The significance of d-routine for wellness

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I had a friend visit last weekend. She, like me, is aged in her mid-40s, is a working Mum and has type 1 diabetes. She was telling me that she had started to suffer with anxiety or panic attacks and that her doctor had put her on medication for it. Not surprisingly her diabetes control was also not in a good place. For me it was somewhat of a shock to hear this of my extremely capable friend, but also was easy to imagine how it could happen when we reflect on just how stressful and overfull our lives have become. It also reminded me of the importance of having a routine, especially for those of us with diabetes, so that we don’t ‘juggle out’ diabetes as a ball in our busy lives. Diabetes really needs to be a very high priority for both mental and physical wellness, and yet it so often drops to a low one, dragging the rest of lives down with it.

As you know, I’m an Accredited Practising Dietitian, and my speciality is food/lifestyle and wellbeing, rather than psychology. In my blog today I wanted to remind people with diabetes about how having a routine every day can get your day off to the right start as well as helping your diabetes to be better controlled across the day, leaving you to focus on those other priorities in your life.

For myself I have created a routine that allows me that great start to the day, knowing that if you start well there’s a greater chance of continuing along that good line. As a dietitian I also am very aware of the evidence that tells us how important food is for mental health, hence the Australian Dietary Guidelines recommendations for a variety of fresh foods from the five food groups so that we get the nutrients we need for energy and for wellbeing, both physical and mental. The first key point in the guidelines reads:

“Good nutrition contributes significantly to maintaining healthy weight, quality of life,

good physical and mental health throughout life, resistance to infection,

and to protection against chronic disease and premature death.”

Australian Guide to healthy eating poster

Planning is an awesome strategy

My routine starts with ensuring I have enough time to fit it all in – Planning! Drawing on my blog from last week where I quoted Accredited Practising Dietitian Jemma O’Hanlon reminding us that “Failing to Plan = Planning to Fail”.

My thoughts for the next day start the night before, and I do that to ensure that I have a good eight hours sleep before the time I need to wake up, knowing that tiredness will not help me in *any* way. There is a lot of evidence around the importance of a good night’s sleep for wellbeing.

young girl sleep

I consider what time I’ll need to leave home to be where I’m going that next day. I know that my ‘d-routine’ takes me an hour and a half to complete, so I set my alarm to wake me an hour and a half before I have to leave, and off to sleep I go. Most days I plan to leave by 8am, meaning a 6.30am start. You’ll need to see how long your d-routine takes to work out your own hours.

My morning routine includes (not in order of importance, but how they occur):

1) Testing my BGL and having my medications

2) Eating a low-GI, high fibre breakfast with a serve of dairy

3) Checking my emails/facebook

4) Going for a 40 min walk/jog/lunge

5) Showering and dressing

6) Planning my snacks and lunch for the day

All six points are important for the success of my day, diabetically, mentally and physically.

No.1 – Testing my BGL and having medications – this one is a no-brainer for me. If I don’t know where I’m starting from with my BGL, how on earth can I know or control where I’m going with it? Same with the meds, there’s just no option not to have them. I’m often surprised to hear that people don’t take the medications they’re prescribed, and that’s why these two are the first on my list.

Glucose meter Insuline pen injection and lancetes

No.2 – Eating a low-GI, high fibre breakfast with a serve of dairy – we all should know the benefits of low-GI carbs as explained in my earlier blog, but when you know that your brain needs glucose to function properly again it’s a no brainer. Even if I’m not hungry, I eat my low-GI breakfast with grains, dairy and nuts to keep me energised for the morning.

Oaty heart

No.3 – Checking emails/facebook – As a person who thrives on being organised and needs to be for my business to function smoothly, I need to clear out my inbox each morning and deal with the quick responses, so I can know issues have been dealt with so they’re not on my conscience when my mind should be focussed elsewhere. If I had to leave one point out of my morning routine this would be it, but I can do it pretty quickly in most cases.

No.4 – Going for a 40 min walk/jog/lunge – I know that if I don’t fit this in to my morning routine I will regret it for many reasons! Exercise brings so many benefits to everyone, and especially to us with diabetes. There’s also good evidence to demonstrate that those with diabetes who exercise enjoy much greater glycemic control. Not only does it give me a chance to think through my day ahead so I’m better prepared, but my diabetes control is so much more stable on the days that I’ve exercised first which makes my day run more smoothly by minimising the highs and lows that happen if I’ve missed it. I also enjoy the sunshine on my skin that will make me vitamin D, and saying ‘good morning’ to other walkers. Definitely a bonus from a mental health viewpoint too! You can read more about exercise and diabetes here. I wouldn’t be without it!

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No.5 – Showering and dressing – Everyone does this one, so nothing special with diabetes here lol

No. 6 – Planning my snacks and lunch for the day – For me I need to know that I can have healthy low-GI (and gluten free as I’m a coeliac too) options available when I need them, so if pushed the least I will do is make a sandwich and take an apple and some nuts. It really only takes a couple of minutes and is well worth the small effort.

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You and Your Routine

Of course my routine will be different to your routine. The main point I’m trying to make is that if you can consider the important things to keep your diabetes on track, your mental health in as good a place as you can, and your physical wellbeing with the good food and exercise then the day in the your life should be easier to manage. Every day is a new day, and routine helps to keep you on track. Routines can change, and if you feel that yours needs an update, then now is a great time to do it!

Mental Health

In terms of mental health with diabetes, if you feel like you’re not coping then it’s advisable to speak to your doctor. Diabetes Counselling Online has recently published an e-book on Diabetes Burnout which may also be helpful, and we offer six free hours per year of e-counselling to Australians who have diabetes and their friends and family – just go here to register.

