Flourishing with chronic illness

I'm taking Dr. Barbara Fredrickson's positive psychology course right now. Dr. Fredrikson is a Psychology Professor at the University of North Carolina at Chapel Hill and a founding pioneer of the positive psychology movement. 

Through her 6-session course, I've been introduced to Kelly Stack, who is also sharing positive psychology as a health coach. Kelly was also diagnosed with multiple sclerosis at 24 and has written a soon-to-be-published book, Flourishing with Chronic Illness. Kelly and I are obviously walking the same path. To learn more, click here

Flourishing With Diabetes

…I discovered that those who are living full, happy, and healthy lives with diabetes seem to hold a certain mindset about it. One I call "flourishing." Their outlook and self-talk is, "I am strong, I can do this." They take the actions that help them live as healthfully as possible, and see that maybe they gained something with their diagnosis and didn't just lose something.

Full article, click here

How a Different Mindset Can Transform Health

In the language of chronic illness we are so used to hearing the word coping, that we don’t stop to think about its connotation. But, notice, your body has a different physiological response to both words. Say “coping” and you feel tense. Say “flourishing” and you feel relaxed and energetic.

In a coping mindset I may spend a lot of time worried I’ll get complications. I think I don’t do anything right when it comes to my management. I beat myself up for getting high blood sugar numbers and it feels like diabetes runs my life. I often feel angry and resentful.

From a flourishing mindset…click here

Is Your Negative Attitude Ruling Your Life?

This is an interview on positivity with fellow health coach and diabetes advocate, Ginger Vieira. 

Ginger: Positivity…that word could be interpreted so many ways. In life with diabetes, how would you define positivity?

Riva: For me positivity in living with diabetes is seeing what you are doing well and giving yourself a pat on the back and then seeing what you can do a little better and doing it. Also, not beating yourself up for not being perfect, which no one can be frankly, and thinking less about the scary stuff of diabetes like complications.

Living with type 1 almost 42 years, it helps me stay positive to see the benefits diabetes has brought me. We all say we wouldn’t wish diabetes on anyone, but if you’ve already got it, you’ll feel better if you can find a few things about it that have value. For instance, I would not be as fit and healthy as I am if not for diabetes; I know I would not walk an hour a day as i do or have lost thirty pounds and kept them off for two decades.

In my workshops, I ask people to tell me one positive thing diabetes has given them. Once they get over the shock, they invariably do find something, and their energy and the energy in the room skyrockets.

For the full post, click here.

We cannot cure chronic illness, but we can heal

I am a big fan of Dr. Rachel Naomi Remen. Remen founded The Healer's Art at  theUCSF school of Medicine and she heads the Institute for the Study of Health & Illness.  Remen's work is dedicated to helping health professionals dig for the deeper expression of their work - to heal where there is no cure.

Remen is the author of three books and a gifted storyteller. She tells stories of what she's learned from her cancer patients during their last months and weeks of life. How we shift our priorities and values; our very identity. Remen has also had Crohn's disease for more than forty-five years.

Currently I'm reading her book, My Grandfather's Blessings. Her grandfather was a Rabbi and scholar of the Kabbalah, the mystical study of the wisdom of the human soul. Like Remen, I believe physicians are taught to cut and cure, but not to heal. Today, more and more people live with incurable chronic illnesses. We need to equip health professionals to understand  the art of healing where curing is not possible. To understand the magic of empathy, connection and listening.

Here's a sneak peek from My Grandfather's Blessings, page 29. 

"In the sixties when I went to medical school, the meaning of illness was seen as irrelevant. We did not know then that there is a healthy way to have a disease, a way to use this difficult experience to come to know more intimately who we are and what is important to us. Our focus was on cure and not healing. Science and its expertise cures, but often it is meaning that heals us. Such healing is highly individual. The same disease means something different to every person touched by it. Over time, meaning heals many things that are beyond cure.

Finding meaning does not require us to live differently; it requires us to see our lives differently. Many of us already live far more meaningful lives than we know. When we go beyond the superficial to the essential, things that are familiar and even commonplace are revealed in new ways. Meaning may change the way we see ourselves and the world. People who have felt themselves to be victims may be surprised to realize they are heroes

Through illness, people may come to know themselves for the first time and recognize not only who they genuinely are but also what really matters to them. As a physician, I have accompanied many people as they have discovered in themselves an unexpected strength, a courage beyond what they would have thought possible, an unsuspected sense of compassion or a capacity for love deeper than they had ever dreamed. I have watched people abandon values that they have never questioned before and find the courage to live in new ways. Often these ways are more soul-infused.

