A Heart to Heart with Ginger.

Ginger Vieira is one of those people from the diabetes community that I look up to and admire.  Not only has she been living well with diabetes, she made a career of helping people live well also.  I had the pleasure of meeting Ginger last year at the Unite for a Healthy Future event.  Her positive attitude, healthy outlook and smile are contagious.  I had some questions I’ve been wanting to ask her and she was nice enough to let me share it with all of you.       

S: Tell me more about your diabetes diagnosis.

G: The most unique part of my diabetes diagnosis is that I actually diagnosed myself and no one believed me for a week. I was 13 years old, in the 7th grade, and the entire 7th grade does a health fair every year. One of the kids in my class, Miles, did his project on “diabetes.” I had been feeling sick for about 3 weeks – my whole family got the flu, and it seemed like mine never went away! I started reading Miles’ poster on diabetes while we were in science class, and I had all of the symptoms listed. I told my mom later that day that I thought I had this “thing called diabetes.” We didn’t know anything about it, so she said, “No, no, that’s impossible.” A week later, I started crying because I felt so awful, and we finally went to the hospital.

S: Tell me more about your celiac diagnosis.

G: I’m really lucky in how quickly I was diagnosed with celiac. Most people don’t even get tested until they’re bodies are suffering and they feel really sick. By then, your small intestine has already experienced a great deal of damage. My endocrinologist just tested me on principle during the second year of my life with Type 1 diabetes.

I was very good at following my gluten-free guidelines throughout high school, and then I teetered out of those lines during college for about one year. In other words, I cheated whenever I felt like it! Because I was diagnosed so quickly, I really don’t have very noticeable symptoms, if any, to gluten. I would get a headache sometimes, but because I was eating small snacks of gluten so often, I stopped noticing how unhappy my body was.

Today, I can honestly say I have no interest in eating gluten (*cheating) because everything about my body feels healthier and happier when there is no gluten in my body. Can I get away with trying my best friend’s chocolate ganache cake pop sometimes? Yes…but I try to keep those “taste-testing” excursions to just 3 or 4 small bites a year.

S: How did you know you wanted to be a trainer/coach?

G: Well, it was really never something I thought about until I had hired a personal trainer for my own health goals during my senior year of college. Within a year of training with him, I knew I wanted to motivate people to take good care of themselves, to see how much they are capable of, to become stronger and more confident in their own skin than they thought possible!

I never thought of myself as an athlete until that year. During the next year, amidst powerlifting competitions and training, I realized I wanted to do more than just teach people how to exercise, I wanted to help them change the way they see the challenges in their health, change the way they pursue their goals, and change the way they literally think about themselves.

That year, I began training as a cognitive coach in David Rock’s coaching program that is based on the neuroscience of the brain – the way your brain thinks, the chemicals involved, and how to create a conversation that leads you to making incredible changes in your thinking habits.

S: Do you have a lazy side? If so, how do you push yourself?

G: I was always fairly active in middle school and high school, but it wasn’t until my senior year of college when I found my passions in exercise, and the confidence in what I’m capable of—I’ll try almost anything now. Today, it’s so easy to convince myself to get up and go to the gym because my body craves it. My brain craves it. And I just feel balanced and at peace when I’ve made time for it.

And that’s exactly one of the things that I love helping other people discover in themselves. It takes an immense amount of commitment and focus to get to that point, but you will get there eventually if you make it your goal.

Don’t get me wrong…I love my couch, though! And the occasional nap!

S: What is your all time favorite food?

G: All time favorite? Oh, goodness. I can’t choose just one. But here are three foods that I could eat every day:

1. Sweet Apple Chicken Sausage
2. Fuji Apples
3. Ben & Jerry’s Pistachio Pistachio

S: Do you ever eat “unhealthy” foods?

G: Yes! I keep a container of Ben & Jerry’s Pistachio Pistachio in my freezer at all times! A healthy relationship with food includes junk food. My relationship with food is about balance. About 90% of my day is good clean food: eggs, meats, apples, carrots, hummus and water. But if I’m craving something sweet, I don’t make that off-limits. Telling yourself that you cannot or should not eat a certain type of food in order to “ be healthy” or even in an effort to lose weight, will probably backfire on your incredible.

When nothing is off-limits, and there are no rules, then junk food is no longer a big. I don’t ever binge on the ice cream in my freezer…because it’s always there! I can eat it whenever I feel like. I basically nibble on it throughout the week. And I exercise so much that every remains balanced. When I was powerlifting training regularly (which I’m not now), I actually needed over 3,000 calories a day, so I had to include junk food just to get it all in! Today, I really only need 1800 to 2000 calories.

This question actually brings up something I am super-passionate about coaching other folks in. Your relationship with food!

I truly, wholeheartedly believe that diabetes skews and twists our relationship with food. It makes food a chore, an evil, a thing that can save our life, and a thing we’re supposed to avoid and count and think about constantly.