I would also recommend a visit to see a diabetes specialist Accredited Practising Dietitian, and an Exercise Physiologist to help you get your diet and exercise routines right for your wellbeing.

My friend and I are going to try a meditation class that we found locally too (hence the meditation pic at the top).

We’d love to hear how you try to keep your diabetes day together. Hoping you found this helpful.

Best wishes, Sally :)

Sally is the Social Media Dietitian with Diabetes Counselling Online, owner of her private practice (Marchini Nutrition), and has had type 1 diabetes for close to 40 years and coeliac disease for many years too.

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The fat and the thin of it all, weighing in on my journey

Me now :-)

I have been on a personal journey of late. One of many I have taken. It is a road I have traveled before and may travel again, but I hope not. It is the road from being overweight to a healthy weight. I could say from fat to fit, from huge to slender, from obese to slim. But these words just make me feel all sorts of things that I do not want to feel and they do not really describe the journey.

What the journey is really about, for me, is from unhappy to happy. From disliking my image in the mirror to starting to try and see the new one. From shopping in the “larger ladies” sections to being able to pull things off racks anywhere I choose to go. From feeling trapped by the injuries, disabilities and chronic diseases I live with each and every day, to feeling freer, not free, but freer from these things and using my body in many remarkable ways. From being puffed out doing the vacuuming to being able to run, for a long time, and feel good. From being obsessed with Lindt Balls, to craving my low fat natural yoghurt with a bananna.

I have always battled weight. It runs in our family. Perhaps we have that “fat gene” that gets tossed about. Perhaps we come from viking stock and were built for surviving long trips at sea and having lots of babies as we fought battles atop the viking ship. Perhaps we are just made that way. Whatever the reason, many of the beautiful, handsome, pretty, smart, lovely people who are in my family are larger than life. Some people may be comfortable with that. But I am not. I don’t feel happy when I am overweight. I would love to change societal attitudes to weight and stop the obsession with anti fat. But I do know that for me, not being fat means I am healthier and happier. This does not however mean being thin. It simply means being a healthy weight, for me.

I remember being a little girl and becoming aware of being “chubby”. I remember being a 12 year old and getting type 1 diabetes and almost fading away to 34 kilos and thinking it was AMAZING as I could get a string bikini for our surfers holiday and look good in velvet jeans (well it was 1980). I remember all the thin pretty girls who I wanted so so much to be. Type 1 diabetes pretty much screwed this all up even more for me. In my head, I was now not only fat, but I was a diabetic. Someone who had something awful wrong with them, who would have terrible things happen to them, that I would rot away and have bits of my body fall apart.

The trouble with type 1 diabetes is you get sooo thin (as you are so sick) and then when you go on insulin you put weight on again and often become a little overweight. Then there is the fact of food being counted, weighed (back in those days) and becoming part of your “medicine” in a way. By the time I was in late high school I was once again overweight. One of my first sort of boyfriends said to me at an intimate moment, “you would be so pretty if you just lost a bit of weight”……do you know how that screws with your mind?

I have always been active – ballet, yoga, calesthenics, netball,basketball, cross country running,bike riding, to name a few. As a young adult moving to the city for study, I started jazz ballet at the gym and later, became a gym junkie. I still felt fat. When I had my first baby 19 years ago, I got post natal depression and I really got obese. I ate. I sat. I cried. I hated my life. After leaving his dad when he was just a baby still,I took control and lost 30 kilos. I felt amazing. The gym was back in my life and I was happy.

Type 1 diabetes does complicate this however. It is far from easy. The battle and effort involved in planning an hour ahead that you will be exercising so you can reduce your insulin enough that you won’t get dangerously low blood glucose during the work out, the need to eat lollies and glucose to get though it, using up all the calories you have burnt dealing with the low, the lack of spontaneity, the lows later in the night, the unexpected highs during a run…but that said it makes you an excellent planner!

Post traumatic stress at work, depression, panic attacks came next in my life. Then another baby. Post natal depression. Again. And more weight. I did get this weight off, but not as much as the first time. To keep this story short, you can toss in a frozen shoulder lasting 5 years, a car injury to my back, arthritis, bursitis, injections in knees, hips, ankles and many huge problems with my entire digestive system due to diabetes making me feel ill and broken and sore – and gradually, little by little, I stopped exercising. Third baby down four years ago and more weight crept on. By this time I was reduced to the occasional walk with the family. Then…nothing. I had become sedentary.

I also have multiple food restrictions and other issues that impact my diet. All of these things led me to once again being obese as I just ate what I felt like and could manage to digest. But I did not really notice. I knew I was overweight . But not really by how much. Then came high blood pressure. It shocked me, shook me out of my comfort zone. So, last November I took control back. I started to take chances, steps. I started counting calories for the first time ever thanks to an amazing APP. I gave myself a reality check about my eating habits. I started back at the gym and this time I PUSHED through the pains and aches and problems and denial and excuses. And discovered an amazing thing, that I could still do these things. Yes there are still things I can not do and I think at 45 this is probably fair enough!

Yet I also still struggle at times, when I catch my reflection, to believe I have gone from an 18+ to a size 12. I still feel the same old issues about my body, yet I know it has changed. I think this mental challenge is one of the hardest. I have given up chocolate, once my dear dear friend. I have learnt about how many calories I need each day, how many when exercise and how many when I don’t.

So here I am 22 kilos down. Feeling fit, healthy. Feeling damn good. Here’s hoping it is the end of the road for me with this weight thing. But somehow, I think it won’t be.

Do you have a similar story to share?

Helen

Helen Edwards

Helebio dad 6

 

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