Category: My Story

Guest Post, My Story

My Story: Nothing Holding Me Back

Posted on by mghdiabeteseducation

By Anne-Maria

I’ve had Type 1 Diabetes for 49 years – next April will be my 50th diaversary.  When I was diagnosed in the 60’s/70’s, there wasn’t as much information about diabetes out there as there is now.  But still, having diabetes never held me back from anything I wanted to do.  I still travel, and I stayed out late in my 20’s and 30’s like any other young person would.  I strongly believe that diabetes is just a part of life.  The key is to accept it and make it part of your routine.

There are professional hockey players who have diabetes.  Gary Hall, Jr. has Type 1 Diabetes and he swam the 50-meter freestyle at the Olympics.  They didn’t let diabetes stop them; they made it work.  Put your sight on what you want to do and figure out how to do it (I just don’t know if they can send you into space yet).  People are happy to work with you if you talk to them about your needs.  When I was still in school, we went on ski trip to the Alps.  At the time, they didn’t have refrigerators in the hotel rooms so I stored my insulin in the one in the kitchen.  I got to know the kitchen staff pretty well and they were happy to accommodate me.  Nobody has ever said “no” when asked to help.

The only time my health factored into any of my life choices was when I decided not to become a physician.  Sleep is very important for me and I knew I wouldn’t be able to function with the little bit of sleep med students get.  But again, it was my choice based on what I needed to take care of my own health.  I know my body inside and out, so I know when something isn’t right and how to adapt.  When I have late meetings, I’ve learned to check my blood sugar and drink some juice before it starts so I don’t go low.

My biggest piece of advice for parents or anyone who has been diagnosed with Type 1 diabetes is:  take a deep breath and relax.  If you were diagnosed as an adult, know there’s nothing abnormal about what you have.  You can maintain your regular routine without much extra effort.  The only time I need to pay more attention to my blood sugar is when I’m sick.  I might have to take some extra time off from work to recover these days, but that could be because I’m getting older.

If you’re a parent, let your kids be kids.  Let them have fun at parties and eat a small piece of cake like the other kids (maybe take of some of the frosting first).  Don’t stress too much about what they eat.  You don’t have to make big formal meals.  Sometimes when I get home late I’ll have cereal and fruit for dinner.  Just use common sense and think about what you need to do to cover it with insulin.

 

 

 

 

 

 

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My Story

My Story: What I Learned Caring for My Grandmother with Diabetes

Posted on by mghdiabeteseducation

By Vanessa

My grandmother is a tenacious and vibrant woman who was diagnosed with type 2 diabetes earlier this year. She had uncontrolled blood sugar levels along with other health issues and limited mobility. With no formal educational background, she doesn’t know much about diabetes or possible complications. Her low health literacy makes it difficult for her to utilize diabetes related health care resources.  “There are too many rules in my diet!” she would exclaim in Twi, her native dialect.  She also has low nutritional knowledge and at times would reduce her consumption of certain staple foods. She assumed that eating less of these foods would cure her body from the disease. Her daily diet in Ghana is mostly starchy and sugary foods with low nutritional benefits.  One staple meal that she eats quite often is called fufu:  a soft dough-like mix of cassava, plantain, and other flours served with different types of warm soups full of meat and/or fish.  Fufu is relatively high in carbohydrates and has a significant and rapid effect on my grandmother’s blood sugar levels.

As my grandmother’s caregiver, I provided diabetes care management and education.  My goal was to help her avoid blood sugar spikes keep her blood sugar in a healthy range before she went back to Ghana. Every day I checked her fasting blood sugar in the morning and again two hours after eating.  These results were reviewed by her PCP and nurse case manager.  I modified my grandmother’s meals and incorporated more green leafy vegetables, fiber-rich foods, whole-grain breads and old-fashioned oatmeal with almond milk and honey for added sweetness. I also introduced her to cooked quinoa and cauliflower rice as substitutes for fufu, white rice, and other fufu-like foods to give her meals a nutritional boost. After a meal, I would encourage her to take a walk to the local shopping plaza or to circle around the neighborhood for an hour.  Despite her stubbornness and fiery temper towards changes to her diet, we were able to improve her eating habits by stressing the importance of portion control.

My grandmother does not know how to pronounce diabetes or manage her care on her own, but making sure she understood that her medications, changes to her diet, and daily walks to her favorite consignment stores are effective tools for managing her blood sugar levels were key components to her care plan.  My experience as a caregiver was a wonderful opportunity to spend time with my grandmother, and it also highlighted the importance of diabetes education in following a care plan and reducing risk of complications.  I also learned how that approaching care in a culturally tailored manner that respects individual preferences, opinions and ideas is necessary for reaching optimal health.

