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I first met Nicole last year when she was the key speaker at Diabetes Sisters’ “Weekend for Women.” I was then, and continue to be, impressed by her passion for better serving people with chronic illness.
This is the sixth in my series of profiles on diabetes change leaders.
Q: Tell me about the project you’re heading, “Bringing Science Home?”
Nicole Johnson: First, it’s a dream come true for me. It’s a four-year funded project where we’re looking at how we can provide the support and tools people who live with a chronic illness really want and need. That means educating patients, families and health students

Two years ago I celebrated Valentine’s Day with 26 women and sent my husband away for two hours. I was the guest speaker at Divabetics, a diabetes support group. It was their usual monthly meeting and I was there to read from my new book, “The ABCs Of Loving Yourself With Diabetes.”
This, my first diabetes book, is closest to my heart. It provides short, powerful, “how-tos” to help readers connect with their inner

When we think of family caregiving, the burdens and potential burnout associated with caring for someone on an often daily basis come to mind. Caregivers do face many difficulties in their role: fatigue, isolation, depression and higher risk for many health conditions. Those of us who work closely with caregivers strive to help them understand how to maintain their own health because so many caregivers remain committed to providing care for their family members for as long as possible. But caregiving has its rewards too, and in the spirit of the season, this heartwarming story seems an inspiration for us all.
When Josephine, a caregiver for her Aunt Vivian in Queens, N.Y., talks about caregiving, she is the personification of caring and commitment. Josephine has been her Aunt Viv’s caregiver for nearly four years. Ninety-one-year-old Vivian is mentally sharp and active, but about two years ago, her arthritis got so bad she really started to struggle, and was finding it harder and harder to live on her own. Vivian gave up her apartment and moved in with Josephine and her husband. “Aunt Viv requires help every day getting dressed, moving around and eating meals,” Josephine says. “I get a little help from my husband on the weekends, but a large majority of the caregiving falls on me.”
Josephine is not complaining. Rather, she is quite upbeat when discussing all the assistance she gives Aunt Vivian. This feels to Josephine like a chance to really make a difference in someone’s life, and she values the chance to get to know Vivian on a deeper level. “I was very close to my mother, Vivian’s sister, but she passed away 10 years ago,” says Josephine. “Spending all this time with Aunt Vivian has helped me forge a strong bond with her, one that reminds me of the relationship I used to have with my mother. I love being there for my aunt, and wouldn’t have it any other way, but some days I really crash hard.”
It helps that Vivian is warm-hearted and expresses gratitude for the help she gets. However, no amount of gratitude can make up for the exhaustion Josephine sometimes feels being on call every day. “I can’t just leave and have lunch with friends anymore,” states Josephine. “I’d worry about my aunt the whole time I was gone.” Naturally, this kind of responsibility can take its toll, but Josephine tries to keep it in perspective.
Even on the days when Vivian isn’t feeling well and Josephine has to provide hourly assistance, Josephine tries to remember that it must be very hard for Vivian herself to live with a chronic disease like arthritis, “and just think how hard it must be to be so dependent on someone else — even if they are family. Vivian was always very strong and independent, and sometimes it breaks my heart to think how she must feel being unable to care for herself now.”
When we talk about how difficult caregiving can be, we sometimes forget that many people find it extremely rewarding. Josephine, among others, gets satisfaction from caregiving, and without minimizing the risks for burnout, she says that “most of what is worth doing in life — any long-term relationship, raising children, even managing a busy career — is hard. This is just one more of the things worth doing.”
So, what do family caregivers find are the benefits of caregiving? We asked family caregivers in the Visiting Nurse Service of New York Caregiver Support program this question, and here’s what we heard:
It gives me a chance to spend a lot of time with my family member, which I haven’t done since I moved out.
We’ve had some very intimate conversations, and I feel now that I understand more of the choices he made in life, as well as our family’s history.
I’m much closer to my sister now; we have to talk all the time about how to take care of Mom, and we’re working together.
I feel this has helped me grow spiritually. Taking care of someone else is hard, but it has forced me to face some questions about my own mortality and it has taught me how to talk with someone who is near the end of their life.
Sometimes this is so exhausting I think I’m going to break. But at the end of each day, when I realize I succeeded again at giving my husband the care he needs, I feel strong, worthy and proud of myself.
I feel good about the role model I am being for my children. I want them to see that it can be very satisfying to take care of another person.
Caregiving has made me slow down and be more mindful of the stage of life I’m in and the good work I’m doing. For more on increasing mindfulness in your life, go to http://blogs.vnsny.org/2010/09/26/mindfulness-presence-tips-for-caregivers/.
While the rewards of caregiving may be an unanticipated silver lining, most caregivers can only appreciate these benefits if they are receiving the support they need to stay healthy and prevent burnout. Here are some tips for avoiding caregiver burnout: http://www.vnsny.org/home-health-care-and-you/quick-tips/avoiding-caregiver-burnout/.
In Josephine’s case, she gets assistance from her husband, her cousin comes over most Monday afternoons to give her a break, and she talks on the phone with a good friend who is serving as caregiver to her father, all of which gives Josephine some much-needed respite as well as support from others in her situation. As a result, Josephine has been able to enjoy some of the positive aspects of her aunt’s personality, and from her role as her caregiver.
What has being a caregiver taught you about living a better life? We encourage you to share your own stories about how caring for someone else has brought you joy. After all, ‘Tis the Season!

