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.

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By: Lauren Eveler Glover, RDN, LD

How many people have a New Year’s resolution to lose weight, eat healthier, and exercise more? A lot. How many people will actually stick to it past January 31st? Not many. The truth is habits are hard to break. If you think about it, however, this is actually a good thing! While it may be hard to break your unhealthy habits at first, once you form those new healthy habits, then those will become hard to break. So, you’re more likely to stick to it. Keep these tips in mind to develop better habits, and you won’t need to set a resolution again. Here’s to a healthy, happy 2016!

N – Never trust fad diets.

They don’t work. While they may deliver short-term results, they usually don’t last forever.  Why? Fad diets are simply unrealistic. They make you exclude entire food groups, include unnecessary supplements, or even worse, starve. If you can’t eat that way for the rest of your life, don’t trust it.

E – Exercise a little every day.

How often do you exercise right now? If your answer is “never,” then you have a great area for opportunity! Even if it’s just a 10 minute walk every evening, or choosing to take the stairs instead of the elevator, every little bit helps.

W – Watch out for phonies.

There is so much nutrition information out there it’s hard to determine what’s fact and what’s fiction. Who can you trust? Have no fear, Registered Dietitians are here! When it comes to a healthy diet, kidneys can be complicated. It’s best to meet with a Registered Dietitian Nutritionist (RDN) to discuss which options are best for you.

Y – You don’t need to focus on weight.

Weight is just a number on a scale that’s affected by many factors. Rather, measure your waistline. Anything greater than 40 inches for men, and 35 inches for women increases your risk for disease.

E – Eat more often.

Instead of eating two or three large meals a day, try eating four or five smaller meals spaced evenly throughout the day. This will help keep your appetite under control since you’re eating more frequently.

A – Avoid junk food.

Your body doesn’t need it. Eating too much processed food is proven to have negative consequences on our health. They are high in calories and low in nutrients, which is an awful combination.

R – Rest.

Plain and simple, your body needs sleep to recoup and reset for the next day. Aim for 7 to 9 hours per night. Adequate rest, along with a healthy diet and exercise, are the secrets to good health.

Remember, make it a habit and you’ll stick to it.

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Donald JonesAn article recently published in Annals of Internal Medicine has many people wondering what role fats, including saturated fat, should play in their daily diet. In a nutshell, researchers did not find any relationship between total saturated fat intake and heart disease risk. This seems to contradict everything we have read for the last 40 years! So is it time to break out the pizza and ice cream?! To get to the bottom of this, let’s take a look at the different types of fats and dietary sources:

  1. Monounsaturated fats (MUFAs) can be beneficial to your health, when eaten in moderation. They can help reduce bad cholesterol levels in your blood and lower your risk of heart disease and stroke. Examples include olive oil, canola oil, peanut oil, sunflower oil and sesame oil. Other sources are avocados, peanut butter and many nuts and seeds.

  2. Polyunsaturated fats (PUFAs) can help improve cholesterol levels and lower your risk of heart disease. Omega-6 and omega-3 (types of PUFAs) are essential fats your body needs but can’t produce, so they must be consumed through foods you eat. Sources of PUFAs include soybean oil, corn oil and safflower oil, some nuts and seeds, as well as fatty fish like salmon, mackerel, herring and trout.

  3. Saturated fats are generally thought to increase your cholesterol and Low Density Lipoprotein (LDL) levels and this can increase your risk of cardiac disease. Saturated fats are found mostly in animal products like fatty meats and full fat dairy. According to the Harvard School of Public Health “pizza and cheese are the biggest food sources of saturated fat in the U.S. diet.”

  4. Trans fats sometimes occur naturally in foods, but are mostly made from oils through a process called partial hydrogenation. Trans fats can increase your LDL (“bad”) cholesterol levels and lower your HDL (“healthy”) levels, thus increasing your risk for cardiac disease. Trans fats are often found in commercially baked goods such as cakes and cookies. Other sources are fried foods, shortenings and margarine. You can determine the amount of trans fats in packaged food by looking at the nutrition label.

