by Michelle | Mar 14, 2018 | Being Well
By Michelle Jenck, M.Ed., Certified Behavior Change Coach
Every day we hear the results of another study telling us “Eat this, don’t eat that,” or, “Move like this, not like that.” While it is good to learn about adopting healthier behaviors, it can be overwhelming to know where to start. Change is hard. Crazy hard. It’s really inconvenient. That’s how we got into this mess in the first place.
It is human nature to take the path of least resistance. It takes time and effort to change the way we live our lives. For most of us, this is where we end up – in a state of knowing we need to do something but not truly believing we are capable of doing it.
Being open to the possibility of changing is key. To be successful, we need to make the changes to our habits small, easy-to-adopt, and even enjoyable. Yes – that’s right. Change can be fun.
It helps to become aware of our habits and begin associating those with how we feel. How do I feel when I eat this and don’t eat that? How much energy do I have for daily activities? If the answers to these questions are not the ones you’d like, then it is probably time to start making some changes.
It is important to explore what is and isn’t working and examine what factors are in play. We tend to look only at the negative – what isn’t working. Looking at our “bright spots” may be a better option. What are we good at? When do we feel energetic? Happy? Fulfilled? How do we use this information to get more of that feeling in our life?
Why we want to make changes is almost as important as what we want to change. The “why” often determines our chances for success. If we are making a change for our spouse or boss, or as a quick fix (think high school reunion), we might not be as emotionally invested as we need to be successful over the long term.
Getting married and having kids are enormous life changes, yet, people make those changes every day. Maybe you want to see your kids or grandkids grow up. Maybe you want to improve your quality of life. Whatever it is, it needs to be meaningful to you.
Work with your strengths and interests when approaching change. If you like to cook, then it makes sense to find healthy recipes you would enjoy making. If you hate cooking, it will be important to simplify nutrition changes so that you can still be successful. Consider choosing the prepared veggie tray and a container of hummus from the grocery store.
This principle is especially important when it comes to physical activity. If you enjoy being outdoors, consider walking or hiking. If you like people, music and dancing, try a group fitness class. If you want something more mindful, try Tai Chi or Yoga. The key is to look for ways to integrate a positive, healthy change with your personality, interests and strengths.
Don’t worry about meeting some “ideal” behavior you saw on Pinterest or Facebook. The important thing is to start somewhere and start with something you like. It might not have to do with nutrition or fitness at all. Maybe you want to learn how to play the piano or knit. If the change is enjoyable and makes you feel better, you will be more likely to try new things later.
Adopting one new health habit successfully, no matter how small, usually leads to another and another. All this eventually opens a door to a much healthier, happier new you. And that’s the kind of change we can all get behind!
by Guest | Mar 2, 2018 | Being Well, Eat Well
By Sara Todd, LCSW, Rinehart Clinic
The shame experience is complex and holds a variety of feelings. Shame can be debilitating and all encompassing. Eye contact may feel painful, even impossible. At its worst, it can result in withdrawing from the world. A retreat into a darkness that feeds upon itself.
Shame is triggered by an external event and this can even include receiving the diagnosis of a medical illness, such as diabetes. The diagnosis may trigger shame because of feeling exposed as inadequate or incapable. A person may feel they don’t “measure up” to an ideal. The diagnosis can end up confirming what someone already feels about her or himself— that they are flawed or not good enough.
Shame has a social context and occurs in relationship with others. We will say, you shamed me. A tendency toward shame in one’s adult life may come from early experiences of being judged, ridiculed and not fully celebrated and enjoyed by one’s caregivers. This fundamental sense of “badness” repeats a cycle that originated in one’s early life. For some, shame may be a foundation underlying everything one does. Diabetes is just one more channel for that shame.
Shame thrives in darkness and loathes the light. Its antidote is radical acceptance, the full embrace of love and kindness by another and towards oneself.
Because diabetes intersects with a person’s relationship to their body, their relationship to food and eating and the authority of medical providers, it makes sense that all of this would trigger a shame response. The combination of society’s unrealistic beauty standards, feeling constantly “graded” through daily monitoring of blood glucose or A1c tests and the way we ignore the institutional reasons for challenges such as poverty and eating healthy, all contribute to an internal dialogue of “I did this to myself”.
