Tips for Starting a New Life
A kidney transplant is better done with a living donor, someone who's willing to give up a kidney to save your life. Generally, a living donor is someone you know who's willing to give up a kidney your spouse, brother, sister, and so forth. Using a living donor has advantages and disadvantages. Kidneys from
The key thing is to get going on improving your health now. Don't wait another day to begin to do the things that can prolong your life and increase its quality at the same time. You don't want to regret your life the way poor George Burns did. When a beautiful girl walked into his hotel room and said, I'm sorry, I must be in the wrong room, he told her, No, you're not in the wrong room. You are just 40 years too late.
Although most of your life you will be faced with patients who are in the progressive stages of PDR, remember that if left untreated the neovascular stimulus eventually fades as the retina just plain dies off. Most of the time, if the disease is allowed to run its course the retina ends up like a shriveled orchid in the center of a blind eye (hence the existence of books such as this one). You may, however, occasionally see patients in whom this process has occurred with little disruption of the central retina these patients essentially avoided the typical disastrous outcome and survived the proliferative phase of their retinopathy. Such patients often have very broad areas of fibrosis in the periphery, where the old neovascularization involuted and became quiescent. Deciding whether to treat such patients can be difficult the standard rules do not apply. These patients have somehow achieved a metastable state, and there is always a concern that by going in and aggressively treating...
Stress can, of course, be either good or bad. It is good when it gives you extra energy to do the things that need to be done during stressful times. In fact, research suggests that a certain amount of stress is normal and necessary. Stress helps you to 'get your act together' and prepares you to handle your life in the best possible way. But when left unchecked, stress can be highly destructive, draining all ofyour energy and possibly worsening any existing physical or emotional problems.
A person with diabetes can, in general, lead a normal, healthy and long life. Looking after yourself (self-care) by learning about your diabetes provides the best chance to do this. Your doctor and the other members of the health care team (made up of doctor(s), nurses, dietitian(s), chiropodist(s)) are there to advise you and to provide the information, support, and technology so that you can look after yourself, and live your life in the way you choose.
The time to do a kidney transplant is when your kidneys are beginning to fail. Don't wait until they no longer function. As soon as you have to start dialysis, your life span is reduced compared to the person who has a kidney transplant early on, before the need for dialysis.
Too many people complain that they just can't find the time to exercise. But a recent study showed that just 7H minutes of highly intense exercise a week had a profound effect on the blood glucose. So this excuse isn't acceptable, especially when you realize how much difference exercise can make in your life and your diabetes. Here are some ways that different amounts of exercise can help you
Another key to success is to build a positive support system and surround yourself with people who support you in your weight loss efforts. Take a few minutes to think about your family, friends, and coworkers, and list those on whom you can and can't rely for support. Take some time to think about the attitudes of those around you and how they might affect your weight loss efforts. Make a point of surrounding yourself with people who have a positive attitude about your lifestyle-change efforts. Tell them how they can help the cause (including not encouraging off-limit treats). You might put a check mark into the appropriate place in Figure 10.1 for each of the key people in your life. As you embark on the journey to change your lifestyle, keep in mind that you are the main traveler. While others can speed or slow the trip, you are primarily responsible. You should be careful that you not make the changes in lifestyle the only focus of your important relationships. We have...
If you are experiencing excessive amounts of irritability or anger, or if your fears seem to be extreme, or if you feel inadequate and worthless, or if you are unable to concentrate on virtually anything in your life, whether it be work, family or other interests, or if you seem to have little or no interest in activities that previously gave you pleasure, or if you have reduced amounts of energy that do not seem to be related to the disease or treatment, or if you have little or no interest in sex or intimacy, or if the way you think, speak and act seems to be generally slowing down, then any of these can also be symptomatic of depression. The more of these symptoms you experience, the more likely it is that you are depressed and should take some action to help yourself.
The fresh meat and fish counter usually offers breaded or battered fish to make your life easier you only have to put it in the oven. The problem is that the breading or batter often contains too much butter, fat, and salt. Ask the person serving you for a list of the ingredients in the breading or batter. Or better yet, skip the prepared fish and head for the fresh. If you notice a very fishy smell, then the fish is not very fresh.
Although virtually every aspect of your life may seem turned on its head after the birth of a new baby, the four basic management tools remain the same insulin or oral diabetes medication (oral diabetes medications cannot be used while you are breastfeeding), blood glucose monitoring, meal planning, and exercise. Exercise may be the last thing you are thinking about after the baby is born. But as soon as you feel well enough and you have your doctor's okay, taking your baby for a daily walk can help you feel better and more relaxed. Having a new baby can affect your diabetes care habits, especially if you have other children to care for. You may find that your baby's unpredictable schedule and your own erratic sleep patterns make it difficult for you to eat or snack when you need to. Using multiple injections may make your life easier and give you more flexibility. Although it is tempting to put your infant's needs before your own, taking care of yourself is important for both you and...
