Category Archives: chronic illness

Now I have Type 2 diabetes what am I supposed to eat?

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It comes as no surprise that one of the first questions someone newly diagnosed with type 2 diabetes asks is “What am I supposed to eat?”.

Let’s face it you’ve probably heard over and over again that type 2 diabetes is a ‘disease of lifestyle’. And lifestyle commonly involves food. When it comes to the food choices we make there is a lot of emotional charge attached to that. For some, it may be the way that they have eaten since they were children and this is the only way they know how to eat. Food is a connecting force between us.

So, a common answer someone diagnosed with type 2 diabetes may receive about what to eat from their healthcare provider may sound something along the lines of ‘eat healthy portion sizes, increase fruits and vegetables, cut down on processed foods’. And all these answers are great recommendations.

You’d think it seems pretty easy right to go out there and, ‘eat healthy portions, increase your fruits and vegetables, and cut down on processed foods’. But we know that’s not really what happens.

A lot of people struggle with food choices. Perhaps that’s why we have such a growing epidemic of borderline diabetes and type 2 diabetes.

Over the course of my 20 plus years as a physician, I have encountered some really strange interpretations of what a ‘healthy diabetic diet’ means to different people. Let’s face it, the amount of information out there on the internet does not help either.

So when I address the topic of what to eat with anyone diagnosed with type 2 diabetes I start by helping them to normalize their experience. Take a deep breath. This is not a punishment for what you have done wrong. And yes, you can make a choice starting today to do things differently.

My invitation is to consider that diabetes eating is healthy eating.

I intend to give a TED talk with that title because it’s something I passionately believe. If everyone diagnosed with type 2 diabetes looked at this as a way their body was inviting them to eat healthier we wouldn’t have people walking around feeling victimized.

The great news is that by making these changes to how you eat, it is possible to halt the progression of borderline diabetes, type 2 diabetes and worsening metabolic health.

Change can be stressful. So I often start by advising you take simple small steps.

This will help bypass the gargantuan alarm signals to your primitive brain- the amygdala which ends up keeping you from making any change smack in the middle of your comfort zone.

So back to the question -where do you start?

The Mediterranean diet

The Mediterranean diet is a great starting point when it comes to making some healthy changes to what you eat. The traditional mediterranean diet attracted interest because people who were living on the Greek Island of Crete had less heart disease.

What makes up the Mediterranean diet

  • whole grains
  • fruits and vegetables
  • extra virgin olive oil
  • modest amounts of poultry, red meat and fish
  • nuts
  • legumes (beans, peas etc)
  • red wine

The Mediterranean diet has been extensively researched. Over 50 studies have shown that by eating this way there is an improvement in overall metabolic health parameters- reduced waist circumference, improvement in lipid profile, blood pressure, weight and blood sugar levels.

Functional Nutrition

Perhaps you want to go a step further and you want to develop an empowered relationship to food.

Food can be used as a powerful tool, to bring about healing. In functional medicine, we call this functional nutrition.

There are several food plans used in functional medicine, each targeting different results.

The cardiometabolic food plan is a step above the Mediterranean diet.

Features of the cardiometabolic food plan

  • low glycemic foods
  • personalized targeted calories
  • helps to balance blood sugars
  • high in fiber
  • low amount of simple sugars
  • a healthy balance of quality fats

One of the exciting aspects of the THRIVE group coaching program, will be working with clients on creating a personalized cardiometabolic food plan designed to optimize their metabolic health.

If you would like more information about joining the program, please send an email to info@doctoreno.com.

How did I get type 2 diabetes?

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Being diagnosed with type 2 diabetes can be a very overwhelming experience. Naturally, those newly diagnosed may have a lot of questions. But one of the most common questions I get asked is ‘how did I get diabetes?’

 A lot number of people may not have a full understanding of how certain factors as well as lifestyle can put them at a higher risk for developing type 2 diabetes.

 In a recent post -summit survey I performed, several participants responded they wanted to learn more about type 2 diabetes. 

For those people who do not have diabetes, this information is still beneficial. It will help you to know what your risk and begin now to make healthy lifestyle changes.

 Insulin and the pancreas

The pancreas is an organ located in the abdomen. It produces a hormone called insulin. Insulin helps the cells in the body to use sugar as energy.

In type 2 diabetes, the cells of the body begin to resist the effects of insulin. This condition is called Insulin Resistance.

I like to use the metaphor of a landlord who changes the locks to the house on his tenant.

In this metaphor, the tenant is blood sugar.  Insulin controls the lock to the house. With insulin resistance, the tenant cannot open the lock, with the insulin.

Insulin resistance is usually present in the body at least five years before type 2 diabetes is diagnosed.

Who is at risk of developing type 2 diabetes?

 Here are some of the things you should know that increases the chances of developing type 2 diabetes:

  • Family History: A big reason why people develop diabetes is genetic. If you have a first degree relative with diabetes, like a parent, sister, brother,  then your chance of getting diabetes goes up five to ten times. So it is crucial to know your family history.
  • Ethnic Groups: Type 2 diabetes is common in certain races such as African Americans, Hispanics, Asians, and Native Americans. So just by being of a certain race puts you at an increased risk.
  • Pregnancy: 3-5% of pregnant women can develop diabetes in pregnancy, also known as gestational diabetes. The difference is that once the baby is born, diabetes goes away.

If you had diabetes while you were pregnant, you are at risk of developing diabetes later on in life. Make sure that after your pregnancy, you have regular medical check-ups. Your healthcare provider will need to monitor your blood sugars closely.

  • Environmental Toxins:  Environmental toxins which can increase the risk of type 2 diabetes have been coined diabetogens. Exposure to toxins such as pesticides, arsenic, as well as ambient air pollution, to name a few, can all increase the risk of type 2 diabetes through several mechanisms.

Ongoing exposure to the toxin load increases our risk of developing type 2 diabetes.

  • Medications: Some medications can cause diabetes. Usually, this happens to people who were already at risk for developing diabetes.

One of the common drugs that can cause diabetes is steroids. Steroids are used to treat many medical conditions such as transplant patients, chronic lung disease, rheumatoid arthritis, and other autoimmune diseases to name a few.

According to the National Kidney Foundation up to 20% of patients after a kidney transplant may develop diabetes.

There are some other commonly used medications which can elevate blood sugars.

These include-

  • Statin medications -used to treat high cholesterol.
  • Thiazide diuretics -used to treat high blood pressure.
  • Beta-blockers
  • Transplant rejection medications such as tacrolimus
  • edications used to treat anxiety and/or depression.

Speak with your healthcare provider if you are concerned about any medications you are on. Do not discontinue any medications by yourself.

It is possible that the benefits of being on the medication may outweigh your risk of developing diabetes.

Trust that your healthcare provider has your best interests at heart.

If you do not feel this about your healthcare provider, then perhaps you need to search for a new one!

For more information on how to pick a healthcare provider that is the right fit for you, click here.

To download a FREE copy of the first three chapters of my award winning book which explains more about type 2 diabetes, click here.

