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 tagged diabetes management

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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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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    Blessed Assurance: Success Despite the Odds

    CALENDAR OF EVENTS
    04/14/12 Writer’s Expo, The Upper Room, Detroit, MI
    04/21/12 Signing Books, God’s World 2-4 PM                 Seven Mile and Schafer in Detroit, MI
    04/28/12 Walking with Jackie’s Crew to cure MS              at Covington School, Bloomfield Hills, MI
    05/01/12 Advocating diabetes and kidney education programs at the American Diabetes Association and National Kidney Foundation’s        Diabetes & Kidney Day in Lansing, MI
    05/12/12 Signing books at Antioch Baptist Church  in Pontiac, MI
    8/4-8/12 Signing books at the Bass Mollett booth at the   National Funeral Directors & Morticians Association convention in Las Vegas, NV
    09/29/12 University of Michigan Transplant Center’s    Vita Redita Gala & Charity Auction  at THE BIG HOUSE! in Ann Arbor, MI
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    Chronic diseases or conditions like diabetes, multiple sclerosis, hypoglycemia, asthma, kidney disease, hypertension, heart disease and transplant living all require a regimen that requires strict adherence. Not following these regimens or staying within the guidelines can cause serious problems, long term complications or even sudden death. Almost all of these conditions require a special diet or dietary restrictions.  Some of them can be controlled with diet alone. Others also require medicines and test procedures.

    This can seem overwhelming for someone first diagnosed with a chronic illness, and it can continue if the patient doesn’t develop a regimen to accommodate the medicine schedule, the dietary restrictions and timing, and exercise requirements. The restrictions that a chronic condition requires can feel overwhelmingly restrictive, but consider the alternative. If a diabetic doesn’t develop a regimen to consistently take medication, follow a low glycemic diet with the prescribed carbohydrate restrictions and exercise as suggested, then blood sugars can dip too low and cause a severe hypoglycemic reaction resulting in loss of consciousness or even death. Other chronic conditions can result in similar serious conditions as well as sudden death.  This is why a regimen to prevent these severe reactions is important.

    How do you manage diabetes? How do you eat an elephant? One bite at a time!

    In other words, you break down what needs to happen and put it up against your usual daily schedule.

    1. 1. List the things that must be done for proper management of your condition. In the case of diabetes, you would list your dietary requirements and restrictions, your medicine doses and times, your test and exercise requirements/suggestions.

    2. 2. List your normal daily activities and job travel and/or timing requirements. For instance if you work 8am until 5pm, and you travel 10%  of the time, typically Tuesday through Friday.

    3. 3. Now blend the lists by figuring out what the breakfast requirements translate into as far as a meal; what you will eat for lunch (whether purchased at a restaurant or packed in a  brown bag lunch) and how you will complete dinner requirements. When you will test and if you will gets some midday exercise walking outside or to lunch.

    4. 4. You should also write down when you will test during these hours and at home.

    5. 5. Finally look over the list of requirements and make sure that you determine what supplies you need to make this regimen work. For instance, if carrying blood testing supplies and the machine is not convenient, then you might want to consider keeping an  extra set at work in a locker or in your desk. If that means keeping medicine at work as well, make sure to consider the storage requirements of the medication. For instance, insulin doesn’t need to be refrigerated; however it shouldn’t be kept in direct sunlight either.

    6. 6. Schedule time for exercise so that it is not an afterthought that is not done regularly.

    The key is to make sure that what your condition requires, you make available and convenient so that it is easy to be compliant to your doctor’s orders.

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    Soul Food has been the blame for Type 2 diabetes and uncontrolled Type 1 diabetes for years.  One of the reasons that it has not been quickly eliminated from the diet of African Americans is because of the social role these foods have played throughout history.  Much like the movie “Soul Food”, the Sunday Diner and family contribution to its preparation is what has historically kept families together.  Therefore for the sake of the African American family, we must find a way to uphold this ritual and at the same time reverse the effects it has on diabetes and heart disease.

    Many of the foods are in fact healthy and nutrient filled at the start.  It is often the preparation styles that rid the foods of their cancer fighting and sometimes blood pressure lowering nutrients.  Adding excess salt and fat also cause some dishes to be unhealthy. With a few slight changes, soul food can become not just good to you, but good for you.