I also truly believe that developing a healthy relationship with food is very possible. I’ve done it for myself, and every coaching client I’ve ever worked with has come to me with a goal of overcoming emotional eating.

This is the next topic I’m writing my next book about. I’ve created the outline for the book, but that’s about as far as I’ve gotten!

S: Have you ever been on an insulin pump? Why or why not?

G: Yes, I was on an insulin pump about 6 months after I was diagnosed. I was the first teenager at Dartmouth Hitchcock Hospital they actually let go on a pump…that was 1999! I went off my pump about 6 years later. My skin really didn’t like it, my infusion sites were always itchy and getting clogged with blood or infected. I didn’t feel comfortable doing yoga with my pump, always stretching and having the infusion site pop out. It would’ve never fit with my powerlifting belt, I would’ve been bruised constantly. Yada yada. It’s just not for me.

My A1C has basically been around 6.8 to 7 percent whether or not I’m on an insulin pump. I’m very happy to be using Lantus and Humalog.

S: I love your dog. What kind is he and is it hard at all to take care of a dog so big?

G: His name is Blue. He is amazing. He’s a goldendoodle (part poodle, part golden retriever).

He was a very stubborn puppy (like mother, like son), so I was very strict in his discipline to ensure that he knows I’m the boss, the leader of the pack, and his mama. Today, despite his size, he’s awesomely well behaved, incredibly friendly, and a lover of life. *However, given him a bath is a pain in the butt.

Meanwhile, because of his size, it’s also really easy to tackle him, wrestle him, and basically wrap my whole body around him when I need him to sit still while my friend is cleaning his ears (he hates that!).

I also recently adopted a 9 year-old pup named Einstein. He’s learning from Blue how great life can be. He was given to a shelter because his owner was dying, and I don’t think his owner took him outside very often. He didn’t even know his name or how to sit when I got him.
Today, due to lots of cuddling, kisses, and walks in the woods, he’s become a very happy canine…and a good friend of Blue’s.

S: I started reading your book (and will continue just as soon as I finish the Hunger Games trilogy!!). So far I loved how you explain things. What was the moment when you thought, I’m going to write this book?

G: Hmm…well, when I started powerlifting training during 2009, I had to learn so much about basic human physiology because not only did the endocrinologists in my area know nothing about competitive sports, exercise and diabetes, but the head endocrinologist there also rolled his eyes at me when I said I wanted to train and compete in powerlifting.

So I was on my own.

I read medical textbooks and talked a lot with my trainer, Andrew, about basic exercise physiology. After really coming to understand it well, and taking a lot of notes around my own blood sugars, training workouts, and competitions, I realized that this was my book. This information that you can’t find easily anywhere else.

It’s frustrating to me, in one sense, that doctors don’t take the time to teach us some of this stuff, but I know they don’t have time. We are all capable of learning it though, and it applies to every part of life with diabetes.

S: Your newest venture was becoming the mental health coach for Team WILD. How is that going?

G: Oh, it’s only just begun! TeamWILD is founded by the awesome Mari Ruddy (a two-time cancer survivor and tri-athlete living with Type 1 diabetes). Working with and for Mari is great because she sees what her staff is capable of and gives them the reigns to be as awesome as they can be.

TeamWILD is holding it’s camp in Boulder this coming June, and I will be one of the main 4 staff members running the camp. You’ll also find three videos from me in your training packages if you sign-up for any of the various programs TeamWILD offers!

Wanting to exercise is the first step, but the next step is making sure that you’ve learned everything you need to in order to exercise effectively, safely, and productively with diabetes. Going for a jog when your blood sugar is 240 mg/dL, even if you don’t have ketones, isn’t going to give you all of the benefits you’re hoping for. You’ve gotta learn how your body works and how to manage diabetes on top of that.

TeamWILD is an awesome source for learning that information, and reaching all of your athletic goals in endurance sports.

If you haven’t already, I would highly recommend interacting with Ginger online – I’ve included links where to find her at Living In Progress, her book Your Diabetes Science Experiment which can be purchased as a paperback or an e book, her services at Team Wild and you can also find her on twitter @gingervieira 🙂

Fancy Lancing.

If you know me, you will be well aware of my interest in new things that come out. Or if you don’t know me too well, you probably have heard about it already here 🙂  With that being said, Accu-chek has a new lancing device out called the Fastclix. I don’t know if there has been some sort of “formal” announcement about its launch or not but I found out about it when I received a coupon in my email from CVS. They were offering me a discount off of a new Aviva Plus meter plus a box of the Fastclix lancet drums. What’s this Fastclix they speak of, I wondered to myself. And of course I went on a mission to find out about it. Right now it is only available for purchase as part of the Aviva Plus meter system. (a special thank you to Rob from Roche who answered my original questions about the new product!) From CVS, the meter costs $19.99 so I purchased one online so that I could check out the new lancing device.