Here’s to your Health & Wellbeing,

Some proven benefits of the ketogenic diet, but is it right for everyone?

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I recall when I first started hearing the buzz around going “keto” “ketogenic” ketolife” I was very skeptical. With the roll of my eyes I dismissed it as a soon to be done fad that would blow over. But it didn’t.

After my community talks, I’d have a few people stop by and ask my thoughts on going “keto”. Again, my response would be I thought it was just another fad and would pass away. And oh by the way if you happened to be someone living with type 2 diabetes, this probably was not for you!

How wrong I was on both counts especially the latter.  

Well you know the saying “what you resist persists”?  Keto has persisted. And now it’s becoming mainstream.

The ketogenic diet was developed almost a 100 years ago- in the 1920s- by a faith healer who was trying to help children with epilepsy. There was some success with this diet intevention at the time. However, when drugs were developed for the treatment of epilepsy it fell out of favor.

How does the ketogenic diet work?

The ketogenic diet works by converting the body’s source of predominant fuel from carbohydrates to fats which are the source of ketone bodies predominantly beta hydroxybutyrate. This leads to an increase in the production of energy source -ATP.  

The ketogenic diet is now being used to treat a host of diseases and conditions. In the article below I list some of the benefits of a ketogenic diet.

Improved insulin resistance and reduced inflammation

By utilizing fats as a source of fuel versus carbohydrates there is less need for insulin. This leads to less insulin resistance. Insulin resistance is the hallmark of type 2 diabetes. There is research showing the benefits of a ketogenic diet to reverse pre-diabetes or type 2 diabetes. Insulin resistance is also associated with more inflammation because of an increase in free radical production. Inflammation is linked to a host of chronic diseases such as auto-immune diseases, arthritis, thyroid disease, bowel disorders, mental and cognitive decline (type 3 diabetes). Less insulin resistance=less inflammation, which allows the body to heal.

Improved Fat Burning leading to weight loss
By definition, being in a state of ketosis means you’re burning fat for energy. If you have excess body fat, you’ll be able to burn it at a much more efficient rate. This trend can lead to weight loss. The advantage of using fat as fuel, is that you do not have as much hunger cravings as when you are using carbohydrates as a main source of fuel.

Mood stabilizing effects
A ketogenic diet changes the energy matrix of the body. In the brain, a ketogenic diet helps to modulate mood by not only a reduction in inflammation but also changes in monoamine oxidase levels, GABA transmission, as well as mitochondrial biogenesis.

Improved Energy
Increased energy from a ketogenic lifestyle is due to a combination of factors including less inflammation, upregulation of mitochondrial biogenesis, more ATP per molecule of ketone and more stable blood sugar.

Improved Mitochondrial Biogenesis &Anti-aging
Our bodies are trained to use glucose (sugar) as a natural source of energy.  Our mitochondria are the energy powerhouse of our bodies. With aging, we tend to have less efficient mitochondria. The ketogenic diet helps to stimulate new and stronger mitochondria. Because mitochondria have such a profound impact on energy production, inflammation levels and gene expression (and therefore an overall function of the body), promoting mitochondrial health can be of great benefit when it comes to anti-aging.

How do you know you’re in ketosis?

There are a number of kits on the market which can help you to detect when you are in ketosis. Kits that measure blood levels are more accurate than urine test strips.

How do you know if keto is right for you?

Despite it’s popularity a ketogenic diet may not be safe for everyone. Despite a plethora of websites offering do it yourself keto plans and diets, I highly recommend that you invest in working closely with a qualified healthcare professional who is well versed on what to look out for if you have any of the following conditions:

  • Type 2 diabetes
  • Very high blood triglycerides
  • Severe depression
  • Older adults
  • Cancer
  • Cognitive decline such as alzheimer’s type dementia
  • Certain gene snps such as ApoE4

The next thing to consider is – how long do you need to be on a ketogenic diet?

The reality is that maintaining ketosis for prolonged periods of time can be a challenge for most.

In summary, a ketogenic diet can be a useful tool for helping to improve metabolic health. Be sure to use it under the supervision of a qualified healthcare practitioner who will be able to customize it to your unique goals as well as determine a safe duration of therapy.

To your health and wellbeing,

Scientific citations

A low carbohydrate ,ketogenic diet to treat type 2 diabetes

Veech RL. The therapeutic implications of ketone bodies: the effects of ketone bodies in pathological conditions: ketosis, ketogenic diet, redox states, insulin resistance, and mitochondrial metabolism.

Peer-reviewed papers from Virta health on ketogenic diet and type 2 diabetes reversal

How to tell the difference between type 1 and type 2 diabetes in adults

A lot of times, I come across patients who have to use insulin and aren’t quite sure whether they have Type 1 or type 2 diabetes.

I hope to be able to clarify the difference between the two, especially in an adult.

Type 1 diabetes

Type 1 diabetes is commonly called ‘juvenile onset diabetes.’ Type 1 diabetes is usually diagnosed in young children, often under the age of 5 years. Type 1 diabetes is an auto-immune disease. An auto-immune disease is when the body forms antibodies against itself.

In the case of type 1 diabetes, the body develops antibodies against the cells in the pancreas responsible for producing insulin. These are called the beta cells. When the beta cells are attacked and destroyed, the result is a rise in blood sugars. Someone with type 1 diabetes requires insulin.

During community talks as well and media appearances, I take the time to emphasize the difference between type 1 and type 2 diabetes.

It is fairly common for people to flippantly state that “Diabetes is a disease of lifestyle” without differentiating between the two.

Type 1 diabetes is not a disease of lifestyle.

Type 2 diabetes

Type 2 diabetes is different. It is not caused by a lack of insulin; instead, it is caused by a condition called insulin resistance. With insulin resistance, the cells of the body do not respond to insulin efficiently. In my book, I compare insulin resistance to the landlord changing the locks on the door to your apartment so that the key no longer works. The beta cells have to put out more insulin to overcome the resistant cells.

When someone with type 2 diabetes starts using insulin, does that mean they now have type 1 diabetes?

No. It is possible that with the ‘natural progression’ of type 2 diabetes, some people may need to start using insulin. They may also have a condition called late auto-immune diabetes of adulthood (LADA).

Individuals with LADA have a slower progression toward needing insulin than someone with type 1 diabetes.

There are also other scenarios where someone newly diagnosed with type 2 diabetes needs to be started on insulin right away. This still does not make them a type 1 diabetic.

What can happen with type 2 diabetes is that with time, the beta cells (the cells that produce insulin in the pancreas) may begin to degenerate and so cannot keep up with the production of insulin. It may be necessary to start insulin to keep blood glucose levels within the normal range and reduce the complications of diabetes.

How can you tell the difference between LADA, and Type 2 diabetes?

There are several blood tests that your healthcare provider can perform to help tell the difference between LADA and type 2 diabetes. This is particularly important as the treatments are different.

So it’s important to be pro-active when it comes to your overall health and wellbeing. Do not be afraid to ask questions.

