Dr. Roizen, Regina Brett and What I Learned at the Cleveland Clinic

Three days at the Cleveland Clinic (CC) for the 'Empathy and Innovation Summit'. There's a trend in health care organizations to create an office or a position focused on the 'patient experience'; CC is in the forefront of this movement.  PE is a highly evolved construct for customer service, and encompasses the environment (art and architecture), caregivers who are carefully selected, trained and focused on the patient; and a holistic view of patient care and treatment that considers the patient AND family.  It's been awhile since I have been to any sort of conference and I am grateful to have had the opportunity to attend this one.  I learned a lot that can help me do my job better; and a lot that can help me live my life better too.  Some of you may remember that the CEO of Cleveland Clinic, a cardiologist, made headlines a few years ago when he tried to kick McDonald's out of the first floor of the Clinic.  He lost that battle; apparently McDonald's was perfectly happy to stay where they were not wanted since they have a long-term lease.  The Cleveland Clinic does not hire smokers; they are in the minority of hospitals.  They have a major employee wellness initiative and another one aimed at the community, 'Let's Move It.'  All of this makes great sense to me.  The conference had two terrific keynote speakers, one of whom I will write a whole post about, Regina Brett (author of 'God Never Blinks' , a book I highly recommend) and Robby Benson.  The panel moderator for the final segment of the conference was MIchael Roizen, M.D.  I had seen him a few times on Dr. Oz with whom he co-authored YOU: On a Diet.   Dr. Roizen is the CC's Chief Wellness Officer, another role found in forward thinking organizations.  It's always tough to be the last presenter at a conference but he made it worthwhile.  Dr. Roizen is passionate about wellness and about the compelling business case for it.  With all the talk about health care reform, the fact that healthcare costs are largely driven by obesity, tobacco use, stress and inactivity sometimes gets lost.  I bought his book and he was kind enough to inscribe it personally when I shared with him that I had lost 25 pounds and have 25 more to go.  The inscription ends, "Go For It!".  He was also kind enough to pose with me for the photo above.  A lot of the tips in the book are things that I already know, but one of them is so practical I would like to pass it on.  We all know that we should read labels, but he and Dr. Oz prescribe avoiding ANY food with ANY of the following five ingredients:  "simple sugars; enriched, bleached or refined flour; all syrups, including high fructose corn syrup; saturated fat or trans fat." He talked about the importance of managing the environment.  And the conference planners certainly did that.  Food and beverages are not allowed in the Conference Center lecture halls.  All the meals and snacks were healthy and delicious, making it easier for attendees to make good choices.  The hotel and Clinic gift shops did the same.   His advice is that we make "living healthy automatic."  It's so much easier when the environment is supportive. 

If this were so easy, Oprah would have done it.

It seems like it's all Oprah, all the time these days as her daily show winds down.  She is a one woman global enterprise, 'OWN'ing her own network, magazine, and millions of followers who look to her for advice, book choices and as a kind of life coach.   She has no equal in what she has built from the sheer force of her personality and will.  I caught a glimpse of her best friend Gayle King last night on Piers Morgan and they were sharing stories of her kindness and simple humanity.  And of course, she has a gazillion dollars that she puts in good use to benefit and encourage others.
So, with all of that, does it surprise you that she still apparently struggles with weight issues?  How many of us that do so too have thought that if we only had a private chef, a home gym, a life coach or a trainer like Jillian Michaels or Bob Greene, we could finally and completely shed our excess weight?  Just when I start to feel that it is easy or that I have this under control, I have a slip-up.  I am working at not having these be major.  But it's hard.  Those of us that are on this journey are in good company.  

Narcissistic Navel Gazing?