We’ve read about the heart, but what about diabetes? According to Mayo Clinic consuming MUFAs may “benefit insulin levels and blood sugar control.” They also state PUFAs may “also help decrease the risk of type 2 diabetes.”

The bottom line is fat is an important and necessary part of your diet but should be limited. At 9 calories per gram, it provides nearly double the amount of calories per gram of protein or carbohydrates. In general, consuming an excessive number of calories from any dietary source will result in weight gain, and excessive weight increases risk for heart disease and diabetes. Heart disease is a risk factor for kidney disease and kidney disease is a risk factor for heart disease because the heart and kidneys are interconnected.

Before you pick up the phone to order pizza for dinner, talk to your health care provider to find out what kind of diet, including what type of fats, will work best for you!

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Although the hottest of weather, heat warnings and advisories seems to have moved past the metro Detroit area, people with diabetes
and organ transplants should continue to exercise extreme caution.

The effect that the heat can have on diabetes is complex

  • Sweating, which burns calories and therefore lowers blood sugar, can lead to hypoglycemic  episodes (low blood sugar). Heat can also make hyperglycemic episodes more difficult to identify.

  • Dehydration due to excess heat can cause hyperglycemia (high blood sugar).  Since dehydration occurs when there is low fluid level in the blood stream, there is a high concentration of glucose, causing hyperglycemia.

  • Medication, such as insulin, and supplies can be damaged by excess heat and manufacturer’s recommendations regarding storing medication and supplies must be followed.

Recommendations for people with diabetes:

 

  • Drink plenty of fluids

  • Keep water convenient and close by to make hydration a thoughtless effort.

  • Test blood glucose more often than prescribed, particularly if you don’t feel normal. Since the heat’s impact on blood sugar

    control can be varied (heat can make it go both up or down) it is best to know exactly what the blood sugar level is, rather than guess.

  • Keep diabetes medication and supplies cool without subjecting them to freezing temperatures.

Kidney Transplant Patients must also exercise caution in the heat

 

  • Excessive sweating—not even dehydration–can cause creatinine levels (a measure of kidney function) to increase. High creatine levels can potentially lead to kidney transplant rejection, or worsening of chronic kidney disease.

 

Kidney Transplant Patients should:

 

  • Drink more than the 2 liters of doctor prescribed fluid each day.

  • Again, this should be done by always having water, decaffeinated and non alcoholic, beverages handy to sip on all day.

  • Remember, both caffeine and alcohol dehydrate.

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 Des Moines Iowa’s Mercy Hospital performed an historic chain of kidney transplants. Beginning with an altruistic donor (someone who wants to donate life because they are healthy and able), patients with willing and able donors who do not match find complete strangers to donate kidneys to until all the would be donors have donated to someone, and those with kidney disease have received kidney transplants. This new vehicle of kidney transplantation will save many more lives as it puts together donors and recipients when they might have never connected. Here is KCCI tv in Des Moines, Iowa’s accunt:

For the first time ever in Iowa, doctors performed five kidney transplant operations with living donors in three days. What makes it so special is how complete strangers gave of themselves to save five lives.

 

It all started with this one man who had the desire to save one life. Tyler Weig, 30, was so thankful for his own health that he wanted to give the gift of health to a complete stranger. “Going through operation to remove my kidney to give it someone who needs it more than I do,” said Weig. “Right now it’s starting to hit me, what it means, how special it is.”

 

On Monday, Weig went into surgery to have his kidney removed, to be transplanted into a patient who needed it to survive. While Dr. Cass Franklin removed his kidney, another patient waited to receive it.

The Mercy staff put the healthy organ into an ice bath to prepare it. A short time later, Doctors began the long, complicated transplant surgery on 42-year-old Lance Beyer of Pella.