I’ll be sharing more details in my upcoming online course, “What your doctor does not tell you about type 2 diabetes’. For more information about Type 2 diabetes, you can download a free copy of the first three chapters of my award-winning book, “Dr. Eno’s A-to-Z Guide to Thriving with Type 2 Diabetes”, by clicking here.

To your health and wellbeing,

What Every Woman Needs to Know About Thyroid Disease

The thyroid hormone is secreted by the thyroid gland is responsible for maintaining the body’s metabolism. Every cell in the body is affected by the effects of the thyroid hormone. When there is decreased production of thyroid hormone, this is called hypothyroidism.

When there is overproduction in the thyroid hormone, this is called hyperthyroidism.

Up to one percent of the general population in the United States has clinical hypothyroidism. Ten percent of women have a condition called subclinical hypothyroidism. Hypothyroidism mainly affects women more than men.

There is also a condition where the body forms antibodies that begin to attack the body’s own organs. When this happens in the thyroid gland, this is called autoimmune thyroiditis. Up to 27 percent of women have autoimmune thyroiditis.

Reasons for loss in thyroid function

There are many reasons why thyroid function becomes disrupted. Some of these may include:

  • Stressors – whether mental, emotional or physical stress.
  • Exposure to toxins- At least 150 industrial chemicals have been shown to affect thyroid function. These include pesticides, mercury, lead, etc.
  • Food intolerances or sensitivities.
  • Infections.
  • Certain medications.
  • Autoimmune diseases such as celiac disease
  • Nutritional deficiencies such as iron, selenium, and certain B vitamins.
  • Sleep disorders

Symptoms of hypothyroidism

Some of the common symptoms of low functioning thyroid include:

  • Fatigue.
  • Weight gain or inability to lose weight
  • Constipation.
  • Dry skin.
  • Thinning of the eyebrows (especially the outer eyebrows).
  • Dry and brittle nails.
  • Hoarse voice
  • Puffiness of the face or the extremities.
  • Depression (including postpartum depression).
  • Difficulty concentrating.
  • Morning stiffness.
  • Enlarged thyroid (goiter).

How is hypothyroidism diagnosed?

Hypothyroidism is routinely diagnosed with a screening test called the thyroid stimulating hormone (TSH). However, there is a caveat when using the TSH level alone. The laboratory reference range for TSH is extensive, ranging from 0.50-4.00 mU/L. Because of this wide range, it’s challenging to assess the presence of hypothyroidism even though an individual’s TSH level may be in the normal range, despite them exhibiting symptoms of hypothyroidism.

I like to explain to my patients and clients that everyone has a set point. If their TSH was at one setpoint and then there is a significant change to that number on another blood test, even though it is still in the “normal range” that is a significant change for that person and deserves further investigation.

More specialists particularly functional health practitioners are leaning toward more detailed testing by measuring individual thyroid hormone levels.

How is hypothyroidism treated?

Using the functional medicine approach, treatment for hypothyroidism includes a two-prong approach.

Lifestyle modification:

Here we are looking for any potential factors that may have caused thyroid disorder. This is where a functional medicine practitioner is an excellent resource in helping to uncover possible triggers, nutrition evaluation, exposure to toxins, medications, etc. as laboratory testing. Your functional medicine practitioner will recommend a food plan that will help provide nutrients needed to support thyroid function. If needed you will also be placed on supplements that provide thyroid support It is also essential to focus on ways to reduce stress as well as increase exercise/movement.

Replacement of thyroid hormone

It may also be necessary to replace the thyroid hormone. This can be done with synthetic or natural sources of supplement. Your thyroid health is an essential aspect of your overall health and wellbeing.

If you are experiencing any of the symptoms I have outlined in this article, please be sure to have a conversation with your healthcare provider.

If you would like to know how functional medicine can help optimize your overall health, feel free to schedule a free 15-minute discovery session with me by sending an email to info@doctoreno.com.

Until next time, here’s to your health and wellbeing,

Dr. Eno


My Journey Into Functional Medicine

 

 

 

 

 

 

The Doctor of the Future will give no medicine, but will interest his patient in the care of the human frame, in diet and in the cause and prevention of disease~ Thomas Edison

 

Earlier on in my career as an internal medicine physician, I began to feel dissatisfied with the status quo. I sensed there was something wrong in the delivery of medical care. The 15 minute double booked office appointments only added to my angst and dissatisfaction. Questions plagued me such as:

  • How come my patients kept coming back time after time with the same complaints?
  • How come I was only resorting to pills to help them feel better?
  • How come I didn’t have enough time to educate them about lifestyle modifications?
  • How come those patients diagnosed with a chronic illness like diabetes, hypertension and heart disease suddenly had these ailments become the forefront of their existence spending time going from one doctor to another, filling one prescription after the other?
  • How come as time went on I saw the light in the eyes of a lot of my patients dim; there was almost a sense of resignation. Their lives had become, one doctor visit after the other, after the other.

In 2005, I left the sizeable multispecialty group I was working for in the southwestern suburbs of Chicago and went into private practice with two other business partners. Perhaps I could create a better model of healthcare delivery.

I saw my mission as not only treating acute illness but teaching my patients living with chronic diseases about taking simple small steps toward healthier living.

 

In my time in private practice, I decided to pursue training as a professional coach. I found there was power in guiding people toward possibility, so they see the answers for themselves while holding them accountable for the results they produce. Writing about the power of coaching still lights me up and gives me goosebumps.

I wanted to promote lifestyle interventions, but could not find a model I could incorporate that entirely resonated with the kind of care I was looking to deliver to my patients. Unfortunately, the practice was not going well. There was high overhead while insurance reimbursements were low.

Finally in 2010, after paying back the business loan we had taken out to start the practice, I made a decision to leave. I have been working in hospital medicine since then. Over the last eight years, I have continued to provide health information on my blog and have published and uodated a book for patients on  how to live with type 2 diabetes. But those questions have continued to plague me.

I’ve contemplated going back into private practice, but I wanted to make sure that I created a structure that would support not only my patients but also me.

As a cancer survivor, it is my responsibility to create a space that promotes my healing; where I can thrive and continue to serve my patients.

Well, I am happy to share that I have found that structure in functional medicine. So this is the beginning of my journey into functional medicine, and I am excited to share this  with you.

  • In this video blog, I share what I understand functional medicine to be

 

 

As always I welcome your comments as well as suggestions for topics you may be interested in learning more about.
To your health and wellbeing,

Health Awareness Topic- Women and Mental Health

 

 

 

This month is Mental Health Awareness month. According to the National Institute of Mental Health, there are 1 in 6 Americans (44 million Americans over the age of 18 years)  living with a mental illness. Mental illness covers a broad spectrum ranging from mild to severe and tends to affect women more than men. Depression is the most common mental illness. Women are more likely to be diagnosed with depression than men.

There are certain kinds of depression unique to women. These include premenstrual dysphoric disorder (commonly known as PMS), perinatal depression (widely known as postpartum depression) and perimenopausal depression.