 

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My Story, Nutrition, Uncategorized

My Story: Gaining Confidence in the Kitchen

Posted on by mghdiabeteseducation

By Kait

I never used to cook at home. In fact I HATED cooking. I had no confidence in the kitchen and burned everything, even toast. Time was another reason I didn’t cook often. I always thought cooking a meal had to take a ton of time; I really just wanted my food to appear in front of me. At the same time, I wanted to eat healthier but had no idea where to start or what to do with things like vegetables and spices. Then a coworker mentioned she had signed up for Plated [a subscription meal service] and suggested I give it a try. It sounded like an interesting concept, so I went for it.

What I like most is that it saves time and effort. Everything you need to make the dish is included and portioned out for you. Some recipes use ingredients I never would have bought on my own because I didn’t know how to use them, so it’s a great way to try new things. I also discovered that cooking doesn’t take up as much time as I thought. We typically cook at home 3-4 times a week (usually dinner). We’re definitely eating as a family more often, and I enjoy getting to spend time with loved ones while preparing meals.

We’ve been using Plated for about a year now and I feel much better about my cooking skills. I know if I made a recipe once I can do it again. You get to keep the recipe cards, so we’ll usually do a little experimenting the next time we make the dish. I’m eating healthier now, too. Before, I never really ate vegetables (or if I did they were just raw). I’d go into the grocery store and see all these wonderful looking vegetables but feel intimidated not knowing what to do with them. Now that I have a better idea how to cook them, I include vegetables with my meals often.

I recommend signing up for something like Plated if you don’t have much confidence with cooking. The recipes are easy and they tell you about how much time it takes to make. You’ll learn how to cook new things and different types of vegetables. My parents actually signed up for another meal delivery service, Blue Apron, because of my experience with Plated.

 

 

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Fitness, My Story

My Story: Benefits of Working Out With Friends

Posted on by mghdiabeteseducation

By Jahnelle Bray
Population Health Coordinator

One of my old coworkers made a commitment to get up early every morning to go spinning. She always had so much energy during her day I thought I’ve got to try this! When a spinning studio opened across the street, I got a group of friends together and that’s what we did. That first class was tough and I had really mixed emotions when it was over. I was sweaty and sore, but also really energized. A little while later I introduced another friend to spinning and she LOVED it. She also suggested we go to a class every week. This was great for me because it has helped me build consistency with my workouts.

If you struggle with staying in shape or sticking with exercise, finding an exercise buddy is really helpful. When you’re by yourself, it’s easy to talk yourself out of exercising or just do the bare minimum. When you make plans with someone else, you’ve made a commitment to be there and do your best. You don’t want to feel like you’re letting them down.

Your exercise buddy can push you to keep going when your muscles start to hurt. If I start to feel like I’m ready to give up, I’ll look over and see how my friends are doing. Seeing them going for it when I’m flagging really motivates me to stick with it. Thinking about the class as a group effort also helps. Everyone is there for the same reason and we’re all going to get through this together. I don’t want to be the only person not doing anything, so I tell myself if they can do it, so can I!

It was great finding someone who loved spinning as much as I do and wanted to go regularly. We have a routine now where we text each other every week to decide what day we’ll go. It’s been about a month since we started doing this, and I’m much less sore than I was after that first time! I look forward to class. It’s a chance for me to disconnect and recharge my body and mind. If I miss a week, I don’t feel my best. Working out is a great accomplishment. If you don’t finish anything else in your day, at least you’ve done that.

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My Story

My Story: Journey Through Weight Loss Surgery

Posted on by mghdiabeteseducation

By Isabel

When I was diagnosed with diabetes in 2010, it was a total shock. Even though diabetes runs in both sides of my family (both my grandmothers had it as well as some aunts and uncles), I never felt I would get diabetes. My primary care provider reassured me that WE would get through this and started me on metformin and I learned how to use a glucometer. At the time I thought I’ll just learn what I need to do. When I got home and started looking through my materials, it hit me hard. I broke down and started to cry. I felt that diabetes was a death sentence. I was also angry because I had been going to Weight Watchers and started losing weight! The diagnosis was devastating, but I said: I. Will. Beat. This.

I continued with Weight Watchers, but started thinking what else could I do to help me lose more weight and control my diabetes. So I thought about gastric bypass surgery. Would it be a good option for me, am I thinking this is an easy way out? So I started doing research about diabetes and weight loss surgery. I attended support groups and talked to people about how they felt after having the surgery. I realized that I was going to be 40 in a few years. I said I wanted to be healthy plus, I wanted to have children and would need to be healthy for them. Because of these reasons I decided to move forward with the surgery. My primary care physician was very supportive of my decision and gave me recommendations for weight loss surgeons at a local hospital.