What is the way out?
The first may be to have curiosity about the shame. Ask questions about the feeling and the storyline that you’re “not good enough.” Why do I feel ashamed about having diabetes? Open it up for exploration. If the shame is connected to not measuring up to an ideal version you have of yourself, you can ask: Who set that standard? Is this an ideal that comes from my own values or someone else’s?
Questioning the self-blame can also be effective. What may be other reasons I have this disease? Why else did it happen? Is there a family history, for example? The point is not to deflect accountability, but to bring a more complex understanding.
We can also begin to unravel this knot of humiliation, self-hate, and feeling outcast by “dropping the storyline.” When these thoughts “I’m not good enough…I did this to myself…I’ll never get it right” come up, take a deep breath, feel your body and then let the thoughts go. A teacher once gave me the tool of: Recognize-Refrain-Relax-Remain. Recognize that you are getting caught again in the feelings and thoughts of shame. Refrain from trying to escape the feelings (don’t numb out). Relax by deep breathing, stretching, taking a walk or simply just letting yourself be. And, finally, remain where you are in that moment. It will pass.
If shame is making it difficult to engage deeply with others and live your life fully, talking to a therapist may also be a good idea. Shame that originates in trauma needs healing with a licensed mental health professional. And as we heal the wound of shame, we begin to love ourselves more fully through the gift of improved health.
Most importantly, shed light on that shame because you, at your core, are good and perfect just as you are.
by Michelle | Feb 23, 2018 | Being Well, Eat Well
By Michelle Jenck, YOW Coordinator
If it seems like you have been hearing a lot about diabetes and pre-diabetes lately, you are right. At the risk of over-sharing, the Year of Wellness team wants to make sure Tillamook County residents are getting the message – loud and clear. A lot of people have prediabetes and there IS something we can do about it.
Our YOW partners at the Y and Northwest Senior & Disability Services are teaming up to prevent diabetes in Tillamook County. This infographic highlights key risk factors and prevention methods. Losing even a few pounds (and keeping them off) can help most people reverse their risk of developing type 2 diabetes. The best way to do that is to follow healthier eating habits and become more physically active than you are right now.
Because we know change can be difficult, our YOW partners are working to provide community-based supports to make these changes easier. Diabetes Prevention Program (DPP) classes are one way to learn about healthy habits and how you can adapt your lifestyle to optimize health. Plan to attend the DPP orientation, March 6th at either 12:00 noon or 6 p.m. at the YMCA, 610 Stillwell Avenue in Tillamook. You have nothing to lose (but weight) and everything to gain (in health)!
Continue to follow us in the Headlight-Herald each week to learn more about local resources available to you and your family. Visit our website at tillamookcountyhealthmatters.org or download the app, Tillamook County YOW, for additional community-based wellness resources and information.
by Guest | Feb 14, 2018 | Being Well, Eat Well
By Dr. Hans Diehl
The diagnosis of Type 2 Diabetes has often been perceived as a death sentence because of its impact on health and lifespan. Diabetes, over time affects every major organ in the body and is largely responsible for markedly increasing the risk of blindness, kidney disease, amputation, heart disease and stroke, and erectile dysfunction. Currently, every second American adult either has full-blown diabetes or has been diagnosed as a person with pre-diabetes. But we can go now beyond merely treating the symptoms of diabetes. The highly respected ACCORD study showed that tight control of the glucose levels actually increased morbidity and mortality.
So we must go beyond just treating the symptoms of diabetes, or managing its blood sugar levels with drugs and injections. Almost all pharmaceutical agents increase appetite, thus increasing weight, thus worsening the diabetic condition and requiring more medications. This only continues the vicious cycle of more drugs, more weight, and a worsening of the diabetes with its devastating health impact, shortened lives and a higher economic burden.
