Blessed Assurance: Success Despite the Odds

by Jacquie Lewis-Kemp, Author & Health Coach for Living life with diabetes and organ transplants, rather than limiting life because of them.

Browsing Posts in Diabetes

Does any one of these situations describe you?

 

I’ve been dieting for years and can’t seem to lose weight

I’m so tired of my doctor harping on my blood pressure, cholesterol, blood sugar.

I wish I could find a routine that allows me to manage my diabetes and live a normal, active life.

 

If so, you are probably one of millions who would benefit from having your own personal health coach to help you to design a lifestyle that helps you to reach yours and your doctor’s goals.

My health coaching practice, Take Control of Your Health is a custom program that is designed to your needs and specializes in Active Diabetes Lifestyles, Living with Chronic Kidney Disease and Transplant Living. Listen in to this free sample health coaching call to determine if the accountability of health coaching is for you. 

CALL IN TODAY, OCTOBER 11, 2012 AT 7 PM TO LEARN HOW YOU CAN REACH THE HEALTH GOALS THAT ARE SO IMPORTANT FOR YOU AND YOUR FAMILY.

Email me at info@jlewiskemp.com for the details of participating on the call.

Decide which type of coaching works best for you:

Individual Coaching

            LIVE, in person, phone or web based coaching

Group Coaching

            Live, conference call or virtual chat sessions

 

(Lewis-Kemp holds undergraduate and graduate degrees from the University of Michigan and is a health coach trained by Hilton Johnson Productions, Inc.  Learn more about Jacquie at www.jlewiskemp.com and health coaching at www.healthcoachingu.com.)

 

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The final leg of our 3 Legged stool of glucose control is diet. Our diet or the food we consume is the source of the glucose our bodies use to fuel our cells. Therefore the more we focus on the ultimate purpose for the food we eat, the more efficiently our bodies can use the fuel and function best.

According to the National Institutes of Health, “It [The diabetic diet] should take into account your weight, medicines, lifestyle, and other health problems you have.

Healthy diabetic eating includes

  • Limiting foods that are high in sugar

  • Eating smaller portions, spread out over the day

  • Being careful about when and how many carbohydrates you eat

  • Eating a variety of whole-grain foods, fruits and vegetables every day

  • Eating less fat

  • Limiting your use of alcohol

  • Using less salt

With these parameters, The American Diabetes Association recommends a “meal plan” which it describes as “a guide that tells you how much and what kinds of food you can choose to eat at meals and snack times. A good meal plan should fit in with your schedule and eating habits. Some meal planning tools include the plate method, carb counting, and glycemic index. The right meal plan will help you improve your blood glucose, blood pressure, and cholesterol numbers and also help keep your weight on track. Whether you need to lose weight or stay where you are, your meal plan can help”.

The Exchange Method

Medicinenet.com gives a detailed account of the food pyramid and how to incorporate each of the food groups into a daily meal plan. It also details the serving sizes in order to comply to the appropriate calorie limits prescribed by your doctor.

http://www.medicinenet.com/diabetic_diet/page4.htm#tocf

Carb Counting

TheJoslinDiabetesCentersuggests the following steps for Carbohydrate Counting.

1.     The first step in carb counting is to have a meal plan.  A meal plan is a guide that helps you figure out how much carb, protein and fat to eat at meals and snacks each day.  If you don’t have a meal plan, meet with a registered dietitian.

2.      Step two involves learning which foods contain carbohydrate. Most people know that starchy foods, such as bread, pasta and cereal contain carbs.  But other food   groups, such as fruit, milk and desserts and sweets, have carbs, too.
There are three main ways to learn about carbs in foods:

o       Ask for a food choice list from your dietitian.

o       Learn how to read the Nutrition Facts Label

o       Purchase a food counts book that provides the number of grams of carb in various foods.

3.      Measuring tools.  In order to accurately count carbs, you’ll need to be accurate with the portion sizes of foods that you eat.  Invest in a food scale to weigh foods such as fruit and bread.  Use measuring cups to measure cereal, pasta and rice, and use liquid measuring cups for carb-containing beverages such as milk, juice and energy drinks.

The Glycemic Index

Web MD defines,  “The glycemic index is a ranking that attempts to measure the influence that each particular food has on blood sugar levels. It takes into account the type of carbohydrates in a meal and its effect on blood sugar.

Foods that are low on the glycemic index appear to have less of an impact on blood sugar levels after meals. People who eat a lot of low glycemic index foods tend to have lower total body fat levels. High glycemic index foods generally make blood sugar levels higher. People who eat a lot of high glycemic index foods often have higher levels of body fat, as measured by the body mass index (BMI).

