Archive for April, 2010

Manage, Influence and POWER over your Diabetes

April 19th, 2010

For Heaven’s Sake, Eat Breakfast!

April 17th, 2010

I am such a hypocrite.  I used to skip breakfast, too.  I thought I wasn’t hungry, or I thought I was hungrier if I ate breakfast.  I knew all the smart weight loss and exercise experts said to eat breakfast, but I thought somehow I defied the norm.

And then I was listening to my favorite radio show in the morning with John Madden and Al Hart a number of years ago on KCBS, and John was ribbing Al about how little he weighed.  (A favorite topic.)  John pointed out that all of the people he knows who eat big breakfasts weigh a lot less than those he knows who skip breakfast.  Al assured John he never skips his breakfast.  Cue lightbulb.

After paying a bit of attention to my habits, I now recognize that when I skip breakfast, I will eat out every cupboard in my kitchen after dinner, before I go to bed.  Really not a well planned system for weight loss, weight management, or healthy fuel consumption!

And there is plenty of research to back me up.  A study presented at the Endocrine Society’s annual conference last summer showed that “when people skip meals, especially breakfast, changes in brain activity in response to food may hinder weight loss and even promote weight gain.”

If you find yourself hungry after you eat a good breakfast that is a sign of your METABOLISM SPEEDING UP.  Hey!  That’s a good thing!!  Make sure your breakfast was a solid one and keep going with a good lunch and the dreaded “sensible dinner”.  If you have eaten well at the start of your day you may not need to remind yourself not to overeat at dinner.  Seriously.

Please stop blaming yourself for overeating if you regularly skip breakfast.  (Blame your brain.)  Eat a good breakfast instead and you may soon be able to avoid the entire emotional drama and watch your weight slide down the scale.

I’ve heard others put it this way: eat like royalty at breakfast, nobility at lunch, and a beggar at dinner.  Or, another favorite of mine: you can’t gain weight at breakfast or at lunch.

So maybe I’m not a hypocrite after all.  Maybe my experiences have made me wise.  I like that option better!  Please take advantage of my wisdom.  Eat breakfast.

A Pretty Powerful Word

April 16th, 2010

As a trainer, I ask/tell/demand/beg people to do things all the time.  What a great job.  (I’m not saying it’s a power trip, but really, sometimes it is.)

The thing about pushing people as a trainer is that I need to know which person needs a push, a kick in the pants, a kind word, and which person needs me to not get in their face that day.  It’s part of the gig, and I work on it because my ability to do it effectively and intelligently makes me a better trainer.

A client comes to me because they want help working out, getting fit, losing weight, for a myriad of reasons.  I have education, experience, creativity, and compassion that I bring to the trainer/client relationship.  But in order for me to help them, my clients need to bring something to the table as well.  They need to be willing to put in some work on their goal in order to achieve success.

So when I hear someone say “I can’t do a pushup” or “I can’t run a mile” or “I can’t run down the block” I admittedly have an incredibly short tolerance.  I generally know that when someone comes to me they will not be able to do everything I set in front of them.  (If they can, what kind of challenge am I providing?)  But “can’t” is not permitted.

 “Can’t” is such a mental door-closer I would not be an effective trainer and my client would lose out if I let them say “I can’t” and leave it alone.  (Let me again say: I do not expect my clients to be able to do everything I ask.  I do expect, however, that they are willing to try.)

So when you are next faced with a challenge ahead of you, try using what I consider to be a pretty powerful word.  Follow up that “I can’t” with a “yet” and everything changes.

“I can’t do a pushup yet” keeps you mentally precisely where I need you to be: realistic and willing to work to achieve success.  “I can’t run down the block yet” shows that you know physical fitness is a process, not an end destination.  Keep at it and keep putting one foot in front of the other, and pretty soon you will be at the end of the block, still running, looking for your next challenge. 

Celebrate your accomplishments when you achieve them and set a new one ahead.  This success will give you one of the greatest confidence boosts of all time—you couldn’t do something before but you put your mind right and you worked at it and achieved it.

Keep up the awesome work.

