Whether you are someone who eagerly anticipates or down right dreads a healthcare visit with your practitioner, these five tips will help you get the most out of your next appointment.
Know your “why”. What is the reason for your healthcare visit? Be clear when you make the appointment and when you walk into the office. Some reasons are obvious; a persistent sore throat, knee pain, new onset insomnia. But often, office visits are for “check-ups”. Who doesn’t like the comfort of hearing “everything is looking good”? The catch is, modern medicine is still very much symptom driven. That means that you will have better results if you go prepared and ready to speak up. If you want a check-up because diabetes or heart disease runs in your family, and you don’t want to carry on that particular family tradition, say so. If you’re concerned about specific issues like arthritis or digestive issues, let your practitioner know. Your input can direct more specific lab tests and diagnostic procedures, which can catch issues earlier than more general screening. While you may put yourself in the hands of a trusted practitioner for the treatment of a specific disease, your overall health is your responsibility. Remembering that can be very empowering.
Write it down. You may have an excellent memory under normal circumstances, but often times, even routine healthcare situations cause stress. Writing your questions out ahead of time does a couple of things. It ensures you will not forget to ask something important and shows that you have prepared for the visit and that you are an are engaged and willing participant in your care. Bring a list of all medications and dosages, including a copy to leave with your file. This allows more time for actual conversation rather than dictation. If you hear terminology that you are not familiar with, be sure to ask for the correct spelling so that you can do further research on the subject after your appointment.
Spread the info. Even though you made the appointment with your physician, or nurse practitioner, don’t dismiss the support staff you encounter throughout your visit. Every opportunity you have to share your concerns, is another opportunity for them to be addressed. Patients frequently hold back on telling the whole story until they are with the doctor. But often, the first summary the doctor hears is from the intake nurse or physicians assistant (PA). This means that the doctor may have already begun to formulate a plan before they even speak with you. You want that plan to be based on as much information as possible.
Write it down. Yes, we’ve already covered this, but you need to keep writing! Taking a few quick notes will not only help you remember what you’ve heard, but will also help you process the information. The simple act of writing will also help you formulate questions you may not have thought of while simply listening. If you are presented with a number of options, jot them all down. Our minds typically chose quickly and then selectively hear only the information pertinent to that option. By noting all of the options, your recall will improve. You may want to revisit all of the options days or weeks after your appointment.
Leave with a plan. You may conclude your healthcare visit with an immediate diagnosis and prescription. Or, you may be asked to schedule more tests. Either way, don’t leave until you have a clear plan. If you are diagnosed immediately, write down any unfamiliar terminology. Ask what treatments are available, as well as how to take any prescribed medications. The pharmacist will also provide this information when the prescription is filled. By asking the prescribing physician, you can minimize the chance for errors. If you are asked to undergo further testing, be sure to understand who will schedule the tests. And, how to obtain the results and their interpretation. Ask for an expected time to obtain results, so that you can follow up if you don’t hear from the office.
If you would like help planning for an upcoming appointment, schedule a complementary strategy session here.
Have you ever wondered if you have Seasonal Affective Disorder (SAD)? Have you ever heard of Light Therapy?
I’ve never been formally diagnosed, and in my family, I’m even known as “the one” who loves dark, rainy days. But, as fall approaches and the days grow shorter, I’ve noticed that my energy has begun to lag. I’m having trouble getting out of bed, even to do things I really enjoy. I’ve noticed these feeling before, but this year they seem to be a little stronger and a little heavier. It’s time to take action.
Rather than taking the white knuckle, mind-over-matter approach that I’ve taken in previous years, this year, I decided to do something a little more nurturing, a little more supportive of my optimal health. I’ve decided to solve the actual problem rather than just fighting my symptoms. And, as with most things, I started with research.
What is Seasonal Affective Disorder (SAD)?
Seasonal Affective Disorder is a type of depression. It is experienced at a particular time of year or during a particular season.
What are the symptoms of SAD?
According to the Mayo Clinic, symptoms specific to Winter-onset SAD, sometimes called winter depression, include:
- Tiredness or low energy
- Problems getting along with other people
- Hypersensitivity to rejection
- Heavy, “leaden” feeling in the arms or legs
- Appetite changes, especially a craving for foods high in carbohydrates
- Weight gain
What are the causes of SAD?
