Category: Disease

Wellness Wednesdays: How to Fit Exercise into a Busy Schedule

Growing up, I was a competitive endurance swimmer. During meets,  I swam events like the 1500 meter (~1 mile) freestyle. For me, training meant between two and four hours of practice in the pool every day, swimming lap after lap (after lap after lap). The conventional exercise wisdom doesn’t leave many alternatives – if you want to increase your endurance, you’ve just got to put in the hours. Or do you?

High intensity interval training (HIIT) has been increasing in popularity over the past few years, with programs like Insanity and Crossfit gathering a huge following among athletes, both recreational and competitive alike. As a graduate student, what attracted me to these programs was their efficiency – in 20 minutes or less, I could see the same long-term health benefits as if I spent an hour or more sweating it out? Sign me up!

So, does HIIT work? According to the latest research, the answer is a definitive ‘Yes’. A 2012 study compared two exercise regimens, a high-intensity interval workout and an endurance workout, both using a stationary bike. The HIIT approach involved 30 seconds of cycling at maximum effort, followed by 4.5 minutes of ‘active’ rest (low-effort pedaling). Participants completed this workout three times per week for six weeks. The endurance (classic) approach involved 40-60 minutes of cycling, at 65% effort (pushing hard, but not gasping for breath). Participants in this group worked out five times per week for six weeks. Two common measures of physical fitness, peak oxygen consumption and time-to-exhaustion, were used to determine differences before and after the six weeks of training.

Amazingly, both groups saw virtually the same improvement in physical fitness, based on the two measures collected. However, the HIIT group saw these improvements with only one hour per week of training, while the endurance group logged 4-6 hours each week.

HIIT seems like it may allow busy people the opportunity to reap the same health benefits of exercise in less time – but is it for everyone? Some evidence suggests that these programs may be less appropriate for people with pre-existing medical conditions, like congestive heart failure, because of the ‘stress’ they put on the body. For these people, lower intensity endurance exercise has shown to be more beneficial for improving overall health and functioning.

However, if your busy schedule is the primary thing keeping you from exercising, HIIT offers a potential solution – after I started critically evaluating these programs, I realized that I just couldn’t use the ‘I don’t have time to exercise’ excuse any more. Now I always make sure to fit in at least three HIIT workouts a week. If you’re looking for a way to fit exercise into your schedule, I encourage you to explore some of the HIIT programs out there to see if they might be right for you.

 

Photo credit: http://www.dailymail.co.uk/health/article-2033197/How-vigorous-workout-burning-calories-day.html

Guaranteed to Arrive Before You Leave the ER Waiting Room

Various mailing services guarantee your package to be delivered by a certain time – often the next day, but sometimes even the same day, but who knew a mother living three states away could be to you before you get out of the waiting room in the ER?  As I mentioned in an earlier blog, I have been diagnosed with gastroparesis.  Last week, I spoke with my primary care, who said I needed to go to the urgent care associated with her practice, because I had been sick and not able to re-hydrate myself.  The doctor at urgent care said I needed to go the Emergency Room (ER) at Duke Hospital.  When I arrived at the ER, at 5:00 P.M., I called my mom at her office in Tampa, Florida and to tell her what was happening.  She said that she was leaving immediately and would get to North Carolina as fast as she could.  She had always said if I ever had a problem she would be to me within hours, but thankfully, I have never needed her to come in an emergency situation.  After checking into the ER, a nurse did an initial evaluation in triage and took me back to draw blood and put in an IV.  I was then left sitting in the waiting room in a wheelchair with two bags of IV fluids.  Around 11:00, my mom arrived at the ER shocked to find me still in the waiting room.  After another hour, my mom talked to one of the nurses who indicated that the 6 hours I had been waiting was actually a fairly short wait time for this hospital, as many patients have to wait 10 to 12 hours in the waiting room.  The nurse who finally took us back to a room in the ER, seemed very abrupt, but when my mom said that she was able to get from Florida to Duke ER before I was taken to a room, her stern face actually broke into a small smile.  Even she recognized the absurdity of this situation.  It is understandable that emergency rooms, especially those at major trauma centers, like Duke Hospital, where the most critically ill emergency cases are handled, could sometimes have long wait times.  However, if it takes over 6 hours to be seen when sent by two different physicians, and the normal wait time is 10 to 12 hours, what is wrong with our healthcare system?  How can we have people wait such long wait times for urgent care?  I am thankful for the services provided by Duke Hospital.  This blog is not intended to speak negatively about this hospital, but rather to make a point about wait times at hospitals in general.  Wait times in general, but particularly in the ER are another aspect of our healthcare system that seems to be broken and urgently needs to be repaired.  What have your experiences with emergency care been?  Have you had positive experiences when needing emergency care?