Making the Most of your Exercise Time

April 15th, 2010

I don’t think any of us have time to waste on ineffective workouts.  The key to remember is that as you increase your fitness, your regular exercise routine becomes less effective as your body adapts to the challenges you’ve set before it.  You need to change things up in order to keep challenging your body and seeing results.

If you belong to a gym and spend 20-30 minutes on the treadmill at 4.0 or 6.0 mph three days a week, and then do the weight machine circuit you learned at orientation two years ago, you are probably no longer benefiting from that routine. 

Your body is an incredibly amazing machine; your muscles strengthen and your cardiovascular capacity increases with nearly every challenging exercise session.  However, when you gain that strength and capacity you must continue to challenge yourself if you want to continue to increase your fitness.

Change your routine and continue to see results.  If you live with diabetes, you will need to monitor your blood glucose before, during, and after these sessions because when you impose a different stress with a different exercise routine, your blood glucose level may quickly drop during the exercise, and may drop hours after you finish.  Be aware and keep a close watch.

On the treadmill, speed up the pace or ramp up the incline.  Even better, try a session of intervals!  You can find guided workouts at www.itrain.com or at www.cardiocoach.com that will tell you at what settings to set your machine so that you can continue to challenge yourself.  If that doesn’t work, try programming your music with fast songs followed by slow songs, one after another—run the fast songs, jog the slow songs and really push your cardiovascular envelope.  (This is also true with a walk/jog or flat/incline session.) 

Every time I do an interval session like this on a treadmill, I know I need to supply my body with extra glucose so I make sure to have Gatorade nearby and sip it during the recovery phases.

With weights, if you use machines at the gym, increase your weights to really speed up your progress.  Incremental steps (from 10 pounds to 15 pounds or 5lbs to 8lbs, etc) will keep you safe—no one wants you to be injured trying to lift a weight you aren’t ready for.  If you always do the muscle groups in the same order, switch it up—any of these small changes serve to shock your body and recruit muscle fibers in a new way

These changes keep your workouts effective and keep you fit and healthy. 

Go for it.

If I had a dollar…

April 14th, 2010

I had a friend ask me yesterday, as we stood in front of a bakery counter, if I could really eat the food in front of me.   As I had invited her to this café for lunch, the question would perhaps have seemed strange.  However, it was one I have been asked countless times before so I knew why she was asking—she understood “diabetes” to mean “stay away from sugar”.

A lot of people do.

It’s why I wish I had a dollar for every time someone asked me if I should be eating whatever I am eating, or if I can eat it as I put it in my mouth. 

Yes.  I can eat sugar.  No, I did not get diabetes because I ate a lot of candy.

Come to think of it, isn’t it kind of rude for someone to ask me?

It absolutely is rude, but knowing that doesn’t really make me feel any better.  Sure; I can feel like someone is incredibly impolite when they shout across the store “do you have your garage door opener on your belt?!” and I can be offended when someone insensitively says “I could never take a shot!” or makes one of the myriad of comments I am sure many of us have had to endure.

The thing is, I don’t want to be offended.  I don’t want to feel like I should hide from my disease or not acknowledge what I live with or what is attached to me or what it takes to literally keep me alive every day.  I see no need for an emotional response; I have enough of those in my life as it is.

So, depending on the time I have and my willingness at the time, I will respond to each of the comments and each of the questions.  Sometimes with a simple “yes” or “it’s my insulin pump” or sometimes I will outline the basic differences for the questioner between type 1 and type 2 diabetes.    I generally keep at least a small smile on my face.

I always want to say “you’d be amazed how easy it is to give yourself a shot if your other option is death”—but that’s just me being snarky with that particular comment I heard so often on my return to fifth grade after my diagnosis hospital stay.

I’ve replaced “blood sugar” with “blood glucose” in an effort to separate the word “sugar” from any reference to my diabetes.  I know this is a losing battle, but it makes me feel better to avoid contributing to my own frustration, so I keep it up.

But still, a dollar would be nice.