Talk to your doctor, a registered dietitian, or a diabetes educator and ask if the glycemic index might work to help gain better control of your blood sugar levels”.

The Plating Method

Here’s a quick video from the American Diabetes Association on how the Plating Method works.

Ask your doctor to prescribe or refer you to a dietician to prescribe a meal plan or daily calorie count, and also ask which diet method is best for you.

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I am a transplant patient and so my medication list is almost as long as your arm.  My husband has a few chronic health conditions that also require that his medication be taken up to three times a day.  With all of those pills, inhalers and vitamins, our meds require a system of organization.

Chronic illness and prescription refills

Our illnesses are chronic and so are our prescriptions. Therefore 90 day refills make economic sense and a mail order pharmacy makes procedural sense.  I order our prescriptions online and they are mailed free of charge to our home.

Storage of the “bulk” meds

I have a 3 step plan for making sure that my husband and I take all of our medicines as prescribed.

The Pillcase

We each have two pill cases–one is in the kitchen stored in a bin with other occassional drugs in a 3 drawer bin. We each have another on our night stand with pm pills and water bottles. My husband carries a mid-day pillcase as well.

 

 

 

 

 

 

 

Filling the pillcases

The bin pictured to the left of the pillcase drawers contains the 30 day supplies of each medication type.

It takes some engineering to fit all the pill bottles into the drawers, but with some thought, trial and error, it works.

 

The bulk or balance of the 90 day supply of medicine

 

I keep all the extra supply that I refill the 30 day supply with in my pantry, in yet another 3 drawer bin.

 

 

 

 

 

 

 

This may seem like a complicated plan, but it keeps the medications organized and it is a method that we can visually manage. I never run out of medication because when I refill the 30 day supply with the last of the 90 day supply, I know that it is time to refill the prescription.

Tell me about your medication organization.

 

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In my health coaching practice I use a Three Leged Stool approach to diabetes management. Simply put, there are three major areas to consider to balance blood glucose levels and manage diabetes: Exercise, Diet and Medication.

This week’s emphasis is on exercise. While food raises blood sugar, and medications ultimately lower blood sugar, exercise too burns blood sugar therby removing it from the blood stram. This is the specific benefit to diabetics, however there are several benefits of exercise for everyone including the heart, lungs, brain, bones, muscles and more.

My friend Jamie Brooks, a personal trainer, and I are working on an exercise video that will offer some exercises everyone can do at home as well as teach the correct way to use equipment at the gym.

Enjoy a sneak peak . . .

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Health Coaching for Success by Jacquie Lewis-Kemp,

author of Blessed Assurance: Success Despite the Odds.

 

Preventing Diabetes Wheel

With the promise of the Affordable Healthcare Act, more people will have access to healthcare. Physicians will be in great demand especially while we train enough physicians to now care for the millions of people who will now have access to affordable health care. What a great problem to have. Just when our college graduates wondered what they would do after graduation, the healthcare industry will be booming with opportunity for several disciplines. Opportunities will exist of course for physicians particularly internists, pediatricians, and family doctors, but also nurses, nurse’s aides, clerks, accountants, actuaries, economists and other business disciplines. A new area is opening up and that is for health coaches.

Health coaches do not replace the role of the doctor or any medical professional. In fact the health coach works closely with the doctor through the client/patient to understand the lifestyle change necessary to become or continue being a compliant patient. My health coaching practice, Take Control of Your Health works with several client issues; however it is focused on preventing or controlling diabetes. I also work with dialysis and transplant patients to focus on the area that presents a challenge that the client would like to overcome.

The physician diagnoses, treats and as time allows, educates the patient, however if the patient doesn’t follow the doctor’s orders or is otherwise non compliant, then the doctor cannot treat the condition accurately. And that is where the health coach comes in. A health coach functions like most consultants: Wears your watch and tells you what time it is. And on the surface it may sound silly to pay someone to wear your watch and tell you what time it is, but as in business when the job demands are so numerous trying to put out fires, it is a good practice to have a person who can give you feedback on how the business is performing. It works the same way with a health coach. When the best intentions to make a change in your lifestyle continues to end up with few or no results, then a health coach can measure your progress and the baby steps that you take to achieve the change that you are looking for.

 

Because this is such a client driven process, there is no one formula or set prescribed time for completion. The client names the goal and it is the job of the coach to monitor or recommend baby steps that are appropriate for the success of the goal. It is the job of the coach to pace the progress, encourage and hold the client accountable.

 

 

Transplant Living Wheel

For more information on Take Control of Your Health, please contact me at Jacquie@jlewiskemp.com.