Living with a chronic illness such as type 2 diabetes can be very overwhelming, and some people may experience depressive symptoms but do not have significant clinical depression.

Examples of depressive symptoms

-feelings of sadness or overwhelm nearly every day
-thoughts of worthlessness almost every day
-lack of motivation or feeling agitated almost every day
-loss of interest in everyday activities almost every day
-the inability of sleep or excessive sleep almost every day
-loss of appetite and/or a significant change in weight
-decreased ability to concentrate
-thoughts of harming oneself such as suicide

So how do you know if you are just having depressive symptoms or if you have a diagnosis of major depression?  Depressive symptoms do not last a long time. A person with major depression experiences at least three of the symptoms listed plus feeling depressed on and off for a prolonged period up- to two years.

What to do if you feel you have a mental illness

If you or someone you know is facing a mental illness, please seek help immediately. Not all depression is mental illness, and not all mental illness is depression.
There are some medical conditions especially in women that may cause a change in the mood and appear to be depression.

Some examples:
Thyroid disorder particularly hypothyroidism
-hormonal imbalances such as menopause
-food intolerances such as gluten sensitivity
-disrupted sleep patterns in conditions like sleep apnea
-vitamin B12 and/or folate deficiency
-low blood count (anemia)

Your healthcare provider may perform some blood-work to make sure you do not have a treatable medical condition.
If treatable medical conditions have been ruled out, then your healthcare provider most likely will recommend you to a mental health specialist.

Treating Mental illness

When it comes to treating mental illness, there are several options. It depends on the nature of the mental illness. Seeking treatment with a licensed mental healthcare professional is essential.  ‘Talk therapy’ may be a starting point. There are many types of talk therapy such as counseling, psychotherapy, or cognitive behavioral therapy. But some types of mental illness such as bipolar disorder, schizophrenia or severe depression may also require the use of medications right from the start.

Nutrition is also important. Pay attention to what you are eating. Eat a well-balanced diet rich in whole foods which contain a healthy ratio of proteins, carbohydrates, and fats, as well as phytonutrients (plant sourced micronutrients).

Suicide risk and mental illness

Mental health illness triggers a lot of stigmas. People with mental health issues may go through a lot of emotional pain and feel isolated. They may be afraid to seek help. Some people dealing with a mental illness may begin to have suicidal thoughts or even resort to suicide.

According to the US Department of Health and Human Services, 90% of people who commit suicide have a mental illness such as depression, bipolar disorder, schizophrenia or alcoholism. Most people who commit suicide may have attempted suicide in the past. They may do so because they want the physical and emotional pain they have been going through to stop and ending their lives may seem to be the only resort.

In summary, it is essential that as women we pay particular attention to our mental health as well as that of our loved ones. If you or someone you love is living with an untreated mental illness, please get help immediately. It is possible to prevent suicide Suicide is preventable with the right intervention.

Some mental health resources:

Depression in women- Five things you should know

National suicide prevention line

Department of Health and Human Services

 

To your health and wellbeing,

Using the internet for online medical advice

 

 

 

 

 

People turn to the internet for online medical advice for a variety of reasons. Some people to help them try to diagnose an illness. Others to get a better understanding of health and wellness issues to improve the quality of their lives.

Numerous websites provide medical information. Some of the well known reputable websites include  WebMD,  the Mayo Clinic, Cleveland Clinic. You can learn a lot on topics such as nutrition, exercise, common symptoms of diseases, drugs, holistic medicine to name a few.

There are more and more independent doctors and health care experts- such as myself- who share their expertise in a particular area such as type 2 diabetes or other chronic illnesses. This is called information marketing and is geared toward empowering people to make healthier lifestyle choices as well as directing people to a healthcare professional who may be able to help with their medical issues.

I love the fact that as healthcare providers and experts in our various fields, we can provide all this information on this global platform.   It is clear based on internet searches that people want this knowledge.

There are also a lot of not so reputable health information websites. Some of the information that may be downright wrong or misleading.

Because of this, it is crucial to verify the credentials of the source you are getting your information. One of the ways you can do this is, to find out if a healthcare professional who is board-certified wrote the info on the website.

A board-certified physician has completed a residency program in their chosen specialty and also has gone a step further to pass a standardized examination. Depending on the specialty, board-certified physicians are required to undergo  ‘continuing medical education’ (CME). Most insurance providers and also hospitals mandate that a physician is board certified. To confirm whether your healthcare provider is board certified click here.

 

Cyberchondria – the danger of online medical advice

A lot of people search the internet for the answers to common health concerns. It is not unusual for patients to come to see their healthcare provider, armed with information from a web search. I experience patients referring to the results of their internet searches on a reasonably regular basis.

There are some dangers with seeking online medical advice. The most common is getting wrong information. Some websites show up high on search engines, but they provide the worse case scenarios. You could be getting the wrong advice–with severe consequences.

Some people become so obsessed with the advice they get on the internet. They may continuously feel that something terrible is happening to them. They are always thinking the worst and use the internet to validate this feeling.

This constant obsession with the ‘worst-case scenario’ for what may be standard medical conditions is called cyberchondria. Cyberchondria can become very serious and disabling. Someone suffering from cyberchondria may not even realize how this is affecting their ability to function.

Cyberchondriacs spend a lot of time and resources going back and forth to see their healthcare provider armed with their latest findings from their internet research. They may end up demanding medical tests and procedures. And they may move from one healthcare provider to another if they do not get the answers to validate how sick they feel.

How to deal with cyberchondria

So let’s say you are that person (or you know a person 🙂 I’ve described in this article, what can you do? Just like a hypochondriac, cyberchondriacs believe that what they are suffering from is real. Dismissing someone with cyberchondria and telling them it’s “all in their head” is not going to work. In fact, it may cause them to isolate themselves and not open up to their loved ones or worse still their healthcare providers.

The best advice I can give anyone obsessed with continually searching the internet for medical illness is to stop searching the web. Just as I would advise an alcoholic not to just ‘drink a little.’  Take an internet and social media holiday.

The next step is to seek the advice of a competent and compassionate therapist. Talk therapy can be very therapeutic. It can help to ease the anxiety associated with cyberchondria. Talk therapy can also provide coping skills and tools.

In summary, the best approach to using the internet for online medical advice is to be curious yet cautious. Use reputable sites. Do not go to the Internet looking for worst-case scenarios. And finally, know when to stop and seek the timely help of a qualified healthcare professional.

To your health and wellbeing,

Five tips on how to live with a chronic illness and still thrive

 

 

 

 

 

 

Hello and welcome back,

In my last blog post I highlighted there are about 117 million people in the United States living with one or more chronic illnesses such as diabetes, hypertension, heart disease, cancer, obesity, arthritis, etc.

Do not isolate yourself. I thrived through a diagnosis of cancer. As a practicing primary care specialist and professional life coach, I know what it felt like to be on the other side facing my mortality head on.

I opted for the support of my life coach, my support network and tapped into my innate wisdom to become my best teacher through this journey.