Kids Need Parents’ Help in Managing Type 1 Diabetes

April 13th, 2010

The ADA published this news item yesterday (the link has since been removed from their site).  The University of Utah conducted a study of type 1 kids aged 10 to 14 years old and their parents to see how the kids handled managing their diabetes as they grew older.  Not surprisingly, the researchers noted poor self management by kids as parental involvement declined in three markers of monitoring their child’s diabetes treatment.

This information should serve as a warning to parents of kids and teens with diabetes: you need to be supportive of your child as they grow, as they learn to do so with their diabetes, and you need to stay involved.

The three markers the study discussed are:

  1. Knowledge of diabetes care behaviors
  2. Parents’ acceptance of the child in general
  3. Assistance with diabetes management tasks

These are common-sense areas to see a decline of parental involvement as kids move from childhood into teenage years.  However, it’s worth the effort to stay involved and keep your child healthy and strong as they live and grow with type one diabetes.

1. Knowledge of diabetes care behaviors. 

How do you as a parent care for your child living with diabetes as they grow?  Do you watch them check their blood glucose?  Do you watch them take a shot?  Do you watch them draw up their insulin syringe?   

When was the last time you were that involved with these daily aspects of diabetes?  Are you reviewing what they report on their logs, are you checking the meter’s memory, or are you watching their blood touch the strip?  Be aware.  The log is just a piece of paper, easily manipulated.

2. Parents’ acceptance of the child in general.

Reading this blog is not going to help you accept your child in general.  Only a lot of soul searching, therapy, and hard work can do that.  However, the fact that the researchers named this as a marker in diabetes self management is crucial to understand and is crucial for your child’s health.

I understand that parental guilt often accompanies a diabetes diagnosis.  If you want to help your child deal with their diabetes, you must be able to focus on THEM instead of YOU.  If you have some unclear feelings as I’m sure you do, try to keep them separated from your child instead of trying to work out your own feelings about your child’s disease with them.  Your child is working hard enough to deal with their diabetes.

Your child knows how you feel about them, and about how you feel about their disease.  Your child is a child.  Not an adult.  They look to you for support, guidance, and comfort.  Be that for them.

3. Assistance with diabetes management tasks.

This one is a simple one, really.  Sometimes, taking a shot or counting carbs or checking your blood is just tiring—especially when your friends and classmates are doing something else.  A vacation from diabetes would be nice.  However, living with type one diabetes means you will never get a vacation.  Ever.

So as a parent, help your kid out.  Learn as much as you can about what your child may be going through, and just be around and be open and willing to help with something.  Sometimes you might need to verbally offer to help.  Sometimes you may need to suggest a check, or count the carbs for them.  Sometimes you probably need to demand your child eat.  But sometimes, you should also probably be quiet, and just nearby.

Whatever it is, be there.  Be willing.  Be knowledgeable.  Let them ask and let your answer always be as supportive and encouraging as possible.

Grocery Tips for Keeping the Errand Healthy and Interesting

April 12th, 2010

We all know that eating better will help us achieve our goals—be they fitness goals, health goals, and even scholastic goals.  Sometimes, though, the munchies hit and we are at the whim of whatever we have in our cupboard, fridge, and freezer.  (Living with diabetes also means we have to always have “low food” around—precisely the kind of food we know isn’t healthy on its own.) 

Where better to start out on our path to better eating than at the grocery store?

When I started on Weight Watchers, I noticed that my grocery trips changed.  I now don’t hit every aisle every trip.  I spend the majority of my grocery time in the produce section, and only rarely head down the cracker/chip aisle.   (I love crackers.  I love them a lot.  A whole lot.) 

I now skip buying meat every trip.  I find the protein my body needs in nuts and beans instead.  (And cheese; see above.  I adore crackers and cheese, and missed them terribly when I had to stop them for a while so I could lose 45 pounds.)  Meat is pretty expensive; a lot more expensive than green beans!

I also set aside $2-5 each trip in case I see something new I’ve never tried.  I figure that there is no better way to find out if I like a vegetable or fruit than trying it.    It’s kind of fun to come home with a treasure each week.  We are encouraged to eat a rainbow of foods and trying new things is a fun way to brighten some of those colors.