Source:www.huffingtonpost.com

I wrote this on my blog DiabetesStories three Christmases ago and it still makes me laugh. Happy Holidays.
***
Dear Santa,
All I’d like this Christmas is for you to take this diabetes away. I’m so tired of it already. All the time stabbing my fingers for blood and guessing when my sugar’s too high or too low.
Now that I’m in menopause I can barely tell whether I’m sweating because I’m losing estrogen or because my blood sugar’s crashing at 50!
And, can we talk… I mean the constant figuring out how many carbs are in a ravioli or bread stick or that fried calamari that will be at the company Christmas party. Some days I just want to lie down and shoot myself. Please, please, Santa, would you take this diabetes away?
Sincerely,
Riva
***
Dear Riva,
I’m very sorry you’re having a tough time during my favorite season. I only want people to be singing carols and drinking eggnog and feeling good cheer. Unfortunately, it says in my contract that I’m not allowed to interfere with life’s natural occurrences. So here’s my suggestion: although you’ve already opened your holiday gifts, go back and look under your Hanukkah bush for the gift in having diabetes.
You may have to spend a few days looking, so why don’t you schedule it for the week between Christmas and New Year’s while you have some down time? Then you can start the new year fresh.
Best wishes,
Santa and the gang
***
Dear Santa,
A gift in my diabetes? What are you, crazy? Meshuggah? Thanks, but no thanks!
Riva
***
Dear Rabbi,
I seek your wise counsel. I wrote to Santa to take away my diabetes, but he wasn’t helpful at all. Surely you who have studied so much and represent our people who have suffered throughout history can help me with this awful diabetes.
It’s such a strain, Rabbi. I have to test my blood sugar when I really want to be lighting the sabbath candles. I forgot all about the High Holy Days this year because I was so busy counting carbs in the Challah, bagels and honey cake.
Rabbi, please, what solace can you offer me? What words of wisdom? Surely you would tell me to just forget about this diabetes thing and study the Torah, right?
Please write soon,
Riva
***
Dear Riva,
Santa and I just returned from the Caribbean, and he told me about your difficulty. He said he told you to look for the gift in your diabetes. I concur with Santa; there are many gifts to be found in diabetes, if you look. For one, my child, you won’t have to drink the traditional Manishewitz holiday wine anymore. The Counsel all agree that it is much too sweet. Bring out the Chardonnay!
When Santa asks you to look for a gift in your diabetes, he is not saying this because you are not Catholic and he is not bringing you anything, although this is true. He is speaking like our brothers the Buddhists, who profess that there is a gift in everything if you look for something positive that it can bring into your life.
Let me tell you a story, my child. My own Aunt Sheila had diabetes, and after she stopped kvetching, she went to a spa and learned how to eat healthfully. She shopped along Rodeo Drive and bought a cute little jogging outfit and started running. On her jog along the ocean she met her fourth husband, Marvin, and they’re very happy. They just moved into a $6 million mansion in Jupiter, Fla. — right next to Burt Reynolds! Everyone’s plotzing! Granted, the house was in foreclosure, but that only means they have more money to decorate!
Darling girl, find a gift in your diabetes, because to be honest, since you’re not orthodox, and all I have are these great wigs I got on sale from my cousin Schlomo, I’m not bringing you anything, either. And really, it’s not very pleasant to whine.
Shabbat Shalom
Rabbi, Local Union 107
***
Dear Rabbi,
I thought about what you and Santa said and have decided to become a Buddhist. I picked up the Dalai Lama’s book, “The Art of Happiness.” He says, “Happiness is a butterfly, which when pursued, is always just beyond your grasp, but which, if you will sit down quietly, may alight upon you.” I told my friend Joe I like butterflies, and I like the robe, so these aren’t bad gifts.
Joe said the quote meant that we are the source of our happiness, that happiness can only come from inside us, regardless of what happens in our lives. Hmm, I said, maybe I need to learn more. So I booked a flight to Tibet.
Now if only I didn’t have to drag all this damn diabetes stuff with me…. ohm… ohm… oy.
Riva

