Archive for March, 2011

Sticking With Exercise

March 17th, 2011

If you have ever battled the motivation gods, emerged victorious, and started following a regular exercise program, you probably know what can happen next.

You stop exercising.

Augh!  That wasn’t supposed to happen!!  You were supposed to start with your New Year’s Resolution and stay with the program!! 

Ah; but we’ve all been there.  Looking through one of my old fitness professional magazines, I came across an article written by Cedric Bryant, Ph. D., the chief science officer for the American Council on Exercise, about sticking with exercise programs.

And, as I am wont to do, I thought I’d share his wisdom here.

Dr. Bryant summarizes the four most critical factors for exercise adherence are:

  1. Injuries
  2. Time
  3. Boredom
  4. Results

Each one makes sense!  You don’t want to exercise if you’re hurt (or fear you will get hurt).  You don’t want to exercise if you feel like you barely have time to get dressed in the morning much less spend 30 minutes sweating!  You won’t keep doing something that bores you (unless you are unusual), and you won’t keep doing something if you have to wait 5 years to see any result. 

So how to battle THESE potential roadblocks?  I’ll go through the first two today and the rest tomorrow.

INJURY.  Of course, first plan for injuries when exercising is to avoid them.  But how often does Plan A work?  You need to make sure that you are being smart when you exercise—don’t go so hard too quickly that your body won’t recover.  Exercise really is breaking down your body, resting and rebuilding, and then repeating the process.  Give yourself enough rest and start slowly and safely.  If you do twist your ankle, rest until you are itching to get back… and then wait another 2-5 days to make sure. 

TIME.  I think a lot of people just don’t put a lot of importance on exercise in their lives.  Chances are you have a load of time in your day that you don’t even know about!  If you make exercise a priority, it will happen.  I read something once about a science teacher who gave his class a jar and both large and small stones; the assignment was to put all of the stones in the jar. 

After several tries, the students saw that the stones all fit in the jar only when they placed the big ones in first.  (Turns out the same exact thing happens with dishes in the dish rack; try it!)

Make sure that your exercise is one of the big stones in your life, and the other smaller things will still fit if you need them to.  I promise.

Happy St. Patrick’s Day!

What Motivates You to Exercise?

March 16th, 2011

I was thinking about motivation this morning.  (As I lay in bed, waiting for the next snooze alarm to blare my poor husband awake for no reason.  Poor guy; his wife’s alarm clock blares Spanish radio every three minutes every morning until she finally gets up… and neither of us speak Spanish…)

Anyway.  Motivation.

When it comes to exercise, how do you get out there and start moving every day, or every other day, or three days a week, or very hopefully not every three years?               

It isn’t logic.  Logic isn’t enough to motivate any of us to exercise each day.  Sure, I can speak and type until I’m blue in the face and develop carpal tunnel syndrome about the benefits to exercise—health benefits, mental benefits, emotional benefits, caloric benefits, anti-aging benefits, physical appearance benefits…

But that isn’t always what we need.  If knowledge were all the motivation we needed, we would all eat right all the time and exercise just the right amount without needing anything more.

It’d nearly put us fitness professionals out of business!

So what else could motivate us to exercise?

Fear is a potential motivator.  I don’t think it’s a good one, though, so I don’t ever use it.  At least, I try to never use it.   Although, knowing that nothing good comes of being inactive, there may be an element of fear in the motivation to exercise.

Then again, if you’ve got a beach vacation coming up, you’re probably scared enough by the thought of yourself in a swimsuit to get you moving!  So maybe fear can be put to good use as a motivator.

Positive feedback is a great motivation to exercise.  I see and hear about it all the time: bootcampers and clients who have been working out for a few weeks love to report all of the comments and compliments they’ve received from friends, coworkers, and family members.

Not to mention their own feedback on how strong and energetic they have become!  Exercise can be very rewarding on several different levels, and that feedback can be powerful enough to keep you motivated.

Another aside: I Googled “what motivates you” and got all kinds of results on job interview questions.  I can’t believe someone asks a potential employee what motivates them.  Isn’t money #1 but we can’t say that so what they’re really asking is how well you can blow smoke in an interview?  What does that tell a potential employer?!  Sigh.