I have staples that I try to always keep in my fridge and pantry.  (Hard boiled eggs, canned garbanzo beans, red onions, etc.)  I know I can make a number of different dishes to have on hand for lunch throughout the week to keep myself fueled for my workouts and to keep the hunger demons at bay. 

I sometimes go to a different grocery store, just to check out what they have in their aisles.  It is usually the same types of food, of course, but seeing it on a different shelf in a different part of the store keeps my eyes open and my mind thinking of how I could prepare whatever food I see. 

I try to avoid eating out of boxes, as only food someone else has concocted will come in a box.  I want to control the chemicals in my body as best I can, so produce always seems the closest I can come to that.  If I make it, I can control what goes into the food and into my body… if someone else made it on the other side of the country with ingredients I can’t pronounce or understand and then packed it in a box, how am I to know what it really is??

These are only a couple ways my grocery trips changed when I started to focus on my health and weight.  How have you made your grocery trips interesting and healthy?

Seeing a Mountain Ahead on My Path

April 10th, 2010

I have a 10k trail run scheduled next month, so I decided to run in a nearby park today so I could get some quality hill work in preparation for the 10k. 

I had a lot to think about during my run this morning.  I found out about a potential complication of type 1 diabetes yesterday.  (I feel for my friend and her husband; this diagnosis must have been stressful since it is so little-known and any cancer scare is, well, a cancer scare.)  Every time I hear about one of these little-known complications I kind of go through my entire emotional routine and feel like I face my disease more head-on than usual. 

As I’m running around this county park, I’m thinking these thoughts and my run is just generally difficult today; my eating yesterday was far from ideal and man the hills feel tough.  I am also thinking about my friends who live in the Midwest, and wondering if they have hills like these to run around in.  So, I’m thinking about how I would describe where I am to those who don’t live in the Bay Area.  Would I call them mountains?  Would I call them hills? 

I determined that my answer depends entirely on where I am when I describe them: am I at the bottom, or am I at the top?  If I’m at the bottom, they are mountains; when I get to the top, they are much more like hills.

The way I get from the bottom of the mountain to the top of the hill?  One little step at a time, one after the other, all the way.

This is precisely how I need to deal with my diabetes and face possible/ potential complications.  I know that I will face complications at some point.  I feel lucky that the complications I have already faced have been minor and manageable, and yet I am pretty sure any complication will become less minor and have a bigger impact on my life as I age. 

But I think, for me, I need to face that knowledge the same way I faced the hills on my run this morning.  Acknowledge what I’m looking up at, recognize it will be difficult, and also recognize that my perspective will change as I progress through and past any issue.  I need to just keep going, one little step after another.

I do what I can do every day with my disease; I require that of myself for my health now and for my health later.  But I also know that even if I were able to do everything there is to do every day, there are no guarantees; no one knows all there is to know about diabetes and its long term effects.  And that has to be enough for me.

I need to be proud of the steps I can and do take, and I need to keep taking them and keep going.  We all do. 

Here’s to us.

Negative Self Talk has No Place in an Exercise Program

April 9th, 2010

When I was a kid I walked to school (elementary and junior high) every day with my neighbor; she was a year older than me and her brother was a year older than her.  We’d kick a pinecone or a rock all the way, and generally chatter about whatever was on our minds.  The thing that bothered me about this girl was the fact she always only had negative things to say about herself, or her hair, or her outfit, or her intelligence, or her body, or really anything.  I don’t know if it was her brother teasing her or really why she picked herself apart in such a negative way, but it will always stay with me as a way I don’t want to treat myself.

I’m quick to point out to my clients that negative self talk such as this has no place in an exercise program.  None

When you start exercising, or start nearly any new challenge, you are in charge of your outlook.  If the voice in your head is criticizing what you are doing, I must ask you—why are you exercising?  If you are exercising to lose weight, but are doing so with a negative voice in your head, what happens when you lose the weight?  Will you replace the negative self talk with positive?  What is the point of the negative words?  How will you know when to start the transfer into positive self talk?