The primary contributor to SAD is a change in exposure to natural light. The amount of sunlight available decreases as the seasons change from summer to fall and winter. This is especially true in the more northern latitudes where SAD is most common. But, what is it about the shorter days that trigger these symptoms in some people? The predominant theories focus on these four points:
- Light hitting the back of the eye sends messages to the hypothalamus; the part of the brain that controls sleep, appetite, temperature, mood and activity. In the absence of sufficient light, these messages slow down and in turn, these activities slow down.
- Our internal body clocks may rely on length of daylight hours to determine activity and energy levels, again as the daylight decreases, our activity and energy level decrease as well.
- The amount of light hitting the retina of the eye helps regulate the production of serotonin and melatonin. Serotonin is a neurotransmitter responsible for our sense of well-being. It’s our all-natural feel-good drug. Melatonin is a hormone that greatly influences sleep patterns and may even affect sleep’s restorative benefits.
- Decreased sunlight, results in decreased production of Vitamin D, which is actually a hormone. Vitamin D is also believed to play a role in serotonin production. Several studies have shown a relationship between lower Vitamin D levels and increased rate of SAD, and depression in general.
What are the treatments for SAD?
Current medical treatment for SAD includes, light therapy, psychotherapy (talk therapy), pharmaceutical therapy and Vitamin D therapy. Light therapy and vitamin D therapy are unique, in that they are low cost and low risk. They are also both easily accessible therapies that individuals can implement on their own, at home. The information presented to this point, is generally well supported by research and accepted across the medical community. What follows includes my own personal experience, with both light therapy and vitamin D therapy.
What is Light Therapy?
Light therapy involves exposure to a light box, or specialized lamp that provides a specific amount of broad spectrum light. This type of light is similar to what a user would experience standing outside on a clear spring day, minus the UV portion of the spectrum. The “strength” of a light box is measured in lux units. A good quality light box emits 10,000 lux. This is about 20 times the strength of typical household lighting.
According to this article, published in Psychiatry, 60-80% of SAD sufferers benefit from light therapy.
Always follow the instructions provided with your specific light box. For a typical light therapy session, simply sit with the light at a distance of 18-20” and slightly off to an angle. You don’t want to be looking directly into the light, but rather have it shining on you and in your field of view. Begin with 10 minutes and build up to 30 minutes or more. Depending on your body’s response, you may want another brief session in the afternoon.
Making time for Light Therapy
Light therapy has become part of my morning routine. I use the time to journal, read, or sip my tea and plan my day. I wake up looking forward to my light therapy sessions and love the efficiency of combining it with other activities I enjoy. For me, the benefits came very quickly. After a couple of days I could feel a difference in my energy level and my ability to wake up before the alarm. The biggest improvement was that I actually wanted to get out of bed in spite of the darkness.
Some research shows that it can take two to four weeks to experience the benefits. Even that is a relatively short period of time to achieve significant results. Another bonus: most mornings my husband joins me. He has also noticed a difference in his mood and energy after using the light.
The prices of light boxes vary, and 10,000 lux lamps will run from $75 to $300 for portable units. I use this one every morning. And yes, the name sounds a bit corny, but in my experience, it’s true! I like the size, because I travel with it and I like the interchangeable lenses that allow new users to ease into light therapy. Here is a smaller version that is even more portable and can be used throughout the day.
Sunlight and Vitamin D
As the weather cools, here in Minnesota, I know that I will not have the opportunity to enjoy as much time out in the sun with my skin exposed. And even if I choose to brave the cold, the sun this far north is pretty weak for much of the winter. So vitamin D therapy is important to me and my family, for a host of reasons. Learning that lower levels of vitamin D may play a role in SAD and other forms of depression just reinforced my decision to maintain a vitamin D protocol.
What is a Vitamin D Protocol?
Besides the obvious, taking supplemental vitamin D, the protocol includes taking supplements in a that the body can actually absorb and use the vitamin D. First, the form: Vitamin D3 is preferable to vitamin D2 because D3 is the form that the body most readily uses. It is critical to take Vitamin d supplements with dietary fat so that the body can absorb the D3 rather than simply excreting it through the digestive process. Individual who follow a low fat diet are frequently deficient in vitamin D as well as other fat soluble vitamins.
