Archive for February, 2011

Are You A Good Advocate for Yourself?

February 11th, 2011

I know we see a lot of different medical professionals when we live with diabetes (and we aren’t alone with that!)… and I know sometimes we feel that “well, they went to medical school; they must know what they’re doing”…

… and while this may largely be true, you still need to be your own advocate when it comes to the care you receive.

If you don’t know precisely WHY your doctor changes something or tells you to start something new, don’t leave.  Interrupt her and make sure you clearly know why she is changing what she is changing.

If you don’t know precisely WHAT information your doctor considers important on that lab result, or what a certain procedure is, ask him.  He knows the answer and he should be able to explain it to you in a way you can understand.

It’s your body, you know.  No one else can possibly care about your body in the same way as you care.  (I believe this is also true with parents: a parent caring about a child is probably more intense than a child caring about her or himself, but I think there is a difference between the two.  Just a difference, is all.)

In my recent experience, I had to advocate for myself in a new way.  It did feel a bit odd, but I’m glad I handled it the way I did.

Once my doctor came into the room, I remembered that I’m now treating my doctors as though they are my professional consultants instead of grade school teachers.  I can’t get in trouble and they can’t make me stay after class.  I can, however, learn from them and their experiences to better my own life.

What a difference.

At my last visit, I asked my doctor to refer me to a dietician.  I haven’t seen one in a number of years and my nutritional needs have changed as I run farther distances more often.  Although I am a Lifestyle and Weight Management Coach, I still think it’s a good idea for me to meet with a professional and re-group.

I asked specifically for someone who knows type one diabetes inside and out and who knows marathon training very well.  Of course, that person had transferred into a different department and no longer sees patients, so I felt on my own.

Nevertheless, she sent me to the nutrition department.  They called to schedule an appointment for me, and I asked the scheduler the same questions: how many patients does the particular RD see with type one?  How many marathoners?

She had me speak with the dietician, and I was very straightforward with her.  I appreciated that she would take time to speak with me prior to an appointment, and told her that living with type one diabetes for over twenty years and being a personal trainer and lifestyle and weight management coach, I know nutrition.  However, just like a hairdresser probably doesn’t (and shouldn’t) cut her own hair, I want again a knowledgeable and experienced expert on my side.

That dietician went out and searched her dietician friends for someone who met my criteria.  Now, I haven’t met with anyone yet, but I know I’m going to reach someone who will be a benefit to me, my health, and my performance as an athlete.

When acting as my own advocate, I feel empowered to make healthy choices and healthy changes so that I can keep going as long as I want. 

So can you!

Paper or Plastic… Candy or Fruit…

February 10th, 2011

Sometimes these studies crack me up, and I want to share them so we can all smile.

This one makes complete sense to me and the life I live. 

Researchers studied how and what people purchase at the grocery store and how they pay for their food.

Not really surprising, but they learned that when people use cash instead of credit or debit cards at the grocery store, they buy fewer unhealthy foods.  (Note: this doesn’t mean they purchase more healthy foods, it means they don’t buy as much of the junk.)

They determined the reason for this is impulse buying, which makes a lot of sense: if you only have $10 on you and you need to buy $9 worth of groceries, you can’t spend $5 on junk food impulsively without rewriting your list or starving your family.

Moreover, the researchers determined that the “budget deviation” (I love scientists) between what someone had budgeted to spend on groceries and what they actually spent was consumed primarily of impulse purchases.  They related the budget deviation directly to desire and willpower.

Isn’t that why the $5 magazines and the $1 candies are at the checkout?  Once we think we’re done shopping we let down our guard?

I was the grateful and fortunate recipient of a gift card this holiday season to Trader Joes.  I just finished the balance up on Tuesday, and I’m sad that it is now gone.  I know I used it on items not on my list that I thought would be fun: I got that cheese I tried once and remember enjoying; I got a bag of my favorite almonds just because; I got an extra bag of popcorn.   (I got a load of other stuff too but I’m not willing to list that stuff on the internet.)

It was so easy to load up since the gift card balance wasn’t factored into my typical food budget!

I’m pretty sure I’m not going to start buying groceries with cash, and I’m fairly certain anyone reading this isn’t going to start going to the ATM before the grocery every time, either. 

But it’s one of those small tricks we should be at least aware of if we are trying to eliminate excess literal and figurative junk in our trunks.


February 9th, 2011

I have been thoroughly enjoying the books born of an Englishman’s blog about daily life on the job as an EMT in London.  I hope that some of my posts are as entertaining, real, and thought-provoking as his.

