Archive for the ‘I Can’t Believe Someone Got Paid to Conduct This Study’ category

Piecing Things Together

August 23rd, 2012

Coming up on my 25th anniversary of being diagnosed with type one diabetes, I finally thought to ask my doctor today why they made me drink those nasty potassium drinks in 1988.  She made the fellow answer, which I thought was funny.  (The fellow, who came in 45 minutes before the doctor did and proceeded to tell me all these things she’s “heard” about me… apparently my doc talked to her about me before she saw me.  I guess maybe they don’t see too many type one attorney slash personal trainers in their offices.  So funny…and cool, too.  Glad to know they reviewed my chart!)

The answer they gave me was enough to fill in a piece or two about my hospital stay and physical condition prior to my diagnosis.  (Once I was diagnosed, my questions were put on hold for a long time as I tried to learn a new life.)  I’m at best paraphrasing here, at worst being completely wrong.  Please if I’m completely wrong and you know it, tell me!!

Anyway, without insulin the cells can’t use potassium in my blood, sort of like glucose.  Without potassium, electrolytic stuff like THE HEART doesn’t work.  So even though I may have had a lot of potassium in my bloodstream, without insulin I essentially had a potassium deficit. 

But once insulin is introduced, all the cells suck up the potassium and then you have a low blood potassium level, which again AFFECTS THE HEART and all the features in the body that need electricity (which I have never ever understood). So they supplement with a potassium drink when they started me on insulin to keep my cells and blood levels happier.

Geez.

Glad I asked… since I had been sleeping so well before knowing this.

Researchers

October 7th, 2011

Researchers crack me up sometimes!

First off, I don’t know what they originally studied here, but the abstract that I can access mentions “re-examining” so clearly there was a first step we can only imagine.

The researchers here checked the brains of young adults with type one to see if either a history of severe hypoglycemia, a history of severe diabetic ketoacidosis, or a history of long-term glycemic control affected cognitive functioning.

Not a bad idea for a research study, if you ask me.

They took 34 non-diabetics aged roughly 19 years of age and they took 33 type one diabetics roughly the same age who had all been living with diabetes for about 16 years.  A1cs on the diabetic subjects was about 8.7%. (This is not a number that I would consider appropriate for the label “long-term glycemic control,” for the record.  Of course, it’s about 6% better than mine was at the time, but I digress.)

The full-scale IQ scores were the same between each group.

The researchers lined all these subjects up and tested them on a few subjects, I guess (have to guess as I have less than no idea how people test brains when brains are still alive and working) and this is what they found: These data suggest no difference in general intellectual ability, memory, and emotional difficulties in our cohort of young adults with early-onset type 1 diabetes compared with control subjects and no deterioration over time.

Woot!

And then the kicker: There were, however, findings to suggest subtle changes leading to poorer performance on complex tasks of executive function.

So, okay.   I understand.  Apparently having diabetes since the average age here of three (3!!) means these 33 young adults may perform poorer than their non-diabetic peers on “complex tasks of executive function.” (Not that I can tell you without Googling it what that means.)

Oh geez!!  Wikipedia says:   Executive function is an umbrella term for cognitive processes such as planning, working memory, attention, problem solving, verbal reasoning, inhibition, mental flexibility, multi-tasking, initiation and monitoring of actions.

Going down that list, from my perspective of living with type one diabetes:

Planning.  What do I need to do to keep from going low?  What do I need to do if I do go low?

Working Memory. What did I eat was it enough carbs to cover the insulin?

Attention. Where are all of my supplies? What is my blood sugar right now?

Problem Solving. I don’t feel great and my meter just said I’m 80.  Now what?

Verbal Reasoning. I need to ask for some sugar but they don’t know I have diabetes so I have to explain it.  (or) My mom just yelled at me for not checking so I have to tell her why I didn’t check.

Inhibition. I didn’t check because I was at the new sports thing and no one knows I have diabetes and I don’t want to deal with the questions.

Mental Flexibility. I think I’m low so I will check.  Oh shoot I’m not low I’m 220 maybe I’m just hungry what am I supposed to do now?

Multi-Tasking. I’m supposed to be taking that test next period but I just had P.E. and I’m feeling shaky and shoot I didn’t finish my assignment for this class and where is my meter and oh no I think I forgot my lunch.

Initiation of Actions.  Feeling junky.  Gotta eat or check.

Monitoring of Actions.  Still feel shaky.  I’ll give it 15 minutes and check again.

This just gets funnier and funnier to me.  I makes me have to ask: Are you serious, researchers??  Did you somehow not account for the COMPLEX TASKS OF EXECUTIVE FUNCTION that is blood glucose management every minute of every day of life with type one diabetes?

I think they should have somehow accounted for the fact we call diabetes the thinking person’s disease for a reason. 

Now THAT is a study I want to see.

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.

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!

Crunch That.

September 19th, 2011

Over the past few years, I’ve stopped doing the 10 minutes of abdominal work at the end of every bootcamp hour that I was taught to lead when I started years ago.  Here’s why:

crunches don’t get you much.

