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Diabetes & Emotions, General, Management & Care

We All Hate the Word “Compliance” – 483

Compliance
noun  |  com·pli·ance  |
:  the act or process of doing what you have been asked or ordered to do
:  conformity in fulfilling official requirements
:  a disposition to yield to others

Keyword being ordered. Really? You gave me an order? Do doctors give us orders or recommendations? I prefer recommendations. Maybe I’m a rebel, maybe I question authority more than I should, maybe I’m adult and I only follow orders from my boss—and sometimes from my Mother. Who knows… but the word compliance has been thrown at me so many times by my primary care doctor, and it only adds to another fancy word we love in the diabetes world: guilt. I don’t like the word compliance when it comes to my diabetes; the doctor tells me I’m not compliant and I feel like I’m going through disciplinary action.

But why do we hate the word compliance so much? A few guesses for me…

  • Managing diabetes involves so much more than following a bunch of instructions from your doctor. Of course they know what you’re supposed to do, they went to school for that crap! I respect my doctor, and her knowledge, but when she talks to me like I’m a robot… that is not cool. I’m not a kid, stop telling me I didn’t do my homework correctly.
  • If you deal with not only one, but two or three (or more!) chronic conditions that require day to day tasks, it can get pretty overwhelming. Sometimes you forget your medication, sometimes your life is so hectic you don’t prioritize too well, sometimes you just want to say eff it. Or at least that’s what happens to me. Is it good? Nope, but hey… sh*t happens.
  • Depression, especially the clinical one, makes you not care… not one single bit. You’re down in the dumps and taking care of yourself is at the bottom of your priority list. You feel like you’re going to die anyway, so why bother. So asking about mental health should be the first thing any doctor should do with a patient that requires a constant regime for any kind of condition.
  • It’s not that we don’t want to do the right thing. DIABETES JUST SUCKS! So the doctor telling me I’m not compliant leaves out the fact that 1) I’m a human being, not a machine; 2) I’m not perfect; 3) I’m freaking tired of poking myself; 4) I just want to feel normal without all the hocus-pocus.

So no, it’s not only about following orders, or fulfilling requirements. The emotional component of diabetes makes it way more complicated than that. And like my good friend Bennet would say, your diabetes may vary. A set of rules and regulations for conformity, which I associate with the word compliance, is not what we need. We won’t conform… it’s not that easy. I want my doctor to work with me on a plan that works for me. I want my doctor to ask me how she can help me achieve my goals, not hers.

Because I don’t want to be compliant… I want to be successful!

Homme tenant son masques faciaux — Photo

Diabetes & Emotions

Good Grief – 107

Although I am generally pretty bad at maintaining and “positive attitude” on things like living a healthier lifestyle, I also work pretty hard at not allowing myself to feel much in the way of self-pity. I’m beginning to wonder if that’s been a mistake.Homme tenant son masques faciaux — Photo

Of course it’s not healthy to spend much time feeling sorry for oneself. But perhaps in trying not to do that, I’ve failed to allow myself a healthy degree of grieving over my body’s broken metabolism and other issues. Perhaps occasional episodes of sadness or anger about this disease are necessary as part of a healthy attitude.

I’ve only begun playing with this idea. (My business card should read “Overthinking Things Since the 1970s!”) It may well be that I will change my mind on it. But I do believe it’s worth considering.

Faites-le maintenant — Photo

Diabetes & Emotions

Then and Now – 110

This month marks my 8th diaversary.  Wow, 8 years ago I got that fateful phone call from my doctor that dramatically changed my life.  Then: the change felt awful, impossible, unfair and overwhelming.  Now: I feel much better.  Yes, I still feel all of those earlier emotions from time to time, but I don’t spend my days feeling as if I drew the short straw.Faites-le maintenant — Photo

I began my personal blog about my life with diabetes 2 1/2 years ago and, when I read over the early blog posts, I realize how much has changed in my life since the beginning of my journey.  Sometimes I say “What was I thinking?” because the early Kate with diabetes did some silly stuff that I don’t do now (like thinking that sugar free candy was my savior!  Give me a break, I was desperate).  Now I’m able to eat a moderately low carb diet when back then it seemed like I would never be able to adjust my diet successfully.  Now I manage to fit regular exercise into my days (well, ok, most of the time, not always) but back then I groaned and whined and railed against the need to exercise.