    Low-Sodium Selections

    Traditional soul food is high in sodium or salt. Replace
    table salt with sea salt. This type of salt has a strong flavor, and you won’t
    need to use too much of it to get the flavor you desire. Select foods that say
    “reduced” or “low-sodium” on the labels. Include dried or fresh herbs and spices
    in your favorite soul food recipes to add flavor without adding
    salt.

     

    Low-Fat Diet Options

    Traditional soul foods can be high in unhealthy fat,
    such as saturated and trans fat. Soulfoodandsoutherncooking.com suggests
    replacing traditional soul food ham hock with smoked turkey and using turkey
    bacon instead of pork bacon. Breading and frying meat and poultry are typical
    soul food preparations. Select a lean cut of beef or skinless chicken breast,
    which are low in saturated fat. Coat the protein with flour, egg wash and
    crushed-up corn-flake cereal. You can add your favorite seasonings such as sea
    salt or dried herbs. Spray a cookie sheet with a nonstick spray and bake the
    meat until done. This cooking method cuts out the fat from battering and
    frying.

    Balanced Carbohydrate and Veggie Options

    Soul foods include starchy vegetables such as corn,
    potatoes and peas. You can still enjoy these foods while having diabetes, but
    you need to balance them with some nonstarchy vegetables. Enjoy steamed green
    leafy vegetables alongside your starchy veggies. Prepare collard greens, spinach
    or kale in a hot saute pan with a splash of red wine vinegar. Drizzle the cooked
    greens with heart-healthy olive oil, and sprinkle with sea salt to finish.
    Black-eyed peas are a staple of soul food. Pair these simple carbohydrates with
    complex carbohydrates such as brown or wild rice. Simple carbs break down
    quickly and may cause a spike in your blood sugar. Pairing them with complex
    carbs may help to stabilize your blood sugar since foods with complex carbs take
    longer to break down.

    Replacements in Baked Goods

    When baking biscuits or cornbread, replace fatty
    buttermilk with a reduced-fat milk. Whipped cream is a delicious addition to
    homemade apple pie. Replace half the heavy whipping cream with reduced-fat milk
    to shave some fat. Use 1 percent or skim milk in recipes that traditionally call
    for whole milk.

    Different Fats and Oils

    Fill your diet with heart-healthy fats, such as
    monounsaturated, polyunsaturated and omega fatty acids. Use healthy oils such as
    olive, vegetable and corn oil in your cooking. Replace butter with margarine.
    Include some nuts that are high in monounsaturated fats, such as almonds,
    cashews and walnuts.

    Read more: http://www.livestrong.com/article/328360-soul-food-diet-for-diabetics/#ixzz1lf3mTmIx

     

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    THE GOOD NEWS

    Jill Scott recently opened up about her weight-loss secrets saying her diverse exercise  routine, which includes boxing and biking has made the journey worthwhile. “We  have fun!” she told Us Weekly referring to her workouts with her trainer.

    Keeping things fun has helped Jill shed the weight –and keep it off — for two years now. She says that taking charge of her health became a priority  when she became a mom. “There’s a world of discovery in [my  son’s] eyes, and I want to be around to enjoy it!” GO GIRL!

    Jill Scott has Type 2 diabetes and shows off her curves and new found energy in this video, “So In Love With You” with Anthony Hamilton.

     

     

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    “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.” Martin Luther King Jr. in a speech to the Medical Committee for Human Rights, 1966

    Today we observe the birthday of slain Civil Rights champion the Rev. Dr. Martin Luther King Jr. It is natural that many measure the impact of what Dr. King brought to citizens of the United States and the world by comparing conditions during the Civil Rights movement with conditions today.

    I think many will agree that landmark legislation like the Civil Rights Act of 1964 and the Voting Rights Act of 1965 were stellar outcomes from the movement focusing America on equal treatment and mandating that certain unalienable rights be protected–not just for some, but for everyone.

    However when we take a look at what Dr. King had to say about healthcare in the 1960s and compare our country’s statistics today, some fifty years later, have we improved? Are those unalienable rights to life, liberty and the pursuit of happiness protected?