My surgery went well with no complications, however I started to have doubts during my first month of recovery. You can’t eat anything except liquids, and the protein shakes I was supposed to drink made me feel sick. That, and dealing with the pain, made me feel depressed and defeated. To get through it, I kept reminding myself why I had the surgery to begin with. At my first month follow up I had lost 40 pounds and my A1C had dropped way down. I was able to stop taking metformin and my blood pressure medication. Beyond that, I started feeling better and noticed my clothes feeling looser.

As I continued to lose weight eventually I did plateau, but I was ready for it. I kept up with my healthy eating habits, making adjustments until I reached a weight range I felt comfortable with. I had my surgery in 2012, and I’ve lost a total of 95 pounds. Much of my success comes from the lessons learned from Weight Watchers and the “no guilt” attitude of my support group. I have gained a few pounds above my goal range, but it’s okay – I know I can lose the weight again and what I need to do to get there.

Diabetes was like a hit below the belt, but never once did I say “Why me?!” I know it will always be there, and it may come back down the line. For me, gastric bypass was a tool to use to control my weight and beat diabetes. Since my surgery, I have more confidence, am more accepting of my body, and have more energy. I’ve become an educator and advocate for taking charge of your own health. Gastric bypass was a good fit for me, but it’s not for everyone. If you are considering surgery, I encourage you to educate yourself about the different types of surgery available and talk to people who have done it. Do some research to prepare yourself for what happens afterward, and make sure you surround yourself with a strong support network. Do not let anyone make you feel ashamed for having weight loss surgery. Your health is yours, and in the end it’s about you, not them.

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Guest Post, My Story

My Story: Overcoming Fears of Starting Insulin

Posted on by mghdiabeteseducation

By Kevin

Rock climbing. Photo Credit: Bryan Wintersteen

Writing a blog post on “Overcoming Fears of Starting Insulin” turned out to be harder than I thought. I mean, who knew writing something like this would be that much more difficult than composing an e-mail at work or posting a snarky comment on Facebook? And to be completely honest, after extending (read: missing) my deadline a few times I was starting to feel a bit hopeless that I could actually pull it off.

But then I saw Steve Martin, the actor, comedian, author, and banjo virtuoso (don’t believe me? Check this out, I think you’ll like it) on Late Show with David Letterman and inspiration struck. Martin’s appearance on Letterman reminded me of one of my favorite scenes from his 1986 comedy ¡Three Amigos!

To set the scene, at this point in the film The Amigos (played by Martin, Chevy Chase, and Martin Short) have decided that although they are merely Hollywood actors who play hero gunfighters in the movies, they will help the inhabitants of a small Mexican village confront and defeat the very real bandits and their ruthless leader, El Guapo (played by Alfonso Alau), who have terrorized the town for years. Lucky Day (Martin’s character) attempts to inspire the villagers with this speech.

What on Earth does this have anything to do with “Overcoming Fears of Starting Insulin”? Well, I think for most people with Type 2 diabetes, like yours truly, our “El Guapo” is starting insulin. It’s something we will have to face eventually and something that once we do, we will be better and healthier for it. For me, when my endocrinologist suggested insulin five years ago, there were two very different fears I had to overcome.

The first was the fear of admitting failure. The suggestion that it was time to start insulin was, for me, like admitting that I had failed myself, my wife, my family – everyone who cared about me.  If I had eaten better, I wouldn’t need insulin. If I had exercised more, I wouldn’t need insulin. And now if I needed insulin, then clearly I failed at managing my diabetes.

When I met with my diabetes educator, however, she reminded me that Type 2 diabetes is a progressive disease, moving on to insulin was merely the next step in my treatment, and that it was my previous treatments that were failing to adequately treat the disease. In short, it wasn’t me it was my treatment that was failing. Once I heard this I was much more accepting of insulin as an option. I wanted to feel better than I was feeling at the time, and insulin was just the next phase of my diabetes management.

The second fear was about the administration of insulin. I had visions of not being able to do anything spontaneously with friends or family anymore (“Sorry I can’t make it, I forgot my insulin so I need to head home.”). I was pretty nervous (and admittedly still am) about hypoglycemia after a previous episode with another class of drug. And while not generally afraid of needles, I had never self-administered an injection. How long is the needle we’re talking about here? I thought it was going to be about six inches long. Would it hurt? I was sure it would be agonizing.