If I could give one bit of advice; one bit of wisdom I’ve gained over the years living with diabetes, it would be that you can change.  It may seem impossible now but if you take things one step at a time and focus on the big picture, you will get there.  I don’t claim to have the answers and I certainly have my days when I need someone’s shoulder, but I am content with my life, despite my diabetes.  It’s along for the ride, but it’s not steering the ship.

Cheers!

Carrière dans le travail — Photo

Diabetes & Emotions

Motivation and Effort – 130

Life is full of ideas that most of us just accept without examining them or even being aware of them. Here’s one:Carrière dans le travail — Photo

“You can do anything if you want to badly enough.”

This idea is what leads some doctors to try to instill fear in their patients. The approach would even seem to have some merit, because some people do respond to a disease diagnosis or serious warning by making significant and lasting changes.

Before we look at whether this idea is really true, let’s flip it around:

“If you can’t do something, it’s because you don’t want to badly enough.”

Here is where our idea starts to become dangerous. I’ve spent a lot of time over the years either feeling guilty that I wasn’t sufficiently motivated to lose weight, trying to psychoanalyze myself to figure out why I wasn’t sufficiently motivated, or trying to artificially pump myself up to a higher level of motivation. None of this has helped in the least.

It seems to me to be useful to break our idea into two ideas:

“Greater motivation produces greater effort.”

and

“Greater effort produces better results.”

Both of these statements are suspect, but let’s concentrate on the first one. Does greater motivation lead to greater effort?

There are at least two things that can get in the way of motivation producing effort. The first is when we either do not know what action we could take to move us forward, or we don’t believe that the possible actions we know about would be effective. The other is that though strong desire can spur us to action, it can also paralyze us.

People differ in how they respond to crises. I myself too often responds to a crisis with both mind and body seeming to shut down. Even in a situation that is not a crisis, strong feelings about something that I want to do seem to strangle clear and creative thinking. I have to find a way to view the situation more coolly before I can make progress. This is part of why I think it is dangerous to try to use fear to motivate others.

I once read a friend’s concern for a relative that had been recently diagnosed with type 2 diabetes. This relative was not testing his blood, was not making needed changes in his diet, and was not doing the exercise which would have benefited him. It may indeed have been, as my friend assumed, that the relative did not understand his situation and was therefore unmotivated. But, it may also have been that he did understand his situation but was frightened past the point where he could take effective action.

If there are changes that we want to make in your self-care that we can’t seem to pull off, it may not be that we don’t want to change badly enough but that there are other barriers we need to find our way around.

Roller coaster — Photo

Diabetes & Emotions

Roller Coaster Ride – 157

Roller coaster — Photo

When you go to an amusement park, many people want to ride the roller coaster. The anticipation. The excitement. The fear. It’s thrilling! Most people who ride roller coasters enjoy what observers would call sheer terror, at least from their facial expressions. The unknown at the top of the hill. Not knowing if it is a turn or a drop. The ups and downs of a roller coaster and the speed are what make it exciting.  At the end, many want to take that ride again.

It’s not the same with the diabetes roller coaster. The ups and downs are terrifying, but not in a thrill ride sort of way. The uncertainty of complications. The anticipation of how food and activity works to benefit or harm of glucose levels. This fear is not exciting. The unknown of when the ride will once again be on steady ground. Faces showing terror that doesn’t end with someone begging to take that ride again.

Many times guilt comes along for the ride. If only I hadn’t eaten that. If only I took a walk today. If only I could keep on top of things. Anger joins in. Yelling. Sometimes cursing. Bitterness toward a disease. Sadness also sits in the next car. Tears. Possible depression. Fear tags along. Hoping to keep complication away.

Yes, diabetes is a roller coaster ride. Not only dealing with glucose levels going up and down, but also the mixture of emotions that go along with it. It may not be a fun ride, but it can be a little less scary with the support of family and friends.

Diabetes & Emotions, Management & Care

Denial isn’t a river in Egypt – 310

 

“A slave that acknowledges its enslavement is halfway to its liberation.” –Mokokoma Mokhonoana

As I sit to relax after eating a healthy lunch (green peppers stuffed with a mix of brown rice, chicken and veggies) I’m thinking why don’t I eat like this more often. In fact, I’m here thinking what happened in the past few months to make me completely derail from everything a person with type 2 diabetes should do in order to be healthy.

