Archive for the ‘My Soapbox’ category

Body Image With A Broken Pancreas

November 11th, 2010

I’m stealing from another blog today because I think it’s a critical message: we need to get to a place for ourselves where we have a good body image.

I have known so many people who just have a sad body image.  I want to shake them and tell them they are SO MUCH MORE than their bodies!!

I have been watching old TV shows on Netflix for the past few years: Magnum PI, Charlie’s Angels, Rockford Files… all great fun.  But one thing strikes me again and again: the people are REAL in those shows.  No plastic surgery, no digital enhancements, no soft focus.  What I see on those TV shows are what I would see if the actors were standing in front of me… and what I see when I see real people, now.

So why do we feel the need to “improve” on nature?

As the blogger explains:

There’s nothing wrong with desiring a shapely or fit body, but the reality of how we are made can often prevent us from being real with who we really are and accepting that genetics, medical conditions and other physiological factors play a role in how our bodies literally take shape.

The key to feeling good about your body is to learn and respect our natural shape. We must get rid negative thoughts and replace them with positive ones. We can do this by learning more about the physiological factors that may influence the result of your training efforts and desired outcome.

Body Image is…

  • How you see or picture yourself.
  • How you feel others perceive you.
  • What you believe about your physical appearance.
  • How you feel about your body.
  • How you feel in your body.

It’s been studied, that people with negative body images have a greater likelihood of developing an eating disorder and are more likely to suffer from feelings of depression, isolation, low self-esteem and obsessions with weight loss.

I think having diabetes gives us yet another excuse to hate our bodies (or at least our pancreas).  But what good does that do?  It just leads us down a miserable and uncomfortable path. 

The blogger here gives suggestions on ways to work towards having a better body image for ourselves.  I think her suggestions are well worth a try:

One list cannot automatically tell you how to turn negative body thoughts into positive body images, but a few tips can help you think about new ways of looking more healthily and happily at yourself and your body.

  1. APPRECIATE all that your body can do. Everyday your body carries you closer to your dreams. Celebrate all of the things your body does for you: running, surfing, stand up paddling, dancing, breathing, climbing, laughing, dreaming, etc.
  2. KEEP A TOP-TEN LIST of things you like about yourself that aren’t related to how much you weigh or what you look like. Read your list often. Add to it as you become aware of more things to like about yourself.
  3. REMIND yourself that true beauty is not simply skin-deep. When you feel good about yourself and who you are, you carry yourself with a sense of confidence, self-acceptance and openness that makes you beautiful regardless of whether or not you physically look like a supermodel. Beauty is a state of mind, not a state of your body.

No one is a perfect “10” but you can see yourself as a whole person. When you look in the mirror next time, see yourself as you want others to see you; as a whole person.

Living with diabetes or without it, we all deserve to feel good in the body we have.

A Way to Spend those Extra 3.76 Years

November 10th, 2010

So I was thinking.  After yesterday’s post, you might be wondering how you are going to spend those extra 3.76 years you add to your life by staying a nonsmoker and getting to a healthy weight.

As you know, men and women traditionally become less physically fit with age.  So adding 3.76 years may not sound like a, well, walk in the park.

But how much does lifestyle influence our fitness as we age?

Fitness levels decline with age and with greater rapidity after age 45.  That isn’t great to hear, is it.  45?!  45 isn’t even close to “old” the way I think of it!!  I can’t even tell you how many people I know in their 40s, 50s, 60s, and even 70s who can run circles around me.  (For the record, I think you need to be well into your 80s before you start saying you are “old.”)

Then again, I know a lot of people who got old before they hit 35.  And every single one of those people are still alive!!  I just wonder if they’re having any fun.

So I started to write a list of what I think it takes to stay young

                How often do you think or say “I’m too old to…”?

                How spontaneous are you?

                When was the last time you ate an ice cream cone?  In an actual cone; not a cup.

                Do you feel open to new things?

