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Life is busy! When there are competing demands on my time, here four strategies I use to prioritize exercise:

Identify the Optimal Workout Time

Right now 6:15 AM is my time. Early morning works for me because (for the most part) the rest of my life doesn’t get in the way. If something does interfere, I can often manage to squeeze in a little exercise later in the day (multiple short walks, evening run, etc.). Another huge motivator - I can dial back the insulin for a couple hours afterward.

Leverage Technology

With so many tech tools designed explicitly to support the pursuit of a healthy lifestyle, why not give some a try? Here’s what I’m using right now:

  • Garmin Connect logo Connect App Garmin Vívofit  – A birthday gift from my family.
  •  5K Runner App Logo 5kRunner App – With this $3 investment I got in shape for my first 5k.
  •  audible logo Audible.com – I got a Groupon for a 3-month trial and liked the service so much, I extended my membership. The trick? I don’t let myself listen to a book unless I’m out for a run.
  • Podcasts – Sometimes I change it up and listen to podcasts while I run. Current favorites include: The Moth, This American Life, New Yorker Fiction.
Recruit Friends and Family

I don't know about you, but I don't get to see enough of the people I care about. So here’s what I did:

  • I got a pedometer for my husband and challenged him to a steps competition. While I know the 10,000 steps are arbitrary, they still serve as a useful milestone. In fact, it was those 10,000 steps that inspired me to start running - because I didn’t have time to walk them all 10,000 of them.)
  • I invited friends to walk and/or run with me. It’s good for us all, right?
  • I invited a few other friends to go to Zumba with me. Just $5 a class at our local rec center. Great music, great company.
  • I signed up for a neighborhood 5k. Did I mention that I am was not a runner? (See what I did there? Now I am a runner.)
  • I invited my 11-year old to run with me on the weekends. (We take turns playing favorite songs for each other. I love learning what she’s into!)
  • I realized that my neighbor and I have memberships at the same gym. Now we go to the gym together.
Vary the Activities

Admittedly, I like routines, and I have to work at introducing variety. Here's what I'm doing now:

  • Cardio and weight lifting (2x/week)
  • Yoga (1x/week)
  • Running (2x/week)
  • Fast-walking (1x/week) or Hiking

How about you? How do you stay committed to exercise?Logo for 7th Annual Diabetes Blog Week

This post is part of Diabetes Blog Week.
The Prompt: Diabetes tips and diabetes tricks.
For more perspectives on this topic, click here.

My Healthcare Wishlist (I can dream, right?)

The current healthcare system feels like a ginormous heap of missed opportunity, so it's not hard to imagine ways to improve it, for example:

The Doctor-Patient Relationship

This is how it works at my endocrinologist's office: I get 15 mins a year with the endocrinologist. The other three visits per year I see the Certified Diabetes Educator. That seems to be the protocol at a lot of endocrinology offices.

In my improved reality, I'd get to see my endocrinologist quarterly. We'd have at least 30 minutes together, so we'd have real discussions. My doctor would come to know me as a person. She would understand my health goals and help develop strategies to maintain and improve my health. Also, any appointments or labs would be based the needs of the patients and doctors, rather those of pharmaceutical and insurance industries.

The Wellness Center (formerly the “Medical Center”)

Illness plays far too big a role in today's healthcare system! Most of us interact with it only when we're already sick or hoping to prevent sickness.

How about framing our system differently?  So that instead of "Medical Centers" (emphasis on medical intervention) we have “Wellness Centers” (like this one), reflecting an emphasis on health rather than on medicine. The Wellness Center could house not only a primary care doctor, nutritionist, and Certified Diabetes Educator, but also a massage therapist, gym, and cafe serving healthful food. As a bonus, the Wellness Center could be near my home so I could walk or bike to it.

Integrated Technology

Right now I rely on data from a meter, a pump, a fitness tracker, and a handful of iPhone apps and none of them talk to each other.

