Coaching Corner - Maintaining Healthy Blood Sugars with type II Diabetes

Coaching Corner  ~ Maintaining Healthy Blood Sugars

-Kimberlee Langford, RN BSN CCM CPC

For many people with type II diabetes – it develops over time – years of strain on a pancreas from a diet rich in easy and quick-to-digest foods that end up putting a lot of sugar in the blood stream and a heavy burden on the pancreas to pump out more and more insulin….and eventually, the strain wears out the insulin-producing capacity of the pancreas. 

Not having enough insulin means that the sugar in the bloodstream from the foods we eat, cannot get into the cells to supply the energy they need to do the work of living.  Blood sugars rise making it harder for the heart to pump the blood – blood pressure increases – over time this damages delicate structures like eyes and hearts and nerves and kidneys.

Meanwhile – those cells are hungry – they have not been fed – so they send a signal to the brain that they are starving and the brain accommodates by creating a craving – makes you reach for the bag of chips or can of soda pop – or the candy bar we saw in the break room at work! 

The increased concentration of sugar in the blood sends a message to the brain that makes you thirsty – wanting to thin out the sugar and the kidneys kick in so we can urinate more – letting off the excess sugar.

It’s easy to dismiss these danger signals – ‘of course we urinate a lot – because we drink a lot.’  Or ‘I just don’t have any willpower.’ 

It’s important to recognize the reason behind the symptoms – your body is talking to you!  When you have a craving for something you know you ‘shouldn’t’ eat – know that is has nothing to do with willpower and everything to do with telling you it needs something you haven’t given it or that it can’t access yet.

Think of your blood sugar like a fire – some foods burn like kindling and some foods burn like logs.  – High glycemic index foods are those with a HIGH effect on your blood sugar – they burn real hot, real fast – and then go out – like that candy bar you saw in the break room – white flour, white rice, minute oatmeal, minute rice – quick foods are quick because they are easier to break down into sugar. 

Some foods burn like a log – not a big or fast rise in blood sugar, but they burn for a long time and keep a room temperate and comfortable.    Throwing a log on your fire at regular intervals keeps a fire going nicely.  If you don’t keep putting a log on the fire at regular intervals, the fire goes out – and you have to re-start it.   These foods are proteins, high fiber foods and fats – they burn longer…break down slower. 

Having a fire go out and having to restart it is a lot of work – it’s hard on your body to have low and high blood sugars. 

For a diabetic – putting a log on your fire at regular intervals – every 3-4 hours – is a key to helping to maintain regular blood sugar levels.   It will prevent you having to chase a low blood sugar and drive it high with those quick, fast foods.    You’ll find that as sugar levels normalize – cravings will go away, you’ll enjoy greater energy and less mood swings – and reduce your risk for heart, kidney disease, liver disease,  neuropathy and skin problems and more!

Coaching Corner - Depression and Self-Care

Coaching Corner  ~ Depression

-Kimberlee Langford, RN BSN CCM CPC

So, I have to preface this post with a disclaimer – I am not a psychologist or counsellor, so I am in no way an expert here.  BUT, as a nurse, a mother, a wife and a friend – I have experienced depression myself, and have been touched by it in every role in my life.  I have lost friends and family to suicide, and have fought hard for people I love who have almost drowned in its depths and have thought about resorting to suicide.   It is so important to be aware of the signs – in yourself and in others, to reach out for help when needed, and to practice good self-care on a daily basis. 

We all go through situations that are sad – times when we are transiently sad – a sadness that surrounds a loss or a situation.  That sadness doesn’t linger – but passes.  CLINICAL depression is so tough, because it doesn’t pass, and is more pervasive.   It can and often does progress and can cause people to think about or actually commit suicide. 

If you have a loved one who is suffering  with sadness and/or depression – please know that YOU cannot make someone depressed.  When people we love are depressed it’s easy to wonder: ‘what did I do’ – ‘what’s wrong with me that is making him/her depressed.’   It is too easy to blame yourself, but please know that it is not you  --  but that you can help.   And if you have any thought or fear or sign that they might want to hurt themselves, or be thinking about hurting themselves – then it’s important to get help – call your doctor, get them to the ER or even to  call 911. 

If you, yourself,  are feeling depressed – especially if you have any thoughts about hurting yourself – know that you are not ‘bad’ or ‘broken’ – but that you need some professional help.  You deserve to be happy – to be whole – not to hurt.  When we are depressed it is hard to think straight.  It affects not only our mood, but our physiology – it dampens appetites, slows digestion and circulation, decreases energy and stamina, dampens our immune system and interferes with our ability to be productive and relate with others.   It is an illness --  and there is treatment.  You and / or your loved one CAN feel better than you do right now! 

Now, that being said – Let’s talk about self-care measures.  When we focus on things that are in our control, that’s where we have the greatest power!

Studies have shown that when we do the things we would do if we weren’t depressed – like singing, dancing, exercise, dressing, eating healthy, ladies – put on your makeup and do your hair! – When we do some of these things, which I’ll be the first to say are hard to do when you’re feeling down, but when we do these things, we actually see chemical shifts in those depression-related hormones: serotonin, dopamine! – Pretty cool.

Personally, I find that when I get out of my head and focus on others – I feel better.  Service is like sandpaper – it smoothes out the rough edges and makes our lives a little softer.   Do something for someone else!  Get out of your own head – and don’t go there alone! 

