Health – Rachelle Goering, MA, FNP

Living With a Type 1 Diabetic and Other Musings

It’s been 2 years since I last updated this blog. So much has transpired over that time that it’s hard to know where to begin. Over the next few months, I intend to let my story unfold for you. I feel in my heart that I have something worth sharing with you. That my journey is your journey. Whether or not you resonate with my process, I know that I cannot keep it to myself. I must write about it, share it–for whatever purpose it fulfills.

To that end, I begin my story at the urging of my partner to write about what’s it is like to live with a Type 1 Diabetic (T1D). I met Todd last year and when we began dating, he informed me that he was a diabetic. At the time, I had no idea how involved I would become in his life and nor how his diabetes would affect me. Todd is writing a book on T1D–and asked me to contribute a chapter on what it is like to live with a T1D.. I share part of that story with you now.

FEATURE STORY

It’s 3:45 AM, I reach across the bed to place my arm over Todd. My arm falls on a mound of wet sweaty sheets. As I begin to awaken, I hear a spoon clanging against a bowl from the kitchen. The hall light is softly illuminating the bedroom. I roll out of bed and make my way down the hall to the kitchen. Todd is leaning over the kitchen bar shoveling spoonfuls of cereal and almond milk into mouth. He’s not speaking, he barely notices me.

“What was your blood sugar?” I ask.

“48 “, he responds.

I know better than to ask: “how do you feel.?” I know how he feels –he feels terrible. He can’t think clearly, he is sweating profusely, his balance is unsteady. He’s scared, he has to get sugar into his body, fast. I wait for him to finish his food. Soon he begins to come around and we check his blood glucose again.

78.

That’s better. I think we can go back to bed now.

All during the previous day, Todd was checking his blood sugar at frequently regular intervals trying to get an idea of when his blood glucose spikes after eating and how long he can go between meals before it starts to fall drastically. He’s trying to figure out how to set his insulin pump so his blood sugar levels resemble more of rolling hills rather than peaks and valleys.Until I met Todd, I had very little contact with anyone with T1D.

I am a nurse practitioner and often see patients with Type 2 Diabetes–a whole different disease. I coach Type 2 Diabetics on proper nutrition, exercise and supplements and how to best manage their disease. It’s possible to reverse Type 2 diabetes; it’s preventable. It comes about because of one’s lifestyle choices. Type 1 is completely different and more rare.

Type 1 diabetes usually manifests during childhood or young adulthood. It is an autoimmune condition where the body attacks the beta cells located within a cluster of cells in the pancreas known as the islet of Langerhans. The beta cells are responsible for producing insulin. They sense sugar in the blood and then release the necessary amount of insulin to maintain normal blood sugar levels. It is not yet completely understood why some people’s immune system, which is supposed to protect you, mistakenly attacks and destroys these beta cells. Trauma is thought to be one of the causes triggering the body to attack its beta cells.

Todd’s condition was diagnosed when he was 14, during a very traumatic period of time in his life.Insulin is crucial to life. Without it, glucose cannot move from one’s bloodstream into the cells of the body to provide them with energy to function. When the pancreas fails to produce insulin, blood glucose levels rise preventing the body from functioning properly. Overtime, high glucose levels damage nerves, blood vessels, organs and eventually cause death.

Living with a T1D has been an eye-opening experience. There is constant pricking of your finger and checking your blood sugar–first thing in the morning, after breakfast, mid morning, before lunch, mid afternoon, before dinner, after dinner, before bed…sometimes in the middle of the night. It means adjusting the insulin pump to raise or lower the blood sugar, it means eating at regular intervals and carefully planning what you eat. If you don’t, you may end of eating anything within reach just to get the blood sugar to functional levels. It means being diligent whether you want to or not. It means that before you do anything in morning, you must attend to your blood sugar/insulin relationship. You have no choice. If you don’t, you will die.

When we were first dating, I thought it was a novelty when we would stop and check his blood sugar levels. I often joined in. We compared numbers–and planned our next meal or snack around his blood sugar levels. He would adjust his pump if too high or too low. I didn’t have to do anything. My pancreas would figure that out for me and administer the correct dose of insulin at precisely the right time and the right intervals. But Todd has to figure that out for himself and program his pump to do what my body does without me thinking about it–as long as I take care of myself, my pancreas will take care of me.