If I must have all these devices, could they at least communicate seamlessly with each other? And let's have all their data consolidated in a single, easy-to-use Electronic Health Record (EHR) that includes real-time data from doctors and labs. Let's make the data accessible via a smart phone, website, or wearable device. And I'd like to own it and be in charge of it, please.

Insurance Companies

Yeah, just kidding. Insurance companies don't exist in this dream.

7th Annual Diabetes Blog Week

This post is part of Diabetes Blog Week.
Today's Prompt:
How would you improve or change your healthcare experience? 

For more perspectives on this topic, click here.

Call me picky, but language matters to me. I believe words and grammar shape how we understand and experience the world (hello, Sapir-Whorf hypothesis and linguistic determinism!). Which is why the word “diabetic,” can really rub me the wrong way in certain contexts.

"Diabetic" (Adj.) + Thing (Noun)

Sometimes the word "diabetic" describes a thing. Diabetic neuropathy, diabetic glucometer, diabetic low. No problem.

"Diabetic" (Adj.) + Person (Noun)

Other times people use the word "diabetic" to describe a person. The diabetic patient, my diabetic uncle, their diabetic colleague. That's when you may see me clearing my throat and shifting uneasily in my seat. The condition is starting to eclipse the person.

"Diabetic" (Noun)

Now, when people use "diabetic" as a full-on noun - as in the diabetic who lives down the street - oooof! It's fingers on a chalkboard to me. Not only is it reductive – the disease is defining the person - but there's a suggestion of permanence that I find wholly dispiriting. I suppose I still maintain some hope that “a person who has diabetes” may some day be rid of it.

This post is part of Diabetes Blog Week.
The Prompt:
Many advocate for the importance of using non-stigmatizing, inclusive and non-judgmental language when speaking about or to people with diabetes. Some don't care, others care passionately. Where do you stand?

For more perspectives on this topic, click here.

I was diagnosed with diabetes the summer before my sophomore year of high school. The initial treatment plan? “Take 2.5 mg of Glyburide daily and restrict sugar intake.” Because it was 1987 and glucometers weren’t available yet for home use, the doctor sent me home with Tes-Tape® and instructions to test my urine once a week or “whenever I felt like my blood sugar might be running high.”

For those who don't know, Tes-Tape® was just litmus paper. You’d tear an inch-long strip off the roll, pee on it, observe the change in color, then compare the color to swatches on the back of the container. The darker the the paper, the greater the urine glucose concentration. As a refresher: for kidneys to spill glucose, serum glucose level has exceed 180mg/DL, high enough to be causing damage. And by the time it shows up in urine, it's likely been that way for several hours. So, any color at all on the test strip indicated some degree of bad news (with no strategy for correction).

Tes-Tape
Image courtesy of perlebioscience.com

I dutifully carried the Tes-Tape® to school every day at school, zipped in an interior pocket of my backpack. But here's the thing: peeing on a narrow, inch-long strip of paper is messy! So, no, I didn't test my urine in my high-school bathroom stall. In fact, I never, ever, would have used it at school. None of my friends had diabetes. None of my friends' friends had diabetes. No teenager I had ever heard of had diabetes.  And, like many teenagers, I just wanted to be like everyone else.

Over Spring break that year I visited my friend in upstate New York. At some point during the trip, her aunt asked me, “I understand you recently found out you have diabetes. How is that going for you?” I replied that it was OK, but admitted that it was a drag not to be able to eat everything my friends ate.

She listened, and then offered a fresh perspective: Had I ever considered how movie stars ate? She went on to describe that movie stars - who lived lives of luxury and ate as they pleased - elected to limit their sugar intake. Movie stars knew sugar was bad for them. It was bad for their bodies, bad for their complexions, and it contributed to premature aging.

I had not considered this, and it got my attention. Sure, she was appealing - very effectively - to my teenage vanity. But I also understood in that moment that I could create a positive framework for diabetes. Instead of feeling deprived of sugar, I could choose to bypass it in favor of something better. Say, ripe, seasonal fruit.

I remember this conversation often when I reach for a luscious July peach instead of a sugary doughnut. "What would Jennifer Anniston do?" I think to myself.