Again, a little education went a long way to allaying these fears. Injecting insulin turned out to be pretty anti-climactic, really. It’s had no negative impact on my life whatsoever. Being on insulin has not limited me socially. With help from my health care practitioners I have had no issues with hypoglycemia. The mini-pen needle is about as long as my pinky fingernail and causes no pain at all.

And most importantly, I’m healthier and happier ever since I faced the Type 2 diabetic’s “El Guapo” – and won.

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Fitness, Guest Post, My Story

Gardening for Body and Mind

Posted on by mghdiabeteseducation

By Rebecca Ocampo
Project Coordinator

phlox

Medulla Oblongata, Phlox Subulata, Calamagrostis Acutiflora, Panicum Virgatum – they may sound alike and look alike but are all very different. The medulla oblongata is the lower stalk-like section of the brain. The rest are plants: beautiful creeping phlox and exotic perennial grass. The photograph to the right is Phlox Subulata or creeping phlox. They bloom in the beginning to late spring and are perennials. They are used for garden edges or “fillers” near a stone wall.

There is an old Chinese proverb that goes like this: “If you drink tea, you will be happy for a day. If you roast a pig, you will be happy for a week. If you get married, you will be happy for three weeks. If you garden, you will be happy forever.”  My love of gardening peaked recently when I moved to the suburbs and found myself in an apartment surrounded by beautiful and lush forestry. Never did I imagine that gardening would be one of my priorities outside of work. It’s very relaxing and a healthy way to exercise. I’m outdoors and not connected to anything electronic.  Most of the time, I do not use my gardening gloves and dig right in the dirt.  It’s like making cake batter without utensils, if you will.  The texture is soothing to the skin.  It may have something to do with childhood, like making mud pies at the beach.

When I was growing up in the Philippines, my family’s ancestral home was surrounded by a variety of fruit trees (banana, avocado, mango and jackfruit) sugar cane, bamboo, and a variety of tropical and exotic flowers including different shades of hibiscus – all surrounding an in-ground (almost Olympic size) swimming pool. Flash forward to the United States where my mom, brother, and I visited several garden centers every Sunday. They would never agree to go to a mall, so it was either another pair of shoes for me or a Panicum Virgatum which is a metallic blue (sounds like shoes to me!) grass that blooms in late summer and grows up to 3’ in height and approximately 18” wide. It has pretty blue blades during the summer and turns to golden and bright yellow blades in the fall.

I mostly grow perennials:  orange and red tiger lilies, pink and white English daisies, bright orange poppies, vinca with purple flowers.  There are purple irises, red knock-out roses (tough roses that will come back every year no matter the weather) and some annuals like impatiens and pansies as well. The benefit of gardening is twofold.  First, it’s a good form of exercise because you rake, mow the lawn, pull weeds, thatch the grass, prune trees, and design your garden so it’s esthetically pleasing. Second, gardening exercises the mind. There is a calmness and peacefulness in gardening. It’s a proven source of good mental health awareness, and releases tension. It means I have escaped confinement from my cubicle. It’s a form of exercise that soothes and calms my mood after a hectic day at the office.

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Fitness, Guest Post, My Story

Spotlight: Charlestown HealthCare Center Activity Tracker Pilot

Posted on by mghdiabeteseducation

By Rajani Larocca, MD
Charlestown HealthCare Center

with Chrisanne Sikora, Senior Project Specialist
Diabetes Self-Management Education Program

FitBit activity tracker

Lifestyle change is ultimately in the hands of the individual, and our job as medical  providers is to find a way to empower people to make those changes. It’s an old problem, but the question is: how do we get there? And can new technology help us solve the problem in new and innovative ways?

In spring 2013, I ran a series of six weekly group visits with a group of my patients at MGH Charlestown HealthCare Center. The group was originally intended for those with metabolic syndrome, but the majority of the patients already had Type 2 Diabetes.  The idea for this program came from an interest in applying a public health approach to medicine. All of the patients volunteered for the program on my recommendation. The focus of the visits was to educate the participants about healthy lifestyle change, to help motivate them to implement this change, and to provide a support system to help keep them motivated.

Each session focused on a different topic. In addition to the introduction in the first week and a summary group in the last week, we discussed nutrition, exercise, stress reduction, and social connection. A key part of the sessions included removing the all-or-nothing mentality that many people adopt when they are trying to be healthier, focusing instead on taking what steps you can and forgiving mistakes in the past.