The other morning I was on my way to bootcamp and saw an ambulance at someone’s home before 6am.  And then a friend of mine needed an ambulance this weekend.

So ambulances and emergency medical services have been on my brain.

I wonder if I’ve ever written about my time in an ambulance.  I don’t think so.

Tom Reynolds (the author above) writes every now and then about treatment he rendered for a diabetic with low blood sugar.  It is very strange for me to see his perspective, and it reminds me that for most people, type one diabetes is a disease or medical condition.

For me, it’s simply a part of my life.

As I’ve gotten older I’ve recognized that I should maybe give worth to both sides, instead of scoffing at one.  I need to respect and acknowledge both those who see my diabetes as a serious medical condition, and those who do not.

Maybe I should re-work my memories of my own medical crisis 16 years ago, and maybe start to see it as something other than “my fault.”

Here is what I know: I was 17 and on my way to babysit a 4 year old boy and his 7 year old sister for the evening.  The parents were friends of a good friend of mine, so I knew them but I think it was the first or second time I babysat for them– but I knew the kids and had spent some time with them all.  It was early evening and on my way I decided to stop and get some candy from the grocery store because I was feeling low.

I can’t explain why I thought it would be good to get some hard butterscotch candy instead of juice or a sugar that was easier to eat in large quantities and could actually raise my blood sugar quickly, but butterscotches were what I got.

I was okay when doing the pre-babysitting walk-through with the parents, and I know I played with the kids some…

…and then I know I was on this strange couch and there was a man standing at my feet and another man crouched at my shoulders and I know I WOULD NOT let go of that man’s hand.

I was scared.

They asked me some questions, I guess I answered them appropriately, and they were happy.  (I think I lost about an hour in there somehow.)  I know I never let go of that guy’s hand.

They asked me if I wanted to go to the hospital, and I said yes.  My parents had already arrived when they were loading me into the back of the ambulance, and I was okay by then but still scared.

At the Emergency Room, I was already better but I was still scared so I stayed where I was.  It felt like I was in charge of what happened at that point, but I was 17 so I’m not sure if my parents were calling the shots or not.

I just feel badly for the little girl who ran next door that evening and told her neighbor something was wrong with her babysitter.

I am grateful to the neighbor who took charge and called 911.

I am grateful to the EMT and ambulance service for making me feel not quite so scared, and for holding my hand the entire time from couch to hospital bed in the ER.

I am confused by the report that says I never lost consciousness.

I am angry at the doctor who later shrugged his shoulders when I told him and said “meh; so you lost a few brain cells.”  (That was my last interaction with that doctor.)

I’m not sure how much personal responsibility to lay on myself even now: with low blood sugar affecting cognition, I was doing my best when I bought the “wrong” low food for myself.  I was going about my business as a 17 year old and taking care of myself as best as I could.

And I still needed help.  And I got it from a load of folks I’ve never seen before or after.

I never saw my EMT guy again but rest assured I search every ambulance as it passes.

I Love Being Surprised!

February 8th, 2011

I have had the opportunity to meet a relatively large number of people in my years of doing bootcamp classes.  This year has been no exception.

I have learned a few things about people and exercise through the years, and of course think I’ve got everything all tied up.


All of that said, I really do love it when a camper surprises me.  It is always so much fun to discover that others have these little hidden talents.  Sometimes they are hidden from me, sometimes from themselves.

I am thinking about one camper who started with me in September.  She’s got adult kids and wants to get her flat belly back.  She works hard when she’s with me, and she has been making steady progress with her fitness as a result.  I think she’s fantastic.

But I will always remember the day I made the class sprint up a hill. 

She let loose and beat everyone there. 

She knew she had it someplace inside her, but hadn’t let that part out for some time.  (She never told me she was a sprinter in high school!) 

How fun.

I had a new camper try the class out today; all I knew about her was that she hadn’t worked out in a year and a half and had young kids.

Of course I don’t know what someone’s capable of just from a phone call—she could have weighed 300 pounds or she could have weighed 90 pounds and I wouldn’t have known.  She could have been in the Olympics in 1992 or she could have not walked farther than a block for thirty years. 

She did tell me that she was “fairly fit” before she had kids, and she said she wasn’t afraid to work (love that, too!).  But again, I never know what that really means.

So how great was it when I met her today and it came time for me to instruct everyone on some sprints, say “GO!” and watch her leave the rest of the class in the dust. 