When I first became ill with Crohn’s disease more than forty-five years ago, I felt profoundly diminished, different, and even ashamed. I had not known then that what challenges the body can evolve and strengthen the soul. I had focused on the curing of my disease and despaired when this was not possible. It took years for me to recognize the movement toward wholeness that was happening in me while my attention was elsewhere."

Talk with outgoing President of IDF's Young Leaders Programme

I asked Alex Silverstein, the Young Leaders outgoing President, what he learned during his two years of service. Below are his thoughts about the organization's growth, and his own.

"The Young Leaders Programme was formed two years ago at the IDF World Congress in Dubai. I am extremely proud of the growth of the group from 68 leaders in 48 different countries to 140+ in 74 different countries. It's a true commitment. Each Young Leader has to be nominated and approved of by their existing national diabetes association and they have to fundraise for their flights and accommodation at the World Congress. 

I quickly learned nobody has a monopoly on wisdom. On countless occasions I thought I had come up with a brilliant idea that couldnt be topped, however, once I received some feedback from the rest of the Young Leaders my ideas were often taken to a level I couldn't possibly imagine.

Our initial 68 volunteers came from different backgrounds, spoke different languages and had different experience of diabetes, yet each of us shared a common goal to help people with diabetes. Learning from each other's experience, in addition to giving each volunteer the flexibility to choose a project relevant to his or her own skills, and the needs of people with diabetes in their country, helped us all to grow under an umbrella of collaborative leadership. I think this flexibility, along with the mentorship we gave each other, was key to the level of success we achieved, with over 70 projects being completed around the world in the first two years.

Overcoming the challenges of diabetes within our countries can sometimes be a daunting task, yet by working together we felt stronger, and this gave us hope and trust in each other, an incredibly powerful combination for inspiring the leaders of tomorrow. I am particularly proud that through this support I was able to deliver my own project, which was to create a network of over 40+ Young Leaders across the UK and fundraise £100,000 for three projects.

Each young leader has been given education, trust and a family to make a change for people with diabetes. In short, this gives each of us a confidence and positivity in managing our diabetes. And I believe if you maintain a positive mentality you are in a better place to respond to challenges and create strong relationships between all of your relevant stakeholders. 

One of the Faculty of the programme, Paul Madden, told me that one of the biggest aspects for behavioural change is Love (Romantic or Platonic love for others, for yourself or for doing something you enjoy). The Young Leaders together as a family provide that love and positivity, which provides a backbone of confidence and hope to be as Gandhi said, that change we want to see in the world. 

I'd be remiss if I didn't also cite the support we received from IDF and others. The idea for the group came straight from the top of the IDF with the President, Sir Michael Hirst, as a Co-chair with fellow Board of Trustee member Debbie Jones as Chair. We are supported by the IDF with a dedicated staff member hired to coordinate the programme and an incredible faculty of volunteers from across the Diabetes Advocacy world Then most important is the support of the National Diabetes Associations themselves and the trust they give to send their Young Leaders and support them to deliver projects in-between the IDF World Diabetes Congresses.

Pearl S Buck said that "The Young do not know enough to be prudent and therefore attempt the impossible, and achieve it, generation after generation." Given the rise in the level of people with diabetes, climate change, the rise in populations and the difficult economic situation over the past ten years, people are looking at young people more than ever to provide the biggest solutions for tomorrow.

For prevention and successful treatment of diabetes we are going to need investment in the leaders of tomorrow. By forming a worldwide network of inspirational young leaders in diabetes now, whilst some are only 18 years old, the IDF have given the Young Leaders great potential to build long lasting relationships between themselves, our member associations, health care professionals and the public worldwide, creating a powerful and unified voice for people with diabetes to be used for many years to come.

The Antidote to Living With Diabetes

As Diabetes Month ends, I don't know how much we've accomplished. I don't know how many more people with diabetes will take better care of themselves. Or how many people realized they may have undiagnosed diabetes and went to get a fasting blood sugar test.