    Al Sharpton said “It’s an atrocity that in a country as powerful as the United States, people are falling ill, losing their homes and going bankrupt all because of a corrupt system that only benefits insurance conglomerates and those in their pockets. Why is it that the U.S. life expectancy today still lags behind 30 other nations? Why does a hard-working factory worker in the Midwest have to choose which finger to amputate because he could not control his diabetes in time? Why does a teenager in California have to die because her insurance company gave her the run around when she was seeking treatment for her aggressive cancer? And why are so many forced to travel to Mexico, Canada and England to get cheaper medicine and better treatment for their ailments?”

    The 2010 Report on Healthcare Disparities reports four themes from that emphasize the need to accelerate progress if the nation is to achieve higher quality and more equitable health care in the near future.

    1. 1. Health care quality and access are suboptimal, especially for minority and low-income groups.
    2. 2. Quality is improving; access and disparities are not improving.
    3. 3. Urgent attention is warranted to ensure improvements in quality and progress on reducing disparities with respect to certain services, geographic areas, and populations, including:

    • o Cancer screening and management of diabetes.
    • o States in the central part of the country.
    • o Residents of inner-city and rural areas.
    • o Disparities in preventive services and access to care.

    Progress is uneven with respect to eight national priority areas:

    • o Two are improving in quality: (1) Palliative and End-of-Life Care and (2) Patient and Family Engagement.
    • o Three are lagging: (3) Population Health, (4) Safety, and (5) Access.
    • o Three require more data to assess: (6) Care Coordination, (7) Overuse, and (8) Health System Infrastructure.
    • o All eight priority areas showed disparities related to race, ethnicity, and socioeconomic status.

    Disparities in quality of care are common:

    • o Blacks and American Indians and Alaska Natives received worse care than Whites for about 40% of core measures.
    • o Asians received worse care than Whites for about 20% of core measures.
    • o Hispanics received worse care than non-Hispanic Whites for about 60% of core measures.
    • o Poor people received worse care than high-income people for about 80% of core measures.

    This is a bleak report of circumstances and can be overwhelming unless we begin to peel these issues back one layer at a time and begin to make progress so that in the next fifty years we are not in this same position as a country.

    The way I see the major causes of the healthcare disparities, they can be described as 1) Genetic causes or predisposition to illnesses, 2) Environmental causes of disease, 3) Education to prevent or maintain illness, and 4) Access to good healthcare. My ideas to close these disparities include the following:

    Genetic causes or predisposition to certain illnesses

    Closing the gap on genetic predisposition to certain illnesses is something that research scientists will have to explore and not something that we can change other to be informed about healthy practices and possible prevention. What will be paramount to obtaining the proper research of these diseases is to train scientists, researchers and policy officials with an inherent desire to repair these inequities. An example of a disease with genetic predisposition is African Americans and Sickle Cell Anemia.

    Environmental causes of disease

    Environmental causes of disease include many cases of Type 2 Diabetes and complications of diabetes, certain types of heart disease and hypertension. Let’s deal with this section in two major categories: diabetes and heart disease.

    Type 2 diabetes, unlike Type 1, is usually caused by a significant gain in weight such that the body cannot produce enough insulin or what is called insulin resistance, whereby the insulin cannot be used efficiently by the body. If the causes of this type of diabetes are not diagnosed and treated in short order, it is likely that the patient will need to supplement or provide insulin to the body via insulin injections. Likewise, if the patient is able to lose weight and eat properly, in many cases the diabetes condition can be reversed.

    In this case, the environment (with a lack of diabetes education, jobs/income to choose healthy foods, and access to healthcare), works to the detriment of ethnic minorities (because of the disparity in unemployment rate) and particularly the poor.

    Heart disease and hypertension are other diseases that exist in large part because of poor food choices, a lack of exercise and education as well as conditions that often go untreated. Stress is another factor that worsens this disease and can exists under conditions of deciding whether to purchase medication or food; strained family relationships or stressful work environments.

    It would seem that if our healthcare system spent more dollars on education and prevention, perhaps it would need fewer dollars to treat illness and disease. No one wants to develop diabetes or heart disease. And so it follows that if people knew how they could prevent certain diseases or manage them if they have already developed them, they would begin to transform their environment to include a healthy regimen. This is at least worth a study, in my opinion.