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Stephen R. Kemp, II

Stephen Kemp, II spoke to a community group at the Farwell Middle School in Detroit about the prevalence of diabetes among African Americans.  His presentation included diabetes education as well as tips for living with diabetes.

No, Stephen is not diabetic himself, however he has lived and been around diabetes all of his life.  His mother Jacquie, a Type 1 diabetic, spent an hour every Monday and Wednesday of her pregnancy in her high risk obstetrician’s office from the time she was 11 weeks pregnant until she delivered a blood sugar normal baby at 36 weeks. She also carried her insulin and a meal to work and kept necessary diabetic supplies in the car so that she could make the treck from work to Stephen’s after school soccer, football or lacrosse. Stephen learned early how to cure an insulin reaction with orange juice.His Type II maternal grandmother picked him up from school many days when his parents were at work.  She taught him the importance of snacks–and lots of snacking they did together.  It was their relationship and his understanding of her diabetes that at the tender age of 6 made him insist that his dad not drive off when his grandmother didn’t come to the door when Stephen rang the doorbell one morning.  When she didn’t answer, he ran to the location of the secret key, opened the door and disarmed the alarm.  Stephen ran to her bedroom where he found his grandmother lying on the bedroom floor.  He yelled to his father who followed behind him, to call 9-1-1.  Paramedics were able to give her instant glucose and arouse her from a bad insulin reaction.  This heroic moment was recognized not only by family, but the American Red Cross. Stephen received an An Everyday Hero medal at an awards banquet from the American Red Cross.

Stephen’s Type II paternal grandfather now depends on him to program cell phones and pick out new cars.Stephen explained to the community group the importance of glucose control and how he watches his diabetic family members do well to manage blood sugars as well as problems they’ve run into.  His presentation also included handouts from the American Diabetes Association and  included a healthy meal that followed. The group organizer asked Stephen to ask God’s blessings upon the meal.

NOW WITH LOTS OF REASONS TO BE PROUD!

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When a child is diagnosed with diabetes, the parents’ natural response is to imagine the worse scenarios–insulin shots, limitations, and long term complications. It is ok to briefly consider those possible realities as long as you the parent and coach don’t dwell in that valley. Imagine for a minute that you are coaching a youth baseball team, and you began your season with the focus, “Well, we can possibly lose all of our games this season and be plagued with injuries, making us the worst team in the league”. It probably wouldn’t encourage the team to do their best now would it? It is the same with parenting a child with diabetes.

The Reality

Life with diabetes is complicated. And the reality is that children with Type 1 and many with Type 2 diabetes have to take insulin, whether they are Pumpers or Shooters (via insulin pump or insulin injections). They also have to monitor their blood glucose and remain in touch with changes in their body.

The Outlook

A child who believes that diabetes management is not an obstacle, but a step necessary for success will flourish. One of the most important things that my parents provided for me is a positive outlook about my diabetes. In all that we did, they reinforced the fact that I could do anything that I wanted to do as long as I was willing to do the work.

The Plan

Successful diabetes management is not something that can be done haphazardly. It requires organization and consistency. Medication, diet and exercise should be planned in concert with the objective to maintain blood sugars within (or as close to) the normal range of 70-120.

 

The Tools

With any task, it is easy to adhere to the plan with the right tools in the right place. What that means for a child with diabetes is that the plan has to include where meals will come from (ie: packing a snack or lunch to eat at the prescribed time), carrying a glucose monitor to check levels throughout the day (and understanding school rules), having insulin handy and stored properly (not in a car that may be too hot or too cold and may denature the insulin. Regularly scheduled exercise and an emergency plan developed with your child and school officials.

The Benefit of Diabetes

Yes, after all of that work, there are benefits! For the novice, all of this seems like a whole lot of work—and it is. It is a mindset, and equipping a plan to manage diabetes. While it may seem like a lot, particularly for a young child, it prepares them for more of the same in life. The road to successful academic achievement is a mindset (GPA 3.5) and a well equipped plan (study between classes at the library and redo all homework prior to tests). The road to a successful career is a mindset (make partner within 5 years) and a well equipped plan (keep schedule on iPad and always be well prepared for presentations).

Said another way, diabetes can provide practice for success in life.

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Managing a chronic illness like diabetes is more an issue of behavioral change than it is a medical treatment. Sure for insulin dependent diabetics, management requires not only learning to administer the injection, but how to manipulate the doses. But the majority of diabetes management involves understanding how various foods and exercise affects blood sugar levels, and learning to orchestrate a routine that keeps a relative flat line of glucose levels within the normal range

The same is true of living on dialysis or transplant living. Other than being compliant with the doctor’s orders, most of the activity while on dialysis or maintaining a healthy transplant, involves a behavioral change.