Type One Tuesdays: “May the Odds Be Ever in Your Favor”

I’m sure many of you have read the book, watched the movie or are at least familiar with the plot of the book or movie series The Hunger Games, written by Suzanne Collins. To recap, it is about a group of districts that each must pick a boy and girl representative to compete in the annual hunger games during the reaping, where all of the selected participants must compete against each other until only one participant remains living.   How does this relate to health and my weekly blog?

Type 1 Diabetes (T1D) is a battle no one asked for, but being diagnosed with T1D and living life with T1D is very similar to the reaping process in The Hunger Games, where Effie Trinket picked our names.  During the reaping process, the older a person is or if their family needs food assistance from the government, that person’s name is put into the lottery process additional times, thereby increasing his or her odds of being selected.  With T1D, if we don’t take care of ourselves, we are putting our names in more times to be picked for a complication.  However, just like the reaping process, a person with T1D can be picked even if his or her name is in only once, that being diagnosed with T1D.  One can do everything to take care his or her T1D correctly and still have complications.  So, we can all think of it as Effie Trinket is determining when we are diagnosed and saying to us every time we go to a doctor’s appointment, “May the odds be ever in your favor.”

So, the moral of the story, or blog in this case, is that we are all in the hunger games in District T1D hoping that the odds are in our favor to not be selected to go to the Complication Games.  This is not say that we should not do everything we can to battle this disease and strive to be the one that is standing at the end of the game.  But, it also says that, to some extent, this is beyond our control and we should not be too hard on ourselves or blame ourselves when outcomes are not as we would hope.

Wellness Wednesday: The Importance of ‘Real’ Food

Full disclosure: I Love cheese (with a capital ‘L’). As a child, a visit to Vermont introduced me to Cabot cheddar cheese for the first time – the rest, as they say, is history. Today, I buy at least a pound of Cabot Extra Sharp cheddar cheese every week.

Aside from the fact that Cabot is wholly-owned and operated by a cooperative of dairy farmers in the Northeast, I buy their cheese because it’s Real. The nutrition facts label reveals just four simple ingredients – pasteurized milk, cheese cultures, salt, and enzymes. With so many foods we purchase today becoming more and more processed, as a Registered Dietician-in-training, I appreciate the wholesomeness of products made by companies like Cabot who so obviously care about the quality of the food they produce.

Unfortunately, it appears that my beliefs on this topic of ‘real food’ diverge from those of the Academy of Nutrition and Dietetics, a trade group representing 75,000 nutrition professionals around the United States. The Academy recently granted permission for Kraft to use the new ‘Kids Eat Right’ label on their Kraft American Singles ‘pasteurized prepared cheese product’ (sounds delicious, right?). This decision only makes it even harder for already confused parents to make choices about what foods they should be feeding their kids.

The majority of children in America between the ages of 4 and 18 do not get adequate calcium and vitamin D, essential nutrients that are commonly found in dairy products. Per serving, Cabot cheddar cheese and Kraft Singles contain the same amount of calcium – however, Kraft has to add calcium phosphate to its product in order to match the calcium found naturally in Cabot’s cheese. The Kraft product also has nearly twice as much sodium, by weight, and less protein (even with a boost from both ‘milk protein concentrate’ and ‘whey protein concentrate’).

