.  It’s just that these quizzes sound like such a quick way to pat myself on the back I cannot resist them.

So here I am, taking this quiz: “what do you know about diabetes?” 

Gee, seems like a slam-dunk 100% for me!  Let me at it!!

But nope.

Nope.  Five questions and I only answered four of them “correctly”. 

There must be a problem with this quiz because there most certainly isn’t a problem with my diabetes knowledge.  I am sure.

Full disclosure: the quiz was true/false so right there that makes it amazingly difficult for me because I’ve been trained in legal persuasion, where we very seldom have anything entirely true or entirely false.  Strike one against the quiz. (See? I can’t even say we never have something entirely true or false.)

And yes, I am aware I am mixing my metaphors.  Sorry.

So anyway, before I stray too far from my original rant, here is the question:

True/False: INSULIN INJECTIONS DON’T HURT.

I know that when someone says “Oh/eew!  Doesn’t that hurt?!” I make the same face I’ve made for 23 years and say something like “not really” or “it keeps me alive so I don’t mind so much” (I don’t think I’ve been brave enough to say that one in real life) or “sometimes, but not very often.”

But I can’t say that insulin injections DON’T hurt, just like I can’t say that insulin injections DO hurt.  They kind of just “are.” 

So I, being the honest and plain speaking person I try to be, answer “FALSE” because one cannot say that a subjective feeling like “hurt” applies or does not apply in every situation across the board.

BUZZER SOUNDS.  WRONG ANSWER.

The answer shows up, and get this:

                Sorry, that’s incorrect.  The companies have worked hard to make the needles so tiny that they really do not hurt.  “The injections are virtually painless.  I know, because I have used an insulin syringe to inject myself with saline, just to find out,” says Elizabeth Kern, director of the diabetes program at National Jewish Health in Denver.

I had to laugh.  Someone takes a shot of saline one time just for kicks and now knows and can assert that across the board for everyone “insulin injections don’t hurt”?!!?!

Here is one of the things that turns me away from the healthcare industry when it comes to diabetes and why I think many of us want to have doctors and nurses and educators with diabetes themselves.

Since, let’s be honest: sometimes, every now and then, you hit something when you give yourself an injection and it hurts.  It doesn’t happen often, and it is no big deal in the grand scheme of things, but it really does hurt.  You get a bruise, it’s all gross and painful for a few days, and you try and get sympathy from friends and family.  Because, after all, IT HURT.

So don’t baby the situation and tell me that injections don’t hurt.  Ever.  Since you’ve done it once.  Compared to my 2-6 times a day for 10 years before I went on a pump, so that makes it… lemme see… at least fifteen thousand shots?!  Yeah, you’d be the one who knew if they hurt after your one shot.

Dang it, I want my 100% score on that silly quiz.  (Am I a type A or am I a type A person?!)

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Posted in Living with Type 1 Diabetes, Random Musings, Uncategorized

How To Fix Common Mistakes on Lower Body Moves: Squats

November 2nd, 2010

I lead my bootcampers through I-am-afraid-to-count-how-many squats and lunges every day.  (Full disclosure: I do about 10% of the number they do each class!  But then again, they go home after that and I go lead another class.)

And the problems I see most often are relatively simple fixes.

I shout “90 degree angle with your front leg and 90 degree angle with your back leg” when they do lunges, and “keep your body weight in your heels” as they squat  just as often.  When they do squats, I say “keep your butt back and your weight in your heels” a lot; oh yes and “keep your knees behind your toes.” 

Yeah.  All those cues.

But sometimes it doesn’t come through and the failure to meet those simple requirements makes every move less and less efficient. 

When you aren’t hitting the right muscle as best as you possibly can, you aren’t getting the best workout or earning the best results as possible.  Additionally, you may place your knees at risk of injury as well by training a dysfunctional movement.

So take a minute and check out what you LOOK like, and what that FEELS like, when you do a squat correctly.  You can take a look in any full length mirror—at the gym, at your house, even in the dressing room. 

You just need to check out where your skeleton is.  You are looking at your hip joint, your knee joint, and your ankle.  You want to have as close to 90 degree angles at each of those as possible.

Keeping your chest up as you squat should help you get a 90 degree angle at your hip.  Don’t lean forward or rest your hands on your thighs until you’re sure of your form.  (It might help to keep your hands on a kitchen counter as if it were a ballet barre.) 

As for your ankle joint, you want to have your weight in both heels as you squat, and in the front heel as you lunge.  You can wiggle your toes in your shoes or face uphill so you get your toes elevated somewhat in order to get a sense of what it feels like to keep your weight in your heels.  If you let your body weight go into your toes, you will lose your good ankle angle.  By keeping your weight in your heels, your shin should stay vertical and your ankle angle will look like a 90 degree angle.