I do know that Nov. 14, World Diabetes Day, the International Diabetes Federation released the latest stats and projections on the rising incidence of diabetes around the world. The situation everywhere is getting worse.

Yet for me, having lived with Type 1 diabetes almost 42 years and with no end in sight, I have to find hope somewhere. So I take it in the attitude I've adopted: You can have a great life, not despite but because of diabetes.

Don't get me wrong: I am not denying the work, the hardship and the fears diabetes brings or it's potentially damaging consequences. I am suggesting what Randy Pausch told us in his "Last Lecture" and what Michael J. Fox has been telling us since he got Parkinson's. That you can make meaning from tragedy and find not just a way to bear it, but joy in a meaningful life.

For the full article click here.

YOU are in control of your diabetes. Take small steps to stay positive.

Aim For Better, Not Perfect!

Aim For Better, Not Perfect!

In my book, "Diabetes Do's & How-To's," I give eight Attitude Do's - and lots of How-To's - to keep positive working with your diabetes. One is Aim for better, not perfect

This Winter's edition of Diabetic Living magazine captured those Do's and How-To's so you've many tips at your fingertips. 

As I write in my book, 

“When I was finishing this book, I was on a flight and I sat next to a young man whose T-shirt captivated me. It said: ‘Tomorrow’s battle is won during today’s practice,’ I can’t think of a better way to say that every step we take now benefits us for years to come.”

Here's 1 Attitude Do to get you started - "Check your blood glucose, but don't keep score." And 1 How-To to do it,  "Keep your expectations realistic, and don't beat yourself up. No matter what you do you want always get the numbers you expect. That's diabetes."

 For the whole article click here. 


A Flourishing Approach to Chronic Illness

My article appears in the Summer 2013 issue of the peer-reviewed, On the Cutting Edge. It captures the essence of my thinking and practice as to how health care professionals can extend their treatment repertoire while working with patients with a chronic illness, and, how patients can better manage their condition and increase their health and happiness. Click for full article.

The Power of a Relationship-Centered Approach

I just returned from the 40th annual American Association of Diabetes Educators conference. This is one of my favorite conferences. I find the passion, caring and commitment of the people who go into this profession almost unparalleled.  

This year's theme was "The Point of Possible" and in accordance with that theme I found a subtle shift of tone in what was shared this year. If terms like "non-compliance" and "adherence" were spoken, they were done so with irony, not regard. Educators are realizing we are all human, diabetes isn't something anyone can do perfectly and one-size-fits-all treatment plans don't work.

My husband and I presented, "Dancing Together: The Power of a Relationship-Centered Approach." In our program we shared a new model for working with patients. For the past several years we've been hearing about being "patient-centered," but that dismisses the expertise of the medical professional. It is in both working collaboratively together, that each's strengths and skills can be leveraged and maximized.  

It is in asking open-ended relationship questions that we learn the context within which patients live and operate, and we should not forget, while information and motivation are viable keys for change, without skills and action, there is no change.

Should you wish to see our slides they are attached here. 

Forgotten Dimension of Diabetes Revealed in DAWN2 Study

Would you be surprised to know family members of people with diabetes share similar emotional difficulties as their loved ones? Many health care providers don't acknowledge the self-blame and anxieties that keep diabetes patients away for years? Enough people report positive experiences with diabetes that it's leading to a new field of research?

Below are highlights from my talk with Søren Skovlund, global director of patient research and engagement at Novo Nordisk and research director of the company's DAWN2(Diabetes Attitudes, Wishes and Needs) study. Above were some of the study's surprising findings.

Read More

Staying Positive With Diabetes

​Many of us living with diabetes at some point experience burnout. Burnout is just as it sounds. You may feel overwhelmed or beaten down by the everyday grind of managing diabetes. You’re ready to toss your medications and meter in the garbage and forget you even have diabetes.

In truth, I rarely experience burnout. I’ve made peace — and made friends — with my diabetes. I’ve incorporated it into my life so that I rarely see it as a burden, and I’ve learned ways to stay positive, which I’ll share with you. Yet, like any friend, there have definitely been times when our relationship has been strained.