She knew she had it in her, someplace, no matter how long it had been since she reminded herself of that talent.

I love that.

I know a few days ago I put up a quote on Facebook that mentioned how we always have something left despite our own belief we are spent. 

So never be afraid to give something new a try: you never know who you’ll surprise!

Latest Half Marathon Report (SF Kaiser Half, Feb 6, 2011)

February 7th, 2011

I don’t know if you will find these interesting or not, but on the off chance you do, here it is:

This half marathon was one I knew I was going to run a few months ago… but somehow, before Christmas, February seems like a really long way away.  Turns out, February 6 is actually pretty close to the holidays!  The extra time I thought I had turned out to not exist… and then I had a week of no running with the food poisoning… and whoops there it is: February 6, 2011!

This was a run I heard was really nice, and my friend’s running buddy was going to run it, so I convinced my friend she needed to run it, too.  (Watch out if you’re my friend and you run; I will make you do things like this.)  So we signed up and we were off.

There has been an odd early Spring this past week around here, which is odd but I’m not complaining.  (I’m sneezing a lot, but not complaining.)  I checked the weather prediction and it said the temperature near the start would be about 55 degrees for the start.  It was a late start (8am) but I don’t really care about that kind of thing, especially since the run was in San Francisco, about 25 miles away.  More sleep for me = a good thing.

I’m not kidding: we walked out of the house (my husband served as my Pit Crew on this one, which is always awesome) and the first words he said were: “this is a great morning for a run!”  Easy to say when you’re the Pit Crew and not the Runner.

But it was a beautiful morning, and I felt good about my choice to run in shorts and a long sleeved shirt.  I had my fuel belt all set, I had oatmeal to eat on the way to the run, I was ready.  I mean, I was ready to start off on the right foot: I had little expectation of a record-setting run.  I was just going for the scenery and the experience.

We waited at the start for the hour they want you to stand around, and we were off.   I checked about 45 minutes before the run started and about 30 minutes after my oatmeal and was happy to be 186Being over 175 when I have insulin on board before a run takes some of the nerves away for me.  Phew.

Now this was a crowded run, and I’m amazed none of us stepped on each other.  I’m also pleased to report I felt no elbow in my chin or nose (happens when I’m 5’2” and there are 6’2” runners next to me) and it was light enough to feel somewhat safe. 

Two miles in, and I’m complaining already.  MAN; IT IS HOT!!!  I’m thinking: how on earth am I going to keep this up for eleven more miles?!  It was so hot!  My decision to wear a long sleeved shirt felt like a very bad choice. 

I spent a little more than a mile trying to figure out (a) at what age is running in only a bra no longer acceptable (note: I have neither the correct age nor the correct figure to do this but again I remind you it was HOT), (b) would I want to see the race photos if I did take off my shirt, and (c) was it really that hot or was I doing something wrong?

Thankfully, we changed directions somewhere along in there and I was able to run again in a colder area of the route.  I opted to eat a Gu at mile 3.5 rather than mile 4.0 because it was hot.  I started to think about how glad I was that I have run so many years and had a sense what to do with the unusual temperatures.  I extended my temporary basal rate beyond my initial plan and opted to start drinking my Gatorade early.

At mile 6.5 I thought it would be good to stop and check.  159.  Yay.  I called my husband, told him where I was, and kept going.  I also opted for another Gu, since it is easier for me to run while high than it is for me to run while low.

(I have my CGM in my arm right now and I don’t know why I forgot this, but I don’t like running with it in my arm if I have on a long sleeved shirt.  This sensor is more painful than usual, and the long sleeves ended up making it feel like it was going to dislodge and I’d be without the sensor for the remainder of the run.)

Awesome that the water stops started to include Gatorade at that point; I skipped that first one (mile 7 or so) but was happy to see I didn’t have to hoard my own supply, as it was HOT and hydration should be a concern in those temps.

Did I mention I was still running?  At least we were on the Great Highway (Hwy 1) and I could run along the beautiful surf.  No small thing, but we were now again facing the sun as we ran.  Sigh; still hot.

Finally I got to the turnaround and knew there was another Gatorade spot coming up.  I checked again at mile 10 or 11 and was 116.  Lower than I would have liked to be with 2-3 miles left, so I downed my third (and final) Gu.  I still had one more low food, but I usually would consume only one Gu by that point.  Stopped and drank a Gatorade (maybe 6 ounces) and kept running.