Through my experience, having been a patient as well as a practicing physician, I have chosen to be a stand for other people living with a chronic illness or life-threatening diagnosis.

Below, are five tips  I learned from my journey. I share them with the hope that they can help others.

Tip number one- pay close attention to your mental, physical and emotional wellbeing

Know that you will experience a myriad of emotions when facing a chronic illness. Your mind and body have just received some life-altering news. Be kind to yourself. Try to make healthy adjustments to your diet and exercise regimen. When considering making a change, consider making simple, small steps Your body is in a state of heightened alert right now. This heightened state causes a rise in the stress hormone called cortisol. If cortisol is released continuously into the body due to prolonged stress, it can have harmful effects. Your body is doing its best to heal. It needs your help. Seek out ways to support your overall wellbeing.

For example, explore practices that allow you to become more centered such as yoga, qi gong, tai chi, diaphragmatic breathing, etc. Look for ways to support or cultivate a spiritual practice. Consider taking on a mindfulness practice. Current research suggests a benefit when it comes to healing that the mind-body connection is essential. For more information on how your mindset affects living with chronic illness click here

Tip number two- choose a healthcare provider that is the right fit for you

You should have confidence in your healthcare provider. I recall when I casually shared my cancer diagnosis with another physician over lunch. He seemed to think that the treatment option being offered me was a little too extreme and that perhaps I should get a second opinion.
But I had confidence in my surgeon. He had taken the time to outline the plan of care, and so I did not feel I needed to get a second opinion.

If you have any doubts or questions, you may want to get a second opinion. Having the right healthcare provider is vital your overall wellbeing.

You need to be proactive in searching for a healthcare provider who is the right fit for you.

For some tips on how to choose the right healthcare provider click here.

Tip number three- take regular social media and internet fasts

One of the first things people do when they are experiencing an illness is to turn to the internet and social media. Remember not everything on the internet is right! Remember that people posting their experiences on social media are just that-their experiences!

You can use the internet and social media to network with other people going through a similar experience as yours.There are many reputable websites. But be careful about information overload. Do not spend countless hours online reading up symptoms. Try not to stay connected 24/7. Consider taking some downtime so that you do not suffer from information overload.

Tip number four- ask for the support of friends and family

People react differently to being diagnosed with a chronic illness. Some people may choose to isolate themselves from friends and family as a coping mechanism. This kind of behavior is not healthy. Isolation can lead to high levels of stress. As humans, we thrive on being connected. People want to know if they can help. Do not be afraid to ask for what you need.

One way you can do this is to create a support system rather than depending on one person. So you have different people who you can call on for different things. For more information on how to build a support system click here.

Tip number five- Learn to define a new normal

You cannot ignore being diagnosed with a life-threatening condition or living with a chronic illness. Too often we spend a lot of idle time and energy pining for the way things used to be, rather than focus on where we are right this moment. Learning to define a new normal is perhaps one of the most empowering things you can do for yourself.

So how do you know what your new normal is?

A new normal differs from one person to the next. Defining a new normal is a journey of self-discovery. I think it is important that people living with a chronic illness should not give up and sit around waiting for the worst to happen.  It is easy to become the person living with diabetes, or cancer or hypertension. Do not allow yourself to be defined by your illness.

Today I call myself a THRIVOR, not just a survivor. In my opinion, a survivor is someone who has just made it through a challenging circumstance.

THRIVOR is a word I coined to mean someone who has taken the lessons learned, is better for it and is choosing to thrive in their lives.

My mission is to create a global online platform providing women living with a chronic illness with tools and support in order to THRIVE.

I invite you to join me in creating this empowering tribe.

To your health and wellbeing,

 

The ABCs of living with any chronic illness

 

 

 

 

A chronic illness is a prolonged illness that is not communicable and which is not expected to resolve.

Some examples of chronic illnesses are type 2 diabetes, heart disease, stroke, cancer, and arthritis.

According to the CDC, there are currently about 117 million adult American living a chronic illness.

In addition to this number, about 1 in 2 adult Americans live with one chronic illness and 1 in 4 live with at least two conditions.

Being diagnosed with a chronic illness is a life-altering experience. I know this first hand. I still remember the shock and disbelief reading my results stating the words ‘invasive cancer’.

A lot of people may have a hard time coping with the diagnosis, and they may begin to experience feelings of overwhelm, despair and even depression.

Some people may even feel they are no longer healthy.

But as with everything else in life, you choose differently by your mindset.

That is why I chose to address the mindset in the first three chapters of my recently published Amazon bestseller book ”Dr. Eno’s Guide to Thriving with Type 2 Diabetes”

Your mindset is made up of three essential aspects. I call them the ‘ABCs of living with any chronic illness.’

I not only write about these, but I used these concepts to help me thrive through my diagnosis of cancer.

So what are the ABCs?

A stands for Acceptance
B stands for Belief
C stands for commit to change

To learn more about the ABCs, download my free ebook which highlights the first three chapters of my Amazon bestseller book.

To obtain a copy of the book from Amazon, click here.

 

To your health and wellbeing,

 

 

 

 

Here are some other articles from our archives you may also like:

Five simple strategies to cope with diabetes distress

Five symptoms women should never ignore

Today’s health awareness topic: The relationship between your emotions and diabetes symptoms

 

Today’s Health Awareness Topic: How mindset affects our health when living with a chronic illness

mindset-and-chronic-illnessIn my over 20 years as a primary care physician, I have noticed a lot of patients living with a chronic illness feel that they have lost their good health. I am here to share with you that does not have to be the case.

As I highlight in my free e-book, it all starts with your mindset. This starts with the following:

  • Acceptance
  • Belief
  • Commitment

Armed with these three attributes, you can make the choice to achieve optimal health despite living with a chronic illness.

What is optimal health?  

Optimal Health is a state of harmony in the body. It is the balance and inner resilience that allows us to meet the demands of living no matter what life throws our way without being overwhelmed.

Our health is never static. Our health is always evolving. Moment by moment and day by day. Our health is the collection of our emotional, physical and spiritual states.

We are learning more and more in the medical field how interconnected our physical state and our mental and emotional states are. This is called the ‘mind-body connection.

This mind-body awareness can also help us to choose how we live with a chronic illness. 

Our body is born with the natural urge to heal itself. When we are in a balanced state this healing can happens easily. For instance, we accidentally cut our hand with a knife whilst cooking. In time the cut heals naturally.

When we disrupt the body’s natural balance, we experience disease (Dis-ease). Only a small proportion of diseases actually have a genetic basis.

Majority of the causes for disease are the result of the lifestyle choices that we make over time. I like to work off the premise that if we know better, we can do better.

Our thoughts impact our overall state of health. How we perceive living with a chronic illness determines the choices that we make. 

Caroline Myss in her best seller book Anatomy of the Spirit writes about the fact that our biography becomes our biology.

We are all living history books. Every thought that you have ever had has traveled through your body and produced a physical response- good or bad. As our lives unfold, our physical health becomes a living, breathing biography. It conveys our strengths, weaknesses, hopes and fears.