But that’s a good point: none of us amateur athletes get paid for exercising.  I wonder if we did, if it would be just as difficult to get out there?

For me, I rely on many different sources of motivation every day to work out.  Yes, sometimes I just enjoy it but there are a lot of other days I would rather be doing something else.  Fear motivates me sometimes, positive feedback motivates me other times, seeing friends on a run motivates me too.  Sometimes it’s a vague sense of competition (Peggy did lunges because I did lunges and because she did lunges I have to do more lunges), a lot of the time I rely on the knowledge that exercise is good for me for so many reasons I don’t have time to list them individually.

Yet I do still need to be motivated every day.

And I’m still left with the Spanish radio blaring every 3 minutes.  Enough to motivate me to get out of bed in the morning, but not enough to motivate me to get into bed earlier each night!

Are there other things that motivate you to exercise?

Parents of Type One Kids and Teens

March 15th, 2011

I went to the UCSF Symposium this weekend and heard a lot of questions from parents as they struggle with being good parents and being good caretakers and being good diabetes nurses and good nutritionists and coaches and therapists for their kids…

I heard some questions more than others, and thought maybe you’d have more questions beyond these.  If you do, please let me know!

One speaker, Bill Polonsky, gave five important general rules for parents of type one kids.  I think it’s a great list so I’m re-posting it here.

  1. Have faith that your type one kid can live a long and healthy life.  Well managed diabetes is the leading cause of NOTHING.
  2. Scaring your child into better management of their diabetes will not work.  Forget it.  It won’t.  Ever.
  3. Develop a sense of humor about life with diabetes.  Learn and accept that aggravations over diabetes will occur and get used to them!
  4. Have a family plan that establishes clear, meaningful, and reasonable goals for action—for everyone in the family.
  5. Listen to each other.  Diabetes is hard on everyone and we all need to support each other.

How handy we have this March Challenge going on, isn’t it?  Here’s where you can look for inspiration to ask for help in different ways—from others in your family, and of yourself.

I’m here to help if you, your child, or your entire family needs a little experienced help with day to day life, or with a current crisis.

Go for it.

23 Years Today

March 14th, 2011

I don’t like to use this blog to toot my own horn (who needs more of that; have you watched TV lately?!) but I do think it is important to use milestone days to mark progress in our lives.

23 years ago this afternoon, I was diagnosed with type one diabetes.  That photo is of me 23 years ago exactly.

Me, now a type one diabetic.

Stopped at home after my doctor diagnosed me. On my way to the hospital for my four day stay.

It still makes me sad to see it.  I was such a sick little girl!!

I know a lot of people refer to their diagnosis date as their diabirthday.  I never have, and I don’t think I ever will, in large part because I don’t think I was born that day! 

I’ve always been me.  Before and after diagnosis.  Sure, I lost my way at times, and sure, I spent years in fear of my diabetes.  But I’ve always been me.

I'm the one in purple; my diabetes is black; circa 1993.

THAT is one thing I’ll celebrate today. 

Another thing I’ll celebrate today is a year of blogging!  I hope some of you have found some of the posts amusing, thought-provoking, motivating, informative, and I hope most of the posts you have read have assured you that you are not alone with your struggles with diabetes.

Yet another thing I celebrate on the anniversary of my diagnosis?  I celebrate that I’m not that sick little girl anymore. 

I celebrate that I’m not the scared teenager anymore. 

I celebrate that my diabetes led me to the people I’ve gotten to meet and learn from that I wouldn’t know existed were I never diagnosed. 

I celebrate and am thankful for each of these things, and never ever take any of it for granted. 

If I hadn’t gone through any of those struggles, I wouldn’t be who I am.  I wouldn’t be able to relate to those currently struggling and I wouldn’t know I could help families, parents, kids, teens, and adults living with diabetes.  I wouldn’t be motivated to take care of my body in the same way: through exercise, healthy living, and with gratitude and I hope grace and humility (today excepted).

Thank you for being a part of my life with diabetes, and thank you for inviting me into your life!


How Are You Today?…

March 11th, 2011

I keep seeing on various diabetes related posts and pages and websites a repeating question that rubs me the wrong way.  Two questions, really, and neither of them are inherently bad on their own. 