Beyer had kidney disease for 25 years. After a successful surgery, two days later, the two met for the first time. “So you’re the donor? Appreciate it…thanks a lot…it’s working real good,” Beyer told Weig.

But how do you thank someone for the gift of life? Beyer said he couldn’t put it into words.

“I see his family, what he’ll be able to do now makes me happy,” said Weig.

 

Weig’s desire to save one person set off a chain reaction, a domino effect, that lead to another kidney transplant that same day. Jay Lindahl, of Boone, was wheeled in to receive another kidney. His donor was the wife of the first recipient, Lance Beyer. “You can give your kidney to someone. Someone will help my husband in that way. It’s a no-brainer,” said Julie Beyer.

 

Her kidney wasn’t a match for her husband, so she paid it forward to help a stranger instead.

After that pair of operations Monday, two more kidney transplants were performed Tuesday. On Wednesday, even one more.

 

None of the recipients knew his donor, but four donors were friends or family of another patient in the chain who they wanted to help, but didn’t match. Mercy will hold a news conference Friday morning to introduce the other six patients and donors.

 

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THE NEW INTRODUCTION TO EXERCISE VIDEO FEATURING JAMIE BROOKS IS NOW AVAILABLE FOR PURCHASE!

 

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It’s not often that I get involved with my husband’s work. My husband is a funeral director and I have lost both of my parents. Empathizing with families who have lost loved ones, brings a familiar heaviness onto my heart–one that takes a long time to remove, and so I try not to become too involved in my husband’s work.

 

But when he has the honor to work with a family of a person who has donated the gift of life, as a two time organ recipient and member of a donor family myself, I can’t help but feel kinship. Whether or not I know anyone affected by the donated organs, I feel compelled to thank the family . . .  unofficially . . . on behalf of the lives that have been saved and enhanced . . .as a part of my unofficial transplant recipient family.

 

If you know anyone with an organ transplant, you notice a special glimmer in our eyes when we speak to one another.  We all have a special kinship. Not just those of us with kidney transplants, but livers, hearts, lungs, pancreases. We don’t discriminate among transplant recipients–even bone, blood, skin or tissue recipients are cousins of sorts.

 

As 2012 comes to a close, my husband received such an honor. I couldn’t help empathizing with the donor family and how courageous they were in giving the gift of life or carrying out the wishes of the donor to give the gift of life.  I also imagined the other story of the amazing gifts of life that were given to make 2013 a very special New Year.

 

Please share your gift of life story, whether as a donor family or organ or tissue recipient.

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Jacquie Lewis-Kemp

Because I have been affected by both diabetes and chronic kidney disease, it has become my mission to help others by providing information and tips on how best to live with these conditions. Recognizing that all people who suffer from diabetes aren’t necessarily affected by kidney disease, and that not all people affected by chronic kidney disease developed it as a result of diabetes, I have separated the blog subjects into two separate blogs.

Over the coming weeks and by the first week in January, this website will be used primarily to buy books and other information products related to Diabetes Management and Chronic Kidney Disease and Transplant Living.  I will have two separate blog sites, one for Diabetes related matters and another for CKD, organ donation and transplant.

If you have subscribed to www.jlewiskemp.com, initially you will be subscribed to both blog sites, however feel free to only subscribe to the blog site you are interested in if it is only one of the subjects.

Look for my new blogs Diabetes Success and CKD Success.

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I will be hosting a health coaching demonstration targeted specifically for people with Chronic Kidney Disease (whether approaching kidney failuire, on dialysis, waiting for a kidney transplant or post transplant living) on Tuesday, November 6, 2012 at 3 pm,

I will also be hosting a virtual demonstration of health coaching for people with diabetes on Thursday, November 8, 2012 at 7pm.

Transplant Living Wheel

You can participate in an Introduction to Health Coaching on Friday, November 16, 2012 at 3pm by registering at https://www1.gotomeeting.com/register/160972280

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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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