This Blogger’s Books from
50 Diabetes Myths That Can Ruin Your Life: And the 50 Diabetes Truths That Can Save It
by Riva Greenberg
The ABCs Of Loving Yourself With Diabetes
by Riva Greenberg

Follow Riva Greenberg on Twitter:
www.twitter.com/diabetesmyths

Source:www.huffingtonpost.com

I wonder almost every day why the world hasn’t yet realized that the attainment of wealth, status, bigger houses, having the latest gadget — and being the star of your own reality TV show — doesn’t make people happy. In fact, it leaves many miserable.
Increasing numbers of people are on anti-depressants largely because they feel empty inside. Boredom and depression reside easily in a life where you are running so fast you never pause to ask the question: What would really make me happy?
So what does it take to be happy, especially when times are tough? “Meaning in our lives,” wrote Viktor Frankl. And he wrote it 50 years ago in his landmark book, “Man’s Search for Meaning.”
Frankl was an Austrian psychiatrist deported to Theresienstadt concentration camp in 1942, with his wife and parents. There he watched his inmates’ behavior consumed by two questions:
What does it take to persevere and come through a monumental, tragic experience?
Can there be happiness in overwhelming suffering?
Yes, Frankl said, if we have meaning in our lives.
Frankl’s views were renegade in his time. The psychiatric profession believed people were best off living stress-free lives, while he saw those in the camps who survived kept struggling and striving toward a worthwhile goal.
Frankl observed that his camp inmates who looked forward to finding their families again or creating their next great work were the ones who survived. He saw when someone found a forgotten picture of a loved one or received an extra blanket that suffering disappeared and joy suddenly existed.
Frankl also believed we each have a unique mission in life and by enacting it we find meaning, and through meaningfulness we experience being happy and fulfilled.
How do we create a meaningful life?
Most people find it when they are in service to others or a cause or doing something they love, something they feel they were meant to do.
I began to experience this about nine years ago, with and through my diabetes, as I turned it into my work in a desire to help others.
I have also spoken to many patients, through a series of interviews, who used their illness to create a fuller, happier, more meaningful life.
They saw diabetes as a wake-up call to become healthier — to eat better and lose weight. Then they took what they learned and helped others. Many redirected a life that had somehow gone off track, realizing that time is precious. They became more appreciative of what they had and made changes in their lives to commit to what was important to them.
Many told me something that surprised me the first time I heard it, but not the twenty-fifth time. Diabetes had made them happier; they weren’t looking at what they might have lost, they were looking at what they felt they’d gained.
This note I received was typical:
Meaningfulness is the ingredient that transforms the feeling of one’s life. Sometimes it needs to be built, sometimes we only need to shift our view to what we already have.
Frankl also witnessed in the camp the crush on a person’s spirit when meaningfulness had gone. When a man sat on his bunk and smoked all his cigarettes, one after the other, that man would soon be gone. Immediate gratification was a sign that a man had given up.
I can’t help but wonder if that translates to living with illness. In the case of diabetes, if you spend most of your time satisfying immediate desires, eating sweets for the momentary pleasure, lying each night on the sofa, forsaking blood sugar tests — are you not choosing defeat in some subliminal way?
After the publication of his book, Frankl received a letter from a young man paralyzed from the neck down after a diving accident he’d had at the age of 17. He wrote:
Having just passed Thanksgiving, if your “meaningfulness” tank is low, ask yourself:
What do I really care about?
What do I love to do?
How can I use my talents to serve others?
Then do something with your answers.
If, like me, you live with a chronic illness, ask yourself: What can it give me? A greater commitment to my health? The strength to follow a passion? The platform to help others? The determination to spend more time doing something I love? And ask yourself, what good thing has it brought into my life?
As Betty Rollin — breast cancer survivor, author and advocate — wrote in a letter in this past Sunday’s New York Times Magazine, cancer survivors notice they’re breathing the way other people don’t. And because they’re breathing, they’re grateful, the way a lot of people aren’t. And grateful is a good place to wind up in life. Grateful shifts our quality of life like meaningfulness. And for Rollin, breast cancer inspired cancer activism.
If you don’t live with a chronic illness, the questions to ask yourself toward your meaningful life are no different from those above. Apply them to any obstacle you see in your life.
This holiday season give yourself the gift only you can give yourself, the richness of a more meaningful life.

This Blogger’s Books from
50 Diabetes Myths That Can Ruin Your Life: And the 50 Diabetes Truths That Can Save It
by Riva Greenberg
The ABCs Of Loving Yourself With Diabetes
by Riva Greenberg