    Education and Access to Quality Healthcare

    Education in terms of providing understanding of the causes and treatments of the diseases found disproportionately in poor and minority communities is something that should be given increased budgetary consideration at health insurance companies and federal and state governments. It is my belief that if people are given understanding about the diseases that occur disproportionately in their community, they will do what is conceivably possible to avoid them. If they are able to avoid the diseases, and it is verified through access to physicians who verify this, then the dollars spent up front on education and prevention replace and reduce the dollars spent on treating diseases.

    For example, if a person diagnosed with Type 2 diabetes is able to control her glucose in large part because she lost weight through a better diet and exercise routine of walking her dog, think of all the money saved (by the insurance company, governments, and the individual) from not treating Diabetic Ketoacidosis, or Neuropathy or Kidney Disease? Think of all the tax dollar revenue governments could collect through her income tax because she was able to continue working.

    Not only does education and prevention help reduce healthcare disparities, but it makes good fiscal sense.

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    On our parents' balcony before Jacquie's wedding

    I can hardly believe that it has been 11 years.  Eleven years since my little brother donated his left kidney to me so that I might live.  In eleven years you would think that I would be pretty used to saying that, but it still brings the same tears to my eyes just writing it.

    You know Jeff has never known a big sister without diabetes–taking a shot is what she did everyday, a couple times a day.  But slowing down because of illness is not what he was used to either and I think that is why he stepped up to become the big brother (despite our ages) and save my life.

    I had lunch with my husband, mother and brother Jeff to tell them that the doctor recommended that I begin dialysis.  Because I was running my dad’s business at the time, Jeff asked, “What will you do?” I told him I wasn’t sure, perhaps I’d have to find a job.  Jeff piped up with a proclamation that no one expected nor could we proove would be possible.  Jeff said that he would give me a kidney.

    We knew that we were the same blood type, but tissue type is another hurdle.  Nevertheless, my hero, my little brother was willing to undergo serious, complicated surgery to save his sister’s life.  And his wife supported his decision.

    While all this is serious stuff–we had a ball making light of the process.   From doctors testing us to qualify us for transplant “from the rooter to the tooter”, to Jeff’s journey in the hospital from his room across the hall, to my room with foly catheter in tow and having to remind the newbie nurse that neither he nor the lead in the catheter were as long as the distance between them, so she should slow down.

    I will forever be grateful to my little brother.

    God bless and keep you Jeff. Much love,

    Jac

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    Diabetes is a patient managed disease. While doctors measure blood glucose and average glucose levels over 3 months (HbA1C), they are measuring in order to give you, the diabetic patient, feedback on whether your efforts are working to control your diabetes. Doctors also check for long term complications and whether other treatment is necessary to avoid the long term complication or to treat them. Beyond those activities, doctors really cannot control diabetes–only you can.

    Let me say it again, DOCTORS CANNOT MANAGE YOUR DIABETES!  Your actions and your commitment to managing this complicated disease will in large part determine your health. The best endocrinologists, internists, specialists and educators cannot control your diabetes, only you can.

    But don’t get me wrong, physicians are absolutely key in your diabetes management system. Your best source of how well you’ve been managing your diabetes is likely from your physician. While that information is about past performance, your doctor should recommend ways to improve your glucose control, whether it is diet changes, exercise changes or medication changes.

    Another source of good coaching is from diabetes educators who perhaps have more time to teach strategy and technique for glucose control. Education is always key whether you are talking about diabetes or technology–understanding leads to better ability to control.

    Having said that, take it upon yourself to map out a way to control your glucose levels as you navigate the sticky road through the holidays. Plan how you will handle company parties, charity functions, family gatherings, and full days of non-stop shopping. Overeating is not the only complication of the season. Forgetting to eat, or not having access to a healthy meal is another. And that is why planning is key.

    Also, don’t forget to get some exercise. Unless we’re winter sports fans, it is easy to become sedentary and work behind a computer all day and watch television all night. Plan some exercise, even if it is walking from the back of the mall parking lot, doing laps at the mall or marching up and down a flight stairs in your home or at work 7 times!

    Burn those carbohydrates by dancing!

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