It’s the ORDER and TIMING of them that gets me.

The first one is “how are you?” which is a fine question that helps us move through the world and our days.

It’s the immediate next question, or horror of horrors, the question posed first: “how are your numbers?

I want there to be a LOAD of time in between those two questions.  I want to answer “how I am” completely, which maybe 5-10% of the time may involve mention of a blood glucose level, and then tell you what my hopes and dreams are for the next hour, day, week, year.  Where I’m going and what I’m doing.

But the “how are your numbers” will sidetrack me every time if I haven’t been allowed to tell you WHO and how I am, first.

Since I’m a lot more than a type one diabetic

I’m just like anyone else.  I just think about my diabetes while I’m doing everything else most anyone else does.  (I think this may explain why a lot of people tend to “hide” the fact they have diabetes from other people in their lives.)

Thankfully I tend to get these questions too close together from people I don’t know.  People I may consider acquaintances.  But I used to get it from my family members a really long time ago.  It’s just what they thought about me, I guess.  They worried about my diabetes.

But I think the more they worry about my diabetes, the less they see ME and that right there is a massive problem that needs to end as quickly as possible.

Fortunately in my life I’m pretty sure it has ended, and I’m doing a fairly good job maintaining my identity on its own separate and distinct from my disease.

This all factors into the March challenge because I think both sides (diabetes side and non-diabetes side) need to recognize this phenomenon out there.  Every person needs time in their day, every day, where they focus on being themselves even if it’s for two minutes.  And for some of us our diabetes will come with us because it’s a part of who we are… but never ever EVER the entire part, or the most interesting, or the most dramatic or emotional.

Next time someone asks you how your numbers are before they ask you how you are, I say: don’t answer.  Don’t answer until you tell them your diabetes is just a tiny part of who you are, thank you very much.  

Have a good one.

The More Things Change, The More They Stay The Same

March 10th, 2011

The USDA releases updates to their recommendations for daily food and nutritional requirements every five years.  That could seem like a very short turnover for a human body that essentially hasn’t changed in, oh, hundreds of thousands of years.

However, the food industry certainly has changed!  (In that, primarily, a food INDUSTRY exists.)

This year the recommendations will soon be accompanied by several additional tips that are good to adopt into your daily life today.  I’m sure a lot of them look familiar:

– Enjoy your food, but eat less.

– Avoid oversized portions.

– Make half your plate fruits and vegetables.

– Switch to fat-free or low-fat (1%) milk.

– Compare sodium in foods like soup, bread, and frozen meals – and choose the foods with lower numbers.

– Drink water instead of sugary drinks.

Many of us with either type one or type two diabetes will recognize these ideas.  I’m sure most of us have already adopted them without specific thinking—we know diabetes and regular Coke don’t always mix!

I do find it interesting that the Agriculture Secretary and Secretary of the Department of Health and Human Services say that the new recommendations now “give the information [the public has been lacking] to make thoughtful choices of healthier foods in the right portions and to complement those choices with physical activity.”

It makes me wonder.  How many of us with type one diabetes or type two diabetes feel like we are lacking the information we need about food?  How many of us aren’t thoughtful when we make our food choices?

Massive kudos to the USDA and HHS for using specific terminology when it comes to the guide: they specifically say “type two diabetes” and also frame the issue to be one of chronic disease as it relates to weight and physical inactivity.  (As an aside, I think the American Diabetes Association could pay attention to this!!  It’s okay to separate the two major types of diabetes, and it’s okay to say “overweight” and “obese”.  Minor rant on these topics.)

As for me, this is just re-saying the same thing.  It’s a great message and essential for everyone’s health, though, so I think it needs to be communicated in as many ways as possible.  As a Lifestyle and Weight Management Consultant, I’m here to guide others toward achieving these recommendations in their lives and to help work toward that achievable fitness. 

Don’t forget: no one is preaching here, we’re trying to help you get where you know you want to goShoot me an email if you could use a little help.

Speaking of a little help, how’s your March challenge coming along?  Have you ordered your Road ID yet? The discount code expires on MONDAY.  (I said I wasn’t preaching I never said I wasn’t nagging.)