                Do you say “I get to X” or do you say “I have to X”?

                Do you move every day?  Your whole body?  *Moving from bed to desk to couch is NOT moving.  (Unless you’re a furniture mover and you are moving the bed, the desk, and the couch from room to room.)

                Do you look forward to activity days filled with movement? 

                Do you have fun?

I think, clearly, that lifestyle starts with mental style.  If you are mentally young, your body will more easily follow.  Keep yourself active physically and your mind will be primed to stay quick and agile as well.  For an uncomplicated action we get to reap amazing rewards—how great! 

The study on this topic went on to confirm that being active, keeping a normal BMI and not smoking were associated with substantially higher levels of cardiorespiratory fitness during the adult life span study.

A substantially higher fitness level despite our increasing age?!  Sign me up!! 

Who else is in?

(As an aside, today’s study included 20,000 subjects.  Nowhere near yesterday’s million, but still a sizeable pool from which to gather good data!)

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!

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.

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!

Get Outside Your Boxes!!

October 25th, 2010

I looked at the article about the causes of diabetes I found in the October issue of Diabetes Forecast.  I didn’t want to sit and read the whole article, because I don’t want to get caught up in the “why” at this point… the help I think I need  these days is more of the “how” than “why”.  At least for now.

I read one paragraph that was about causes for type 2 and a few paragraphs about type 1.  The type 2 paragraph caught my eye:

Finally, modern society should probably shoulder at least some of the blame for the type 2 diabetes epidemic.  Access to cheap, calorie-laden foods may even influence type 2 risk beyond simply their effects on body weight; the stuff that is in processed foods, like high-fructose corn syrup, could alter the body’s chemistry or gut microbes in a way that affects health.  Add to that the fact that most Americans are sedentary, spending their time sitting in cubicles, driving in cars, playing video games, or watching television.    The lack of exercise, plus the abundance of unhealthy foods, cultivates a fertile breeding ground for diabetes.

I think that if I had written this article, I maybe wouldn’t say “finally”… I think modern society has stacked the deck against healthy living in a lot of ways!

It reminded me of a trainer I worked out with at a fitness convention once: she said we are all about BOXES these days.  We lie on a box, stand up, shower in a box, sit at a box and read a box while we eat, get into a box, drive in our box to sit at another box and stare at a computer box for hours before we climb back into the box, drive to our big box and sit on a box and stare at a box before we go lie down on our box for the night.

A little sad when one thinks about it.

I’m glad I can eliminate a couple of my boxes, or at least minimize my box time.  I’m glad I am outside for 2-3 hours every day, and more when I run outside.  I’m thrilled when I have time to walk to the grocery store instead of driving there. 

Of course, I’m staring at a box right now and typing on more boxes, but aside from that, I’m about to go for a run.  Outside a box.

Maybe I’ll see the sidewalk squares a bit differently today.  ;)

Enjoy the time you spend outside the box!!

JDRF isn’t for me

October 21st, 2010

On my facebook pages, an ad for the JDRF comes up all the time.  Seeing the ad makes me want to smack it.

Type 1 diabetes is a chronic, debilitating disease affecting every organ system that can strike suddenly. Are you T1D Aware?

 

Well, yes, I would say that I am T1D aware.  And given my experience, type one did not strike suddenly—it made me pretty darn sick for a long time before I was diagnosed.  (I see my school picture from fifth grade, taken in September, and I don’t look like myself in any of the other years.  I wasn’t diagnosed until March.  That isn’t sudden.)

Chronic, yes.  Unending, yes.  It’s my life.

Debilitating?  DEBILITATING?!  (I’ll get back to this one after I count to 10 and take some deep breaths.)

Affecting every organ system?  Yeah, can’t help that.  Every part of my body is connected to every other part.  I’ve got a major flaw since I have no beta cells to monitor the glucose in my body.