Core strength is important, of course. But you’ll strengthen your core anyway when you are doing other exercises with proper form!

(I think everybody loves crunches during bootcamp since that’s a time I’ll let them lie on their backs!)

I’m pasting in a portion of a discussion below, taken from a continuing education provider that has given me loads of great information.  The article points to several studies that
were published in the New York Times last monthIt’s worth a gander if you care about your core strength!

Are Crunches Worth the Effort?

When researches at Indiana State University began research on strength of core muscles vs athletic performance, the results were not what they expected. The thinking was that those with sturdy cores would perform better on physical performance tests. However, the results showed otherwise. But don’t give up on those core exercises yet.

While Indiana States results were not expected, other studies have shown novice runners do benefit from stronger cores. Those with better core strength were able to
reduce their 5K running time.

While studies vary across the spectrum on whether strong cores help with performance, what is known is if you train for your sport, the core strength will come. So what
does this mean for us? Avoid performing dozens of crunches. In fact, 6-8 good quality crunches a few times per week are best. Perform them correctly by maintaining the natural curve of the spine and lift only enough to feel the first bit of contraction. And remember, we all have a “6-pack,” but some of us need to reduce the body fat.

I KNEW IT!!!

September 14th, 2011

I think I had maybe two phrases that carried me from about age 2 to age maybe 16 (when I promptly added the obligatory third phrase involving driving):

ONE: if my sister can do it why can’t I do it too [because she’s older than me]

TWO: WHY. CAN’T. WE. HAVE. A. DOG.

I’ve never gotten over either one of them, quite frankly.

But this study would have made me even more preposterous on that second issue.  (The dog issue.)  Every time my parents wanted me to go out and stop irritating them or otherwise entertain myself I could have shown them the results of this study, and explained to them how important exercise is for kids.

It would have been AWESOME.

Researchers studied 618 pairs of adolescents (12.5-17.5 years old) and parents for about 18 months to get the data.  They looked at how active the kids were on a daily and weekly basis.

The families with dogs in their homes and lives were much more active, and correspondingly I presume healthy, than those without a pet in their home.  (The study mentions dogs in particular and pets in general so I do too.)

See?  ANIMALS ROCK.

It wasn’t necessarily that the kids were in charge of walking the dog (I mean for real how often does THAT happen).  It was the fact that the dog was around that got people off the couch to feed, water, clean up, open the door, close the door, find the ball in the backyard, throw the ball, hide the leash, bend down to pet, bend down to scoop and bag, kneel to hug, crouch to defend against love attacks, dry off with a towel after the sprinklers went on at the new time, and on and on and on.

I’m telling you:  We all, every single one of us living with and those living without diabetes need to be as active every single moment of every single day as we can manage.

If we get a bunch of CRAZY FUZZY LOVE at the same time, we score bigger than a rock star.  No joke.

So who’s going to adopt a new fitness friend?!  Let’s go, Mom and Dad!!  I’m ready!!

She doesn't look like she would make me more active... but she does!! (on one of her white mats!)

(I also must be completely fair and say that my cats get me off the couch just as much as I think a dog would.

They chase each other and crash into things and I need to go check what broke.  They want dinner.  They want breakfast.  They want to see who is doing something outside and they look so curious that makes ME curious too.  Gracie will see us coming and race to a white mat and expect to be petted on that mat.
George will jump onto the bed and want to be brushed.  Yes, we cater to them.  Yes, they have us convinced we wouldn’t have it any other way.

We are so lucky!)

Go Climb A Glacier

September 13th, 2011

My family seemed to vacation only at national parks when I was a kid.  I swear we were always driving to one park or another.  (At least for a squirmy kid like me, it felt like that: drive, drive, drive, set up the tent, deal with bugs, spend an hour with the camp stove, deal with bugs, go up a hill, go faster down the hill, deal with bugs, repeat.)

My favorite national park tee shirt said “GO CLIMB A GLACIER”.  I wasn’t old enough to come up with other words the shirt alluded to, but I got the gist and loved the fact my parents let me wear it anyway.

Sometimes, it really is all about the tee shirt.

But OTHER times, it’s about the National Parks!

The Journal of Forestry came out with a great set of facts on National Parks. They say that each year more than 170 million people visit national forests for recreation. And the physical activity associated with these visits burns 290 billion food calories. That equals enough french fries laid end to end to reach the Moon and back – twice.

How awesome is that?!

They looked also at what people do when they visit a National Park.  They said that hiking, walking, downhill skiing, fishing, relaxing, camping, and driving for pleasure are among the primary activities accounting for about two-thirds (68 percent) of all visits to the national forests.

What else is there to do at a national park?

Oh.  S’mores.  Of course!  I forgot.  (How could I forget S’MORES?!)

I love the fact I lived in a national park for three summers when I worked at Bearskin Meadow CampThat’s the kind of experience you just never get out of your bones or blood.  (Nor should you.)

The whole topic makes me want to visit a national park as soon as I can.  Maybe I’ll even climb a glacier when I’m there!