Follow Riva Greenberg on Twitter:
www.twitter.com/diabetesmyths

Source:www.huffingtonpost.com

I’ve had a series of encounters with doctors recently. Some caused by ridiculous accidents (aren’t they all?). Some possibly the result of minor nerve complications of diabetes. But all have left me dispirited and fatigued. Because I find something crucial lacking in so many health care professionals — mindfulness.
Mindfulness is the act of paying full conscious attention to whatever you’re doing in the present moment; it’s the act of being right where you are fully present in this moment of now. Imagine how different the quality of an interaction would be between a mindful doctor and patient.
It’s ironic that many health care providers have forgotten, or don’t realize, the enormous healing power of merely being fully engaged and present with their patients. When my provider is mindful I feel calm enough to hold onto a world where my nerves are running riot. I feel safe when I’m not sure I am. I feel confident that even if my world has just tipped on its axis I can still live in it as me, and that together we will handle whatever has happened.
Yet, increasingly I find my providers multi-tasking when they’re with me.
Benefits of Mindfulness
For a patient, a doctor’s full attention immediately creates an environment of safety and support. In such a space worries lessen and a patient can better hear what her doctor says. For a physician, a mindful patient offers more and higher quality information to help you more quickly and effectively diagnose and treat, leading to better outcomes.
While most insurance companies require doctors see multiple patients in an hour, no matter how little time there is for a visit, a mindful interaction is already healing.
My visits feel so perfunctory that “care” has gone missing from the term “health care provider” and the healing power of human connection is on my, and I imagine many patients’ Most Wanted List.
Below are a few recent medical encounters I’ve had both with mindless and mindful providers. Plus 10 suggestions for more mindful encounters with patients.
Examples of Mindless Encounters
Hand surgeon: Due to severe pain in my wrist I go to a hand surgeon. After the nurse shows me to a treatment room, she stands with her back to me reading my intake form. Still with her back to me, she asks me a question. I have to say to her, “Can you please face me when you talk to me?”
The hand surgeon examines my hand and gives me a clinical diagnosis I don’t understand. I have to ask several questions to understand what is wrong with me. He answers each question before I finish asking it. He talks so quickly my brain cannot process the information. By time he gives me my options I’m in a brain fog.
Podiatrist: My foot falls asleep while I am working at my computer. Unaware, when I get up from my chair and put my foot on the floor, it buckles underneath me and I hear “crack, snapple, pop.”
My podiatrist begins our session by typing notes into his computer. He tells me he’ll be with me in a minute. Several minutes pass before he looks up and asks me what happened.
After developing my X-rays, he rushes back into the treatment room and tells me while whizzing past me, “h.lama.m. rrfemmema..a,, wlejjejs OJK.” His next sentence is even more garbled — delivered while stacking the X-ray plates back in the closet. I ask him what he said. “Looks like a hairline fracture. You’re going to be OK.” I really would have liked hearing that the first time, since as a type 1 diabetic with a foot problem I’ve been hyperventilating since the incident.