It's no secret that I am a pretty conventional Roman Catholic, the product of 12 years of Catholic education in the 1960s and 1970s.  The fact that the Vatican recently held a meeting for bloggers gives me an opportunity to reflect on the whole blogosphere thing.  Why do people do this?   One of my frequent time wasters, or multi-tasking diversions while I am on conference calls (oops, did I really write that?) is to click on the 'Next Blog' button that appears on blogspot.  It is amazing to 'surf' blogs and see the stuff that people write about and post.  Lots of family blogs, travel blogs, business-promoting blogs, 'cause' blogs for diseases, organizations and points of view and many dead or at least terminally inactive blogs where no posts have been made for months or years.  When I read that the Vatican invited bloggers to come to Rome, it impressed me as pretty cool.  After all, people think the Vatican is old and stodgy, but taking the initiative to host a blogger conference with people from around the world strikes me as more in-touch than most people give it credit for.  Then I learned that Pope Benedict XVI has written on the subject of social media and encouraged priests to adopt these forms of communication to reach out to people who are not the ones usually in the pews on Sunday.  At the blog conference, Federico Lombardi, SJ, commented on the potential for good in that bloggers can inform and explain the Church.  He was also quoted as being concerned about the inherent problem of self-centeredness and ego among communicators in general, and particularly among bloggers.  It is an issue I think about regularly, not so much related to blogging specifically, but social media in general, although I often ask myself why I am really doing this.  
I read another quote from another Vatican spokesperson related to the use of Facebook,  Monsignor Paul Tighe, from the same Social Communications Office as Father Lombardi.  "What we have found is that Facebook doesn't just share information, it creates community,  People begin talking to each other and sharing ideas."   I get that and hope that is what I am doing with both my Facebook page and this blog.   And if I step too far over the line into the world of 'me, me, me'  feel free to let me know. 
P.S.  Early yesterday evening as I was driving home from work, I got a phone call from my cousin, who shared sad news with me about the untimely death of another of our cousins, whose sister is a fairly prominent blogger.  This morning, I saw that she had posted a poignant reflection on their relationship.  Now that's building community.  More later on that issue. 
P.P.S. For my Facebook friends, learning what you had for dinner or that you are going to sleep now is TMI.  I love the ideas, the funny stuff, the photos, but let's all think before we post. 

Those Who Fail To Plan

… plan to fail.  Isn’t that how the saying goes?  I have not written a lot of posts lately about the ‘Eat’-focused portion of this blog.  But the last few weeks have been a struggle.  This is party-time, with lots of social stuff going on related to work and personal life, including retirement dinners, nurses and hospital week celebrations, graduation parties and reunions.  I’ve been avoiding the scale and when I checked this morning, it showed an increase of 2.3 pounds since my last Weight Watchers weigh-in on April 26.  Yikes!  It’s kind of freaking me out.  Now, overall I am still down 22 pounds from my peak weight and 11 since January.  But still, it’s going in the wrong direction. 

But let me digress.  I am not a very organized person – I don’t typically make lists; my desk is cluttered; I’d have a hard time finding my social security card if I had to; and right now, have been unable to locate the parking pass that opens the gate to the hospital garage for several days.  The only good thing about not knowing where the parking pass is?  I have to walk from one of the outlying lots so I get more exercise.

This disorganization is itself a source of stress.  I truly am in awe of those who are blessed with the organization gene.   You know, they’re the ones who send thank you notes promptly, keep track of birthdays, can locate the family mailing list, the ones you call when you need an address or phone number and who don’t have to move stuff out of the front seat of the car when driving you somewhere. 

What I have noticed in the last few weeks is that I get into trouble when I do not meticulously and consciously plan meals and snacks or when a meeting involving a meal or at mealtime interrupts my typical schedule. 

So next week, I have a three-day business trip with a group from work.  I have started thinking about how I will take food with me to help me get through it.  It’s at a world-famous healthcare institution known for a focus on wellness, but I am not going to take any chances.  Mentally, I have begun packing an insulated tote bag with some low-carb staples like cut vegetables, Greek yogurt, Mary’s Gone Crackers, Yumnuts, etc.

Not willing to wing this one.  Not willing to skip another Weight Watchers weigh-in either. 

What makes a highly effective diabetic?

I skipped two days of the D-Blog week, having been affected first by the blogspot outage and second by the compelling sense that I had nothing important to say.  So many of my fellow bloggers who are parents of Type 1 children have not just inspired me, but intimidated me.  Then I was sorting through some papers yesterday and came across a pamphlet called "The 7 Habits of Highly Effective People with Diabetes", by Steven Covey.  His best-selling book, "The Seven Habits of Highly Effective People", has sold millions and has spawned other books and workshops; California University of Pennsylvania even offers it free of charge to students as part of the curriculum.  (It would have been a wonderful addition to my college studies.)  This free pamphlet was written by Dr. Covey in collaboration with the American Association of Diabetes Educators, compliments of Bayer Diabetes Care.  He takes the Seven Habits and applied them to the AADE (TM) Self-Care behaviors.   You can download it at http://www.simplewins.com/sections/livemylife/7-Habits-of-Highly-Effective-People-Diabetes  He invites us to "see diabetes not as a setback, but a journey of self-discovery".    There is so much wisdom in his words and I decided to do a kind of examination of conscience against his habits and I invite you to do so too:

1. Be Proactive (TM) -- am I making choices and taking responsibility for them?
2. Begin With the End in Mind (TM) -- am I acting out of vision and my deepest values?
3. Put First Things First (TM) -- am I spending my time on what I believe to be truly important?
4. Think Win-Win (TM)  -- am I thinking in terms of helping others succeed, not just myself?
5. Seek First To Understand, Then To Be Understood (TM) -- do I truly listen first?
6. Synergize (TM) -- am I working with others, building relationships with the goal of progress, not perfection?
7. Sharpen the Saw (TM) -- am I working on my whole self (body, mind, spirit and relationships) to continuously learn and grow?

It's so easy to be negative and cynical, turning towards worry and anger.  I was at a continuing medical education program conducted by a lawyer last Thursday night.  In the middle of a somewhat interesting, but tedious presentation on health care reform, he made a comment that gave me pause at the time, and to which I have returned in my head numerous times over the past four days.  He was talking about the challenges of delivering health care and making difficult resource allocation decisions (remember the scare about death panels?)   He said the only infinite resource is God's mercy.  Wow -- it helps to be reminded that we all fall short, life is hard and ultimately we are not God, so we do the best we can and keep trying.  That is the lesson I am taking from this D-Blog week.  Looking forward to posting about something other than diabetes soon! 

Ten Things I Hate About Diabetes

1. That split second just before the needle pricks my finger (sounds like whining, I know).
2. The internal battle between what I know I should eat and what I want to eat when it's a special occasion and there is awesome food that I really like.
3. Counting carbs -- or more accurately, rationing carbs since I love them and that's how I got into this position in the first place.
4. Its effects on the health and lives of me, family and friends, particularly the amputations and foot issues.
5. The stupid television commercials, with people who look a lot like me, promoting the benefits of some diabetes drug.
6. The supposedly diabetes food products, including one that starts with the letter 'g', that is full of high fructose corn syrup and other unintelligible and unnatural ingredients.
7. The conflicting dietary advice (I so wanted Dr. Barnard to be right, but his advice backfired badly for me.)
8. The unpredictability and fickleness of blood sugar readings, especially in the morning.
9. Carrying supplies and just-in-case food around.
10. That it exists. 

No Bloopers and Not Really Poetry

I don't have any bloopers to write about.  One of the alternative topics for the day suggests poetry or other creative arts as an appropriate posting.  That's not me either; then I remembered haiku -- five syllables, seven syllables, five syllables.  I offer this and promise to visit the sites of other participants in D-Blog week to encourage and recognize them for their efforts so far.   

Consciously Choosing
To Encourage Those Who Need
Hope and Help Today

Dearest D,

Day 2 of D-blog Week asks that we write a letter -- and this is my letter to Diabetes itself:

Dear Diabetes:
Well, you finally got me. You've been stalking me for years while I have hidden from you, taunted you, resented you and downright hated you. You've caught my family, friends and now me. You tormented my mother and made her final years ones of pain and distress.
I hate when people say, "I am a diabetic".  While I may have you, I AM NOT YOU AND YOU ARE NOT ME. I refused to be defined by you. 
Now that I've got the anger out there, now what?  What do I do with you?  How I live with you since I apparently can't live without you? 
There is growing usage in business and in life of 'coaches' -- you know, personal trainers, gurus, executive coaches, life coaches, etc.  I'm not totally sure about reasons for this phenomenon.  Does it reflect the complexity of modern life?  The demise of large families where advice and counsel is readily available from people who know and love you?   A true desire for self-improvement or just narcissism?
I don't have a coach per se, but a former colleague of mine makes his living as an author, sports performance coach and professional speaker.    His name is Dr. Kevin Elko and you can link to his website from the links on this blog.  We talk periodically and I follow his work. 
Kevin's advice is always that one must live, not from circumstances, but from vision.  So, how do I live from vision, with you?  It has occurred to me that you are not all bad (did I really just write that?).  You have forced me to confront reality, to deal with numbers I would rather not even think about, to find more compassion for others and for myself.  You humble me, hold me accountable, make me think, and are leading me, kicking and screaming, into a lifestyle that is more about balance -- physical, mental and spiritual.  You have brought me closer to family members and a deeper understanding of my mother, whose struggle I have written about in other blog posts. 
Yes I hate having you, but you are making me better and my life's journey richer. 