Regardless of the 

new medicines, technology, and devices

 that make managing diabetes easier, if you don’t have the strength and emotional resilience for the everyday tasks diabetes demands, you won’t be helped much. So here are some strategies I use and teach for staying positive. These may help you avoid burnout or bounce back more quickly when you feel overwhelmed...

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Changing Lives As An AYUDA Volunteer

An excerpt from my interview with Sam Wohns, 22 years old, who's been an AYUDA volunteer since his diagnosis with type 1 diabetes at seventeen. 

Sam: “When I was diagnosed, I knew how fortunate I was to have access to first-rate supplies and education. I recognized that my diabetes might be inconvenient at times, but that it would not change what I could do with my life.

I knew that wasn’t true for people living with diabetes in lesser-developed countries, where type 1 diabetes is a life-threatening condition. That disparity deeply bothered me then, and it still disturbs me today. I do not think your access to essential medicines should depend on the chance circumstances of your birth.

I’ve always been aware that I was lucky to be born to a loving family in an affluent country. My parents instilled a global outlook in me from an early age. When I was 10-years-old, they gave me a book about the world’s different cultures. On the last page was a spinner. Whatever country the spinner landed on you had to answer this question, “How many calories do people there eat every day?”

I discovered that many young people live on less than 900 calories per day. My leftovers were equivalent to many children’s daily food consumption. The next day, I only ate 900 calories of rice, as an act of solidarity. I wanted to do more, so I asked for donations to hunger relief organizations for my eleventh birthday.

Diabetes inequities strike even closer to home. I see the inequalities in access to diabetes supplies and education as a threat to the human right to health. I wanted to help end that injustice through advocacy and education, which led me to AYUDA.

I’ve been involved with AYUDA since the week after I was diagnosed with diabetes. Before enrolling in college, I volunteered and studied for a year in South America, where I met people living with diabetes who are so thin that you can see their ribs. In Ecuador, there isn’t a single pediatric endocrinologist or nurse educator. In Bolivia, many health clinics lack basic diagnostic devices, like glucometers. AYUDA trains young people to become peer educators and helps local diabetes foundations expand their capacity. It makes all the difference.

While in Ecuador, I met one little girl and her grandmother before a weeklong diabetes family camp. The little girl had a glucometer, which she usually used to test her blood sugar once a day. She ran out of strips four days before camp started, though, and her grandmother decided not to come because it would mean missing work.

They lived several hours away, so a group of us drove to their house and persuaded them to come to camp. There the grandmother met other parents and children with type 1. She left better educated on how to take care of her granddaughter. We didn’t solve all her problems, but I am hopeful that she and her granddaughter will be able to lead healthier, happier lives with a peer group and the support of the Juvenile Diabetes Foundation of Ecuador.”

An excerpt from my interview with Isabel and Madeline Chin, high school students who are also AYUDA volunteers. Isabel got type 1 diabetes at the age of two, yet her twin sister, Madeline, doesn’t have the disease.  Madeline and the twin’s four siblings get tested for diabetes every year.

Riva: Based on your experience with AYUDA, what do you see governments and businesses can do to help more?

Isabel: Something AYUDA and the foundation where we were in Ecuador does, which is great, is speak to governments sharing with them what living with diabetes is like and how it impacts people’s lives. I'd like to see more being done to educate people who don't have diabetes, to create a more empathetic culture. But the foundation is working on this. 

Madeline: We had a representative from the government talking to those of us from AYUDA and the Ecuadorian foundation and you could tell he didn’t have a grasp on diabetes at all. He said you guys should have a march and let yourselves be known. It made me realize you can’t just tell a government what diabetes is and how it affects people, there really needs to be a paradigm shift for how people view chronic diseases and public health in general.

R: What surprises did you encounter during your AYUDA experience?

I: While we bring all these supplies to have a safe environment for the kids at camp, we're really trying to mimic what the kids will do at home, so that when we send them back home they’ll be able to sustain whatever they learned. So, if they’re from a poor region and, for instance, can only take one or two shots a day and  wouldn’t take insulin after snacks at home, that’s what we have to do at camp. It was hard watching a kid have a snack and then not be able to take insulin for it and then have their blood sugar go high.

M: Positively, one thing that surprised me was how responsive the kids were and how willing just within a few days they were to try new things. It was amazing too to see the kids help each other. There was one boy we couldn’t get to try something but the other kids got him to do it. 

