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

 

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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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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Andrea Boccelli

Did you know that Andrea Bocelli is blind? You know Bocelli, the opera singer known as the fourth tenor and disciple of Lucciano Pavaratti. I didn’t know that, and just the other day I watched the PBS fundraiser that featured Tony Bennett’s Duets II CD and Bocelli is one of the vocal collaborators. No, I’m no opera buff, but I enjoy classical music while writing and like to understand the music.

To listen to Bocelli’s classically trained voice is romantic bliss, even as my fingers type along the keyboard. It doesn’t surprise me that he is blind however, for there have been several other great singers and musicians who are blind—Stevie Wonder, Diane Shuur, Ray Charles, Jose Feliciano just to name a few. It’s just that when a person perfects their craft, you imagine that they used all of their resources to achieve it. How does one understand beauty without sight?

Therein lies the complexity of perfection. Perhaps it is not the quantity of resources or specific resources that reach perfection, but the desire to reach perfection.

I don’t believe it ends with music and blindness. Chronic illness does lots of things to us—makes us tired, susceptible to other illnesses and infection which create another list of problems in addition to the ones we already deal with on a daily basis. It can appear to be a downward spiral if we don’t keep that saying in mind, “When one door closes, another opens”. Bocelli can’t read music and so he overcompensates by listening. In other words, because kidney failure or a heart condition forces you to change direction, it doesn’t mean that you cannot perfect another craft; maybe even something that you really wanted, rather than what you’ve been doing.

So how do you make that transition from the closed to the open door? Here are some suggestions

  1. 1.     Recall what some of the things you’ve always wanted to do are, but somehow never got around to them. Perhaps school took you in a different direction—accounting instead of guitar; maybe the man (or woman) of your dreams came along and instead of pursuing your dream, you were pursued; maybe starting a family got in the way of the perfect career. Think back to what got you up without an alarm clock.

 

  1. 2.     What do you enjoy doing most? Optimally we are already living the dream! Maybe you have already made a career of what you love most. And if you have, great, figure out how to do it in harmony with the medical deficits that you may now have. But if you weren’t living the dream, really reach back and imagine what makes you most happy.

 

  1. 3.     What do you need this new venture to do? Is it a hobby or a job? If you are already independently wealthy, perhaps you don’t need to make what you love earn a living. And even in that case, a hobby that you love and can perfect is important to self worth. We all need a project, or something that adds to our value. But if you are one of the 99% of us, and need that project to also earn a living, then you need a plan for that to happen.

 

 

  1. 4.     How can you make money doing it? Explore all the ways people earn a living doing what you love to do. Imagine yourself doing it and what you would need in the way of support, materials, time and routine.

 

  1. 5.     Finally, say it out loud so that others will hold you accountable, practice and perfect it!

 

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Perhaps one of the most difficult aspects of chronic kidney disease is the diet.  After you get past figuring out how you will schedule dialysis and what you need to do in order to have energy and strength, you find that diet plays a large role in making that happen.

Salt Restriction

It is common knowledge that too much salt isn’t good for you. However for dialysis patients high, sodium foods impact a dialysis patient immediately. Already plagued with water retention, something as simple as a slice of pizza or a bag of potato chips can cause dialysis patients severe ankle swelling or swelling in the abdomen causing shortness of breath.
Excess sodium also causes blood pressure to rise and cause headaches, mental dullness and a loss of energy. At its worse, hypertension (high blood pressure) can incite cardiac complications.

Phosphorus Restrictions

Who ever thought that potatoes would be something restricted on a diet? But they are a very special case when it comes to kidney disease. The kidneys filter waste from the blood and it is expelled through the urine. When your kidneys don’t function properly, one of the chemicals that don’t get filtered is phosphorus. Doctors prescribe phosphorus binders which make it so that phosphorus can be cleared in the stool rather than urine. However, the best option is to limit consumption of high phosphorus foods like nuts, organ meats, chocolate, cola drinks and beer.

Potassium Restrictions

An orange on the restricted list? For the same reason that phosphorus builds up in the blood stream for dialysis patients, potassium also builds up in the blood stream. Excess potassium can cause problems such as weakness, muscle cramps, tiredness, irregular heartbeat and, worst of all, heart attack. Potassium is found mostly in fruits, vegetables and dairy products. Certain fruits and vegetables are very high in potassium while others are lower. However, eating a large amount of a low-potassium food can cause potassium to add up to dangerous levels. Be aware that most foods contain some potassium — meat, poultry, bread, pasta — so it can add up. Butter, margarine and oils are the only foods that are potassium free.
Refer to the charts below from DaVita Dialysis, as simple reminders of which foods should be restricted and some suggested alternatives.

High potassium

High phosphorus

Double jeopardy —High potassium and high phosphorus

Fruits

Meat

Milk

Vegetables

Poultry

Dairy products

Fish and seafood

Nuts and seeds

Wild game

Chocolate

Eggs

Whole grain products

Dried beans and peas

Check the list below to see if you are eating any of the double jeopardy foods on the left. Using some of the alternatives listed on the right will help improve your chances of keeping potassium and phosphorus under control.

Double Jeopardy Foods (High Potassium & High Phosphorus)

Alternatives

Cheese

Vegan rella cheese, low-fat cottage cheese, sprinkle of parmesan cheese (use very small amounts of extra sharp cheeses for the maximum flavor)

Chocolate

Desserts made with lemon or apple, white cake, rice-crispy treats

Cream Soup

Broth-based soups made with pureed vegetables or make soups with Mocha Mix® nondairy creamer or Rich’s Coffee Rich®

Dried beans and peas

Green beans, wax beans

Ice Cream

Mocha Mix® frozen dessert, sorbet, sherbet, popsicles

Milk

Mocha Mix® nondairy creamer, Coffeemate®, Rich’s Coffee Rich®, Rice Dream® original, unenriched rice beverage

Nuts

Low-salt snack foods including pretzels,tortilla chips, popcorn, crackers, Sun Chips®

Peanut butter

Low-fat cream cheese, jam or fruit spread

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African Americans are disproportionately affected by diabetes and hypertension which make up more than 2/3 of all cases of kidney failure. Understand these risks and take charge of your lifestyle to prevent kidney disease.

Further, share what you’ve learned with family, friends, your neighborhood and your congegation.

 

 

 

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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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Kidney Transplant

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