An individual with diabetes can, in general, lead a normal, healthy, and long life. Looking after yourself and learning about your diabetes provide the best chance to do this. Your doctor and the other members of the health-care team (made up of doctors, nurses, dietitians, and chiropodists) are there to advise you and to provide the information, support, and technology for you to look after yourself and live your life in the way you choose. It is important for you to know what your health-care providers should provide to help you reach these goals and what you should do.
Killing all your invaders is just the first step, though. It is indeed the life-saving step. But getting well is more than saving your life. Next comes the more tedious task of finding their sources. Where did they come from Why did they invade you so massively. Why you
Throughout the course of your life, your career, and your diabetes, you need to periodically evaluate your health insurance situation. Ask yourself if your needs are being met. If you are unhappy with your current situation, evaluate the options. But don't be too quick to jump ship. Any change in your health insurance coverage requires careful evaluation. You need to make sure that any new situation provides the health care coverage you need. There may also be times when you want to make changes in your life. Maybe you want to switch jobs, retire, get married or divorced, or move out of state. Each of these decisions can affect your health insurance coverage. Before you make a change in your life, think about how you will continue to cover your health care expenses.
You may already be reaching your glucose goals. Your A1C and blood pressure may be right where you want them to be. Or you may firmly believe that you are doing fine without intensifying your diabetes management. But even if you have your diabetes settled into a manageable routine, you may not like the idea of having your life dictated by your diabetes care or a schedule. So the idea of taking on intensive diabetes manage-
As we have discussed, successful lifestyle change that leads to weight loss involves more than just changing your diet. In fact, diets alone don't work for permanent weight loss. But you will need to learn to manage and plan your eating how you eat, where you eat, why you eat, what you eat, and when you eat. It's a long-term commitment to your health, not a short-term test of your willpower. That means getting rid of the diet mentality. A diet does not sound permanent. It suggests an element inserted 134, into your life rather than the consistent long-term change in When you truly change your lifestyle, you'll be able to eat and feel satisfied. So before you begin your effort, review the following list to make sure that you have a plan for success.
If you understand only one hormone in your body, insulin should be that hormone (especially if you want to understand diabetes). Over the course of your life, the insulin that your body produces or the insulin that you inject into your body (as I describe in Chapter 10) affects whether or not you control the glucose levels in your blood and avoid the complications of the disease.
Type 2 diabetes is a lifestyle disease. Some harmful choices for your lifestyle contributed to your development of type 2 diabetes and some helpful choices will help you control it or prevent it if you don't have it yet. Unlike the people in your life, who can hardly be there with you 24 hours a day, the Internet is only a mouse click away at any time. On the Internet you can find help for the two key aspects of your lifestyle that affect diabetes, diet and exercise.
When you first find out your child has diabetes, you may be overwhelmed with feelings of shock, disbelief, sadness, anger, or even guilt. It can seem so unfair. You may experience self-doubt as you wonder whether you can give your child the care she needs. With all the stresses in your life and all the demands on your time and energy, it may seem that you just won't be able to handle it all. Don't forget that your child is looking to you for guidance. Your attitude will have a direct impact on how your child sees himself and how he comes to terms with his new lifestyle. If you take your child's diabetes in stride, it will be easier for your child to accept it. If you react with anxiety, apprehension, and fear, so will he. Deal with diabetes in a matter-of-fact way. Don't downplay your child's fears or concerns, but address them in a straightforward fashion.
This part takes you on the road to long life and great health as you incorporate the needs of being a person with diabetes into the rest of your life. It begins by showing you all aspects of a healthy lifestyle and continues by focusing on food and its importance to you. When you cook for a person with diabetes (either yourself or a loved one), you must keep some special considerations in mind, but this part shows you that a diet for diabetes is an excellent diet for anyone. We guide you around the kitchen and take you to the supermarket to find out about meal-enhancing ingredients, as well as the ones to bypass as you navigate the aisles.
Everyone seems stressed out these days. And living with diabetes adds even more stress to your life. People with diabetes sometimes try to do more than everyone else, just to prove that diabetes doesn't make them any different. But you, too, need to allow yourself enough time to relax and recover from the stresses of everyday life. Stress can produce hormones that can shoot your blood glucose levels up and out of your desired range. Stress can also be a hidden contributor to unexpected swings in blood glucose levels. The effect of an angry driver who cuts you off on the interstate can't be as easily measured as grams of carbohydrate, units of insulin, or calories burned during exercise. When you can't figure out why your blood glucose level is so high despite doing everything right, think about the stresses in your life. Also, think about how you respond to stress. Do you eat when you are under stress This can bring up blood glucose levels. Do stressful situations make you more active...
Everyone gets the blues now and then. It's easy to feel blue when there is too much stress in your life, when sad things happen to you or your family, or simply from the everyday strain of living with diabetes. Learning new ways to cope with stress, figuring out what is important for you, solving the problems that you can, practicing your religion, and getting support are some ways to get past the blues. Taking care of your diabetes can also help. People with type 2 diabetes who have blood sugars closer to normal report feeling more zest for living and an improved quality of life. It is important to recognize the symptoms of serious depression and seek help right away. Unfortunately, when you feel depressed, you probably feel even less able to seek help. But it is the best thing you can do to get your life and health back on track.