I am learning to be more appreciative of my body, to feed it regular meals and never to take it for granted. I am learning how fortunate I am that my body works really well. I have very few health issues and mostly what I do have–achy joints and the tightness in my neck or shoulders– is manageable with stretching, yoga, massage, rest, etc.

Todd needs to plan his day with great attention to detail. He didn’t always do so and he is paying for it now with damaged vision and peripheral neuropathy (nerve damage in his legs and feet). There are other side effects too, and we don’t even know some of the long-term damage that may occur from the drastic blood sugar swings that have ravaged his body for so many years.

For many years I struggled to be in my body. I frequently ignored its signals of hunger, fatigue, pain. I pushed myself to keep going when I should have stopped to rest. I exercised rigorously to stay in shape, lose weight or keep those dreaded extra pounds at bay. Often I skipped meals either because I was too busy to stop and eat or because I thought starving myself would help me attain that perfect body. Then there were those times when I would polish off a carton of coconut ice cream or a bag of chips–my body craving immediate gratification. As I grew to love myself and listen to my body’s messages, I began to find refuge being in my body. It’s still something I am getting used to.

More recently I was experiencing some old thoughts and patterns reminiscent of my early days with my disordered eating and body dysmorphism. Frustrating because I thought I had laid this behind me. Then in walks Todd into my life, and I get to look at this head on. I am a firm believer that there are no accidents. I know without a shred of doubt that Todd and I were brought together for some very important reasons. I know if he had not met me and my access to cutting edge health care, he would be on a rapid train ride to some serious and likely irreversible medical problems. I have a strong intuition that he and I have something very important to share with the others regarding his healing journey to health.

But I wasn’t aware of how impactful his journey would have on me. I had no idea that I would get to face my unfinished business regarding my relationship with my body.

Living with a T1D requires patience, compassion, understanding, commitment. I am as committed to his health as he is and fortunately he is fiercely committed to his health. Just like an infant who cries incessantly until he is fed, Todd’s body requires the same attendance. You can’t reason with a baby and let him know that gee, this isn’t a good time to stop and eat. We’re too busy, too tired, too cranky to attend to your needs. Todd’s body won’t listen to any “reasoning”. When his blood sugar gets low, he HAS to eat. When it gets too high, he HAS to adjust his insulin pump.

I call him at work sometimes and ask him if he has eaten. When we prepare dinner, we cook for 4 so we have dinner for two and lunch the next day for the both of us. Being prepared is key to living healthily as a diabetic. It’s important for all of us–diabetic or not. It used to never bother me if I ran out of food in the house. I could always grab a protein bar for breakfast and run to Whole Foods or other healthy deli for lunch. Now when I see food getting low in our refrigerator, I panic. We need to replenish–now.

We never leave the house for a hike, a drive or a bike ride without food. We never go anywhere without his glucose monitor, we always make sure there is extra insulin on hand. Meals are planned out, carbs are counted, most food is prepared at home. Gone are the days for him of pizza, sandwiches, fast foods, convenience foods, sugary foods.

I cannot and will not ever ignore that Todd has T1D. Yes some days it is a huge inconvenience. Some days it would be so nice to just to lay in bed and get up for a late leisurely breakfast. Some days it would be nice not to have to sleep with an insulin pump next to me. His disease is part of our relationship, it doesn’t define who he is or who we are. But it is something that we both attend to every day. I am seeing how much it requires of him to manage his blood sugar:insulin:food ratio. I want to help him. To take some of the stress and responsibility from him. He managed it by himself for over 40 years. He doesn’t have to do that anymore. It is not a burden and it never occurred to me to not be with him because he has T1D. But I can truthfully say that I had no idea how involved it is to live with this disease.

For those of you interested in reading more about Todd’s personal journey on becoming a Type 1 Diabetic and what he is now doing to heal this condition, you can access his Kindle version here.

Holiday Greetings

Blessed is the season which engages the whole world in a conspiracy of love.

– Hamilton Wright Mabi

I want to take this opportunity to wish all of you a very joyous and peaceful holiday season and to thank you for your continuous and unwavering support throughout this past year. I look forward to serving you in whatever capacity I can in the New Year. We are poised for an exciting year filled with opportunities for growth and expansion in so many areas, especially around health and consciousness.