The lesson here? Parents, if you want to help your kids grow and mature into healthy adults, feed them Real Food. The more packaged, processed, and manipulated a food is, the less Real it gets. They may tout ‘all natural’ or ‘no artificial ingredients’ on the front, but next time you go grocery shopping, turn the package over and have a look at the ingredient list for Kraft Singles or a Lunchables product. What you’ll find will encourage you to put it back on the shelf, instead of in your cart.

 

Photo credit: http://www.nyctaughtme.com/2012_05_01_archive.html

Type 1 Tuesdays: Oh No! Not Him/Her Too!

We all have fond memories of our Moms – whether it be their hugs, voices, cooking or just their amazing support. What is your fondest memory of your Mom? On a similar note, what comes to mind when someone says that name Emma Watson? Many may know this young talented star as Hermoine Granger, the female heroine in JK Rowling’s blockbuster movie series, Harry Potter, or the new Belle in the live Beauty and the Beast Production.  However, did you know that her mother has Type 1 diabetes?  Watson is now speaking out about how her mother is her hero, specifically because she has T1D.  Will we see more of Ms. Watson in other T1D advocacy movements in years to come?

Another British actor with even more personal ties to T1D is Jeremy Irvine, who stars in the film Warhorse. He has been a T1D since he was six years old and is actively involved in the bionic pancreas project.  In a quote on the JDRF website he said, “Thanks to the huge developments being made in the treatment of type 1 diabetes, no child should have to feel diabetes needs to stop them following their aspirations.”  These celebrity spokespersons spread awareness and understanding about T1D, helping all of us who live with this disease.  They are out heroes along with our mothers, both playing a major role in helping us successfully live with this disease.  Who is your favorite star with T1D?  Mary Tyler Moore? Halle Barry? Crystal Bowersox? Brett Michaels? Nick Jonas? Any others?

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Photo Credit: Steven Mezer (In Photo: Amanda Mezer and Karen Mezer (Mom)).

Type One Tuesdays: Conferences, Bonding and Life Long Friends…Priceless!

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As Spring Break approaches and, hopefully, with the snow days behind us, we eagerly look forward to and begin to make plans for summer.  Do you have a favorite place to visit during the summer or a conference to attend?  Over the summer, there are many interesting and fun diabetes camps and conferences.  Two major national conferences that occur over the summer are Students With Diabetes (SWD)’s National Conference and Children With Diabetes (CWD) Friends for Life Conference.

Conferences provided invaluable information, networking opportunities and lifelong friends for people with Type 1 diabetes (T1D).  There are informative sessions that provide information on the latest technology, inspirational and encouraging presentations by successful T1Ds and social activities that provide time to meet and bond with fellow T1Ds.  The relationships made at the conferences provide a great resource for support on the other 364 days of the year when you are not with people who understand your disease.  I met one of my closest friends at the SWD conference several years ago.  Attendees at the conferences relate to each other in a way that is rarely experience in any other setting.  The commonalities between attendees and conference events create an atmosphere for bonding over just a few days.  Even if you don’t keep in touch regularly, some of these people will cross paths with you at other conferences or through other aspects of your life.  Recently, I reconnected with a person, who I had met at a Friends for Life Conference many years ago, when we both participated in a national group project.  It was so great to have a familiar person in the group!  Additionally, when you go back the next year, it is like a family or high school reunion, with the opportunity to also meet new attendees or create stronger bonds with people from previous years.  The experience is priceless.  Are you going to any conferences or camps this summer?  What is your favorite memory?  Don’t let your summer go by without a conference or two to make life-long friends!  Hurry and sign up before registration closes!

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Type One Tuesdays: Celebrity Advocacates – You Can Be One Too!