During the meeting in which we discussed exercise, everyone who participated was given a FitBit activity tracker to wear. Once the trackers were on, the group went on a short walk through the neighborhood. Many were surprised to learn they didn’t have to walk far to reach 1,000 steps.

In subsequent sessions, reviewing the Fitbit data was part of what we did during our time together. Interestingly, everyone liked the Fitbits – even those who didn’t have ready internet access or who weren’t really internet-savvy. Because the trackers had a display which showed results in real time, everyone could tell whether they were reaching their goals on a daily basis. While there was some friendly competition among participants, most were only competing against themselves, trying to beat their totals from the previous week.

After the program ended, the participants were allowed to keep their FitBits, and some were still wearing them eight months later. Some of those who stopped wearing them said it was because they had incorporated their new habits into their routine and didn’t need the tracker anymore. When asked how he would keep up with his daily walks during the winter, one gentleman responded “I’ll wear a coat!”

Electronic trackers like the FitBit make developing healthy lifestyle habits more fun, but we can’t underestimate what the social connection of the group did to foster people’s success. The participants really enjoyed the group setting, especially the sense of community that developed and the confidence they gained from learning that others face many of the same challenges. Living with a chronic disease can be isolating, but in this group, people realized that they were not alone.

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Fitness, Guest Post, My Story

Facing Challenges and Overcoming Fears

Posted on by mghdiabeteseducation

 By Monica 

Rock climbing.

As good as we are at watching what we eat, sometimes we do slip and have a  little too much (or a few too many sweet treats).  There is a program where I work that helps employees learn how to eat healthy and exercise to lose weight.  Several people in my department have done it and enjoyed it, but I was always reluctant – I didn’t really like going to the gym.  But, when the new session started a few weeks ago I finally signed up.  I’m so glad I did. 

On the first day, we had an assessment of where we are now so we can track our progress and chose a goal for what we wanted to accomplish.  There are several teams doing this program at once, and each meeting starts with a rally where the program’s leader shares with the groups where each team is as far as weight loss, steps taken, and amount of exercise.  The team with the most improvement for the week gets a trophy.  It keeps you motivated to work hard and win that trophy!  

The most unexpected thing about this program is how much I’m enjoying being there and doing the exercises.  It’s changed how I look at going to the gym.  Before, I’d been afraid of not knowing how to use the equipment properly and too shy to ask for help.  Going through this program has helped me overcome my shyness; now I’m not as scared to ask questions if I don’t know how to use a machine or need help getting started.  I’ve also enjoyed meeting with our nutritionist and learning more about mindful eating and portion size. 

I feel great, my clothes feel looser, and I know I’m getting stronger.  I really recommend finding a program like this.  Being with a group can help keep you motivated, and some of the nutrition information might stick with you to help improve your family’s eating habits.  If you have a gym near you, check out their class schedule.  Many offer things like yoga or Zumba; ask if you can try a class to see if you like it.  And don’t be afraid to ask questions if you need help.

(Photo Credit: Bryan Wintersteen)

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Guest Post, My Story

Taming Holiday Temptation

Posted on by mghdiabeteseducation

By Monica

nuts and nutcracker. Photo credit: Mike Coombes

The holidays are here.  It’s hard to not be tempted to eat a tasty pastry when there are so many holiday lunches at work and parties to go to.  I have a few suggestions for warding off holiday temptations that have worked for me—and they might work for you too! 

First, if you’re out shopping and know you’re going to a lunch party later, try to hold off on buying a pastry in the morning.  Sometimes not seeing the treat anymore can take away your craving.  So for instance if you’re in the supermarket facing a large display of cakes and pastries and starting to feel tempted, just walk away.  Go to the produce section and get a healthy snack like a piece of fruit or a handful of nuts—that can help take away cravings too. 

But what if you’re baking at home?  All the ingredients are out on the counter and the kitchen smells delicious—how do you keep from being tempted then?  What I usually do is leave a small bowl of dried fruit and nuts on the kitchen table so when we’re doing our baking at my house, there’s a healthy snack in easy reach to help take care of my cravings.  This is good for other times when you’re at home and need a snack, too.  You can also put a bowl of hazelnuts (or other type of nut still in the shell) out along with a nut cracker.  Cracking open nuts before you can eat them makes you slow down so there’s no repetitive, mindless eating.  You also need to chew longer which can help you feel full faster so you eat less.  I also find cracking open the nuts myself is therapeutic because all your attention is focused on what you’re doing. 

Finally, I’m not going to say you can’t ever have pastry.  But, if you do decide to eat a holiday treat, go lightly and have just a small piece.  Have a good holiday!

(Photo credit:  Mike Coombes)
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