I’m not big on making New Year’s resolutions, but I do like to take time to reflect on the past year and see what is enriching my life and what makes me feel good. Additionally, I’ll assess what didn’t work, hone in on what is draining and distracting. This helps me to make adjustments in the present moment so I can expect different outcomes as I move forward. I’ll write these reflections in a journal and sometimes I’ll make a vision board about how I want to feel and what I want to create in my life for the new year. When I get in touch with my core desired feelings, I am able to be clear about what I want.

If what you want for 2013 is more health and vitality, then you may be interested in one or both of the programs I’m offering in January. The first is my 21 Day Whole Body Cleanse. It’s a great way to kick off the new year and release all the those toxins that may be accumulating during this holiday season. It’s also a great jump start to a weight loss program. One of my previous participants just emailed me to say that she lost 22 pounds during the detox and went on to lose another 10 pounds for a total of 32 pounds!

My wish for you in 2013, is that may you move more fully into who you are, that you have more joy, experience (even more) health and vitality, and that Love fills you from the inside out and from the outside in.

With Love and Kindness and Holiday Blessings,

Rachelle

Transformational Weight loss

Weight loss is a huge business with countless men and women struggling with obesity and overweight. Losing those excess pounds and maintaining that loss is not for the faint of heart. It requires dedication, commitment, a willingness to change, and the courage to look at the underlying issues that contribute to overeating, emotional eating, or choosing the wrong kinds of foods.

Transformational weight loss is about transforming your relationship with food, your body, and your Self. Ultimately it’s about transforming your approach to life and learning to truly nourish yourself on all levels: physically, mentally, emotionally, and spiritually.

For some, it may be about transforming your state of health from “sick and tired” to “vibrant and energetic”. For others shifting from depression and low self-esteem to self-confidence and personal empowerment is the key. Weight loss is so much more than reaching a specific number on the scale. Transformational weight loss can take you from fear and stagnation to finding and fulfilling your life’s purpose.

Physical Transformation

My approach to weight loss uses a customized integrated system. I look at an individual’s biochemistry through sophisticated lab work and metabolic assessment forms that my patients complete when they come to me. I also evaluate their current nutritional status and eating habits. Patients complete a food and mood diary so we can see not only what they are eating and when, but how that food affects their emotions and their energy levels.

We may even do food sensitivity testing. Often people are sensitive to foods and don’t even know it because their symptoms are subtle or delayed or both. It may take up to 4 or 5 days for some symptoms to reveal themselves and by then you may not have a clue that it was the corn tortilla you ate last Sunday that is giving you the belly ache or bloat you are feeling today.

With these tools and information at your disposal, the path to lasting physical transformation is clearer and in many ways easier to navigate.

Mental Transformation

Using your mind to help you lose weight is equally important. Align your subconscious with your weight loss goals by visualizing your body healthy and at your perfect weight. This will help you make wise choices around food and exercise. Yes, your mind can easily help you make healthful choices instead of always thinking about hot fudge sundaes or pizza!

You mind can also help you to discover a deep appreciation for your body and develop a positive relationship with food. It is the power of the mind that lets you learn to eat without stress or fear so you don’t trigger the hormones that cause you to eat more and turn much of what you eat into stored fat.

Emotional Transformation

Discovering the feelings, thoughts, and stories you have around food that underlie the habits and compulsions that are sabotaging your health and fitness is one of the most important steps to weight loss.

Self-defeating thoughts and emotions can drive a person to overeat, causing more self-loathing and low self-esteem that perpetuate the cycle of overeating because you feel so bad about your self that you are driven to eat to try to numb out those feelings.

Compassion and patience can replace the angst and fear around food and eating. The more you develop a healthy relationship with your body and self, the more you will WANT to choose to take care of yourself by eating healthy foods in an environment that is nurturing and pleasant. This change in perspective helps you live life to the fullest without unhealthy habits or addictive behaviors continually holding you back.

Spiritual Transformation

The more you believe in yourself and the better you feel about yourself, the more capable you are navigating life’s challenges successfully and potently. You can rise above self-doubt by trusting in yourself. It is possible to transcend negative thinking and release unhealthy relationships and move into a state of peace and self-confidence.