Many times, dietary restrictions like low sodium, low fat, low glycemic, means that people need to learn to eat and cook differently. Often times this means a change not only for the person afflicted with the chronic condition, but the entire family. For instance, my husband has a condition unrelated to diabetes or transplant that requires him to eat a low sodium diet. Since I prepare about 99.99% of the meals in our house, that means that after a life of no sugar and low carbohydrate diets, I now add to our meals, low sodium! But it doesn’t work if I prepare his meals separately. In a world of processed foods with lots of added salt, eating low sodium is healthy for everyone.

Since a lot of chronic conditions are aided and best managed by lifestyle changes and establishing a routine, I’ve started a health coaching practice which works is concert with your doctor’s care plan. Once your doctor has prescribed the necessary activities, I work with the patient to develop a regimen that makes those changes fall in concert with your current life.

Perhaps the busiest and most difficult to manage time in my life was when I was a dialysis patient. I was CEO of a manufacturing company, married with a son in elementary school. My job was an hour away from my son’s school. He played soccer and went Kumon twice a week after school. Peritoneal dialysis required that I did one midday exchange and connected to a Cycler at night to perform the dialysis as I slept. My diabetes required glucose monitoring four times a day and insulin injections twice a day. Because dialysis can cause the blood pressure to fluctuate to dangerous levels, I also needed to monitor my weight daily and blood pressure several times a day.  At that time I was sodium restricted as well as on a diabetic diet, and so the best way to control sodium and sugar was to prepare meals myself. As a busy wife, mother and CEO, that was more than a notion, but necessary and therefore not impossible.

All of those requirements—medical, occupational and familial could be summarized like this:

  • Eating out had to be a rare treat

  • I needed diabetic and dialysis medication and testing supplies handy at home and at work

  • In order to cook healthy meals and eat at reasonable times, I had to have them prepped to the point of spending an hour to finalize them for dinner.

  • In order to attend my son’s sporting events and participate in the snack schedule or take him to Kumon even when I would normally work late, meant I had to have business resources at home (computer, fax, printer, binding equipment, presentation folders, etc.).

When I finally got my Ultimate Multitasking Routine in swing, this is how it ran…typically.

  • My workday began at 5:30 am in order to disconnect from my cycler, do all of my testing (weight, glucose, blood pressure), take my insulin plan and prep dinner, prepare lunches for everyone to take to school or work, prepare a light breakfast, and if necessary complete any last minute items for work.

  • Our routine was that my husband usually took my son to school and I usually picked him up from school. As they left, I dressed and left for work. My commute was about 45 minutes which allowed me time to clear voicemail and not walk into any surprises.

  • I kept a three drawer plastic storage cabinet under my desk to store a glucometer, testing supplies, dialysis fluid, blood pressure cuff and supplies, an extra pair of pantyhose and nail polish remover—for other emergencies. The key to being compliant with doctor’s orders is to make the process easy to do and have all of the necessary items available. So at midday, I was ready to test and do my midday dialysis exchange. I kept my stock of dialysis fluid replenished by loading up the car on Sunday night and bringing it into the office each Monday morning.

  • If my son had an after school activity, I would also load up the car the night before with the team snack or whatever was necessary so that I could leave work, pick him up from school and be ready with whatever supplies.

  • Because dinner had been prepped that morning, it was usually within an hour of being done, if not crock pot ready. While completing dinner, I supervised my son while doing homework and was available for questions.

  • In the evening, I completed bedtime testing, took medications, and finished any job related work and prepared for the next day.

 

While of course, things didn’t always work out this smoothly, it was my home base, and when things like illness or other family functions got in the way of this routine, I knew where to return.

I would like to help others with chronic conditions to develop the routine that works best for them to be compliant to their doctors orders and live healthy lives without making overwhelming changes to their current lifestyle.

FOR MORE INFORMATION ON HEALTH COACHING, click on the Health Coaching Tab above.

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This week I celebrate two anniversaries. The first was May 27, 2012. My husband and I celebrated 23 years of marriage. Wow, that’s a long time, especially for a 25 year old, huh? 😉 On May 30 I celebrate 10 years of living with a pancreas transplant.

I would never have imagined that I would one day not have to take an insulin shot! When I was diagnosed with diabetes at the age of 7, my grandfather told me while I was in the hospital that we would “pray it [diabetes] away”. My parents worried that I might not learn to take care of myself and instead hope for a miracle.

I had the most wonderful parents who continually made sure that I understood that I could do anything that I wanted to and be anything that I wanted to be as long as I worked hard at it. So instead of sitting by waiting for a miracle cure from God, I worked hard in school and hard at work.