The flexibility in your calves will dictate the ankle angle, so try to stretch your calves after each workout.  Good flexibility and increased range of motion will help you feeling young and going strong.

If you can manage a 90 degree angle at your hip and at your ankle, the knee angle will come easily!  The strength and health of your knees will dictate whether you actually achieve a 90 degree angle with your knees.  But it’s worth working for!  Keep that ankle and hip angle in check and you will be well on your way to a picture-perfect, safe, effective and powerful squat.

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Posted in My Soapbox, My Workouts, Random Musings, Uncategorized

My Marathon Report

November 1st, 2010

Yesterday I ran my second marathon.  I was lucky to have a friend find me and get me through miles 11-26.2 much speedier than I would have if I were by myself.  I didn’t want to let him down, and he wanted me to set a PR (personal record)!!  I finished the 26.2 miles in 4 hours and 26 minutes.  Not bad!  I completed my first marathon in January in 4:36 so I peeled 10 minutes off my time yesterday.  Yay!

I was lucky twice yesterday.  The blood sugar gods definitely smiled on me.  I’m not sure why, but I went with it.  I was fortunate to know in advance they would be passing out my gu of choice– Accel Gel.  Accel Gel has 20 grams of carbohydrate and 5 grams of protein in each packet.  (And there is a chocolate flavored one I can choke down with less difficulty than the other flavors.)

From my heart rate graph, it looks like I stopped running 14 times over the course of the event.  I know I used one of my early stops to call my husband and complain that I was running too fast!  I used that break to re-start my pace to a slower, “marathon pace” for myself.  (I can run much faster in a 5k run than I can in a 10k run, and can run much faster in a half marathon than I can in a full marathon.)

I checked my blood sugar it looks like 5 times during the 4.5 hour run.  I don’t have a plan for most of this; it’s how I’m feeling each run that will determine when I check and what I do.  When I eat a gu, I take 0.1 or 0.2 units just to have a record of when I ate that I can see quickly with a look at my pump’s status screen.  It helps me from overloading on gu and it helps me to remind myself I may be due for the next one.  I’ve learned from experience that on a long run I do best with a gu after 3.5-4 miles for some reason, and that if I skip the gu due to a high blood sugar I will regret it and have a horrible run: I must stay fueled!

So here’s my rundown, in case you’re curious.  Like I said, I’m absolutely amazed I wasn’t higher than this.  I kept my basals between 33% and 67% of my normal rate beginning an hour before the start of the run. 

TIME (am) BG CARBS/FOOD BOLUS MILE  
4:33 140   0.2    
4:35   27 (oatmeal) 1.3    
6:06 242   0.2    
7:00 START MARATHON   Mile 0 0.5 active insulin units
7:37 — accel gel 0.1 Mile 4  
8:06 — accel gel 0.2 Mile 6.5  
8:30 159     Mile 8.3  
8:52 191 accel gel 0.3 Mile 10  
9:15 161     Mile 13.3  
10:15 159 accel gel   Mile 18.3  
10:45 131 accel gel   Mile 21  
11:25 FINISH MARATHON   Mile 26.2  
11:40 116 (finish)      
12:25 92 (finish)      

14 stops overall; stop = walking through water break

Most (all) of this comes from years and years of trying to figure out what works for me.  I’m posting it FYI and not as a recommendation.  My recommendation is to learn what works for you through trial, observation, and error. 

Have fun!

(If you’re interested you can check out my complete marathon data here: http://connect.garmin.com/activity/55068794)

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Posted in Living with Type 1 Diabetes, My Workouts, Random Musings, Uncategorized

Doctors and Motivation

October 29th, 2010

I got a notice from the ADA the other day that someone did a study to see how weight loss changed based on how medical advice/recommendations was offered by physicians. 

Gee, go figure: cajoling‚ coaxing‚ scolding‚ and reproach have all been found ineffective [for weight loss].

It’s almost like some of the physicians had never tried to get anyone to do anything in their lives!  If you’ve ever even babysat you know that people don’t respond well to scolding or reproach.  (I’m sure some bosses at all sorts of jobs could stand to learn the same thing.)

The study found that the more effective method of counseling was what they called “motivational interviewing.”  Motivational interviewing enlists patients’ own desire for change‚ emphasizing that change cannot come from the doctor‚ but places doctor and patient in a collaborative effort. The study‚ published in the October issue of The American Journal of Preventive Medicine, noted that motivational interviewing has already been found effective for reducing alcohol use and smoking‚ and could hold promise in weight loss. 