A fearful thought such as losing our job, or being diagnosed with cancer stimulates the sympathetic nervous system. It causes the release of stress hormones- adrenaline and cortisol. These hormones are responsible for fright, flight or fight. The same fright, flight or fight response occurs if we come face to face with a big grizzly bear whilst on an outdoor camping trip. The sad news is our body does not know the difference between the fear thought and the real fear of being in an endangered situation. They both produce stress in our bodies.

Research shows that sustained stress day in and day out can affect our chromosomes. Stress affects the telomeres that are located at the tip of the chromosomes. When the telomeres break off, they speed up the aging process.

Being diagnosed with a chronic illness elicits a fear response in most people. But it takes a concerted effort to create a mind shift in order to achieve optimal health

This is your responsibility not that of your healthcare provider. 

I am passionate about motivating and inspiring both patients and clients to take an active role in their overall health. It starts with their mindset.

Accept that you are responsible for every part of your life. Your physical history, relationships, every attitude and opinion that you hold or belief that you carry inside yourself, affects your biological makeup.

You may have been diagnosed with type 2 diabetes or borderline diabetes. Being sad and resigned may seem like natural emotions. But does it make it any easier.

If dealing with a chronic medical condition and your whole mindset is that of hopelessness then this only leads to further dis-ease.

Negative emotions around illness only serve to promote self-suffering

It’s time to make a choice to adapt the ‘ABCs’ of living with a chronic illness so that we can start on the way to optimal health. Accept. Believe. Commit.

If you have not already downloaded a free copy of the first three chapters of my upcoming book “Dr. Eno’s A-Z Guide to Living Powerfully with Type 2 Diabetes” click here.

Until next week, here’s to your health and wellbeing,

511952242dd5056a22054e09-2

How stress can cause a ‘broken heart’

Hello there and welcome back,

February is heart disease awareness month. In my last article, I promised that I would share how stress can cause heart disease.

I recall the first time I met a patient diagnosed with this condition more than seven years ago:

She was close to 80 years old. She came in ‘feeling poorly’ for the last few months. Her husband had died from a chronic illness almost 15 years ago, and she never remarried. Despite being afflicted with constant back pain, she still tried to remain active. She attended regular outings of her red hat society and other senior activities. She was a delight to interview. I admitted her to the hospital, and we began running a battery of tests to find out what was the problem.

By the next day, her test results started to come in. Her heart enzyme levels were dangerously high. But she had never complained of chest pain to explain this. A cardiologist (a heart specialist) was asked to see her. She had a heart test called an echocardiogram. The results of the analysis showed that she had a heart condition called Takotsubo Cardiomyopathy.

OK before your eyes glaze over, I know this sounds like a mouthful. But let me gently break the news to you- it is also called ‘Broken Heart Syndrome.’ This particular heart condition could be caused by-you guessed right if you said STRESS!

It was first described in Japan and is more common amongst women. The kicker is that either intense emotional or physical stress causes it. Anything from a medical illness, to domestic abuse, heated arguments, devastating financial loss, the death of a close relative. The list goes on. The word ‘Takotsubo’ in Japanese means ‘octopus pot.’ It describes the unique way it causes the bottom part of the heart to balloon up.

It is not sure how precisely takotsubo cardiomyopathy damages the heart. It is thought to be related to the release of a significant amount of the stress hormone called epinephrine released into the bloodstream. Unlike the more common type of heart disease-coronary artery disease- that is caused by blockage of the arteries.

The use of over the counter cold medication called phenylephrine, as well as illicit drugs like methamphetamine and cocaine, can also cause takotsubo cardiomyopathy.

It can cause the same symptoms as a heart attack like chest pain. Some patients may have shortness of breath (like my patient) or have a fainting spell.

The good news is that takotsubo cardiomyopathy if discovered and treated early is reversible. The sad story is that if left untreated eventually the heart muscle becomes too weak and can eventually lead to heart failure. Unfortunately, this was the case for my lovely elderly patient.

I share this information with you because it became clear to me that just as stress is insidious in our lives, so can it’s effects be in our hearts.

Who would believe that a heart could break from our life experiences?

The truth is that there are far too many women out there just like my patient. They are going through life oblivious to the effects that stress has on them.

They are our sisters, our neighbors, mothers, co-workers, and yes- even ourselves.

How many times have you felt a twinge of chest pain and chalked it down to ‘just stress’? Now I’m not saying to you that every twinge that you feel is a heart attack about to happen. What I am saying is that as women we have been given an ‘innate knowingness’ about our bodies. It is called a woman’s intuition. It is that intuition that signals that heart pain (ache). Then we dismiss it as ‘only stress.’ It is our body’s inner knowingness signaling us to stop and pay attention, to search within.

I know from firsthand experience as a primary care provider that being diagnosed with a chronic illness such as type 2 diabetes adds another layer of stress. But I am also here to assure you it does not have to be this way.

I do not want to see one more woman suffer from a broken heart.

It is my vision to form a TRIBE of likeminded women who want to THRIVE and experience ‘stress less’ lives.

Here are some things you can start doing today:

  • Pay attention to the signals that your body sends to you. Be still, take notice, and check within.
  • If these symptoms persist, please schedule an appointment to see your healthcare provider.
  • If you are not satisfied with the answer that your healthcare provider gives you, please be persistent. Don’t get blown off.
  • Make it a priority to learn how to handle stress
  • If you are a woman living with chronic illness find ways to create a network that supports you.

As always I look forward to your comments.

To your Health and Wellbeing,

 

Is the story you tell yourself stopping you from reaching your full potential?

 

 

 

 

 

 

It’s been a while since my last blog post. But I’m excited. I want to share that despite my silence , I’ve been working behind the scenes with an amazing team of people, including my virtual manager who has been instrumental in helping migrate my online business to a more robust platform.

You see for the last ten years I have kept ‘planning to plan’ to transition from clinical medicine into more of a wellness based business that focuses more community outreach programs as well as online group coaching.

I’m being transparent in sharing that this has been a process for me to get past ‘my story’. And don’t get me wrong, this is something I am still working through.

Do you have a story that you keep telling yourself? Do you know this story may be holding you back from reaching your full potential?
So now that I’ve piqued your curiosity, you might be wondering what do you mean by ‘ a story’?

A story is a tale that you repeat over and over again. In the beginning, the story may have been told to you by an authority figure in your life such as your parent(s), a teacher, a pastor.

The important thing about a story is that is that someone initially TOLD this story about you. And you believed it. It became your reality. Your story now becomes the lens through which you see your life.  Every aspect of your life. A story can limit you from reaching your full potential.
So let me share the story that has been limiting me for a good deal of my life:

I was born a premature baby in London, UK. In the 1960s the odds of a premature birth under or close to 7 months surviving were a lot less than they are in the 21st century. My mother was a nurse. She understood the odds of me surviving with no permanent deficits. She promised herself that if I did survive, I would become a doctor in order to ‘give back’. From my traditional roots-in Nigeria-the career path a child takes is largely determined by their parents.