So this is one of the reasons I’m not a big supporter of the JDRF.  For one, I think the need to find a cure is too easy for people to focus on rather than learning to deal with their disease, or their child’s disease.  (How happy with yourself and at peace can you really truly be if you are always asking for a cure to take away your diabetes?  What are you teaching your child when you walk for a cure?  Most likely, they don’t need a cure as much as they need your support and acceptance of their disease RIGHT NOW.)

This other reason comes back to the “debilitating” portrayal of type one diabetes.  Seriously; a foundation built upon the notion of supporting people living with type one diabetes is the one out there using the term “debilitating” and all the connotations of weakness or “less than” that goes with it simply misses the mark entirely for me.

I don’t need a cure.  I don’t need to be associated with an organization that refers to my diabetes as something that debilitates me.  I don’t think my diabetes de-anythings me!  I understand they are trying to play up a sympathy card with these dramatic words and dramatic imagery, but it offends me.

JDRF, take a good look at the type ones around living and loving and learning and really embracing their lives.  Take a good look at ME. 

I guess I really should say: enjoy the taste of my dust.

What to do with a nonresponsive pump company?

October 20th, 2010

 (Got this question on facebook yesterday and decided I had enough to say in response I might as well blog about it.  Thanks for asking, and I hope something here helps you out somehow!!)

What do you do when your insulin pump company fails you and won’t send you supplies?

My first reaction when I read this question was to question “How does a pump company fail anyone?  What promises does someone think they made to you?”

But I do recognize that I have been disappointed in MiniMed for several years; after Medtronic purchased MiniMed I felt their service levels changed.  I now spend a minimum of 30 minutes on hold before I can speak to anyone.  That disappoints and frustrates me.

And that wasn’t really the question.  Seems to me the question was based on a current crisis.  Even if it isn’t a real crisis (maybe you still have 3 weeks of supplies), it most assuredly feels like a crisis!  I do hate that—as if we don’t have enough to think about, we spend time worrying if we will get our supplies in time.

But really, a pump company will hold up supplies usually for two reasons.  One, there is a problem with your prescription for supplies.  Perhaps it was unclear, perhaps it expired.  Either way, they won’t send you a thing until your doctor okays it.  Two, there is a problem with your account.  Maybe they missed recording your last payment, maybe your insurance changed, or maybe there is some wacky hold on there for some reason.

But the bottom line is you need to take care of this as soon as possible.  If that means calling from work, that’s what it means.  If it means calling your doctor’s office and asking them to call the pump company to straighten out what they need, that’s what it means.  It simply will not get resolved without your repeated efforts to get a response from the pump company.

And yes, this is one of those things that just completely bugs me about having diabetes.  Seriously.  We all deal every day with everything we EAT, everything we DO, everything we THINK ABOUT, and we pause our lives several times a day to check our blood sugar levels.  And this is what bugs me: having to stay on top of the administration of my disease. 

But that’s the truth: no one else is going to care as much about your own health as you do.  No one else is going to stay awake worrying if you will get your supplies on time or not.  (I imagine they are busy worrying about their own health.)  So it really is up to you to take care of the administrative side of your disease.  (Maybe a spouse can help, but even that can get complicated these days with HIPAA.) 

My suggestion and response, then, is to 1) recognize that the pump company is a company and not someone who owes you anything or can fail you on a personal level; 2) recognize that any problem you face with getting your supplies probably has a simple root hidden amidst the tangled mess you see now, and 3) recognize that no one else has the same motivation you have to get resolution.  Ask for help from your doctor’s office; ask for help from the customer service people at the pump company; ask for help from anyone you can think of! 

Good luck getting a resolution and more importantly, getting the supplies you need!

What Can A Family Do?

October 18th, 2010

I’ve been reading comments about various things I’ve posted on Facebook and I’ve seen a theme among some people: they wish their family did something or didn’t do something or helped in some way, and they are frustrated by their family’s response to their disease.

I can understand that.