It is very common to feel overwhelmed after learning that you have a condition such as diabetes there is no easy way to accept the fact that your life is going to change. When first diagnosed, you may not be able to react at all, since it may not seem 'real' to you, especially if you don't have any noticeable symptoms. As the full impact of the diagnosis sets in, you may experience a whole variety of feelings ranging from sadness and anxiety to anger and frustration. You may feel upset because you will need to make some lifestyle changes, and you may be afraid that you will never adjust to living with diabetes.
For some people with diabetes, the extra self-care that diabetes management requires can certainly be a source of anger. You may be angry because you feel that you cannot eat what you want. You may become angry if you believe that your diabetes has imposed limitations on your life. You may get angry if you feel that your family is not understanding enough, or you may think they are trying too hard to protect you. Or you can become frustrated if you cannot seem to keep your blood sugar under control no matter how hard you try, and this may cause you to feel angry. Thoughtless comments from others can also cause anger. You must, of course, become aware of anger before you can deal with it and realise that resolving your anger will not make your diabetes go away.
First, learn all that you can about diabetes. The more you know, the more you are able to weigh the positives and negatives of the choices you have to make. Ask your provider for a referral to a diabetes education program in your area. Second, work with your diabetes care provider to develop a plan to manage your diabetes that matches your goals and abilities. Be honest about what you can and cannot do. Remember, you are the one who has diabetes and lives with it each day. You are the expert on yourself and your life. Third, be honest with yourself. It may be tempting to shift the decisions to your health care team or blame the people around you for your outcomes. But when we do not accept responsibility, we become victims of our situation. Power comes from accepting responsibility for our choices and our lives. Taking responsibility for managing your diabetes gives you power and control over your diabetes and your life.
Making a big change in your life takes time. It might help to keep a record of your weight each week, so you know when you're making progress, and when you're not. And don't worry about occasional relapses. Don't be harsh with yourself if you overeat once or twice, or regain a pound or two you thought you'd lost forever. But do try to identify the causes of your relapses, so that you can avoid them in the future.
One thing that helps a lot in diabetes is if you have a fair amount of order in your life. If your life is disorganized, controlling your diabetes will be much more difficult. You must take your medications at about the same time each day and eat at about the same time. You must test at about the same time and exercise at about the same time. But you don't have to eat the same thing all the time. An endless variety of delicious foods is available to you.
The other day she was relaxing on the couch. She looked at me and said, I don't want to have diabetes anymore. Feeling terrible I responded, I know sweetie I don't want you to have it anymore either. I then explained that she would have diabetes for the rest of her life. With a very concerned look she then asked, Will you be the dummy for the rest of your life
Diabetes is a challenge because you have to think about doing certain things that others never have to worry about. It brings out the quality of organization, which can then be transferred to other parts of your life. When you're organized, you accomplish much more in less time.
Avoid phrases including words such as 'difficulties', 'problems' and 'help' as this implies that you perceive them as having problems when this may not be the way that they see things themselves. Closed questions require a yes or no response they can be used once discussion has been initiated and are a useful way of checking your understanding of the conversation. 'Did you say that you have tried that diet five times before ' Another useful opener to establish rapport would be to use a typical day (21). For example, 'Can you take me through a typical day in your life, so that I can understand in more detail what happens ' or 'Can you think of a recent typical day Take me through this from beginning to end'.
Recognize you as an individual and are willing to help you create a plan that fits your life. Don't agree to a meal plan containing foods you don't like or an exercise program you know you won't do. Tell your health care team what you can and are willing to do. Remember, it's your plan. Respond to your questions and concerns. You and your family members should be able to ask questions openly and trust that the health professional will take the time to listen and answer you patiently, completely, and honestly. Recommend the best possible strategies for the care and management of diabetes. All professionals should be aware of and follow standards of care recommended by the American Diabetes Association.
Most insulin plans try to mimic the effects a normal pancreas could produce (see Graph 1, page 131). A pancreas puts out a steady stream of insulin (a basal or baseline dose) day and night. It also secretes an extra dose of insulin (a bolus) in response to meals. This is the way insulin pumps are usually set up. If insulin injections are preferred, a longer-acting insulin is used to mimic the basal insulin secretion. To substitute for the bolus of insulin, a dose of rapid-acting or regular insulin is usually given before each meal. Which combination of short- and long-acting insulins you use is up to you and your provider. Together, work out a plan that will suit your life and schedule. If your plan is not working out for you, talk to your provider. There are usually many other plans you can try.
Your body has been trying to rid itself of its parasites and pollutants all your life It had its own ways. It made stones, it made mucus secretions, it made itself toxic dumpsites. These were good tactics but now of course, they are no longer necessary. Can you help your body get rid of these accumulations and sweep itself clean again
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