Sunday, March 23, 2014

Growth & Renewal

I started a new job this week.  I’m working with Type 1 diabetes, Type 2 diabetes, Type 1.5 diabetes (yes, there’s such a thing), Gestational Diabetes, and people with Prediabetes.  Diabetes has always been an area of interest to me because it’s a disease that you can manage.  After a person is diagnosed with diabetes, they often feel overwhelmed and frightened.  But I let them know the good news, they CAN manage their diabetes.  ¡Si se puede controlar la diabetes!  That’s where my job as a dietitian comes in to allow them to know how foods affect their blood sugar level as well as how much food they can eat at once.  As I was sitting in on a few sessions this week with the nurse, I was able to observe.  Sometimes as an educator I go into the mode of teaching and want to provide the patient with all the information they need to be successful, when it’s always better to let the patient tell you what they need. So with this 1st week, as I’m entering into a new job, I observed a few education sessions to get me started on the right foot and then began to start a few sessions on my own.   Here are a few observations and that I made:

Our bodies are amazing! – No, I didn’t just realize that this week J  But if you really sit back and take the time to process all that our bodies do day in and day out – our heart alone beats 100,000 times per day, pumping five or six quarts of blood each minute, or about 2,000 gallons per day - we should really treat our bodies better than we do!  People that have been diagnosed with diabetes are in a situation where they’re forced to or else their health will be compromised.  But what if we were all faced with this possible diagnosis?  Would we try and prevent it or just think that in due time we’re bound to get some disease?  From the moment a bite of food enters the mouth, each morsel of nutrition within starts to be broken down for use by the body.  You’ve heard the whole adage, “You are what you eat.”  Well it seems there’s an updated version surfacing on social media, “You are what you eat – so don’t be fast, cheap, easy, or fake.”  Our bodies are remarkably adept at making do with whatever type of food is available.  And so begins the process of metabolism, the series of chemical reactions that transform food into components that can be used for the body’s basic processes.  Give your body the nourishment it needs to be able to perform at an optimal level – don’t be fast, cheap, easy, OR fake.
 
 
 
 
 
We should all be as conscientious as a diabetic has to be – Diabetes Mellitus means high levels of sugar (glucose) in the bloodstream (circulation) and in the urine.  Our body needs a certain amount of glucose to help us think clearly and function, as well as give our bodies the energy that we need now and for later.  In order for our bodies to use glucose for energy, they rely on insulin.  Insulin is a hormone that is produced by the beta cells in the pancreas.  If the pancreas is not able to produce enough insulin (insulin deficiency) or if the body cannot use the insulin it produces (insulin resistance), glucose builds up in the bloodstream (hyperglycemia) and diabetes develops.  The goal in diabetes treatment is to keep blood glucose and blood pressure as close to normal as possible.  How does one do this?  Diabetes can be controlled by food, exercise, and medicine.  (Otherwise, with chronically high blood glucose levels it can damage many parts of the body, including the eyes, kidneys, nerves, and cardiovascular system.)  I teach the patient what foods contain carbohydrates, the body’s main energy source, and how fat and protein play a role as well. 

 
I use this picture frequently when educating the patients.  It’s a good visual to show them how quickly a fruit can be broken down, but when combined with a protein and fat source, i.e. nuts, how the two mixed together will make for a more balanced blood glucose level.  This is the key to diabetes – balancing what the person eats and not eating too much of any one food.  I then go on to explain to the patients that this is the way ALL people should eat.  The diabetics always look at me as if they don’t believe me, but it’s true.  We should ALL be as conscientious as a diabetic has to be – the problem is we aren’t.  What if we had to not only count how many carbohydrates that we were having at each meal but also limit how many carbohydrates we had?  I think many of us would be surprised at how much “extra” they’re eating. And with all this “extra” food that makes our bodies work that much harder.  Over time this excess consumption is what makes us sick. For some it will surface sooner than for others and for some maybe it will never surface.  I guess as I was sitting and observing this week I was in my nutrition dream world and began to hope that people would see this as clearly as I was and maybe begin to start to change and make healthier habits one at a time.
Just because you talk loud doesn’t mean the patient will hear – How many times have you done this – you have a person in front of you that speaks a different language.  They understand English but it is their second language, so it takes them longer to process/understand.  While you’re having a conversation with them your voice begins to rise.  All of a sudden you feel like you’re yelling at them, but for some reason you think you’re getting through to them.  We’ve all done it.  This week we had help from a son translating for his mom.  She only spoke Italian so I was grateful he was there to help translate.  As the session went on I realized he wasn’t helping.  And not only that but by the end of the session I had a headache from all the yelling that went on (and yes maybe part of it is cultural to talk loud) but let me explain.  I began by showing the foods that contain carbohydrates, I showed how much of each she could have at each meal, and then allowed her to help me create meals to show me her understanding.  All along the son was translating this and I’d wait for him to translate back what the mother was saying.  All of a sudden the son began to tell me that the mother was hard headed and I needed to be firm with her and not allow her to have gelato.  The only time I had mentioned the word gelato was in the explanation to her that it does affect her blood sugar level, but I know I never mentioned she could have a limitless amount.  The son began to tell me I needed to tell her she could never have it.  The mother kept repeating the word gelato.  And that’s when some louder talking began and the translation stopped.  Lots of other things were going on needless to say, but I am happy to say that by the end of the session a few things were discussed and addressed.  What the son had on his agenda was completely different from what the mother needed from the session.  There I was watching what I knew wouldn’t work and trying to help the son understand what the mother was going through.  It’s a great reminder that just because we want someone to hear what we have to say it might not be what they’re ready to hear. 
Spring is always described as a time of growth and renewal.  It’s fitting that during this 1st week at my new job it was also the 1st day of spring.  I have a lot to learn and am excited for where this journey is going to take me.  I’ve always been passionate about helping people live a healthier lifestyle.  But with this new start it has only made me more passionate (so watch out!)  I’m at a place where not only do people need to know what they have to eat in order to be healthy but also where people want to know.           
 
 

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