I wonder how many doctors have thought about some of this; I’m sure quite a few have.  I hope everyone who is reading this blog finds a doctor who thinks about and uses motivational interviewing.

It’s worth it.  YOU are worth it!

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Posted in I Can't Believe Someone Got Paid to Conduct This Study, My Soapbox, Random Musings, Uncategorized

Walking for Exercise

October 28th, 2010

I sometimes think you would like to read a blog entirely about my diabetic life.  And then I think, I don’t really HAVE a diabetic life… I have MY life!  So just like my life, my posts have a lot to do with diabetes but they have a lot to do with other things, too, like exercise and how I think physical movement and exercise impact my diabetes and the rest of my life.  And how having diabetes affects my thinking.  And on and on and on!

I ran an errand on my way home from bootcamp this morning and passed by the high school after the students had started class.  This meant I drove past the track as the students were in P.E.

Woah.

Now, I know for a fact that not all high schoolers like physical activity.  I know for a fact that not all high schoolers like, um, well, ANYTHING. 

But they DESERVE something more than a saunter in circles for their P.E. class: yikes.

And not one of them looked or acted like their heart rates were elevated.  At all.

Not one.

This is what concerns me about telling people to take a walk.  “Walk” can simply mean almost anything to anyone, so let’s lay some ground rules for walking.

  1. Walking at any speed is preferable for our health to most other modes of transportation.
  2. Walking for transportation is different than walking for exercise.
  3. One cannot walk for exercise AND hold a cup of coffee.  (Sorry.)
  4. One should sweat and be out of breath during and after walking for exercise.
  5. One cannot walk for exercise AND hold a cell phone.  (Still sorry.)
  6. I’ve seen friends walk for exercise and it turns into a stroll-and-chat.  Good, but not the “moderate exercise” so recommended for everyone’s health.  If you are going to walk for exercise with a friend or family member, speak together before you go out and discuss the goals: is it to walk quickly and raise your heart rate and keep it elevated, or is it a stroll-and-chat?  You will slow down if you aren’t both on the same page.
  7. One cannot walk for exercise AND carry a shopping bag.  (Sorry again.)
  8. Walking for exercise is free.
  9. Walking for exercise can be performed in almost any weather.  (Really.)
  10. Walking for exercise gets you outside in the fresh air.
  11. Walking for exercise is easy to do.  Just… walk.

So what are we waiting for??

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Posted in Living with Type 1 Diabetes, My Workouts, Random Musings, Uncategorized

It’s Lower-Carb Than “An Apple A Day!

October 27th, 2010

I used to get sick all the time.  When I was in school, I’d have a cold several times per year!  When I was in high school and even college, I was okay with missing a day or two (sometimes up to a week) but as I grew up and had more responsibilities getting sick became more and more of an inconvenience.

Not only that, I didn’t feel good!

But now I can count on one hand the number of times I’ve been sick in the last six years. 

Pretty cool.

I guess my immune system is doing its job fairly well!  I credit my exercise habit for the positive change.

Since I have been fairly active for years and exercise 5-6 days per week, I can credit my healthy immune system because of the fact that during moderate exercise immune cells circulate through the body more quickly and are better able to kill bacteria and viruses.

Score!

But just like nearly everything, moderation is key.  Exercise is fabulous for warding off sickness, but overdoing it can cause the opposite effect. 

Cortisol and adrenaline, known as the stress hormones, raise blood pressure and cholesterol levels and suppress the immune system. This effect has been linked to the increased susceptibility to infection in endurance athletes after extreme exercise (such as marathon running or Ironman-distance triathlon training).

I do need to keep in mind that with the marathon coming up on Sunday I need to pay extra attention to my recovery after the several-hour event. 

After several months of training and slowly increasing mileage and hours running, this Sunday’s event will culminate in 26.2 miles run in hopefully less than 5 hours.  This mental cut-off is only a time I set for myself; if something goes wrong, I’ll need to change the plan.  One thing I’ve most definitely trained is my ability to be flexible as I run: I never know how I’ll feel that day, what my numbers will do, what the weather will do, how my mind will be.  I’ve trained and learned as much as possible to be adaptable in as many circumstances as I can; time will tell how that goes!

For me, this means I get to take it easy after I cross that finish line.  I don’t have plans for Sunday evening other than lying horizontal and having my husband man the Halloween door.  I’m not sure I’ll be up for the constant flow of trick or treaters!   

Maybe I’ll get a massage, too.  I’ll be trying to avoid getting sick, you know… ;)

http://sportsmedicine.about.com/od/injuryprevention/a/Ex_Immunity.htm

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Posted in My Workouts, Random Musings, Uncategorized