Vitamin D3 is also better utilized by the body, when taken with vitamin K2. While vitamin D3 assists calcium absorption, vitamin K2 guides the calcium to into the bones rather than having it absorbed into organs, joint spaces or arteries. The function of these two vitamins is complex, but supplementing doesn’t have to be. I use this one. It combines the two vitamins in a useful ratio. Its dropper dispenser makes it simple to adjust dosage and the peppermint oil makes it pleasant to take.
Where to go from here:
Check out the links found within this article. As always, form your own opinions. Decide what fits with your optimal health program. If you have any questions about the above information, or would like to share your experience with either of these therapies, I would love to hear from you. And, although I did not discuss the other two common treatments for SAD, please note that any type of depression should be taken seriously, and readers who are, in any way, contemplating seeking medical help should do so.
What do athletes, writers, chefs, speakers and even surgeons have in common? Highly Effective Rituals.
The word ritual may summon visions of mysterious practices, but in reality, rituals are simply habitual activities that hold meaning and invoke intention.
Rituals prepare us mentally, physically and emotionally for what is ahead and allow us to experience the benefits of an activity before we even begin . So, how does ritual impact nutrition? And, how can we create rituals that support our nutritional goals?
#1 Proper digestion starts with food preparation. Prepare your own food whenever possible. This is a sound recommendation for a number of reasons, most commonly for the benefit of knowing the type and quality of ingredients being used. Here’s another good reason. By selecting and preparing your food, you set an intention very early in the process for these items to nourish your body.
Create a simple ritual around preparing meals. Grab a favorite apron, turn on the music, pour a glass of wine. Preheat the oven or set the water to boil. Anything that broadcasts the message “I am in the kitchen—wonderful things are about to happen.” Once you’ve established a ritual, you will be surprised how quickly it becomes a focal point of the day and how inviting this time and space will become for you. By preparing the food at home, the sights and smells of food preparation engage the body and prepare it for digestion even before the food enters your mouth. When was the last time your mouth literally watered? That was the start of good digestion.
#2 State of mind, while eating, can literally affect the nutritional impact of that meal. Eating under physical or emotional stress raises cortisol levels, which may prevent the body from producing the necessary enzymes to digest food and extract nutrients properly.
Create a simple ritual around dining at home or away. Turn off the TV, sit down at the table—yes, we’ve all heard that one before. Put your napkin on your lap, pause for a moment to feel gratitude for the food before you and set the intention for it to nourish your body. If the food was prepared by someone else, take a moment to appreciate that gift as well. These brief, intentional moments can provide health benefits even if the meal itself is simply carryout.
#3 Take special care when preparing meals eaten away from home. Do you typically scoop some leftovers in a plastic dish and toss it, along with an “energy bar” and a piece of fruit, in a paper bag on your way out the door? Is it any wonder that most of us would rather go out and grab something else, anything else, than eat that lunch?
A little preparation can change the whole experience. Create a simple ritual around packing your lunch. Start the evening before, after dinner, while you are still in the kitchen mindset. Leftovers are very popular (and easy) in our house. When practical, precut food for easier reheating and eating. Be sure to include condiments, sauces or dressings if they were part of the original dish. Use a reusable lunch bag that is big enough to hold your dishes, flatware and condiments. Avoid plastic. Reusable glass dishes, in a variety of sizes are more pleasant to eat from and safer to reheat than plastic. Use real flatware. Plastic utensils are expensive and rarely hold up to a salad that’s worth eating. Grab a napkin and you’ll be ready to eat where ever your day takes you.
These simple rituals not only contribute to the pleasure of eating, they can enhance the nutritional value of the meals you eat.
Optimal Health is a lifestyle choice and rituals are a great tool. What rituals do you use to enhance your health journey?
According to the Center for Disease Control (DCD), more than a third of American adults—around 86 million—have prediabetes, and 90% of them don’t know it. They predict that unless major change occurs, 1 in 3 adults with have diabetes by 2050.
You don’t have to be one of them!
Pre-diabetes and Type 2 diabetes are lifestyle diseases. Any true solutions need to be lifestyle based. And the best news: your lifestyle is completely within your control.
I know that those of you reading this, those of you who have commented and sent questions are invested in actively managing your health. I congratulate you and I’m excited to be moving forward with you to not only to prevent diabetes, but to optimize your health.