Neurologist: After the hairline fracture in my foot heals I’m still in pain so my podiatrist sends me to a neurologist.
I learn I have a nerve entrapment. I also learn that my neurologist grew up in France, lived in the jungle of Vietnam for years to study meditation with a Buddha. He left Vietnam just before the war and came to America with $100 in his pocket. He supported himself as a chef until he got cancer. He was so appalled how doctors treated him as a cancer patient that he decided to become a doctor. He knows neurology is perfect for him because it combines his interest in the body’s energy meridians, chi and caring for patients.
Funny thing is he never learns a thing about me. In three visits he never asks me anything other than, “Does this hurt?”
Without intending, his powerful personality and lack of interest in me intimidate me from asking many questions — even though I can’t understand his French accent. I actually leave his office not sure of my prognosis. If he would have asked me this one question, “Do you understand what I’ve just told you?,” he would ensure that I had.
Physical therapists: I now go to physical therapy three times a week to unlock the nerve entrapment. I work with two different assistant therapists, one mindless and one mindful.
They both perform the same exercise with me separately. They hold a strong, thick band around my ankle as I move against the tension. The mindless assistant, looks around the room and gives instructions to other patients while working with me. Each time her attention is diverted the band she’s holding goes slack and she loses count of our repetitions. I feel I am wasting my time.
Examples of Mindful Encounters
The mindful assistant looks only at me, talks with me, counts the reps, never eases up on the tension. I feel myself growing stronger.
I had to dig deep to think of another interaction I’ve had recently with a mindful provider. It was my diabetes educator.
She came out to the reception area, smiled, shook my hand and walked me back to her office. She pointed to a chair for me to sit in. She asked me questions both related to my diabetes, and some just about me in general.
When she learned I write books about diabetes, she talked to me like an industry peer. She listened more than she talked and I never felt judged.
When she wanted to share information on her computer, she turned the screen around so we could look at it together. At one point she pulled my chair over so we were sitting together.
She gave me her email address when I left just in case I had any questions.
It’s ironic, but while providers may feel they’ll lose time by not multi-tasking, they’ll actually gain time by helping patients more immediately through more meaningful interactions.
Tell me, would it make a difference to you if your health care provider were more mindful? As a physician, can you imagine the quality of your interaction with a patient who is more mindful?
In a future post I’m going to share with you how Kaiser Permanente, one of the nation’s largest not-for-profit health providers, is training physicians in a mindful approach that’s increasing positive health outcomes.

Follow Riva Greenberg on Twitter:
www.twitter.com/diabetesmyths

Source:www.huffingtonpost.com