Report on My Doctor Visit

March 9th, 2011

(Ironic, isn’t it, that Diabetes Outside is about Living with Diabetes Outside the Doctor’s Office and here I am yapping about my visit to my doctor?)


It has gotten easier now that I expect it (and talk to myself all the way as I drive there).

However, Point subtracted from doctor for this cruel and unusual infliction of pump-less moments in my life.

Second things second: I’m liking this doctor more and more.  I don’t know what your experiences are, but I’m surprised when I have seen her out of context and she knows who I am.  I like that!  I never expect it, much less from a doctor who sees hundreds of patients.  I know I myself don’t forget faces or names much, but I never expect others to be similar.

Anyway, this is a good thing.  Point to doctor.

Random thing inserted at will: I don’t understand what happened to the first two weeks of information stored in my new pump.  The reports won’t pull it down and thus it is as if the information doesn’t exist.  If a tree falls in a forest… and there is no data collected from the fall…

Half point subtracted from Medtronic.  (Good thing they won like 20 points with their Revel, which reminds me I wanted to blog about that, too.  Another day.  Oh, and they have about 3 gazillion points for giving me an insulin pump to begin with, as it changed the entire course of my diabetes management.  Although their customer support/supply order sales bites the big one and they should be docked accordingly.)

Third things third: I do love how she can look at my graphs and mess with my ratios, basals, targets, and everything.  I’m not saying I’ve seen too many changes in my A1c or daily life as a result of her changes, but I still think it’s pretty cool.  I like that there is someone besides me who has devoted large chunks of her days looking at pump screens and meter and pump printouts.  She doesn’t have diabetes herself so while her choice confuses me,  I still appreciate it.  I like feeling like I’m not the only one who knows what buttons to push.

So long as they let me keep it in the room.

Fourth things fourth: omg she wants me to do basal testing.  Ut oh.

Point awarding suspended until I get through that task. 

(I’m not sure how to test my basals without eating or touching my pump for several hours in the morning.  I run and lead two bootcamps in the morning.  Sigh.  I generally like to eat sometime in there too. 

But she’s right. So I shall basal test.  I shall.  Really.)

Wait; what am I awarding points for??  This isn’t a competition!! 

“Mice Prove Exercise Is Anti-Aging”

March 8th, 2011

I’m so glad I’m not a mouse. 

Especially when I read about a study like this one. (I’m keeping my comments short so you have time to read the NYT article.)

The mice in this study have a genetic mutation that makes them age at an accelerated pace.  (If you weren’t already happy you aren’t a mouse…)  Researchers took these mice and separated them into two groups: exercisers and non-exercisers.

The exercising mice at 3 months of age (the human equivalent of age 20) were allowed to run briskly on a wheel for 45 minutes three times a week for five months. 

The non-exercising mice were left to age at their (mutated) “normal” pace.  After 8 months (human equivalent of 60 years) they were extremely frail and decrepit.

The exercising mice were still youthful and maintained almost all of their muscle mass and brain volume.

Good work, exercising mice! 

So who’s up for some quality exercise today?  I am, after reading this!

Exercise Motivation: As Elusive As A Double Rainbow…

March 7th, 2011

I was thinking to myself as I ran this morning before D.O. it Bootcamp! that there must be a reason I was one of only four people out and exercising at 5:00am.  (Two walkers, Two Runners, 1 Dog who I’m not counting attached to the other runner.)  I remembered my mom asking me a number of months ago if I ever skip a workout.

And I realized maybe you’d be interested to read how I get myself to work out at ungodly hours or inconvenient times six days a week.

 1.       I think of a reason for now that will get me to work out now.

It may be a blood sugar reason (if I have started a temp basal and skip the workout I’ll be high), it may be a scheduling reason like today’s 4am wakeup call (don’t have time to do it later), it may be a separate motivation altogether (I think my energy level is better at bootcamp if I’ve already gotten a run in beforehand).  Whatever that reason is, I value it and use it to get me that much closer to the start line.

2.       I think of a reason for later that will get me to work out now.

The “later” here can come in many many different forms: it can be 3 months away when I run a marathon; it can be 20 years from now when I schedule an appointment for a bone scan to evaluate my bone density.  It can be an upcoming trip, an upcoming 5k event, an upcoming season and clothing options that accompany that season.  It can be a dinner out later in the week. 