There IS hope. A new approach is emerging that has helped close to 10,000 diabetics enrolled in the CHIP (Complete Health Improvement Project). This diet-centered lifestyle intervention lowers blood sugar levels within days. It is an approach that was used more than 80 years ago but it was overlooked and forgotten. Today the evidence is quite stunning when we use a diet very low in fat, oils and grease but high in unrefined complex carbohydrates. The body usually recovers, and within four weeks about 75% of patients with Type 2 Diabetes on drugs and about 50% of these patients on insulin will have normalized their blood sugar levels while being off their medications.
Dr. Singh, as published in the respected Lancet Medical Journal as far back as 1955, had 50 of his 80 insulin-using Type 2 diabetics off insulin with normalized blood sugar levels within 6 weeks by using a very low fat, yet very high, unrefined starch diet. We are now beginning to understand some of the mechanisms that will be carefully discussed in more detail in my presentation on March 2.
The answer to this largely lifestyle-related disease is not found in pills and shots. To disarm and reverse this rapidly expanding killer disease, we need to go beyond pills and shots. We need to alter the causes of this disease. That involves our lifestyle, and especially our dietary lifestyle of “sweets and meats” and of “junk and bunk”.
Type 2 diabetes has tripled in the United States over the last 30 years. This is not a genetically induced disease, because it takes about 300 years to change the genetic make-up of a nation. However, a healthier lifestyle will turn this disease around, not only preventing it but also disarming and reversing it, often within days. The very lifestyle that will heal the diabetes, will also extend to healing heart disease, hypertension, overweight and other chronic diseases.
Dr. Diehl will be making this presentation at a luncheon on Friday, March 2 at 12:00 – 1:15 pm at Wirick Hall at the Nazarene Church, 2611 Third Street, Tillamook. There is no charge for this event. Please RSVP for the meal to 503-815-2270 or gabelgl@ah.org. Sponsored by Tillamook Regional Medical Center.
by Guest | Feb 3, 2018 | Being Well
By Autumn Bruce, BSN, RN and Operations Manager
As a key partner of the Year of Wellness (YOW), Tillamook County Community Health Centers (TCCHC) is supports this community-wide effort to reduce diabetes risk and improve disease management for individuals diagnosed with type 2 diabetes. With more than 11% of our county’s population already diagnosed with type 2 diabetes, it is imperative that we work together to prevent and manage disease risk for all residents.
There are many things people can do to reduce their risk. Having an A1C screening is the best, first step. Hemoglobin A1C (sometimes referred to as HbA1C) is a blood test that shows what a person’s average blood sugar level has been for the past 2-3 months. Doctors and nurses use this test for two reasons. 1) To see whether a person has diabetes, and 2) To monitor how well diabetes treatment is working.
While anyone could benefit from an A1C screening, people who are at a higher risk should be screened regularly. This includes individuals who are/have:
- Age 45 and older
- Overweight/obese, especially if excess weight is located around the mid-section
- Related to someone who has been diagnosed with diabetes
- Sedentary
- Part of a high-risk ethnic or racial group (e.g. African American, Hispanic, Native American, Asian American, and Pacific Islander)
- High blood pressure (greater than 140/90 mmHg)
- High triglyceride levels
- Polycystic ovary syndrome
- History of gestational diabetes
- History of vascular disease (heart disease and stroke)
- A1C greater than 5.7%, impaired glucose tolerance or impaired fasting glucose
When being screened for diabetes, a person’s A1C should be a score of 6 or less. If it is 6.5 or higher, it probably means the person has diabetes but they should be tested again, just to be sure. If A1C level is between 5.7 and 6.4, the individual is at risk for getting diabetes. In that case, it is recommended they begin doing things to prevent the condition from developing. Becoming more active, adopting a healthy eating pattern, quit use of tobacco products, and achieving moderate weight loss have all been shown to reduce diabetes risk. Often, a person will benefit from working with a mental or behavioral health professional to improve health habits to reduce risk. The goal is to return to normal blood sugar levels. It is important that lifestyle changes can and will be sustained for long-term success.