R: What do you take away from this experience?

I: We’ve both been interested in advocacy and medicine, but now public health has really become our passion. Being at the camp, it wasn’t just about teaching the kids but seeing them get excited about taking control of their life with diabetes. I also just loved being a diabetic with them. 

M: I’d worry at times if a five year old really got an educational lesson. But by the end I understood it was about creating a safe environment where they could participate in the activities and be with other kids who have diabetes, rather than learning any one lesson. We really feel like we helped empower them to take care of themselves. And I found visiting families’ homes and seeing how little they had shifted my perspective. It gives us both a lot of gratitude for how we live here. 

Finding strength in diaversity (diabetes adversity)

Here are nuggets of wisdom from my fellow diabetes online advocates. I asked them to answer two questions, and their answers carve a path through the light and darkness we all experience living with diabetes. (If you saw my article, "Tweets of Diabetes Experience" on The Huffington Post, these are the comments that weren't there.)

1. Give one way in which diabetes has helped to shape your personality, character or values? 

"The loss of my insulin-producing beta cells, has helped me, slowly but surely, increase my production of empathy. Living with this burdensome and dangerous chronic disease has shown me that we all have challenges and that we all need help and support to live life to the fullest." Kelly Rawlings, editorial director, Diabetes Forecast magazine, Twitter: @Kelly Rawlings 

“Diabetes is a large piece of what has shaped who I am, not as a symbol of someone who is sick, but as someone who is healthy and not easily knocked down.  Diabetes is an uphill hike everyday and it takes thinking and caring about yourself; because of that my resolve is unwavering.” Ann Bartlett, Body In Balance,  Health Central, Twitter: @annbartlett

“Diabetes has made me -- with the exception, of course, of my chronic incurable illness -- healthier than most of my friends.  I will always eat well, and I will always go to the gym.” Catherine Price,  A Sweet Life

“Diabetes has given me a sense of purpose outside of myself to try and help better the lives of other people with diabetes and a desire to educate everyone I meet. I would have never thought I would feel the way I do about diabetes 22 years ago when I was diagnosed. Plus the power of peer support feeds a wonderful desire to reach more people! I love it!” George Simmons, Ninjabetic, Twitter: @ninjabetic

“Diabetes has taught me that I'm stronger than I thought and able to do things I didn't think I could do.  I'm more empowered now.” Kate Cornell, Sweet Success: My life with Type 2 Diabetes, Twitter: @SweetenedKate

"Diabetes has taught me discipline in the most unforgiving way, but I've learned to appreciate it.  I don't even think about slacking on my diabetes care because I know I'll feel bad if I do." Jessica Apple, A Sweet Life, Twitter: @jessapple.  

“Diabetes has given me more determination to succeed because I'm the type of person who, when you tell me I can't do something, I'm going to do everything in my power to show that I CAN!  Thanks Diabetes!”  Brandy Barnes, Diabetes Sisters, @diabetessisters

“My daughter Tia, who's 12, has become a mentor and role model helping many other children. It has given my life a purpose in my work at Carb DM.” Tamar Sofer-Geri, carbDM

“I think living with diabetes has helped shape me into a stronger, more appreciative person.” Stacey D., The Girl with the Portable Pancreas, Twitter: @PortblPancGrl

“My relationship with diabetes is constantly evolving: we both reshape ourselves from moment to moment, often a reaction to the other. It's given me the ability to sense when change is necessary; to embrace change, for better or worse, and adapt myself to it. Diabetes also gives me a sense of mortality that I live with everyday: I can be extremely impatient when people waste my time - I feel like yelling, Get outta my way - I'm dyin' here!!!” Haidee S. Merritt, Haidee Merritt, Twitter: @BirdWingPress

“Diabetes has given a clear focus to my desire to serve others. We were overwhelmed at the time of our diagnoses. I hope to serve others in their time of need.” Bennet Dunlap, your diabetes may vary, Twitter: @badshoe

“I have learned to overcome challenges better after being diagnosed with diabetes and living with its everyday challenges.  It has also taught me to go after my dreams now because my diagnosis was with a blood sugar of 858 mg/dl and I knew that could have had serious implications.” Chris Stocker, The Life of a Diabetic

