Healthy attitudes: Living with (and beyond) chronic conditions

Physical and emotional wellness go together like bees and honey: It’s hard to have one without the other. This has definitely proved true in my life as I learn to manage Type 1 diabetes. But how do others approach living with a chronic condition? How do our attitudes toward those conditions — and life, in general — affect our overall health and happiness?

Transformation through gratitude

Six years ago, frustrated with a new element in my treatment, I yanked the thin plastic tubing of my insulin pump loose from my skin (not recommended), and chucked the whole machine at the wall. I went back to giving myself up to seven injections a day, after trying the pump for only six months. At the time, I felt freed from the burden of wearing the device as if it were my scarlet “D” for disease.

But now, managing diabetes adds more to my health than it takes: Through my interaction with the Juvenile Diabetes Research Foundation. I’ve come to know more people who are living with Type 1, in and around Asheville. Through the foundation, I met Maggie Thomas, a Davidson University graduate who is studying acupuncture at Asheville’s Daoist Traditions College of Chinese Medical Arts, and living with diabetes. Together, we started a local support group for Type 1 adults who will meet monthly as a way for people living with the condition to connect and share ideas.

I’ve learned that, sometimes, we can shake off our negative glasses simply by remembering gratitude.

And while exploring what my own approach should be, I asked my Asheville peers what they were grateful for about life. Their responses illuminated gateways to wellness that are based in their individual passions. My neighbor, David Clarke, as he steered us down the French Broad in a two-man canoe, admitted, “I don’t think I could stay sane without the Green River.” He shares his love for rivers with middle-school students at the French Broad River Academy, teaching Spanish and music, and taking kids out in the school’s canoes — or on other outdoor adventures — every week.

Another friend, Ziggy Scandrick, reminded me to pause and appreciate my community. He spoke about his experience at the YWCA, where we both work: “I’d been in the Marines, trained in that discipline, pumping iron and seeing myself as the tough guy. But slowly, doing the dirty work and listening, I started to ‘unlearn so I could relearn,’” he said. “Working with so many women and seeing all that y’all were doing allowed me to appreciate the power of women, what they’ve been through, how they’ve struggled against subservience over and over again. For me, doing this job with pride has been a way to contribute to that movement for equality, for women to be seen as full people.”

Obstacles and alchemy

Recently, I went to Mission Hospital, where a certified diabetes educator and fellow Type 1 taught me how to use my new Omnipod Insulin Pump. My journey back to such a device started because I was once again searching for freedom. I’d given myself time to work through some difficult emotions and was ready to flush some long-held perceptions. Now it feels reassuring rather than frustrating (the new pump is tubeless and sticks on with tape). Finding freedom in spite of (or maybe guided by) our limitations gives us confidence and self-efficacy.

For example, my co-worker Charley Cox served 10 years as an Asheville City Firefighter. She said that her goal now, as a personal trainer, is to help individuals regain their power and take control of their health. When faced with struggles, she chooses not to view herself as a victim but to focus instead on what empowers her — because only then can we see opportunities for change.

That wisdom rings true for Rebecca Chaplin, regional coordinator, master trainer, and leader of the Living Healthy with a Chronic Condition or Diabetes program. She said that through her work, “I am reminded that I am not a victim of my own chronic condition or any circumstance in my life, but rather I am at the center of my response to what’s happening, and my choices will make a difference in the outcome.”

Developed at the Stanford University School of Medicine’s Patient Education department and implemented internationally, Living Healthy teaches practical methods for change that you may not find in other health-education systems. It integrates self-management techniques — like brainstorming, action planning and problem solving — that work for all patients, no matter their level of health knowledge and awareness.

To Chaplin, this approach helps participants as much through the confidence and empowerment they gain as it does through the information they learn.

She told a story about a man, diagnosed with diabetes, who attended a Healthy Living course with his wife. On the first day he declared, “Just so you know, I’m not going to exercise, that’s not what I’m here to do, and you’re not going to make me.” Nonetheless, his action plan involved walking up and down the hallway in his home during commercial breaks. After six weeks, he was walking outside for a mile at a time and his A1C (the measure of average blood glucose over the past three months) had dropped into a healthy range. The best part: He was enjoying socializing with his neighbors on those regular walks.

Chaplin points out that as long as the system or other people were telling him what to do, this man put up a wall, resisting change, but when the choice came from within, the changes were actually what he wanted.

This transition — as participants’ “perceptions of themselves change” — encouraged Chaplin to advance her training as a program leader.  “The way people look actually changes, [so] through the course of the program, I could see how vibrant people were, even though they were dealing with a chronic condition. I was drawn to these radiant individuals because I perceived [their] well-being.”

Trusting in the process

Transforming our relationship to the limitations in our lives, and viewing them more like the planks of our foundation, can make us stronger. Four years ago, when Gordon Smith, an Asheville City Council member and a children’s and family therapist, was diagnosed with Type 2, he chose to use it as his “roadmap for change.” Now, through hard work and lifestyle modifications, he has brought his blood sugars back into normal range. He jokes with his doctor about wiping the whole thing from his medical record.

Just one tiny shift in routine can set off a spiral of positive effects, as it did for Smith. In a beginner’s class at the Asheville Yoga Center, full-time instructor Joe Taft told students that his mantra for many years has been “open to the power of the practice.” The practice, he said, doesn’t have to just mean yoga; it can be caring for your children or cooking for yourself or family. Whatever you do with your whole self — with passion, love and faith — becomes your practice, a process that never ceases to teach.

So I’m seeing health more and more as a process of gradual change, moving us from impossibility, to integration, then to ease. In any condition — acute, chronic, emotional or physical — a big part of the impact on our well-being comes not from the condition itself but from our relationship to it. Often, when we bump up against a problem that seems insurmountable, we might need to reframe the issue, or break it into smaller steps. Just saying “no” to ideas that might improve our health — like cutting back on soda or packing a lunch instead of eating out — will prove that we cannot change.

But if we are willing to get creative, be courageous, and go for an opening, we may find the freedom that fuels well-being.

For more information about the Living Healthy with a Chronic Condition or Diabetes program — administered locally through the Land-of-Sky Regional Council’s Area Agency on Aging — go to livinghealthywnc.org or call Rebecca Chaplin at 251-7438. The program assists residents in Buncombe, Madison, Henderson and Transylvania counties.