This post is part of Diabetes Blog Week.
The Prompt:
How does diabetes affect you or your loved one mentally or emotionally?  Any tips, positive phrases, mantras, or ideas to share on getting out of a diabetes funk?

To read more posts on this topic, click here.

SaveSave

Hooray for Diabetes Blog Week! It’s as good an excuse as any for me to resume blogging (ahem), and a great opportunity to discover other diabetes bloggers. (Follow these links to see who else is participating and join in the fun! You can also follow along on Facebook or on Twitter with the hashtag #DBlogWeek.)

Today’s Prompt: Why are you here, in the diabetes blog space? 

In early 2004 I was pregnant with my first child. I had recently switched to insulin therapy since the pills I had been on for years were not FDA-approved for pregnancy. So, I was learning to count carbohydrates, manage multiple daily insulin injections, and minimize the effect of fluctuating hormones on blood sugar. I was excited about the eventual baby, but felt acutely overwhelmed and isolated by diabetes. I pined for someone who understood what I was experiencing.

I searched online and found a diabetes message forum run by the Joslin Diabetes Center. I drafted a short post describing my situation and asked if anyone could relate. When I logged on later that day I found FIVE friendly, supportive responses. One that I found especially encouraging was signed "Type 1 Mom of two grown sons, 20 & 23."

Years later I came across Kerri Morrone Sparling's highly relatable blog Six Until Me, and was again inspired by (wait for it...) a person with diabetes talking about what it's like to have diabetes. When I had trouble finding blogs specific to MODY (my form of diabetes), I realized I should start a blog of my own and contribute something to the conversations!

***

To learn why other people blog about diabetes, click here.

 

OscarBanner

Have you heard about Oscar? Oscar is a “start-up” health insurer that launched in 2013 and serves consumers in New York and New Jersey. The company aspires to leverage technology, data and design to improve customers' engagement and experience with health care. I like these goals, so when Oscar invited me to write post to help spread awareness about diabetes, I was happy to oblige. Oscar’s campaign is designed to highlight how people live unique lives through common approaches to diabetes.

What type am I? I'm a walker…

I have had diabetes for over 25 years. I’m an active person - I jog, swim, life weights, practice yoga and Pilates, play volleyball, etc. But hands-down, what works best for me for staying healthy is walking. Among the known benefits for people with diabetes, walking:

  • Lowers blood glucose levels
  • Improves the body's ability to use insulin
  • Lowers stress levels
  • Raises “good” (HDL) cholesterol levels while lowering “bad” (LDL) levels
  • Reduces risk of heart disease and stroke

I aim to walk 12,000 steps a day (roughly 6 miles). Finding time for those 12,000 steps takes some planning. Here’s what works for me:

  • Instead of catching up with friends at a coffee shop, we get our coffees to go and walk around a park.
  • Whenever possible, I schedule “walking meetings” during the workday. (Not a good option for meetings with lots of note taking, but this format works great for strategy and big-picture planning meetings.)
  • I do a lot of walking errands. Since I happen to live close to a grocery store (6,500 steps) and a library (5,000 steps), these errands contribute significantly to my daily goal.
  • I opt for the stairs instead of the elevator.
  • When really pressed for time, I jog some of my steps. (The efficiency of jogging is hard to beat.)

The best news? The benefits of walking are good for everyone - not just people with diabetes. So, it’s pretty easy to recruit others to join in the fun!

Since yesterday would have been Edward Lear's birthday, how about a limerick?

The guest – we’ll call her Amalia –
Stood chatting amongst the regalia.
On hearing it squeal
She dared not reveal
The pump in between her mammalia.

Diabetes Blog Week 2014

This post was written for Diabetes Blog Week.
The prompt
(suggested by Tu Diabetes): Write a poem, rhyme, ballad, haiku, or any other form of poetry about diabetes.

I ran my first 5k yesterday.