We all know that diet plays a major part in the development of as well as the prevention or treatment of diabetes. But have you heard that sleep is almost as important? Did you know that too much or the wrong type of exercise can adversely affect blood sugars? Sometimes the solutions seem simple:
Diabetes is a disease of hyper (above) normal glucose (sugar) in the body. The solution would seem pretty straight forward: stop eating “too much” sugar. But when the questions of what is “too much” and what should we should actually be eating come up, it can get pretty confusing.
High Intensity Interval Training (HIIT) is all the rage, for a very good reason, it’s a great way to exercise. BUT, only if you can tolerate it, otherwise it will cause more harm than good. Proper types and levels of activity are about balancing the benefit with the risk of injury.
Even getting the proper amount of high quality sleep isn’t as straightforward as it may seem. Finally getting your solid eight hours may be counterproductive if it’s accomplished by sleeping until 10 am on Saturdays and Sundays.
The optimal formula for each of us is not only different because we are individuals, but also changes as our bodies change. Age, chronic illness, childbearing, nutritional status are just a few of the factors that impact what our bodies need right now to be truly healthy. And, yes, I believe you can optimize your health even with a chronic illness.
Look, I know you read the books, you listen to the podcasts, you are so ready to make a change in your life, but you still have questions and there are still some things that you’re unsure of. Let’s clear up the confusion.
You don’t have to figure this out on your own. And most importantly, you don’t have to end up with a diagnosis.
This is an opportunity to take charge and turn your health around. I’d love to share the journey with you.
BUT…the comments from the first two segments have convinced me that I need to pause here and do a Q & A. So here are the top 5 comments and my thoughts.
“My sugar [level] was 110, but my doctor didn’t say anything about it.” Doctors have become quite accustomed to seeing abnormalities in lab values and many do not address levels that don’t dictate medical (prescription) intervention. This is very similar to the standard medical approach to overweight and obesity. Many physicians won’t bring up excess weight of “only” 20-30 lbs unless the patient specifically asks about weight loss. Even physicians are sensitive to the issue offending patients and in many cases they can’t offer a real solution, so they don’t bring it up. Additionally, in the presence of multiple abnormal lab values, other areas of concern can be perceived as more critical and/or easier to address. For example, elevated cholesterol levels can easily be address with “dietary advise” and a prescription. If you’ve been following my work, you know that cholesterol is not the enemy and addressing blood glucose levels will have the most significant impact on overall health.
“I don’t really want to go in and get tested because I don’t want to take drugs.” This statement reflects the way that many people feel– completely at the mercy of someones else’s decisions. In spite of popular talk tracks and even the stated mission of healthcare facilities, very few people truly feel that they they are in a partnership with healthcare professionals. And many argue, why bother going to a doctor if you aren’t going to do as he/she says? It’s important to remember that medicine is driven by Standards of Care (and reimbursement codes). Standards of care may dictate that a physician prescribe a medication. For example, certain drugs in certain doses are prescribed for specific cholesterol levels. Even more important to remember is that your decision to take medication is entirely your own. Knowing your body and how it works empowers you and gives you confidence in working with your physician as an active participant in your health. I strongly advocate taking responsibility for your own health. Does it take more effort, yes. Does it put you in control, yes. Is it completely worth it, YES!
“I’m not overweight, so I can’t have type 2 diabetes.” Approximately 15% of individuals diagnosed with type 2 diabetes are not overweight. Inactivity, poor nutrition and genetic predisposition can lead to metabolic disorders in individuals that may otherwise appear healthy. Although optimizing blood glucose levels frequently leads to optimizing body composition, even greater benefits occur internally through optimizing metabolic health. Developing your optimal health formula means understanding not only your body’s response to glucose, but also to sleep, exercise, stress and many other factors.
“I don’t want a diagnosis of pre-diabetes in my permanent medical records.” This is a very real concern for people. When someone receives a diagnosis (Ha! it sounds like a gift!) they will forever have that diagnosis in their medical records. In the traditional medical paradigm, there is no cure for diabetes, it can only be managed and controlled. So regardless of subsequent normal blood glucose readings, “once a diabetic, always a diabetic.” There is also the affect that being diagnosed with a “chronic” illness has on an individual. Living daily with the thought “I am diabetic” does not contribute to overall health, in fact it does just the opposite. It can be extremely challenging to feel healthy when you are constantly being reminded that you are sick. Many of my clients have had elevated blood glucose, they make changes in their lifestyle and optimize their health. There is no value in spending emotional energy on a diagnosis for a situation that no longer even exists. There is tremendous power in taking charge of your own health. You can have that power and you don’t need to figure it out all by yourself.