If someone has been diagnosed with diabetes, they will work with their primary care provider to identify the best course of treatment. This will include education and guidance to successfully adopt lifestyle changes. Additionally, A1C tests will show how well controlled their blood sugar is, with the goal of having a score of 7 or less. It is important to check with one’s doctor to know what your level should be. Not everyone with diabetes is the same. Some people need to aim for different A1C levels than others.
TCCHC, like other local providers, uses care managers who work with patients one-on-one to help them set SMART (Specific, Measurable, Achievable, Relevant and Time-bound) goals. They meet for 6-9 months for education and coaching to help the patient achieve their goals, and patients are seen by a behavioral health provider who helps them to manage their condition.
There are many great resources available to help, including the Living Well with Chronic Conditions program. Through group discussion, participants learn new ways to deal with issues caused by many chronic conditions. Over the six weeks, they cover such topics as handling stress, depression, talking to their provider, managing medications and fighting fatigue and frustration. There is no charge for this evidence-based class but registration is required by calling (503) 815-2270. Classes meet Tuesdays, February 21-March 28, 1:30-4:00 p.m. at NWSDS and September 5-October 10, 1:30-4:00 p.m. at the Herald Center.
Information Source: uptodate.com, an electronic clinical resource tool for physicians and patients.
by Guest | Jan 27, 2018 | Being Well
By Leigh Ann Hoffhines, Communications Manager, Rinehart Clinic
Rinehart Clinic applauds Tillamook County Year of Wellness for its decision to focus on diabetes. The clinic’s healthcare team has long recognized the challenges patients with diabetes face and the impact the disease has on the health of the broader Tillamook County community. With roughly nine percent of Tillamook County residents diagnosed with type 2 diabetes, and nearly 33 percent of adults at risk for the disease, it merits our attention.
As the community becomes aware of the need for healthy lifestyle choices, we also need to make it easy for people to be active participants in their own health. From a patient’s perspective, the hardest step may be that first one: walking through the doors of a healthcare facility for treatment and education. The care team at Rinehart Clinic has found the single most important factor in bringing about positive change is creating a supportive environment for treatment and for group classes.
Last summer (July 2017), Rinehart Clinic launched a comprehensive Diabetes Risk Reduction Program made possible by grant funding from the Columbia Pacific Coordinated Care Organization. The program helps patients make positive strides towards overcoming some of the risk factors of diabetes, including obesity and sedentary lifestyles. The clinic holds a variety of healthy lifestyle classes throughout the seasons, shying away from traditional lecture-style trainings, and opting instead for informal and interactive conversations that are often driven by the participants themselves.
To help make it easier for patients to participate, the clinic offers incentives for patients who join in the programs. This past year, the clinic’s weight loss/walking group members received pedometers, healthy eating class participants went home with fresh vegetables each week, and many class members received vouchers for free fitness and aquatics classes at North County Recreation District.
The program has been in place since mid-2017 and the clinic is already seeing positive outcomes for participating patients: lowered blood sugar numbers (A1C), lower blood pressure, healthier eating habits, and even weight loss.
Rinehart Clinic’s class lineup includes:
– A Weighty Discussion series, which offers an informal conversation around healthy eating and weight loss. Some of the participants also joined in a weekly walking group during the summer months.
– The popular Art of Eating class, where patients learn how to increase the use of vegetables in their diets in healthy and creative ways.
– Living Well with Diabetes, which offers supportive tools to help patients manage diabetes and pre-diabetes conditions.
Several community partners who believe in the importance of a healthy community have rallied behind Rinehart Clinic’s Diabetes Risk Reduction Program:
- North County Recreation District, which provides fitness and aquatics passes for patients to help them become more physically active.
- Moon River Farms, a local organic farm that provides shares of vegetables through its Community Supported Agriculture (CSA) program for the Art of Eating classes.
- Manzanita Farmers Market offers participating patients vouchers for free fruits and vegetables at the market throughout the summer and fall program.
- Manzanita Grocery and Deli, long known for its commitment to the well-being of the community, is also offering a voucher program to provide fresh produce in winter when the local farms are not producing.
All of these programs and resources will continue at Rinehart Clinic throughout 2018. For information on upcoming class sessions visit www.rinehartclinic.org.