Over the last 20 years I have enjoyed a successful medical career in the United States as a primary care physician. Over the course of my career, I have also seen the impact lifestyle choices have on overall health. I have treated the effects of those lifestyle choices when people get ill or develop chronic medical illnesses.

As time went on, I became passionate  about helping people become aware that they could change certain behaviors before they got seriously ill. It starts with not only their mindset, but the lifestyle choices they make. The body and the mind are related.

I also saw the impact my talks had when I went out to speak at community outreach programs. The general feedback was that people were able to grasp the information I offered and were eager to take action.

Do you know that patients do not understand more than half of what a healthcare provider especially a physician tells them?

About 10 years ago, I was introduced to the field of professional life coaching. It lit me up. For me, this was a model that went beyond the examining room could  impact people at the root cause.

But I have been allowing my story to limit me from transitioning into a career as a full time speaker, consultant and coach.

Do you know that we even have stories about everyday stuff? For instance when someone cuts you off in traffic, what do you think? Or when you are in the grocery line that just seems to go very slowly what’s your story? Or think about where you are now in your diabetes journey-what story are you telling yourself?

Own Your Story

It was not about the person cut you off in the traffic, for all we know they may have been rushing to see a dying relative in the hospital!  The grocery store line just goes slowly because that’s what grocery store lines do; not because you happen to be in the store. And how you get decide to relate to living with  diabetes or any other chronic illness is also a story you tell yourself.

So here are some of the things that I have been taking on to help me dismantle my story and keep me moving forward in my plan to transition out of clinical medicine. I invite you to take them on also:

  • Notice everywhere you are tell a story. Usually you’ll notice yourself going back and forth or making a judgment. Or it may be that you spend time  justifying why you can’t achieve a goal.
  • Next notice where you tell stories about other people or other things.
  • Now work on taking simple small steps to start dismantling your story. Start by telling yourself a story that leaves you feeling empowered. For instance, tell yourself  YES- it is possible to live a full and productive life despite being diagnosed with type 2 diabetes.

So here is the story that I am committed to telling myself moving forward-Yes, I am a great coach. It’s what has made me a good physician. I believe that patients should be actively engaged in their medical care. As a physician, I provide patients with resources and information which allows them make informed decisions in their healthcare.  Some of those conversations are not easy to have. But that truly is what coaching is all about.

There are lots of  things being planned for this platform over the next few months. In summer 2017, I  will be releasing the updated version of my book, “Dr. Eno’s A-Z Guide to Living Powerfully with Type 2 Diabetes”. If you have not already had a chance to preview the first three chapters in my free e-book, click here.

I would also love to hear your feedback on how you think a story has been running your life and preventing you from reaching your full potential.
Until next time,

To your Health & Wellbeing,

Seven Tips People Living With Diabetes Mellitus Type 2 Can Use to Make the Most of an Office Appointment with Their Healthcare Provider

Diabetes MellitusFor some people living with diabetes mellitus type 2, an appointment with their healthcare provider, particularly a doctor, can be overwhelming.

When I was in a primary care practice, I often told my patients that for the most part they had an average of four to six office appointments a year. The typical primary care visit is limited to only 15 minutes. So you need to prepare ahead of time to make the most of the appointment.
Here are seven tips you can use to make the most of your office appointment. If you use all these tips, you will get the most out of every visit to the doctor.

Tip Number 1: Take a Long Record of Your Blood Sugars

Make a habit of keeping a record of your blood sugars. Keep it simple. You do not need fancy computer software. All you need is a small notebook. You can get this at any office supply or drug store. Divide each page of the notebook into at least two columns.

The first column is for the date and time that you check your blood sugars. The second column is to a record of your blood sugar levels.

Some people do not like to prick their fingers to check their blood sugars. I’ve shared in an article some tips on how to check your sugars once a day. Over the period of a week you be able to trend of how your blood sugars are running.

By keeping a log of your blood sugars, it helps provide important feedback for you as well as your healthcare provider. For instance if your blood sugars suddenly begin to run high or low, you can pinpoint the exact time this happened. Perhaps you were sick, had started an exercise program or went on vacation and over-indulged in food. All this information can help you and your healthcare provider to make important decisions regarding your diabetes management.

Tip Number 2: Take Along Your Glucometer

When I was in an office based practice, I liked to look over the blood sugar readings on my patients’ glucometers. A number of the new generation glucometers provide a lot of valuable information. For instance some machines average the sugars over say a 14-30 day period. Others may average the blood sugars before and after meals. This is a great teaching tool for diabetic patients. It allows them to see how their blood sugars affects their overall health and wellbeing.

Tip Number 3: If Your appointment is First Thing in the Morning Do Not Eat Breakfast

Take advantage of an early morning appointment with your healthcare provider and arrive ‘fasting’. Nowadays, a lot of healthcare providers perform blood tests in their offices to check blood sugar, A1C and lipid profile. For more information on the importance of knowing your numbers, click here.

Tip Number 4: Always Carry a Snack

Has this ever happened to you? You are at the doctor’s office and the wait time is longer than you planned. But you had taken your medications earlier on in the day. Next you begin to experience the ‘bottoming out’ sensation as your sugars take a nose-dive.

Next thing you know it you’re being carted into a waiting ambulance to the emergency room!

I advise people living with diabetes to always carry around a piece of ‘hard candy’. I also recommend meal replacement bars such as glucerna. So always be sure to take a snack along with you wherever you go.

Tip Number 5: Keep a Journal and Take This Along to Your Visit

Living powerfully with diabetes requires that you do things a little differently than the crowd. Keeping a journal or a diary is one of those things. A lot of times, a journal is for your personal use. However at times it may help your healthcare provider to detect why your sugars may be running high or low.

There are several ways you can choose to journal. For instance, you can keep a food journal. If you keep a record of what you eat, you may notice there are certain foods that make your blood sugars go up.

This gives you a good idea of knowing what foods to reduce or what to take out of your diet completely.
You may find out that stress affects your blood sugars. Some people may prefer to journal and record their blood sugars in the same book. Decide what works for you and just do it.

Tip Number 6: Be Prepared to Take Off Your Shoes and Socks

Foot care is a very important aspect of diabetes care. Inspecting the feet helps to prevent or detect early foot infections, which could lead to other complications. I always insisted on looking at the feet of all my diabetic patients at least every 2-3 months.

It is also important to make sure that you have sensation on the bottom of your feet.

Your physician can perform a very simple test called a fine filament test on your feet. This is a simple instrument and as there name suggests a thin filament. If you do not feel the filament being pressed on the bottom of your feet, you may be developing a complication called diabetic neuropathy. This is when the nerves are damaged and you can no longer feel your feet. The danger is that you could step on a nail for instance and not know because you could not feel it.

Diabetic neuropathy is one of the leading causes of amputations in people living with diabetes mellitus. So make sure that your doctor performs this test on your feet every three months.