2013 has been hectic. For almost a year I was working two jobs so I could afford health insurance (see the irony?). My schedule was so crappy, I ate whatever was available, which means there were a lot of late night shifts that ended at the BK drive-thru. Decent sleep hours became a joke, so don’t ask me about exercise. My routine got completely screwed up, and I won’t get the award for taking my medications on time. Now my jeans feel tighter, you do the math. I feel tired which means my thyroid is angry. So it hasn’t been a good year for my diabetes management.

About a month ago my life changed for the better when I was offered a wonderful position at the college where I work. Now I have a regular week day, first shift, full time job. That certainly gives me time to plan things and take care of myself, but it’s taking me a while to get back on track.

The first thing I did was reassess my health and realize I haven’t seen my doctor since the beginning of May. My last A1C dates from March. I don’t remember when was the last time I tested my blood glucose levels because I ran out of strips, and the doctor will want to see me. But for a month I’ve been afraid to call and make that appointment… I am almost 100% sure my numbers will make her eyes cross.

Because taking my metformin has been rather an irregular thing, now that I’m taking it every day, as many times as required, my stomach is all messed up and I find myself cursing the diabetes demons. And while trying to decide how to soothe my poor stomach, I was thinking if I need a medication change, if it would be better to manage my blood glucose levels with insulin or if there will soon be a magic cure. Truth is, all I need to do is get out of denial and do what has always worked for me.

This is the story of my life. The story of the life of a person with type 2 diabetes. Especially one who doesn’t live on insulin. It’s homework every single day. Every decision affects our numbers. And the guilt paralyzes us.

I made my appointment with the doctor this morning. I know it won’t be pretty, but I ran out of excuses.

Diabetes & Emotions, General, Management & Care

Don’t be a victim – 463

The word “victim” never entered my vocabulary when it came to my life with diabetes. Why would it? Sure, it isn’t great luck that I developed type 2 but, other than genetics, no one “gave” it to me, so how am I a victim? Well, yesterday the light bulb finally went on over my head. You see, yet again, there was an uproar in the diabetes online community revolving around a “joke” that inferred that soda causes diabetes; that sugar causes diabetes. Immediately, the type 1 community was up in arms defending their disease, including a high profile singer who has type 1. I don’t blame them at all! The “joke” was insulting, wrong and does nothing but perpetuate harmful myths about diabetes. The perpetrator of this kerfuffle was quick to point out that they weren’t referring to type 1, only type 2. That just made it worse. Due to the high profile singer, the story was picked up by several news channels and magazines. When the difference between types was discussed, video of overweight Americans were shown to indicate type 2. <sarcasm> You see, apparently, only fat, lazy people develop type 2. They are the ones who are guzzling soda and should stop. </sarcasm>

I can’t tell you how tired I am of trying to stop the hurtful, always inaccurate myths surrounding type 2 diabetes. It’s like canoeing upstream without a paddle. It feels like David against Goliath without a stone. It’s akin to removing a snow drift with a spoon. It’s nearly impossible. I’m not here to bust any myths. I’m not here to correct the inaccuracies. I’m here to tell you that you need to stop being a victim.

The stigma that is attached to type 2 diabetes is doing huge amounts of harm in our community. We are made to feel as if we did this to ourselves (we didn’t). We are told that we just need a little self-control, to stop eating junk, and we’ll be cured (bunk). Those types of mainstream thoughts not only keep people from making donations to diabetes research funds but it makes those of us with this disease feel awful; feel less-than; feel guilty. People who feel that way may be less likely to take proper care of themselves. Why bother? It’s my fault, right?

Stigma is bullying. Cowards who hide behind their computer screens and sling ugly comments to people who are struggling with a disease that they didn’t ask for, are bullies. No better than the mean kids on the playground. They must be stopped. As a mother, I’ve had some experience with bullies picking on my son. I found that when they were confronted, they backed down. Calling them out worked, although there was quite a bit of fear on my son’s part, I’m sure. He learned a valuable lesson though: don’t be a victim.