Putting it All Together

When working with a client on weight loss, or any health issue, I individualize my approach depending on the unique needs and history of that person. It is never a one-size-fits-all approach. Each person’s physical, mental, emotional, and spiritual history is unique and must be taken into careful consideration to achieve success.

I love the one-on-one relationship I develop with each patient and find that the most successful are those that see me on a regular basis, checking in with me either in person or virtually at least weekly. Our interactions are not about judging success or failure, but more about identifying right or wrong behaviors and understanding where and how I can best support each person.

Success is not about reaching a specific number on the scale. It’s so much more than that. It’s about changing one’s lifestyle, internal belief system, and shifting negative thinking to compassion for one’s self. It’s about trust, and healing and feeling good inside your skin.

Sometimes the changes you make are big strides, sometimes baby steps are a cause for great celebration. And sometimes there’s a slide backwards, but all of this is part of the process. Finding success is all about learning from what is and isn’t working, and getting up and starting again when we fall short of our ideal.

Partnering for Success

My intention is to be your coach, your guide, your confidante, the wind beneath your wings! I develop life-long relationships with my patients so I can be there when they lose their footing, need a little assistance to get back on course, or just need to check in from time to time.

Change doesn’t come easy for most of us and old habits are sometimes extremely hard to break. We can all use a compassionate comrade to rely on who won’t judge us or fault us if we slip and fall. I hope I can be that someone for you when you most need it.

Get the Most Out of Your Summer – For Life!

I just love summer! It’s my favorite time of the year and I always look forward to a season when the days are long, and the Earth warm and in full bloom. Everyone seems to be lighter, happier and more carefree.

Though I might want to sometimes, I can’t slow down the unfolding of time and this summer like every other will pass into autumn and then winter. That’s all the more reason to set your intention toward enjoying the beauty and abundance that exists right now.

Here are several things you can do to harvest the most out of your precious summer season and beyond, as these practices are useful in getting the most out of your life any time of the year.

1) Begin with gratitude. Instead of spending energy longing for your next vacation, start by appreciating what you have right now. Begin the day with a prayer of gratitude and make a point to notice more to be grateful for each day.

2) Live with intention. When you get up in the morning, consider what you want to get out of your day and what you are willing to put into it. As the Buddha said, “All that we are is the result of what we have thought”.

3) Be daring. Take the plunge and do something this summer that you’ve always wanted to do but keep putting off. Maybe it’s taking a paddle board lesson, learning Zumba, going out for a night of dancing, reading that novel on the bedside table, going to a baseball game…whatever it might be, set a date and do it!

4) Be spontaneous. Relax a little and let yourself flow with the rhythm of life. If someone invites you to dinner, a movie, a walk on the beach…GO! Last minute and unexpected invitations can open a door to magic and delight. The to do list will wait, I promise!

5) Get up early and watch the sunrise. Sunrise is a powerful time of day. The world is still waking up and the day’s potential is unlimited. Harness some of that fresh new-day energy yourself by sitting in peace watching the world wake up.

6) Go for a picnic. Find a special spot in nature, pack a delicious picnic for one (or more) and watch the sunset. Eating fresh, colorful foods (especially from a nearby farmer’s market) and savoring each bite in a tranquil, natural setting is a wonderful tonic to unwind from your day.

7) Be in nature as much as possible. Nature is grounding, balancing and calming. Leave your screens and devices behind (or at least power them down) and go for walks in the park, dip your toes in the ocean, join a hiking club or simply find a shady spot in the back yard and bask in the beauty of this gorgeous planet.

Try one (or all!) of these ideas and let me know how it goes. Maybe you’ll come up with a few ideas of your own – I’d love to hear about it! For now, have a safe and joyful summer. I look forward to connecting with all of you in early fall.

Aging and Beauty

Anti-aging, age management, healthy aging, graceful aging…these are just some of the terms used to describe what is happening to all of us: AGING. While we age, most of us want to age well. Yet what exactly does that mean, and how do we go about doing it?

From the moment we are born, we begin to age. At first it’s exciting to pass each milestone birthday but eventually for many of us, aging is perceived negatively, and indeed can create problems as we hit a certain age. For some that may be around 40, or 50, or 60. Though for others, especially in our beauty and youth obsessed culture, the worries and fears begin as early as the 20s or 30s.