There are many different future goals and times and events that I know are coming, but what I pay attention to is how much I will appreciate THEN at that point what I invest NOW in my workout.  It’s a big part of my motivation.

3.       I stop thinking and DO IT.

I can procrastinate a workout a lot better than I can procrastinate writing a blog—and that’s saying something!  I can procrastinate a workout so well that some days I opt to not set a temp basal in advance since I can’t depend on when I will actually begin my workout. 

Yet in the end the only thing that really matters is whether or not I actually did work out.  So one of the most effective techniques I’ve found to motivate myself to work out is… to… go… work… out.  Just get out there and go.

When I have what feels like a potentially stressful month coming up, I will sit for 15-30 minutes in front of a calendar and write down what workouts I will do what days.  (For marathon training this kind of planning is essential.)  This helps me later in the month when my mind is going a mile a minute to simply look at the calendar and do as it instructs. 

When I STOP THINKING and START WORKING a lot of things fall into place.


Then again, I am what some might call a Professional MotivatorMaybe your March Challenge includes me!  Think  about it:  Do you need some additional accountability to someone when it comes to your workouts?  Do you want some extra help planning what to do what days or how to get across a certain finish line?  I’d love to work with you no matter where you are if you want to face Spring and Summer with a more fit self.  Check out the Be Fit page at Diabetes Outside!

Teens With Type One: I Can’t Believe I’m Quoting Nick Jonas

March 4th, 2011

How has week one of the March Challenge been treating you?  Have you been thinking about ways to ask for help or ways to help your son or daughter living with diabetes? 

This blog is primarily directed at parents with pre-teen and teenage kids with type one diabetes.  Note that ALL parents of kids need to think about these issues because even if your son or daughter is four years old right now, these issues will be in front of you before you know it.

Diabetes Forecast featured another article on Nick Jonas this issue (March 2011).  It’s entitled “Checking in with Nick: the pop star grows up” He sounds like he’s got a good head on his shoulders at least for now.  Good job, Nick! 

They asked him whether his feelings about his type one diabetes have shifted from the time of his diagnosis at age 13 to now, when he is 18.  I like his response:

“One of the biggest changes has been that I think the mind-set of a man came on when I was diagnosed, at 13—realizing this is something I had to take on, on my own, and grab hold of.  Obviously, I had the help of my parents and doctors, but I’m an independent parson, and I really rely on myself in situations like these.  I have been independent for a while—I just am that way—but when it comes to my diabetes, in the past four to five months, I’ve been taking even more responsibility.  I’m really taking it on myself—relying on friends and family when needed, but knowing this is something that I have, that I have to deal with.

It’s just about, with my parents and my family, knowing they’re there when I need them, but also that they trust me enough to take care of it myself, which is important for me…”

If you are a parent of a teen living with type one diabetes, do you think they would say that their parents trust them to take care of some diabetes things on their own?

I’m guessing they wouldn’t say that in large part because how many teens compliment their parents voluntarily, really.  But think about it for a minute:

DO YOU TRUST YOUR SON OR DAUGHTER WITH ASPECTS OF THEIR DISEASE?  Do you trust that they will be able to ask for juice or a soda if you aren’t there?  Do you trust them to flag their own low blood sugar?  Do you trust them to count their carbs accurately?

If you don’t trust them to do any of those things, is there a reason you don’t trust them?  Is that reason itself preventing the development of that necessary trust?

I’m sure you don’t trust them with all of these issues all of the time, and that may very well be appropriate.  But you all need to work toward a balance every day as your teen transitions into a young adult.

No one benefits from a micromanaging parent who is so afraid of what “might happen” that they prevent their son or daughter from ever taking over management of their own diabetes. 

Now is the time to think about ways you can work with your son or daughter on their diabetes—just like you work with them on everything else. 

Taking out the trash, making their beds, being on time, completing homework assignments, changing sites, counting carbs, checking blood sugars before bed.  They are each responsibilities kids with diabetes need to learn, accept, and master. 

I’m here if you are looking for support with your daughter or son as they wrestle their tough teen years.  We all want them to make it out with as few scars, bumps, and bruises as possible!!