My plea to you is this: Don’t be a victim. Don’t give the bullies power over you. Do what you can to show the world that, even though you have diabetes, it doesn’t have you. Don’t let the naysayers keep you from doing what you need to do to live a healthy life. We may have a hard time busting those myths but that doesn’t mean we have to stop trying. What we can do, and should, is defend ourselves and not hide. No one should have to apologize because they have a serious condition. Everyone deserves kindness and compassion when they are dealing with diabetes of any type. Speak up and speak loudly about what living with type 2 diabetes is really like. Arm yourself with a few myth-busting truths you can pull out and use when someone tries to bully you or any PWDT2. Don’t be ashamed. Don’t let them win. I don’t know about you but I refuse to be a victim.

Dessin et planifiée de rénovation d’une salle de bain — Photo

General

Not As Planned – 136

In life, there are plenty of things that don’t go as planned. Last week I had plans with two people. One forgot and didn’t show. The other had a sick kid and had to cancel. It wasn’t anyone’s fault, really, but it changed my plans. It was out of my control. There was nothing I could do about it.

Things didn’t go as planned.

I could have gotten upset, but I knew there was no point. Letting myself have a moment of disappointment helped me to move on. I was able to quickly come up with a new plan for the morning.

However sometimes it’s not as easy to recover from a change of plans. There isn’t always a pleasant alternative.

I knew there was a high probability that I would become Type 2 at sometime in my life. My grandfather was Type 2. My mom is Type 2. I had gestational diabetes for all five of my pregnancies. The odds were not in my favor. Heredity was not in my favor. I was expecting to develop Type 2 some time in my 60s.

Things didn’t go as planned.

I was diagnosed two weeks before my 38th birthday. That’s not what I had planned. I have to admit the diagnosis wasn’t a surprise though. After all, I was the one who requested the blood work. Something told me to ask.

After getting the diagnosis, I had a plan. I was going to test my blood sugar four times a day every day. I was going to exercise every day. I was going to eat low carb every day. Of course I also knew I was going to let myself have occasional treats like ice cream or Snickers bars, but only when my numbers agreed.Dessin et planifiée de rénovation d’une salle de bain — Photo

Things didn’t go as planned.

I don’t always test my blood sugar. No every day. Not even every week. I still eat french fries every now and then. I don’t always check my glucose levels before having a Snickers. I’m not the perfect diabetic that I planned to be.

There. I admitted it. I’m not perfect. That’s not so bad, is it? Then why am I tearing up as I write this? Why can’t I remember to test as often as I should? Why is it so hard to exercise every day? And why are those treats so tempting? Why is it that I get so upset with myself when I don’t do it “right”?

Things didn’t go as planned.

I may feel out of control, but there is something I can do about it. Maybe today I’ll start by testing my blood sugar once each day. Ideally it would be fasting, but for now I’ll just try for once per day. Baby steps. Just one step at a time.

Journal de la santé — Photo

Eating & Cooking

Food diaries and honesty – 397

People with diabetes are constantly aware of food, that’s a given. We need to pay attention to what we’re eating, how many carbs, when we’re eating and longing for foods we crave but probably shouldn’t eat. I have kept food journals in the past to get a grip on how different foods affect my blood sugar. I find them to be helpful. I was somewhat careful to write down what was in a particular meal (along with before and after glucose readings) but I never spent time writing down everything I ate in a day. A recent attempt to pinpoint another health issue, separate from my diabetes, was not only eye-opening but a bit uncomfortable.

Journal de la santé — PhotoI’ve been having “gut issues” for months now. I got to thinking about the possibility of lactose intolerance since I have family members who deal with that. Pretty much the only dairy I eat these days is cheese and a bit of cream in my coffee  but I figured it was worth a try. A food diary seemed like a good idea because, who knows, it might be something else I’m eating that’s causing me grief. If I just kept track of everything I ate for a week maybe my doctor could look at that and say, “Well there’s the culprit!” So I began. I lasted two days.

Have you ever really paid attention to everything you eat? Regardless of the fact that I think about food all the time, I never realized just how much I was eating. It was embarrassing. When you have to stop and write down what you’re eating, it puts a huge spotlight on that snack you’ve decided to eat. Knowing that I had to “own up” to eating something, I would either change my mind and eat something “safer” or else eat it anyway and then feel guilty. I even considered not writing something down just so no one else would see what I’d done! Talk about feeling like Big Brother is watching. It was awful.