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Krysta Rodriguez, Broadway actress and film star, added another credential to her name last week.  She began writing a blog about her journey with breast cancer, which coincided with her admission that she has breast cancer.  She uses her website, Chemocouture, to use humor and a very blunt approach to share her very difficult journey with cancer.  Since her announcement, there has been an outpouring of support from celebrities and fans.  In her blog, she describes her cancer.

“Now as far as cancer goes, I have the Cadillac of tumors. It’s slow growing, highly treatable and not really interested in spreading. My doctor calls it an “old lady cancer.” I always knew I was ahead of my time! Picture a lump sitting in a BarcaLounger eating Cheetos and enjoying the warm, cozy studio apartment I’ve been providing for it on Left Breast Lane.  No one would want to leave that, am I right?  Well, sorry buddy.  I’m the landlord from hell and it’s eviction time.”

Krysta Rodriguez is a true inspiration for people dealing with cancer or any chronic illness.  She is using her fame to make a difference in health of others, which is amazing and admirable.  Celebrities, discussing their health problems, can bring attention to topics many people may not have the courage to talk about.  This can be beneficial for other people with the same disease, but also for others who are supporting loved ones or just dealing with difficult life experiences themselves. Celebrities can help inspire and educate people dealing with the disease to be their own advocates and speak out like the celebrities do.  Krysta Rodriguez is not the first to be a celebrity health advocate.  Some other notable celebrities who advocate for their diseases are Michael J. Fox (actor, Parkinson’s disease) and Nicole Johnson (1999 Miss America, Type 1 diabetes).  Each of us has the ability to do what these celebrities have done, by being our own advocate and embracing our disease(s).

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I am by no means Krysta Rodriguez, but I hope to have a positive impact on the Type 1 diabetes community.  I have chosen to focus make my career and my life on helping others through my experiences with T1D.  If I learn something new and helpful, I want to share it with others.  Even difficult or challenging experiences provide opportunities to help others by sharing how I dealt with the issue and to let them know that I got through it.  Do you embrace any diseases you have? Do you incorporate them into other aspects of your life? Are you your own advocate? Do you think more people should be like Krystra Rodriguez, Michael J Fox and Nicole Johnson and speak out about their health problems?

Photo Credit: Steven Mezer (Photo 1: Krystra Rodriguez and Amanda Mezer; Photo 2: Nicole Johnson and Amanda Mezer).

 

Wellness Wednesdays: How to Weather the Winter

As a wicked ice storm has kept me cooped up inside for the past two days, I’ve been thinking how the many barriers that get in the way of making healthier choices somehow seem to multiply during the cold, dark winter months.  Exercise? It’s freezing outside. Healthy diet? Most fruits and vegetables are out of season. For the many of us who already struggle to make better decisions, these extra hurdles can sometimes prove to be just too much.  Here’s how to keep the winter weather from ruining your health.

Less sunlight. Fewer hours of daylight during winter months means you are more at risk for vitamin D deficiency, which can make you more susceptible to viruses by weakening your immune defenses. Vitamin D is produced in the skin when you are exposed to ultraviolet (UV) radiation from the sun, i.e. sunlight. However, the winter sun is too weak to stimulate vitamin D production, especially in northern latitudes. Few foods are naturally high in vitamin D – eggs and some fish provide some, but the majority of dietary vitamin D comes from fortified foods like milk and orange juice. Just be sure to read the label – not all products are fortified. Start your day off right with a couple of hard-boiled eggs and a glass of orange juice – you’ll get a third of your daily vitamin D before you even leave the house.

Cold temperatures. When my fiance gets cold (which is always), the first thing she does is reach for a blanket. Resist the urge to hunker down – get up and move instead. Your working muscles produce internal heat that helps you fend off the chills, along with all the other benefits that exercise brings. You don’t need an expensive treadmill or fancy equipment to be physically active inside – with a bit of imagination, some dumbbells and a staircase are all you need to get a full-body workout.