2. What habit have you developed that makes managing your diabetes easier?

“I don't eat many carbs. And I wear a CGM.” Catherine Price, A Sweet Life

“I do not beat myself up for being imperfect in diabetes. When I miscount the carbohydrates in a meal, and wind up with a high blood sugar afterwards, I make a note of what I can do next time to prevent the high blood sugar and carry on with my life. I'm always trying my best and I'll never give up.” Ginger Vieira, living-in-progress, YouTube: Ginger Vieira, Twitter: @GingerVieira

“I have developed the habit of planning each day to prepare for the obstacles that lay ahead. Planning the day helps me to understand insulin and food needs to keep my blood sugar in control.” Brett Griswold, Diabetes is like..., It’s only diabetes!

“My habit that makes managing diabetes easier is keeping my supplies on one shelf and always keeping it organized.” Marie Smith, Joy Benchmarks, Twitter: @cellobard

“Thanks to the Big Blue Test (shameless plug), I exercise more now than I have ever before in my life. I am no athlete (far from that) but exercise is definitely a more important part of my life these days.” Manny Hernandez, Diabetes Hands Foundation, Twitter: @askManny

“Honestly? Reality checks. I tend to be much more aware now about my body than I was before. I have learned to "listen" to the way I feel and I make decisions accordingly.” Beatriz Dominguez, Cranky Pancreas, Twitter: @crankypancreas

“Staying active makes my diabetes management easier.” Scott Johnson, Scott’s Diabetes, Twitter: @scottkjohnson

“I try to stay calmer because I know it affects my health. That's less a habit than a state of mind and it's all relative - I try to work at this every day and all my friends and family would point out there's still lots of upside <grin>.”  Kelly L. Close, editor in chief, diaTribe, Twitter: @diaTribenews

“A lot of stuff gets thrown at you when you or a loved one lives with Type 1. I try to let it slide off my back, but when I can't... that's when I know the experience needs to be written about. Blogging is my habit.” Scott Benner, Arden’s Day, Twitter: @ArdensDay. Scott's book 'Life Is Short, Laundry Is Eternal' will be on shelves this April.

“The habit that makes managing diabetes easier is testing my blood sugar.  You can't manage properly if you don't know your blood sugar!” Stacey D., The Girl with the Portable Pancreas, Twitter: @PortblPancGrl

“Accepting that a “bad” number is good information. A chance to fix a problem, not
an indictment of my control, or me as a person.” Wil Dubois, Diabetes Author, Educator, & Advocate LifeAfterDx, Diabetes Mine, dLife, etc., ad nauseam :-)

“Daily movement through walking and yoga help keep my blood sugars and A1c in good range, while also providing a sense of emotional wellness and vitality.” Cynthia Zuber, Diabetes Light, Twitter: @diabeteslight

If you want to live a long life, get yourself a chronic disease

Viktor Frankl is a psychiatrist who spent years in a concentration camp. I’ve found many insights in Frankl's landmark book, Man's Search for Meaning, that can be translated into living with diabetes. The second half of Frankl’s book examines his concentration camp experience with a single question, 'What does it take to persevere and come through a monumental, tragic experience?' Can there be happiness in suffering? Yes, Frankl says, if we have meaning in our lives. 

Meaning in the most personal sense, "What is the meaning of my life at this time?" For us, with diabetes? Frankl believed everyone has a specific, unique mission in life and that we each find meaning through enacting it. Being in service to others or a cause, loving someone or something and turning tragedy into triumph are all ways to live a meaningful life.

Of the more than 150 people I've interviewed who have diabetes, many see diabetes as an opportunity to pursue a more meaningful life: An opportunity to become fitter and healthier, lose weight, follow a dream and or help others. They see diabetes as a wake-up call and are reminded that life is short, life is precious, and it comes with no warranty.

For many years I’ve been writing a blog about living with diabetes on my web site, DiabetesStories.com. Someone sent this to me in response to one of my posts: “Riva, two years ago at age 68 I had a heart attack, a triple bypass and was diagnosed with diabetes all within one week. I'm doing well, have changed my diet and take exercise seriously now.
It hasn't been lost on me that I got a second chance at life and believe me I'm not about to squander it. Someone once told me, if you want to live a long life, get yourself a chronic disease to take care of.  I didn't think of diabetes as much of a "gift" but you are right, it can be. I'm in better shape now than I have ever been.
We all should look at diabetes as a gift - a nuisance and a pain in the neck sometimes, but it really is a gift.”