As people age, especially women, they are frequently devalued. The wisdom and maturity that comes with living a long and full life is not recognized as important or worthy. When it’s all about appearance and the only value we are seen to have is skin deep, it affects one’s entire identity. No wonder aging is frequently so difficult to accept!

While it’s true there are many changes that occur as we age, if we want to age well, with a sense of beauty and joy, the question becomes how do we acceptthese changes that reach deep into the core of who we are, and what do we do about it?

First, it’s essential to recognize that aging isn’t something that needs fixing. It isn’t a disease to be cured. The only thing that needs fixing is our attitude about aging.

Developing an increased awareness about what affects the aging process and debunking many myths associated with aging can free us up to live with greater vitality and self-acceptance than we previously experienced.

Aging with grace and glory, is a term coined by a dear friend and mentor Celedra Gildea. I love that phrase because it gives us permission to embrace all that aging is about. To age with grace and glory means celebrating the process of aging.Aging, not a linear process, is about going deep into the layers of who you really are and giving yourself permission and encouragement and strength to evolve into your fullest potential. A few lines or spots or sags have nothing to do with what is most amazing and beautiful about you.

As we shift our attitudes about aging, we also can shift our attitudes about beauty. When we begin to experience aging as a miraculous process, we can naturally accept that aging itself is Beauty! You begin to shift your focus from looking younger to feeling better. And when you feel better about yourself, you will likely want to adopt a lifestyle that supports you continuing to take better care of yourself.

Looking better/feeling better vs looking younger is a big shift and once you accept that you can’t turn back the clock, you can take positive steps. We are fortunate to have so many options to take advantage of today. Those lines, spots or sags don’t have to get the best of you.

You can go get a little Botox or laser treatment to smooth out some of the wrinkles and tiredness. You can eat healthier, stay active, and find something you are passionate about to keep the creative, living juices flowing. You can even choose cosmetic surgery if that’s right for you. But whatever you choose to do or not do, if you’ve done your inner work, you have a much better chance of being happy with the results.

When you nurture and heal all levels of your being, from your body to your heart and soul, you build a solid foundation to support the rest of your life and a renewed energy to reach your full potential. And there is nothing more beautiful than that!

Get the Most out of Your Summer – For Life!

Here are several things you can do to harvest the most out of your precious summer season and beyond, as these practices are useful in getting the most out of your life any time of the year.

Treat Yourself with Loving Appreciation

We are given one body to carry us from birth to death during our lifetime and it is up to us to determine how we will care for that one precious vessel. With the demands of work, raising children, family life, and a whole host of other commitments, it is so easy to lose sight of the importance of taking care of our bodies and ourselves.

There was a period of time in my life when I didn’t pay any attention to my body at all. In fact, I was unsuspectingly abusing it. I worked long hours, exercised vigorously (thinking that I was actually taking care of myself), and I ate what seemed like a healthy diet. But I really wasn’t listening to my body nor was taking time to appreciate it. And when it started to complain loudly to me, I responded with irritation or anger: “why are you (my body) causing me pain”, or “why are you putting on weight”, or “why aren’t you strong and sexy anymore”? I felt that my body was betraying me. After all, I thought I was doing all the right things to care for it.It took me a number of years to turn that belief around and it’s still an on-going learning process. I realize now that our bodies are sacred beautiful vehicles and homes to our souls. It is because we have a body, that we are able to experience pleasure and pain, to see, hear, smell, touch, feel and sense or intuit our internal and external worlds. It is because we have a body that we can make love, laugh, cry, sing and speak. But do we really appreciate our bodies? Do we ignore our body’s wisdom when it says it is time to eat, time for sleep, time to slow down, time to move? So often, our mind overrides our body’s messages and denies the needs that it is trying to communicate.

Some people are challenged with serious physical or emotional/mental conditions that can make it even more difficult to love and appreciate their bodies. I’m sure you have noticed how some individuals accept their challenges, and even consistently feel gratitude, while others find themselves feeling frustrated and victimized by the circumstances in their lives. There comes a point where we must choose how we are going to respond to the challenges this life presents.