I’m writing this to bring up the point that, even though we may have made dramatic changes to what we eat on a daily basis, even though we may be committed to a healthier lifestyle, even though we “know better”, it can be so easy to derail our good intentions with mindless munching. This is not to say that we can’t have a treat now and then, but it would be in our best interest to make it a planned treat and curtail the munching for munching’s sake. My short experiment in food journaling may not have been the success I was hoping for but it did cause me to pay closer attention to what I’m eating. I’m much more aware now and have been making better choices. What could you do to improve your diet?

Exercise & Lifestyle, General

You’re Fat and it’s Your Fault! – 507

Got your attention, didn’t I? Before anyone gets all tied up in knots ready to behead me for my apparent rudeness and lack of sympathy, I don’t agree with what the title says. This was just my attempt at click-bait because I feel that this subject needs to be addressed from another point of view.

The website Upworthy recently posted a link to an article that talks about a study that was done at the University of Pennsylvania funded, in most part, by the National Institute on Aging. This study looked at the idea of “fining” fat people if they didn’t exercise. Wow. Apparently the study was trying to look for ways to motivate people to become healthier and thinner. But here’s the thing: weight isn’t the best indicator of health. There are many overweight individuals who are otherwise healthy and many thin people who are horribly ill. The idea that we can tell someone’s health by just looking at them is ludicrous and yet that is what most people will do, including many doctors.

While this subject isn’t specific to those of us with type 2 diabetes, it is certainly closely related. We all know of the stigma that is attached to our disease and it is continually perpetuated in the media and medical communities. The fact that this study was even done is very telling. You want to fine fat people for failing to exercise? Really?

Now let’s look at this from another perspective. Lack of added exercise is a HUGE problem in our society (and that pun was not intended. Lack of exercise is a problem for everyone, not just the overweight). Our hectic lives, jobs that require us to sit for hours a day, cities that are designed for cars and not people, the Internet and exhaustion have all made it easier to just not exercise. But we should exercise, in fact I’ll go further and say that we must exercise! Really! I’ve posted on my personal blog before about how exercise has benefitted me. I also know how difficult it is to keep it up when life gets in the way. I’m not here to say that it’s easy but it is worth doing.

Here’s what gets under my skin about this study and what it implies. Quit pointing at fat people and saying that they’re a problem! (I should have used caps.) People who are overweight are vilified as being lazy and saying that we should fine them for not exercising is indicating that they’re stupid and need to be tricked into walking like some toddler who won’t pick up their toys. YES, overweight people should exercise. YES, it will benefit their lives. NO, they’re not the only ones who should be moving. I’m not implying that overweight people should be coddled and patted on the head while telling them that it’s not their fault. Maybe it is and maybe it isn’t. Exercise is hard. Exercise is even harder when you’re heavy. Should we condemn people who are struggling with this? I don’t think so. Another very important thing to consider is that there are many medical reasons that people are overweight; insulin resistance has been shown to encourage fat storage, thyroid issues, medications can cause weight gain and the realization that processed carbs are addicting is rarely discussed in the mainstream.

So, what should we as a nation do to fix this issue? How about figuring out a way to re-teach our society about the importance of eating real food as opposed to processed junk? How about subsidizing vegetable farmers (other than the corn growers) in order to decrease the cost of vegetables? Community cooking classes and vegetable gardens sound awesome. Why can’t communities put some bucks into making it easier to walk instead of drive? What about having employers put programs in place that encourage their employees to exercise while at work, you know like a room with a few treadmills like you see at hotels or a mandatory 20 minute stretch or walk break with extra kudos for taking the stairs? People don’t need to be bullied or shamed in order to improve their lives, that doesn’t work! People need to be shown what a healthy life looks like and be given the opportunities and information to make it possible for them to achieve that health. Yes, overweight people should be exercising and so should everyone else. The reward will be healthier individuals who are happier with their lives. That is worth much more than a few pennies in their pocket and it can be done without shaming. Quit pointing at the overweight as the problem and begin solving the real problems facing all of us: lack of real opportunities to improve everyone’s health. Let’s find ways to encourage each other instead of blaming and shaming. I can get behind that.