“My doctor said if I just lose some weight, even 10 lbs my blood sugar will improve. But I just can’t lose the weight.” This is the comment that most frustrates people, especially people that have tried very hard to lose weight, only, in many cases to gain more with each attempt. This statement is frustrating to me because it is completely backwards! It is almost impossible for the body to burn fat in the presence of elevated levels of glucose and insulin. The body is burning the sugar that is needed immediately and then storing the excess–that’s what insulin does, signals the body to store excess energy. By optimizing glucose levels, the body is able to access fat stores for energy resulting not only in weight loss, but more specifically in fat loss.
Thanks to the folks who are brave enough to share! I will continue to respond individually as always and when the comments start becoming common, I will share them with all of you.
Together on this journey,
Welcome back! I hope my last post inspired you to take a look at your numbers and see where you fall on the blood glucose continuum. If you haven’t seen Pre-Pre-Diabetes Part 1 you can read it here.
So perhaps you have been diagnosed with pre-diabetes. In accordance with the standards of practice, you most likely would have been referred to a dietitian or the American Diabetes Association for dietary guidelines. And faithfully following these guidelines, including eating whole grains, lean meats, starchy vegetables and non-fat milk and yogurt will almost guarantee that you will develop diabetes.
Or perhaps you were curious, like I was, picked up a glucose monitor and tested your blood only to find that you weren’t spending as much of the day under that 85mg/dl as you would like. Remember, 126mg/dl is the diagnostic value for type 2 diabetes, 100-125mg/dl is considered pre-diabetes, but research has shown that levels below 85mg/dl correlated to the best long term health. Now what do? Research!
I started reading everything I could find on the causes and management of elevated blood glucose levels. Ironically, the massive amounts of information available in print and on line make sorting through all of it the real challenge. What I found, boiled down to two schools of thought: The entrenched, ever repeated American Diabetic Association dogma and “alternative” health sites. This dichotomy left me feeling stuck. I could play it safe and follow a standard of care, blindly, which meant ignoring so much of what I had already learned– so much of what was starting to make practical sense to me.
Or I could “go it on my own”, and take full responsibility for my health. I didn’t want to manage a disease, I wanted to be really healthy for a long time. And although this take-charge option appealed to me, I couldn’t help but feel a bit hesitant. What if I made a mistake? How would I be judged if I needed medical care at some point? The real irony being that, in my experience, people are judged less for their poor health decisions like smoking than they are for choosing a nontraditional healing path. I also wondered if I would have the energy to take control of my health and deal with family and friends who choose differently? A support system can be really critical. And on top of it all, I’d spent years as a nurse in the traditional medical system, those entrenched ideas don’t die easily! I had encouraged low-fat, low sodium diets and tried and struggled with them myself. I realized I couldn’t keep doing the same thing and expect different results. I had to take the leap.
I took control of my health and haven’t looked back. I learned exactly what causes my blood sugar to rise and how to maintain consistant levels. I learned exactly what causes my body to store fat and to burn it. And most importantly, I learned that there wasn’t some secret formula out there that I could read or buy. The secret formula was unique to my body. Optimal health is not one-size-fits-all.
Discovering your own optimal health formula is the critical piece missing from so many programs. We may all start out with similar body function and chemistry, but through years of living, each of us develops our own imbalances and subsequent health issues. That’s why the Doctor-approved, best selling diet and exercise plan that works so well for your sister or your friend may not do a thing for you and may even be harmful.
Choosing differently is the only way to get a different result.
I work with three types of people: Those who have been diagnosed with diabetes or pre-diabetes, who don’t want to spend the rest of their lives on medication. Those, like myself who had a suspicion that they may have something going on metabolically and people who have tried diligently to lose weight, aren’t able and somewhat fearfully wonder if something more is going on in their bodies.
If you are reading this and thinking, this all sounds so familiar! Let’s talk. You don’t have to figure this out on your own. You don’t have to end up with a diagnosis. You don’t have to spend years doing research to learn that there are other options when it comes to reclaiming your health. This is an opportunity to take charge and turn your health around. I’d love to share the journey with you.