Tasteless produce. Most fruits and vegetables are out of season during the coldest parts of the year, which means that the ‘fresh’ stuff you see in the produce isle has likely traveled thousands of miles since being picked three weeks ago to get to your store. Buy frozen produce instead – you’ll get a lot more for your money, nutrient-wise. The fruits and vegetables in these products were frozen immediately after harvest, conveniently preserving all the nutritional benefits of fresh produce. Throw a mixture of frozen berries and kale into your smoothie for an added vitamin boost!

 

Photo credit: http://www.ucar.edu/communications/quarterly/spring03/winter.html

Type 1 Tuesdays: Friends, Laughter and Entertainment — Oh My!

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 As  you may have heard the proverb, “laughter is the best medicine,” and you may also know the benefits of spending time with family and friends.  However, have you thought of combining these two behaviors?  Laughter actually results in chemical changes in your body which has a positive influence on blood flow, immune response, blood sugar levels (diabetes alert!), relaxation and sleep.  Did you know that 10-15 minutes of laughter actually burns 50 calories?  Are you trying to lose holiday pounds?  Could laughter be the solution to your diet woes?  In addition, the health benefits of social support from family and friends include having a sense of belonging, increased sense of self-worth and feelings of security.  Therefore, spending time laughing and having fun with family and friends can double the positive impact on your health status while improving your mood as well.

This past weekend, I went to Tampa, Florida for Valentine’s Day weekend, where the Straz Center for the Performing Arts Center is producing the musical “First Date.”  It is a 96 minute show full of laughter that was especially enjoyable since it was also a great opportunity to share the evening with family and friends.  We laughed throughout the show and even after as we discussed the funniest parts of the show.  At the end of the evening, there was a sense of well-being and contentment.    Laughter and socialization truly are the best medicine, particularly for those of us with chronic illnesses.  Do you think you can add a bit of laughter and socialization into your routine?  I assure you that you will be glad you did!

HPV Vaccination: It’s Not Just for Girls

While vaccines have been around for many years and are able to help prevent many diseases, there remains a lot of controversy over whether children should be vaccinated for many reasons, including the potential adverse side effects from the vaccine.  Parents have raised concerns about the HPV (Human Papilloma Virus) vaccine including: (1) the child is not sexually active, so there is not a need to vaccinated; (2) safety concerns related to side effects and (3) they claim that the vaccine is not needed or necessary.  In addition, many times this vaccine is not recommended by the child’s medical provider, so the parent does not know about the vaccine.

Regardless of the reason for not getting the vaccine, that decision has major ramifications. Currently, there are 30 types of HPV that are sexually transmitted and over 100 types that are t skin-to-skin.  Dr. Joan Cates, a Senior Lecturer at the University of North Carolina Chapel Hill in the School of Journalism and Mass Communication, has participated in several studies, some currently in the process, on the issue of HPV vaccination, specifically with young boys.  In 2011, the recommendation came out that young boys should receive the vaccination that historically had only been recommended for girls.  HPV can lead to a variety of cancers, not just cervical cancer in females. The “Protect Him” campaign focused on increasing the 13 year male vaccination rate.  In this campaign, two major factors appeared to be important in influencing parents.  First, parents reacted positively to information involving their son’s risk and the use of the word “protection” against disease.   The measures that were evaluated in this study included: immunization registry data, awareness, attitudes, beliefs, provider recommendation, vaccination intentions and initiation.  It was found from the study that those in the intervention group were 34% more likely to be vaccinated.  In Dr. Cates’ newest HPV awareness study, responses pre- and post-intervention were remarkably similar regarding awareness.  Dr. Cates is currently in the process of creating a video game study that would introduce adolescents to the HPV vaccine and provide them with important information. As someone with a chronic disease, Type 1 diabetes, it makes sense to be able to be protected from as many harmful diseases as possible.  Many of the diseases that we have vaccines for are potentially deadly, if contracted.  Who would not want to minimize his or her risk from these harmful and deadly diseases?

 

Photo Credit: Amanda Mezer