Years ago, when my brother was killed at 16 years old, depression swept over me in a deep and pervasive way – put me in the ER with heart palpitations.  I was stationed in Boston at the time and was active duty in the Coast Guard.  I did begin counselling.  I also found that I began some ‘therapeutic shopping!’ – I loved going into KMART because people were so happy there – they smiled at me and it was just a pleasant place to be.  I actually applied for a job there – and when the manager asked me why in the world I’d want to work there – being active duty, I told her that I just wanted to learn to smile again and that her staff always made me feel good when I walked in the store.   I was hired on the spot!    I loved working there and had some amazing experiences there as I worked with other staff and customers.

One of the reasons I love being a nurse is that I freak-out love to help people.  Focusing on others brings out the best in us.  Try to make someone else’s day brighter.   – Now these things may not cure a clinical depression – but they can help.  Please don’t delay reaching out to your doctor or counsellor…. You created your tomorrow from the things you do today.

You deserve happiness, fulfillment, to live a life of purpose and beauty.   From time to time we all need a little help.  You don’t have to do it all by yourself!  - I believe

Coaching Corner: High Blood Pressure and Self-Care Measures

Jenny * had a splitting headache  that day.  She did remember having a conversation with me earlier 

about how that could be a sign that her blood pressure was too high, but she hadn’t purchased an

 electronic blood pressure cuff so she couldn’t check it herself.  She decided to stop by the hospital where she worked in the billing office and have one of us nurses check it for her.   – ah, but there were some errands to run on this – her day off.   She stopped at the dry cleaners, and the bank and the post office….. and finally, parked her car in the parking lot at the hospital.  Before she could even get out of the car, she had a stroke  - a CVA (Cerebrovascular Accident).    Today, years later, she remains weak on her right side, and can no longer work. Her speech is difficult and so social gatherings that she once enjoyed are often difficult and taxing, leaving her feeling somewhat left out. 

High Blood Pressures – Hypertension--  can lead to Strokes,  Heart Attacks /MI (myocardial infarct), and CKD (Chronic Kidney Disease).  

People aren’t cookie cutouts – so everyone’s situation can be a little different.  But in general – there are some factors we can control, and some we can’t.  We can’t change our race, our genetic makeup….. so we won’t talk a lot about those factors today, but we’ll focus on those things we DO have control over, and I’ll bet you know them too:  Diet, Exercise, Stress Management, Sleep, Maintaining a Healthy Weight and Blood Sugars, watching your Cholesterol levels and NOT smoking. 

In a nutshell:

DIET:  in general – water follows SALT. – So, if I eat a lot of salt (sodium), then my body will hold onto water to try to dilute the sodium to maintain the proper salt level.   And just like turning up the water volume in your garden hose increases the pressure….so does extra fluid for your heart, and we see a rise in blood pressures.    Eating a low-salt/sodium diet can help keep blood pressures in line.  So watch for those hidden sources:  anything in a can, anything frozen dinners, sauces, cheese, hot dogs, lunch meat….get the idea?  Get good at reading labels so you can make smart choices!

EXERCISE & STRESS MANAGEMENT: - these two can go hand – in – hand.  Besides helping to maintain a healthy weight, exercise is a great tool to help us deal with stress.  Our late, great Caveman, Uncle Joe had 1 of 2 responses when facing a dinosaur:  Fight – or Run;  and for either response, his adrenal glands would pump out a surge of chemicals with the aim of getting fuel to muscles so he could fight – or run fast, and afterwards he would bask on a rock somewhere and recuperate and regenerate.    Today, however, we don’t usually do either -  We don’t usually physically fight off our stressors, or run real fast…we just LIVE in this soup of high-stress hormonal soup of chemicals, and over time the effects of which can be felt by just about every body system:  heart, stomach problems and ulcers, depression, worry, trouble sleeping, even weight gain!   Exercise is a great way to move those chemicals along  and for helping us deal with stress.    Balancing rest and relaxation with exercise helps us maintain healthy patterns of dealing with these stress hormones.  

SLEEP:   When we sleep (deep sleep in particular), the pituitary gland kicks in and growth hormone is secreted –  have you noticed that when your babies wake up in the morning they look bigger?  While as adults, we aren’t growing upwards- but we do grow new cells, new tissues – regenerating our bodies.  Not getting enough sleep means that we don’t get to regenerate and rebuild.    Lack of proper sleep has been linked to a host of issues that we won’t get into here.

BLOOD SUGARS:  it is harder for the heart to pump sugar-rich blood – much like it would be harder to pump syrup than water;   And high these high sugars and high pressures do damage to delicate structures  like eyes, hearts, nerves, livers, and kidneys.  

CHOLESTEROL (and SMOKING): - In general, when cholesterols are high, it’s a lot like pouring bacon grease down your kitchen sink – over time, these plaques narrow the diameter of your plumbing…making it harder for fluid to flow….much like narrowed arteries make blood flow harder – resulting in a  higher blood pressure.

Taking care of yourself is important to help your blood pressures stay in normal range.  If you have a diagnosis of hypertension and are on medications – don’t stop taking your medications…. Sometimes stopping them can cause a rebound hypertension and blood pressures can go even higher.   

If you have hypertension, keep your medical appointments and follow up with your healthcare provider. 

 Know your numbers – keeping track of cholesterols, A1C’s, weights – these are important measures to help you make decisions on how you take care of yourself every day.   If you have symptoms of a high blood pressure – headache, vision changes, stomach upset/pain  -- please don’t wait….get checked.  After running your errands – it might just be too late. 

*Name changed, but story is based on an actual event