I figure you can see your diabetes in two ways: 1. Geez, I hate this. It’s not fair. Damn x%$!!! Or, 2. Hmmm…O.K., I’m going to turn over a new leaf, lose those 20 pounds and feel good! What do I really care about? It’s time to make it happen, wow, I’m smokin’! Mind you, these two ways of looking at life are not mutually exclusive; you may find you put on one attitude one on Monday and when Wednesday rolls around, you’re wearing the other. But, you probably live in one of these mind-sets more than the other.

Diabetes can be the very thing that makes you recommit to a healthier, happier and more meaningful life. It can be your motivation to pick up a dream you left abandoned long ago. We get the most out of life when we discover what we care about and do it.

After losing my job at 48 I searched for a way I could use my talents to contribute to the world. This was a desire I’d long had but wasn’t specifically acting on. That urge prompted me to take one small step after another creating my road to here, helping others with diabetes. Since diabetes was my arena, I gained more and more knowledge of it, and it's been reflected in my own better management. But even if diabetes were not my focus, the excitement of waking every day to add new strokes to this canvas I'm painting, gives me tremendous happiness, and an even deeper desire to be healthy and enjoy life.

It mystifies me why the world hasn’t yet realized that attaining wealth, status, a bigger house and the corner office doesn't make most people happy. In fact it leaves many pretty miserable. More people are on anti-depressants chasing these outward status symbols.

Frankl found that camp survivors who looked forward to finding their families again or creating their next great work, persevered to survive. And they actually experienced joy in the agony by treasuring small moments, like finding a forgotten picture of a loved one or getting an extra blanket. In that moment elation eclipsed their suffering.

So here's my advice--see your diabetes and taking care of it as the bedrock from which to create your meaningful life. Even better, see your diabetes tasks as gifts you give yourself, because they will reward you with even greater health, possibly greater than if you’d never even gotten diabetes.

If living a meaningful life is the road to happiness, then use diabetes as a catalyst to create a life of greater meaning. Most people I’ve talked to feel diabetes has not made them any less happy. Rather they find great joy in life, and many find diabetes has enriched their lives, by prompting them to create greater health, appreciate what they do have and help others. Now that’s a meaningful life.

Mind-Shifting: A Valuable Tool To Control Diabetes

The day I heard "Diabetes is not the leading cause of heart attack, blindness, kidney disease, and amputation," my life changed. I had believed the opposite to be true for the 32 years I'd been dealing with diabetes. Complications had always hung like a knife over my head.

Coping with diabetes

I was attending a "Coping with Diabetes" workshop given by diabetes psychologist Dr. Bill Polonsky, founder of the Behavioral Diabetes Institute. Dr. Polonsky opened his workshop by asking the 100 people with diabetes in the room, "How many of you have heard that diabetes is one of the leading causes of blindness? Raise your hand."

Hands all over the room flew up.

"How many of you have heard that diabetes is a leading cause of stroke and heart disease?"

The hands stayed in place-up.

"How many of you have heard that diabetes is a leading cause of kidney disease and limb amputation?"

Well, now everyone's hand was still up, right? We've all heard this.

"Wrong!" he said.

We sat there, dumbfounded.

"Poorly controlled diabetes is a leading cause of these things."

I had to replay it again in my head, "Poorly controlled diabetes ..." When has any doctor, magazine article, or TV ad ever stopped to give us that fine print? Pretty much never.

Removing "inevitable"

Knowing that complications are not inevitable and that if I take good care of myself, they may never come, has created a shift in my head, not to mention my care. I'm actually more diligent in my management because now I feel like I have a chance.

Here's a second mind-shift that I took away from Dr. Polonsky's workshop that day. Actually, it's a little stickie that sits on my meter and says, "Hey, it's just a number!" It reminds me every time I test that no matter what number pops up, it's just information. All it does is tell me whether I calculated something I ate correctly or whether I need some food or insulin to keep my blood sugar in range.