I've never been much of a runner. So I downloaded a running app and started training the next day. I registered for a local race (Denver’s Adelante! 5k). Then I recruited a few pals to run with me once a week. The other days I ran on my own. In time, I began to look forward to the trainings as a way to spend time with people I don’t see often enough or to just zone out and listen to music.

With 7 weeks of training under my belt, I was feeling reasonably prepared on the day of the race. I ate an apple, drank some water, and stashed a juice box in my jacket pocket, just in case. My family came with me to cheer me on (it being Mothers’ Day, what choice had they?). I ran most of the way. And since I wasn’t running for any particular time, I was happy to complete the course in 36:12.

The numbers I care more about are the ones on my meter. And I was less happy with those yesterday. Given that I’d been testing and adjusting for weeks to determine a sensible strategy for the run, I was vexed by my body's response. Here’s what the day looked like in diabetes terms:

7:15 Test: 89mg/DL
8:15 Test: 81mg/DL
Eat apple (skip bolus) Preventively, to avoid mid-race low.
8:45 Decrease basal rate by 20% Again, preventively.
9:00 Run (mostly) for 36 min.
9:55 Test: 176mg/DL Woah…
Check site (it’s fine).
Bolus 2.5 units Hope that’s not too aggressive.
Hydrate.
10:10 Test: 172mg/DL Really?
Ponder test strip inaccuracy.
Verify recent changes to pump settings.
Second-guess skipping the apple bolus.
Second-guess the 20% basal decrease.
10:20 Test: 164mg/DL Still?
Bolus 1 more unit.
Head home.
Change site.
Spot a few air bubbles in line. Maybe?
Open new vial of insulin. It’s time anyway.
Continue to bolus against a stubborn high for most of the day. Sheesh.

It’s difficult to convey how damn squirrely diabetes is to people who don’t live with it every day. The best-laid plans often deliver uncertain results. It can be super frustrating. And yet, diabetes didn’t spoil yesterday; my first 5k was rewarding and fun.

Diabetes Blog Week 2014

This post was written for Diabetes Blog Week.
The prompt
(suggested by Kim of Texting my Pancreas): Change the World.  

By all accounts, participatory medicine is a growing movement. And The Pew Internet and American Life Project, which studies such trends, reports that people with chronic conditions (e.g., diabetes) are more likely than our peers to consume and share health information. The Diabetes Online Community (DOC) doesn’t replace my professional care, but I increasingly rely on its vast network of diabetes patient-experts for general support and practical advice.

I&D marks its first anniversary this January. Looking back on a year of blogging, it's clear to me that being part of the DOC has engaged me in new ways. I participated in Diabetes Blog Week, World Diabetes Postcard Exchange, and the Big Blue Test. I learned practical tips from fellow bloggers (e.g., the best sticky tape for securing a port; how to keep insulin cool in hot weather). I found new blogs to read like Karmel Allison's Where Is My Robot Pancreas and Kim Vlasnik's Texting My Pancreas.

Even when the DOC doesn’t have the answers, it’s reassuring just knowing that others are asking the same questions.

We don't usually exchange Christmas presents, but I got you one anyway - this clip from a favorite episode of The West Wing (No. 32, Noel.) Enjoy!

Pasta doesn’t do my blood sugar any favors, so I don’t eat a lot of it. At roughly 55g of carbohydrate per serving, I’d rather eat this:

bagelor a generous slice of this:

chez_panisse_pizza

But the rest of my family loves pasta, so I was happy when a friend turned me onto Dreamfields pasta. dreamfieldsIt tastes exactly like regular boxed pasta, but contains only 5g of “digestible carbohydrates.” It's a pretty amazing feeling to eat a bowl of pasta, dose for only 5-10g of carbs, do a post-meal BS check and find that I am perfectly in range.

There is one important caveat: over-cooking, re-heating, or letting Dreamfields pasta sit in cooking liquid/sauce breaks it down and raises the digestible carbs. So, on the rare occasions I make a pre-sauced pasta dish, I use “regular” pasta. To offset the ginormous carb hit, I also flip the typical pasta-to-vegetable ratio so the bowl is filled mostly with vegetables and accented with pasta.

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