Having worked through major challenges around loving and accepting my body as well as other conditions, I understand that rising to meet the obstacles in life with love and appreciation is not an easy road to take. What I learned for myself is that the journey of coming to terms with my body and all the stories I had going about it is the real gift. Once I really got that, I developed appreciation for and a loving relationship with my body that I didn’t know was possible.

Now I see my body as a gift and that it is an honor and a privilege to care for it as exquisitely and attentively as possible. Am I perfect? Of course not! And when I don’t get the rest I need, or enough exercise or the right kind of nutrition my body lets me know. Sometimes it complains loudly, sometimes it gives me a gentle nudge.

And you know what is beautiful? When I bring things back into balance and care for my body the way it deserves to be cared for, it responds accordingly. You see the body is always paying attention to what we say and think and do. The body is a living, breathing creation that never lies. I may not always know why I am not always feeling on top of my game but those are moments when I need to stop and listen closely or seek out professional help if I can’t figure it out myself.

Following are a number of suggestions that you can do to practice loving-kindness and develop a deep appreciation for your body. Start with one or two that speak to you and gradually integrate more into your practice. You might even come up with some of your own that work better for you. I’d love to hear from you and find out what worked for you and what sort of results you had.

1) Be nurtured by nature.
Time spent in nature can be profoundly healing and revitalizing. Actually placing your bare feet on the earth for 15 minutes everyday can balance emotional and spiritual energies and increase a sense of connection to the web of life.

Try taking a break outside everyday, no matter the weather. Observe the ebb and flow of the seasons and remind yourself that just as you are, you are a perfect manifestation of mother nature.

2) Greet the day with intention.
Each morning take a moment to say something nice to and about your body. If you notice that your first thoughts upon waking tend toward the negative, you might try doing this as soon as you wake up, before you even open your eyes or get out of bed.

3) Bathe yourself with loving-kindness.

Once a week – or whenever you feel the need – take a ritual bath. Fill the tub and consider adding rose oil, which is associated with balancing the heart and often used to soothe anxiety and depression. Light candles and play soft music if you desire.

As you bathe each part of your body, reflect on how strong and wondrous it is. If it is injured or damaged send love to it. Think of everything each part of your body does to keep you alive, to give birth, to carry you from place to place. Honor your body as a divine vessel and appreciate all that it is capable of.

One Size Does Not Fit All: A Holistic Approach to Break Free from Abusive Eating™

Most weight loss programs take one of two approaches: focusing on what you can or cannot eat, or advocating giving up dieting once and for all and focus on healing the underlying reasons why you eat emotionally. Which approach is right? I say both are!

Abusive eating, like most addictive and destructive behaviors, evolved over a period of time. It started out slowly and built gradually so it likely didn’t even seem like there was a problem; maybe for many years. But over time, the behaviors solidified into patterns that are now a problem affecting your soul, your mind and heart, as well as your body. In order to overcome these deeply ingrained patterns and behaviors, one needs address the issues within the body, the mind, and the Spirit. The process of unraveling can seem daunting and endless but once we begin to actually drop in and experience what is there to be worked with, it’s usually not as intimidating as the thought of it is.

I remind my students that it is the journey not the end result where we experience our true nature and divine healing. This, my friends, requires us to stay in the moment and not lament about the past or worry about the future. This is an ongoing practice where we gently bring ourselves back to the present when we find ourselves planning, worrying, regretting the past or fearing the future.

I wrote in last month’s newsletter about the importance of being in your body to be able to know what it is telling you it needs, whether that be food, rest, touch, etc.

My holistic integrated approach to healing abusive eating takes you through practical steps to be in your body. We address:

Dietary guidelines that meet your body’s current needs – these often change as your body’s biochemistry changes.
Hormonal and blood sugar imbalances that could be triggering your emotional eating.
Eating guidelines adapted from my own practice to help you relearn healthy eating habits.
How to distinguish emotional hunger from physical hunger.
How to manage emotional hunger; hint: it will never be healed with food.
Self love and Self care practices to feed yourself with love and nourishment on a Soul level.
How to love and enjoy your life as it is right now.
Ways to bring more pleasure into your life.

I do not embrace a “one size fits all” approach. Instead, I tailor my program to meet your individual needs. With this holistic approach to healing, your life will simmer with possibility and an abundance of gratitude as you are freed from the torture of abusive eating.