Let me stop here for a moment. I have been a long time user of the Multiclix lancing device, also from Accu-chek. I have a few lying around places in case I should ever lose one. Or one should break. I refuse to use any other kind of lancing device no matter how many different meters I have acquired over the years (and that’s many). You may then wonder why I was so eager to try the Fastclix? I wanted to see what the “1-click” was all about.

Multiclix shown above.

Fastclix shown above.

(image credits: Accu-chek)

So I’ve been using the Fastclix for almost a week. My initial thoughts was that it is different compared to the Multiclix even though they look a lot alike. Each drum contains 6 preloaded lancets which is the same and something Accu-chek should never, ever change! The 11 depth settings are also the same and a great feature There is a new lever that advances to a new lancet, as opposed to turning of the plunger. This may prove easier for some, especially if conditions like arthritis in the hands are present. There is nothing to press to prime it prior to lancing and there is no release button. All you do is press the plunger at the top like a pen. Hence the “1-click” mechanism. This I really like. Not that it takes more than a second or two to prime, but add up each second gained for each BG test and it adds up! Especially if your fingers are hardened like mine and at times takes a few tries to get blood out of those darn things. The actual lancing feels pretty much the same – which is a very good thing for your fingers. Overall it’s good and I don’t dislike it. However part of me feels more comfortable with the button release of the Multiclix. But that could be just the result of a longtime habit. Either way you can’t go wrong with either of these devices. If you haven’t tried either one, I would seriously recommend it. Your fingers will thank you!

Disclaimer: the contents of this post are strictly based on my own experience and I have no personal connection to Accu-chek or Roche Diabetes.

Too Much to Ask?

I’ve posted before about the lack of glucose meter accuracy and if we’re friends on Facebook, you’ve seen pictures I’ve taken comparing meter results. When I was using the One Touch Ping meter that worked with my pump, I had issues with it giving me false low readings. Luckily I have the Dexcom CGM so in seeing the discrepancy between meter and sensor readings, I would retest to get a higher reading. One Touch was very accommodating and sent me a new meter which solved that issue. Mostly. At the time my CDE suggested I try the Freestyle meter which I did and switched for some time to primarily use the Freestyle Lite.  I did many comparisons between the two meters with the same blood sample and got substantial differences. I put a stop to that pretty much for my own sanity. In the end I stuck with the Ping meter mainly for convenience of the remote bolus function with my pump and also being a long time One Touch user.

Then, two months ago, I switched to the OmniPod system and the Freestyle PDM became my primary meter since it also functions as the manager to all insulin dosage functions. In that same time period, I purchased the new One Touch Verio IQ meter. Although the Verio is not my primary meter, I do like it a lot. Of course I have done some reading comparisons between the two. And I’m back to getting very considerable differences.

A couple of weeks ago I read a post by Mike over at Every Day Ups and Downs. He had reviewed the new iBGStar meter from Sanofi. In his review, he noted that the iBGStar was giving him readings higher than other meters (Accu-chek Expert and Contour Link). In posting his results, he got confirmation from Sanofi that “the iBGStar has been developed to give readings which are automatically corrected against Haematocrit* and plasma values. Both of these corrections can mean that your new iBGStar monitor may give readings higher than you are used to. If you have any concerns over what this change of readings may mean, we would advise you to consult your doctor or other healthcare practitioner for further training.” This made me wonder if the new Verio has been developed similarly.

Also, a few days ago I read a post by Adam over at diaTribe, reviewing the new meters on the market, including the Verio. In his findings, the Verio had 100% accuracy with results under 75 mg/dL and 95% accuracy with results over 75 mg/dL compared to lab readings. That is some pretty solid findings. It also made me wonder about my own comparisons using the Verio.

While I appreciate all the new technology coming out or being worked on – mySentry, Telcare, AP, etc. and think they are hugely beneficial to the lives of those living with diabetes, what I want the most is a BG meter that will give me results I can rely on. One that will not be just plus or minus 20% of my actual BG. My next endo appointment is in 3 weeks and I plan on taking both the PDM and Verio meters to be tested at the lab. If the Verio results are indeed more “accurate”, as much as I wouldn’t want to, I would consider changing it to my primary meter. It will be an inconvenience in some ways but may be worth it if it means trusting the results more.

FDA and BG meter companies – without accurate BG readings, all else in our management means nothing. I can eat all the right things, count every last carb, test 20 times a day, exercise every single day and dose the most precise amount of insulin. But if my readings aren’t accurate all of those other things will not help me keep my diabetes in control. I can’t help but wonder if this is the very reason I cannot seem to get my a1c under 7. My BG levels may not actually be what they seem. And that to me, as a person with diabetes, is a huge problem.