So by the end of the run I was back to climbing since I had been at a low basal for three hours instead of my normal two  hours (if I’m planning to run for 2 hours, I lower an hour before and the first hour of the run and see where I’m at) and my blood sugar was starting to climb once I stopped running.

All in all, a fine showing yesterday.  I didn’t beat any records, but I stayed where I wanted to be as I ran despite the crazy heat wave.  And I think most importantly, I kept my shirt on.

(Sorry for the length of this one!)

Look at the Size of that BRAIN!

February 4th, 2011

I don’t know about you, but I tend to expect our brains become less powerful as we age.  I didn’t know they actually SHRINK though; that’s weird and I’m not going to lie, scary.

I know memory function declines with age… (in my experience I’m not speaking of only 75 years plus kind of age, either)… and I would have thought it was something we can do very little to prevent.

But this is not true! 

Researchers (those wacky folks) performed a study on 120 older adults to see what they could do to improve brain function.  Now, notice that it was a small study and there is nothing in the abstract to explain what “older” means, so to me this is somewhat vague. 

But the results of the study were fairly conclusive: aerobic exercise training increased the size of the anterior hippocampus, leading to improvements in spatial memory of the 120 participants.

That is pretty cool.

Another thing to note is that they performed this study on participants who were previously sedentary.  They took MRIs of their brains at the start, at 6 months, and again after a year’s time.  The MRIs revealed that exercise training increased hippocampal volume by 2%, effectively reversing age-related loss in volume by 1 to 2 years.

I mean, what more could I want from a study?!

The senior author of the study said: even modest amounts of exercise by sedentary older adults can lead to substantial improvements in memory and brain health.  To me, this is proof that exercise does more to improve dwindling brain function due to aging than anything else available.  I’m on board!

Of course, I want to see the study on active older adults to see what their brain size is to begin with compared to their sedentary peers.  I’ll keep an eye out for it and report back if I ever find it.

In a not-entirely-unrelated note, HAPPY BIRTHDAY DAD!!!  (He turns 66 tomorrow and is still bootcamping and golfing like he was thirtysomething.  Right on, Dad!)

Salty Salty Salty

February 3rd, 2011

I can hide nothing about my love of salt.  I don’t even want to hide it—I want to proclaim my love of salt from rooftops at high volume: I love salt.

I remember reading all the Little House on the Prairie books and asking what a salt lick was.  I’m still looking for a salt lick to show up in my life.  I’m telling you: I love salt!

I’d much rather have something salty than something sweet: the taste in my mouth after having too much salt (if there were such a thing; I probably just wasn’t properly hydrating correctly) doesn’t signal to me a high blood sugar like the taste in my mouth after having too much sweet food does; if I order dessert at dinner that’s very unusual! 

I also sweat like a pig, and I spend the last mile of my longer runs (9-20+ miles) wondering what kind of salty food I will eat when I return home. 

Salt: I think it’s lovely.

So all these warnings and admonishments about Americans consuming too many foods high in sodium make me a little sad: I don’t want to be made to feel badly about my love of salt!

But check this out: the February Diabetes Forecast (yeah I still read it) mentions something in the American Journal of Clinical Nutrition last November.  Researchers analyzed studies done between 1957 and 2003 and concluded that Americans today are eating as much salt as they did 50 years ago.

So why is everyone up in arms right now about the salt?  Well, since it’s still “too much” to consider healthy. 

But since rates of high blood pressure and heart disease have continued to grow despite salt intake remaining relatively constant, the researchers concluded the culprit in the rise of these diseases is likely…


No way.

Despite my own salt-loving experience, I don’t have high blood pressure.  I don’t have heart disease (in fact I have a pretty awesome and fantastically healthy vascular system if I do say so myself). 

I’m not saying that I have any super genes or that I’m an abnormality in the world: I’m saying thank you to exercise for letting me enjoy my salt and not worry too much about any side effects. 

Please pass the salt.

Misdirected Energy?

February 2nd, 2011

I know not everyone is going to agree with me on this one; that is perfectly fine.  Sure, I’d like it if you saw my point of view and appreciated it and every now and then you could come over and agree, but I’m okay if you don’t.  I’d love to hear other sides to this one, too, so please feel free to comment and share your thoughts.

I don’t understand the point of the fighting.  Type one diabetes isn’t like cancer: fighting (more specifically the stress of fighting) doesn’t make living with diabetes any better.  In fact, the blood sugar swings stress can cause will in fact make living with type one more difficult.