I always kind of assume my family knows what I think about when it comes to food.  I learned the hard way how wrong that assumption was when I sat down to a family meal a few years ago and asked my mom how much sugar she had put into some dish.  She told me and I calculated the appropriate bolus.

Ten minutes later, I took my first bite and turned to her and asked her the question again.  I pressed and said “real sugar?” and she then said “yes, well, Splenda!”

Whoops.

I have a number of these same types of stories and I’m sure you do too.  It does seem to weaken my trust in my immediate family members when I realize they just don’t even think about what I have to think about all the time every day. 

But on the other side, I’m not sure they need to think about all of the ins and outs.  I already need to think about my disease continually in order to preserve my own health; I’m not sure why I should need them to do it as well.   

I’ve used each of these surprises with each person as an opportunity to teach my family members what they missed—was it that I can’t be without my insulin pump for more than 30-45 minutes?  Or that I need to know accurate carbohydrate counts so that I cover the carbs with my insulin?  Or that I can’t take a surprise hike after dinner to an unknown destination up a hill 4 miles away with only 5 glucose tabs? 

Does it mean having to explain to a family member that the comfort you once found in cookies now carries a heavy burden instead of the comfort they intended to offer?  Does it mean you have to teach them about what happens to your body when you have a high blood sugar, or a low blood sugar?  Does it mean they need to learn from you how you want them to treat you, all over again?

It most assuredly does.

You are in charge of your diabetes.  You are in charge of how you see your disease, and how you see yourself with it.  You are in charge of how you handle yourself when it comes to your family’s reaction to your disease. 

Are you going to stay quiet, internalize and complain later?  Forever?  Are you going to get through whatever crisis it is, and come back the next time with a different attitude to explain what it felt like when they didn’t recognize your constant fight with your blood sugar levels?  Does it mean you invite them to your next doctor’s appointment so they can hear what you hear every few months?

Maybe so.  Because I promise you they are never going to understand if you don’t take the time to explain.  And explain.  And explain again.  They already love you and want to support you as best they can, so what do you have to lose?

So Much Talking!

October 13th, 2010

While I was at the DYF Fall Education Retreat this past weekend, I observed the family interactions throughout the days and during various activities.  I was really kind of pleased with what I saw!

The families were relatively young families, with kids ages 3-13 for the most part.  This means that for the most part, kids were still on speaking terms with their parents… the Teen Years hadn’t fully hit yet!  (There was a simultaneous teens-only program running in the same place, but I wasn’t involved in that one.)

What struck me the most was how many conversations parents were having with their type one kids.  As an adult I don’t really have many conversations at all about the numerous diabetes-related decisions I make in my day.  If I did have them, I would have a LOT of them, and the person I had them with would have to be just as knowledgeable about the disease as I am.  What a tall order!

As an important aside: I can see, too, how these conversations throughout every day (starting with: what did you eat, what was your number, do you want to check, how much insulin did you take, how much do you want to take, are you going to play kickball, and on and on) with one kid can affect the other kids in the family who do not themselves have diabetes.  I remember being very young and jealous that my sister got to go to art class and piano lessons and go out and do activities and come back and report on them around the dinner table; I wonder how the jealousy manifests itself around a dinner table affected by type one diabetes.

I’m never one to say it is easy to live with type one diabetes.  I’m never one to say it is easy to be a parent of a type one kid.  But I hope I’m often one to applaud (quite loudly but never loudly enough) those who are making the best of either situation.

So, no matter what, keep talking.  Keep talking as long as you can.  Even when they stop responding, and even when you wish they hadn’t responded in a way they just did (I heard “who is this thing and what did they do with my adorable child” a couple times this weekend in pre-teen talks), keep it up.  Keep it up if only so they know later that you are there if and when they need someone to be there.

Yes, it takes a lot of thought to be a type one kid.  It takes a lot to be a type one adult.  It takes a lot to be a parent, and a parent of a type one kid. 

And yes, it’s all worth it.