How about changing from negative talk to positive talk RIGHT NOW

When it comes to learning how to speak positively to yourself about your effort and your results, ask yourself: if you were to say some of that aloud or if you heard your son or daughter say those words to themselves, would you encourage those words or would you try to change them? 

If it’s negative words you hear when you speak to yourself, stop that voice.  You aren’t exercising to discourage yourself.  Stop the negative self talk.  Change it to positive and encouraging words you say to yourself!

You are out there, trying.  You are doing something by choice to improve your health and fitness.  You are working to support your body, and in turn have your body support you.  You will come closer to every goal you set for yourself with each day you show up and put forth the effort.  That right there is worth a pat on the back.

Fitness is not a goal that is ever truly achievable; one can always be stronger, or faster, or quicker, or more limber.  That’s part of the fun!  But with negative talk crowding your brain, you are finished before you begin.  Celebrate yourself and your achievements, large or small, when you exercise

High fives for you!

Keeping Track of My Diabetes: The Diabetes Log

April 8th, 2010

I’ve never been any good at keeping a log of my numbers.  It doesn’t help that my doctors wanted me to when I was a kid and teen.  (Not so good at doing what someone else wants me to do without at least one Very Good Reason and a lot of Instant Rewards.)

I’ve always considered that keeping a journal of my numbers, activities, insulin, food, and feelings was not as important as living my life.  I can do it for a few days, but the thought still makes me unhappy. 

My Anal Self doesn’t like my Options (and I’ve looked at and designed a load of journals)

The little boxes with the little times on them—if I check at 9:13am and then again at 9:50am, where do I put those two meter readings?  At the 9am?  The 10am?  What if I then check again at 10:30am?  Where do I put that number??  Some of the logs have only four boxes- Breakfast, Lunch, Dinner, and Evening; that system isn’t ever going to work for me!  I check my blood glucose 8-12 times a day, and rarely at the same times.

The little boxes for “exercise”—do you want me to write in what I did?  Really??  Where do I put what my meter reading was when I was on mile 4 of a 6 mile run?  What do I do when I’m leading bootcamp or when I go to IKEA?*   I’d rather just exercise and keep moving instead of trying to figure out how to record what I’m doing.

The food journal.  It is a great idea, and rather helpful when trying to lose weight or catch an unknown pattern, but for a daily log of my life, can’t I just skip it?  Writing down the number of carbs I ate isn’t enough information, since it matters what I ate along with those carbs.  (Was it straight crackers, or was it crackers and cheese?  Those two snacks will affect my blood glucose differently.  What about the veggies?)

On my pump, writing out each bolus feels cumbersome.  Yes, I have a record in my pump that I can easily transcribe, but again, transcribing seems like maybe not the best use of my time. 

Back in the day before I was on a pump and when my mom was in charge of the food I ate and I kept my meter at home, it was probably easier to keep a log.  But for the past fifteen years or longer, it just hasn’t made much sense for me as a way of life. 

Overall, I just think I’m not a Record Keeper

I just am not good at writing down what I do.  I’m not good at taking photographs, either.  I tend to see both as a kind of distraction from participation in my actual life. 

And yet, the diabetes log looms at many doctor visits.  It is a great tool for someone else to look at to evaluate my choices and decisions.  (Great.  Just what I need after 22 years of school; more evaluations.)  I really do see that it is a great tool when I’m having trouble with a certain time of day or can’t see a pattern. 

The smart CDEs have asked me to just keep a log for a week.  The smarter engineers have built meters and pumps that can download all my information to a computer for my doctor.  (Thanks for that!)  My favorite doctors, of course, are those who can read the computer printouts and have never asked to see anything I have written down.

For now, I say thank you to everyone who has ever tried to ease my record-keeping burden or erase it altogether. 

And if we ever go away on vacation, you’re the one in charge of the camera.

*I go low at least once every time I enter that store.  I don’t know why.  Magic doors?  Insulin spray circulating through the vents?  It happens at every IKEA location I’ve ever been.