Despite my hard work, my kidneys failed. My brother volunteered to save my life and donate his left kidney. My transplant team had an even more complete plan to treat my kidney disease. Their full plan of action was to perform the kidney transplant to end dialysis, and a pancreas transplant to end the cause of the kidney failure in the first place.

And so, on May 29, 2002, I took my last insulin injection. And on May 30, 2002 my new pancreas provided enough insulin to move glucose from my bloodstream to my cells, and has done so for the last 10 years.

So back to what Granddaddy said. Did he pray my diabetes away? Sure he did, not through a miraculous prong on the head, but through technology and medical science. And despite the fact that Granddaddy has been gone for 28 years, that doesn’t mean that 2002 wasn’t in God’s time.

Actually, I still consider myself diabetic. My body lived through 32 years of diabetes and I still manage some of the long term complications. I received a bronze medal for living with diabetes for 25 years from an insulin manufacturer. Do you think that they will give me the 50 year medal without having bought their product?

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Americans with Disabilities Act

Published January 23, 2012
Written by Linda Hepler, RN | Reviewed by George Krucik, MD
Reprinted from Healthline.com
Many health experts consider diabetes to be the biggest public health problem of the 21st century. Consider these sobering statistics from the National Diabetes Information Clearinghouse:
  • 18.8 million people in the United States have been diagnosed with diabetes.
  • It’s estimated that an additional 7 million people have the disease, but don’t know it.
Diabetes is the 7th leading cause of death in this country.
  • Diabetes is a major cause of heart disease and stroke and a leading cause of kidney failure, non-traumatic lower limb amputations, and new cases of blindness.
  • At any given age, a person with diabetes’ overall risk of death is twice that of those people of the same age without diabetes.
  • Why the grim statistics for a disease that can be controlled or even prevented? According to the International Diabetes Federation (IDF), an umbrella organization of over 200 national diabetes associations around the world, a major problem is lack of public attention to the early diagnosis and management of this disease—and to people’s fundamental human rights to life and health. As hard as it is to believe in a country as wealthy as the U.S., there are millions of Americans with diabetes that go undiagnosed until complications arise, lack access to affordable health care, medicines, and needed equipment, and are denied opportunities to manage their diabetes properly in schools and workplaces.
    The IDF strongly believes that those with diabetes can play an essential part in confronting this silent killer by knowing their rights, so they developed an International Charter of Rights and Responsibilities of People With Diabetes (see the document at http://www.idf.org/advocacy/charter-of-rights).
    Do you know your rights and responsibilities as a person with diabetes? In a nutshell:
    Your Diabetes Rights
    1. You have the right to care.
    Good healthcare is essential for diabetics. You deserve access to affordable and quality healthcare at all stages of your life. When receiving diabetic services, you should expect to be treated with respect and dignity and allowed to make complaints about any aspect of your healthcare without it affecting your treatment.
    2. You have the right to information and education.
    Knowledge is power! You should expect your healthcare providers to give you sufficient education about managing your disease, and information about where to access additional resources for learning. You should be allowed to be involved in planning your own healthcare and setting your health goals. You should be given the names, dosages, actions, and possible side effects of any medications your healthcare provider wants you to take. You should have access to your own medical records, as well as the right to share that information with others only as you deem necessary.
    3. You have the right to social justice.
    You have the right to be treated fairly in the workplace, at school, and in other public settings. You must be allowed time and privacy as well as a clean and safe place for blood sugar monitoring and medication administration, as well as sufficient time off for medical appointments. You should also have access to affordable medications and monitoring technologies.
    Are all of these rights legally enforceable? Many of them are. While you may have to champion your own cause when it comes to insisting upon adequate diabetic education at your doctor’s office, you can get legal help to end discrimination at school, work, and other settings where you are being treated unfairly because of your diabetes. One place to start is by talking to a legal advocate through the American Diabetes Association. By calling 1-800-DIABETES, you’ll be put in touch with someone who can help you to understand your legal rights and help you to take action.
    Responsibilities
    Along with rights come responsibilities. The IDF lays out some major responsibilities for those with diabetes. These include:
    • Being honest with your healthcare providers about all aspects of your life that may influence your diabetic care, such as your lifestyle behavior, the medications you take, and your allergies.
    • Carrying through with the agreed-upon treatment plan for your diabetes, such as blood sugar monitoring, medications, and healthy lifestyle behaviors.
    • Sharing any problems you’re having with your diabetes management with your healthcare providers so the plan can be revised.
    • Telling others in your life about your diabetes if this knowledge can help them to support you, such as those at home, in the workplace, and at school.
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