I see the ones promoting “stick it to diabetes” really more the parents of type one kids than the kids themselves.  It makes me wonder: what are you fighting against?  Are you fighting against the considerable added work that having a type one kid involves?  Are you fighting against the type one kid being somehow different than her friends or siblings?

How is that fight helping the kid with type one?

I can understand fighting against antiquated notions of what living with type one means; shoot, that’s part of what I’m doing with Diabetes Outside.  I can understand fighting against limits uniformed people think a life with type one diabetes involves.

But the “I hate diabetes” campaign to me doesn’t achieve any progress on those fronts.

To me, celebrating a fight against a child’s type one diabetes takes everyone, child included, further from the goal of healthy living.

Diabetes isn’t like a tumor that can be excised from the body and, once removed, life returns to what it was before diagnosis. 

It just isn’t.

I’m not saying to stifle any fight; all emotions are useful to a point.  I just see so many people, again a lot of parents in this category, stuck in the fighting stage.  Being stuck doesn’t solve anything or make anything easier for the type one kid.

How can a child grow into a healthy strong teen, young adult and adult if something about them is something their parents visibly and vocally fight at every turn?

Look at the type ones you admire.  Listen to their messages.  Look at how they treat their own diabetes.  Do they fight the fact they have diabetes?  Do they fight the fact their pancreas doesn’t work? 

Or do they do their best, move past the uninformed person trying to use the disease to limit opportunities available, and: climb mountains, sit on the Supreme Court, sing on American Idol, travel the world to win a million dollars, advocate for equal treatment in the workplace, quarterback for the NFL, play major league baseball, write award-winning novels, make others smile and laugh, earn multiple graduate degrees, give back to the globe, care for the sick, and educate everyone around them.

See, there is a load of living we have ahead of us.  Make sure you are supporting those efforts and not spending too much energy stuck in one unproductive spot.

Am I A Broken Record or What?!

February 1st, 2011

Are you one of those people (I’m speaking mostly to the women) who go for 30 minutes on the elliptical or attend spin class or other cardio, finish, shower, and pat yourself on the back for a great exercise session?  Are you avoiding the weights in your workout routine??


I’m quoting an old article here but the points are the same:  reasons abound for you to start lifting weights.  You can call it pumping iron, lifting, weight work, whatever you want.  I just want you to get started on a routine for yourself!

10 reasons we should all lift weights: (taken from Oxygen Magazine, February 2009)

  1. Increase Strength.  Forget about relying on other people to help you lift boxes, carry groceries or piggyback your toddler because strength training makes everyday activities easier than a walk in the park.
  2. Lose Fat.  Each pound of muscle you gain can burn up to 50 extra calories a day and you can gain nearly two pounds of muscle in just two months by weight training a few times a week.  Better still, you can lose 3.5 pounds of fat at the same time.
  3. No Bulking.  Research shows that women do not typically gain bulk from strength training like men do because women produce 10 to 30 times less testosterone than men.  You will, however, define and tone your muscles.
  4. Healthy Bones.  Research has shown that weight training can improve your bone mineral density by as much as 13 percent in just six months.  This becomes crucial as women age to minimize their risk of developing osteoporosis.
  5. Improve Performance.  Hitting the weights on a regular basis can improve your overall performance in sport and decrease your risk of injury.  Extra strength can power up your drive on the golf course and reduce the risk of injury among skiers.
  6. Keep Yourself Healthy. You already know that strength training builds stronger muscles, but did you also know that it increases joint stability by strengthening ligaments and tendons?  Well it does.  And a stronger join helps prevent injury and eases the pain of osteoarthritis. 
  7. Strengthens Your Ticker.  Weight training can keep your heart healthy by increasing your HDL cholesterol and lowering both your LDL cholesterol and blood pressure.
  8. Ward Off Type 2 Diabetes.  Research has shown that regular weight training can improve glucose utilization in the body by 23 percent in just four months.  This may reduce the risk of type 2 diabetes.
  9. Age is Irrelevant.  It doesn’t matter how old you are; strength improvements are possible at any age, even 80 years old.
  10. Keeps You Smiling.  Working out with weights has been shown to improve a woman’s self-confidence and reduce the symptoms of clinical depression.

For those of us living with Type 1 diabetes or Type 2 diabetes, we know how susceptible we are to heart trouble, clinical depression, and carrying around extra weight.  Training with weights will give us that extra strength to fight some of the certain complications we face.

What do you have to lose?  Oh yeah: the flab

Go grab some weights.