One Cigarette Butt at a Time

I confess to not understanding smokers at all.  I can relate to smoking as an addiction and appreciate that it is a compulsive behavior.   My workplace is smoke free, including buildings and grounds.  But the sidewalks and driveways approaching the front entrance are littered with cigarette butts from smokers who discard their butts on the ground.  You've surely seen smokers toss their butts indiscriminately out windows of cars or while strolling down streets.  While working last weekend and crossing the driveway from the Emergency Department to my office, I passed a newly planted flower garden littered with cigarette butts.  I've passed this particular spot dozens of times before when it was bare dirt.   A burst of anger and energy came over me, and I marched to my office, put on latex gloves that are kept there for housekeeping, and stormed back to the flower garden.  I then spent the next few minutes picking up butts that had been planted like seeds next to the flowers, in the rock beds nearby and on the sidewalk.  Today, three days later, I passed by again and no new butts!  I feel like the young man in the starfish story, making a difference, one cigarette butt at a time.  If you don't know the story, here it is. 

The Starfish

Strolling along the beach, a woman catches sight of a young man who appears to be dancing at the water's edge. The young man bends down, straightens to his full height and then casts his arm out in an arc. Drawing closer, she sees that the sand is littered with starfish and he is throwing them, one by one, back into the sea.

She says, ‘There are stranded starfish as far as the eye can see. What difference can saving a few of them possibly make?’

Smiling, he stoops down and tosses another starfish out over the water, saying, ‘It made a difference to that one.’

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.