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 healthy living

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I’m thankful for being able to celebrate this Thanksgiving with my 92-year old grandmother. A few weeks ago, her house caught fire while she was getting ready for bed. When she first smelled smoke, she checked her kitchen to make sure there was nothing burning on the stove. Satisfied that there wasn’t, she returned to bed.

She woke up again smelling smoke and when she entered her dinning room, it was full of smoke. She managed to escape out of her back door where she flagged down a car passing her house. The Good Samaritan helped her into his car, called 911 and my cousin to come to get her. The fire was an electrical fire that demolished the basement and smoke damaged the remaining items in her house.

While this fire damaged lots of wonderful memories of Thanksgivings past around Granny’s dining room table, the bottom line is that God spared her life, our cherished memories are not “things” in that house, but experiences burned onto our consciousness.

As you can imagine, at 92 my grandmother has attended lots of loved one’s funerals. As I look at the calendar, I realize that November 20, 2012 marks the 29th anniversary of her husband’s (my grandfather’s) death. I remember having a very somber Thanksgiving in 1983 anticipating his funeral the day after. So losing her house, the home she vowed never to leave despite its size because it was the home that Granddaddy provided, is particularly devastating as I know she is mindful of the anniversary of his death. We will wrap our arms around her and take a new step much like the one she took in 1983.

Granny and I share that this fire proves that even at the ripe age of 92, God still has something that he needs for her to do here on earth.    

 

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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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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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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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Bernando LaPallo

Hard to argue health best practices with a man 109 years old! Sounds like something you just listen and learn from. Enjoy this recipe, visit his website and consider his book.

 

 

 

 

 

 

 

 

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Join walkers from all over the state of Michigan to support the National Kidney Foundation in its quest to advocate for patients in all stages of chronic kidney disease.

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