I no longer see my numbers as "good" or "bad": you know, those nasty judgments we make all the time. Granted, it didn't happen immediately. A 265 used to feel like a slap in the face even with that little stickie, but more and more, 265 has come to mean "I see, I didn't take enough insulin to cover that slice of gingerbread; good to know for next time."

Permission to be not perfect

A year later, I sat in on another of Dr. Polonsky's workshops, this one for people with diabetes who had fallen "off track" with their diabetes management. I was there mostly as a researcher. After having interviewed more than 100 people who live with diabetes, I wanted to know why some were so much more diligent in their management than others. While there, though, I learned that I too did something that negatively impacts my diabetes management: I was wedded to the idea that I had to be perfect.

I had long heard that I would get complications unless my blood sugars were always in target range.  But that day, I learned that not only is achieving perfect blood sugars impossible, but also the relative value of perfect blood sugars over good blood sugars is nearly insignificant. Wow, another mind-shift! With this one, oddly, I felt more energized to do diabetes really, really well, but the stress was gone.

These relatively simple new lessons have changed how I live with diabetes. They have allowed me to become more relaxed, to feel more hopeful, and to put my effort where it will do the most good. It makes me very aware of the power of those thoughts running around in our heads: thoughts of perfection, good and bad, right and wrong, They are an integral part of our management, even though most physicians, including endocrinologists and diabetes educators, barely acknowledge them.

So here's what I've learned:  Keep your blood sugars in good control, and you won't be the person they're talking about when they say, "diabetes is the leading cause of a million and one horrible things." Know that perfection is impossible, but that good is possible and important. And see your blood sugar numbers as information, not judgments. It may take some mind-shifting, but it's worth it.

Originally published on Diabetes Health.com

My Pride Alert Bracelet

Just between you and me, in all my years with diabetes (thirty-five and a half to be exact) I've never worn a medic alert bracelet. While I'm no fashionista, I don't like the way they look, and I don't like the reference I make in my head - "damaged goods." Then, too, just to be clear, I've never (yet) had an incident where I needed one.

But recently, adorning the wrist of a friend of mine, I saw a really nice piece of jewelry serving as a medic alert bracelet. I was so taken with it that I went directly to the website where she got it, TAH Handcrafted Jewelry. I clicked 'Bracelets' along the left sidebar and scrolled through. There are several designs to choose from. Mine, pictured above, is seventh from the bottom, #9-S.

I wanted something inscribed, but none of the expressions I saw on the site was just right. So I called the handcrafter, Tim, and asked if he could put two words on my bracelet. I wanted it to read "diabetes" to the left of the center garnet and "pride" to the right.

Just enough to send a message to myself, and to anyone who eyes my new bracelet, that not only am I not damaged goods, but I also have reason to be proud: a lot of work, as you well know, goes into managing diabetes. It's something extra we do along with everything else we manage in our lives. Why shouldn't we be proud? And most people don't even know we're working this extra job.

Imagine if all of us who in some way feel "less than" turned it into feeling "more than"? Imagine turning this ugly, old image of diabetes on its head! After all, so much has changed in diabetes today: people are coming out of the closet, for one, and there's also dynamic new research, fast-acting insulins, cool pumps, and diabetic mountain climbers, triathloners, and Olympic swimmers. Why shouldn't we have a new image? As for my new bracelet, it's slim, light, and bright, and that's how I feel wearing it. Powerful stuff, methinks.

You should know that ten percent of the purchase price of the jewelry on Tim's site is donated to the foundation of your choice. You get to choose among Children with Diabetes, the Juvenile Diabetes Research Foundation, the Diabetes Research Institute, and the American Diabetes Association.

Now, if I should ever be found in distress, I think my really nice bracelet will catch some young paramedic's eye and he'll see that I have diabetes. He'll also see I have attitude and extremely good taste in jewelry.

Originally published on DiabetesHealth.com

If you want to live well with diabetes, live well with diabetes

Time passes much faster than it used to so I'm trying more and more to follow the words of a very wise man, "Be the change you want to see in the world." These were Ghandi's words. So, if you want to have love, be love. If you want to enjoy peace, be peace. If you want to find joy, be joy.

If you want to see yourself live well with diabetes, live well with diabetes.

I also follow the words of another great seer, Christopher Robin who said to Pooh: "You must remember this: You're braver than you believe, and stronger than you seem, and smarter than you think."