Yours truly,
Rosanne

Jan, Nan and Rosanne

I am still in the toddler stage of my blogging career -- ranting, sometimes negative, questioning and not sure of the right way to put words together. I wanted to see who was out there blogging about diabetes, since my diagnosis with Type 2 was the impetus for the creation of this blog. I had no idea there were so many people  blogging about diabetes, until I searched  'diabetes blogs' on Google; and literally millions of hits came up.
Then coincidentally (which I really don't believe in; I think all things that happen are meant to be), I happened across the site for D-Blog week and signed up, before I even knew what the topics were. Then I checked out some of the others who signed up, including Nan of http://www.eatpraybolus.blogspot.com/ and Jan of http://www.bloodsweatcarbs.blogspot.com/.
Apparently, I am drawn to three-word blog titles that remind me of mine and to bloggers who use Google with names that also rhyme with mine. Then, when I looked at their blogs, they both turned out to be relatively new sites, just like mine.  Nan's blog header is, "stories of food, faith & family (oh, yeah...& diabetes!), kind of like my header.  Jan's blog header is, "Random thoughts and reflections about the 3 things I am most passionate about: Diabetes, Exercise, and Cooking, while raising a 10 year old son with Type 1 diabetes".So they are both moms with kids who have Type 1; I am in awe of these women who on a constant basis, are responsible for managing, coaching, encouraging a child with such a serious health condition.  Nan's description of the effort involved in preparation for her child's track meet gave me an insight into her reality that makes mine seem pretty easy to manage.  And Jan is a serious athlete, describing herself as someone who is, "extremely active and loves running, cycling, triathlon, and numerous other sports. In my spare time I also love to cook and promote the importance of a healthy, active lifestyle".   Her athletic event schedule is posted on her site and includes Cyclebetes, a relay from Vancouver to Calgary -- and I think I am doing well when I take a 30-minute walk every day. 
This post is a shout out to all the incredible moms of kids with Type 1.  Sometimes I blame myself for lifestyle choices that contributed to my diabetes.  That seems to me to be a big difference between me, Jan and Nan.   But just reading their blogs (and I hope to continue to follow them) is motivational and inspirational. 

Goodbye, Race for the Cure

For the last several Mothers Days, my cousin and I have attended the Race for the Cure in Pittsburgh. I have no plans to attend next year. The first year I was inspired. This year I have a level of disappointment that must reflect a change in me, because the Race seems pretty much the same. What has changed in me? Well, the event that triggered the creation of this blog, a diagnosis of diabetes. Today's Race for the Cure provided an opportunity to show support for my cousin, who is a survivor, but she, like me, has diabetes. At the Race, there is lots of commercial promotion tied to breast cancer awareness, involving megasponsors like Ford and New Balance. I get the marketing connection and the need of advertisers to connect with the female demographic. What I don't get is the prevalence of food that is at worst, bad and at best, inappropriate to be associated with this event. I thought, and I am by no means an expert, that our Western diet is known to contribute to lifestyle related diseases and certainly obesity, which is a risk factor for breast cancer. So does it seem weird to you that they were serving donuts, bagels, ice cream, custard and birthday cake at 9 o'clock this morning? Next year, I plan to Sleep-In for the Cure -- by the time I registered this year, the Sleep-In pillowcases were all gone. Maybe those people have the right idea: avoiding temptation for a good cause.

Grief, Yoga and Irish Wakes, Part 2

Going to a yoga class after Anne Mullaney's wake reminded me that I had done so the day of my mother's funeral in 2009.  This is the reflection I wrote:

My M(OM)

Since beginning a yoga practice over a year ago, I stand taller, breathe more consciously, and have gained in strength, balance and flexibility.  Then in June 2009, my mom died and yoga gave me something much more – a place and a way to grieve.     

Dementia had invaded her mind.  When she spoke it was as if the keyboard that spelled out words in her head had shifted, and out of her mouth came unintelligible syllables in a language only she understood.  She also had diabetes, osteoporosis and arthritis and was confined to bed.   She could barely move. 

My brother and I were with her when she died, in the nursing home where she spent the last 17 months of her life.  I got a call at work that her condition had deteriorated, and within five minutes of arriving, she died.  My brother Frank and I touched her forehead, told her we loved her and kissed her.  She took several labored breaths and then …stopped.

My rote response, when someone would express their sympathy or support, was:  “That’s OK, my mom was sick for a long time”.   Or, “I said my goodbyes to my mom years ago”.   Tears did not come easily because frankly, I was relieved that her suffering was over.

On the day of my mom’s funeral, after everyone went their separate ways, I took a yoga class.  I could not think of any other constructive way to cope or anything I would rather do.  A pregnant woman, apparently taking her first class, was two mats away.  Kris, the instructor, was particularly solicitous in adjusting her postures and assured her that they could be different after the baby was born.  Something about my awareness of her full body and impending motherhood and the intensity of the day’s events became overwhelming. 

During final relaxation, tears trickled from the corners of my eyes and fell to the mat.   

I got into yoga to benefit my health.  At first it was primarily an interest in my physical health.  Then it became more about mental and spiritual health.  One of the more disconcerting (to me, anyway) aspects of yoga that is part of some classes is chanting ‘Om’; it feels too Hindu or Buddhist for my Catholic sensibilities.   

I don’t usually chant.  But that day, at the end of class, I did, three times…“Mom…Mom…Mom”. 

Charles Darwin, the Internet and the Nature of Existence

Do any of you remember when you first learned about the Internet?  I remember the place and the occasion, but not the specific date.  It had to be sometime in the early 1990s. I taught for nearly 20 years at Carnegie Mellon University and they held regular workshops for adjunct faculty.   During one of those workshops, the facilitator/professor introduced what were to me the first websites I had ever seen.  I recall being intrigued by being able to view restaurant menus online; my fascination and vision of what the Internet meant was clearly limited.  One comment made by this professor has stuck with me for over 15 years.  He remarked that people who were not connected to the World Wide Web, through sites or through email, would essentially cease to exist at a certain level of being.  They would become like dinosaurs and fade away as part of ancient history.  He reasoned that social discourse would be conducted this way and that if one was not able to participate in it, or to exchange information through it, they were in effect, dead.  My brother and I were talking about this idea of existence in cyberspace and he was commenting about the prevalence of blogs among professionals, particularly economists.  He opined that in order to be part of the public exchange of ideas, you have to communicate in this way, in real time and have followers and commenters.  This builds the modern version of dialogue.
A few weeks ago, I met a friend for lunch and as we were catching up, I told her about how much fun I have been having with facebook and with blogging.  Carrie, as I'll name her, has no personal email account, no facebook page and does not use a computer except at work.  I can't use what are key tools in my communications repertoire to keep up and connect with her.  And I was reminded of the comment from that years-ago workshop. 
So, I blog, therefore I exist?

Memories and The Italian Garden Project

Growing up, the garden in our backyard was a source of embarrassment to me every summer.   No other house in our neighborhood had a garden.  My mom spent countless hours digging, planting, weeding and picking.  My dad mostly watched and supervised.  I thought it was a weird kind of ethnic thing that made us stand out; there were not a lot of Italians in Munhall.  Coupled with my last name of obviously Italian ethnicity, which I thought was even weirder, I spent most of my youth embarrassed and wishing my dad could do something more normal for a living, like work in a steel mill and that my mom would stop spending so much time outside, wearing a sunhat, digging in the garden.  

By my late twenties, following a trip to Italy with my father that involved visiting his hometown and the hometown of my mother's parents, I discovered that ethnic could be cool. 
Yesterday, the Pittsburgh Public Market in the Strip District hosted a slide show presentation by the Italian Garden Project, "Come Back to the Garden:  Italian Gardens of the Pittsburgh Region."  Unfortunately by the time I read about it, it was over.  It seems that now I am in my 50s, the whole Slow Food, CSA and home garden movement is totally trendy.  The Italian Garden Project, based in Sewickley, is planning tours this summer of some of the better ones in the area.  And on June 25, there will be a presentation at the Public Market from 11:30 a.m. to 12:30 p.m. on "Italian Wedding Dances and Wedding Cookie Recipe Exchange."  The photograph of the cookie table at our wedding is one of my favorite photos (remember my first word was 'cookie')  See www.TheItalianGardenProject.com.