Tip Number 7: Be Prepared for Change

In diabetes type 2 is a disease that has the potential to change over time. Regimens that worked earlier on may not work so well as the disease advances. As time goes on it may get harder to control your blood sugars. So be prepared for change.

For example you may have been on a medication for a long time and your blood sugars had been well controlled. All of a sudden your blood sugars start running high. Your doctor may decide to add another medication or even insulin. Always believe that your healthcare provider has your best interest at heart.

I know that there are a lot of skeptics out there about the pharmaceutical industry. Research is being conducted to develop new drugs, which may help preserve the function of the pancreas.
To reduce the potential complications of type 2 diabetes follow your doctor’s advice. In the first three chapters of my upcoming book, “Dr Eno’s A-Z Guide to Living Powerfully with Type 2 Diabetes” I address three strategies that are important in order to embrace change. To download a free copy of my e-book that covers this, click here.

As always I welcome your comments and suggestions about more topics you would like to learn about.
To your health & wellbeing,

Five Simple Strategies To Cope with Diabetes Distress

diabetes distress

A lot of people living with diabetes may sometimes become overwhelmed and stressed out. From checking blood sugars, watching your diet, making time for exercise, taking medications, appointments with healthcare providers, the fear of complications, or simply whether you are doing the right thing. The list of things to know and do may seem unending. It may seem that diabetes is taking over who you are. You can’t take a break from being a diabetic. All this can place a huge emotional toll on people living with diabetes.

These mixture of emotions was first described by two psychologists and is called diabetes distress. Diabetes distress is not just depression, although research has shown that there is a higher incidence of depression in people living with diabetes. And these feelings may not be the same thing for everybody. Every person living with a chronic illness- such as type 2 diabetes-experiences it a different way.

The important thing is to pay attention to your feelings. If you are feeling overwhelmed then it may be time to speak with your healthcare provider. It is important that you have a healthcare provider who has empathy and is able to validate your feelings. Your healthcare provider should not brush off your feelings or simply suggest that you start taking medications for depression.

Not all sad feelings associated with living with a chronic illness such as diabetes is because someone is depressed.

In addition to speaking with your healthcare provider it is also a good idea to learn some ways to cope with these feelings.

Here are five simple strategies that you can learn to overcome some the feelings related to diabetes distress. You may also find that you can apply these to any area of your life.

Identify the breakdown

What is a breakdown? I’m not describing a nervous breakdown here, although to some people it may feel that way. A breakdown is an emotional response that happens when things do not go as planned. For instance let’s just say that your goal was to get your A1C less than 7% at the next visit to your healthcare provider. But this did not happen.

So, you have not reached the goal you set for yourself. State in one simple sentence what it is that you say should have happened.

For instance you could simply say, “My A1C is not less than 7%’. In this example, not getting your A1c less than 7% is the breakdown.

Identify the upset

Write out your thoughts, feelings and emotions. For some people this may be a good time to journal. Even if journaling is not your thing, simply take out a sheet of paper and write. Try not to be judgmental about what it is that you are writing down. Just take the time to write these all down.

So going back to our example, about the A1C you could write something like “I feel upset, and discouraged, because I did not get my A1C to less than 7% as I promised myself”

Upsets can keep us stuck. This is because we become judgmental about ourselves. We let this judgement mean something about us that may not be true. I suggest you keep writing your feelings down until you feel like you are no longer judging yourself. Some people may begin to feel more compassion toward themselves. This is not the same thing as making excuses.

Write out the facts surrounding this breakdown

How would a news reporter describe this breakdown? Try doing this in one sentence. So back to the situation here, “I did not get my A1C to my goal of less than 7%”

If you cannot summarize the facts of the situation in one sentence then you may still be feeling upset. If that’s the case then circle back to the upset and continue writing until you begin to feel compassion for yourself.

What you are committed to next?

Now it is time to commit to reaching your goal. It is okay to commit over and over again. Don’t feel that because you failed to reach your goal before, that you will never reach your goal. If Thomas Edison had felt that way, we would not have had the lightbulb.

When we commit to something we have the power to create something better. What are you committed to? It may be time to look at a bigger picture than simply getting your A1C less than 7%. It may be living a powerful life and thriving despite having type 2 diabetes!

Write whatever you are committed to out as a statement. For instance our goal of achieving an A1C of less than 7% may be transformed into a statement that says “I am committed to getting my A1C to less than 7% so that I can experience vibrant health and serve to inspire other people living with diabetes to reach their goals!”

Ready, set ACTION!

After completing these steps you will be inspired to get into action. There is no time like NOW to get into action. Remember what you are committed to. Do not be discouraged.

You may notice that you can use these strategies to not only deal with setbacks when it comes to living with diabetes but all aspects of your life.

So get curious and see how many other areas of your life you can get past overwhelm, feeling stuck and back into action.

To your health and wellbeing,

Today’s Health Awareness Topic – Women and Heart Disease

 

heart healthFebruary is heart health month. I am committed to helping women, especially women living with chronic illnesses such as diabetes, learn all they can to enhance their health and wellbeing.

But I have found that a lot of women do not know the facts when it comes to heart disease. Only 54% of women know that heart disease kills more women than breast or lung cancer.
According to the most recent statistics by the Centers for Disease Control, heart disease is the leading cause of death in the United States in women over the age of 35 years.

Although the rate of death from heart disease for men has dropped in the last thirty years, they have not done so for women. In 2013, heart disease was responsible for killing close to 290,000 women. This translates to 1 in every 4 women dying due to heart disease.

There used to be a time when there was a general belief in the medical community that women under the age of 50 could not suffer a heart attack. So you can imagine what happened if you were a woman and you went to see your doctor with a complaint of chest pain. Your doctor would usually reassure you that it was not your heart and perhaps you had indigestion or were under a lot of stress and prescribe something for that.

As a woman it is extremely important to arm yourself with facts about your heart health.

Some other heart health facts that you need to be aware of:

  • Heart disease will kill six times more women this year than breast cancer.
  • 71% of women do not experience the early signs of a heart attack as chest pain as do men. They may experience a sudden onset of weakness. Almost 2/3rds of women who die suddenly of heart disease did not have any symptoms.
  • Women who smoke are twice as likely to have a heart attack as men who smoke. The risk of a heart attack is 19 years earlier than women who do not smoke. So think about it, if you are a woman and you have been smoking since you were in your teens (which by my experience is the time that most people start a bad habit like smoking ☺), then your risk of having a heart attack begins to rise toward your forties.
  • Type 2 Diabetes increases a woman’s risk of developing heart disease. Women living with diabetes who have had a heart attack have double the risk of having a repeat heart attack in their lifetime or developing heart failure.
  • Women with metabolic syndrome have an increased risk of developing heart disease, especially at a younger age.
  • Women under the age of 50 have twice the risk of dying from a heart attack as men in the same age range. This is all the more reason to be persistent when something does not seem right. I have often shared that as women we have an inner knowingness about ourselves and/or situations. This is called intuition and you can learn to use it to guide you in all aspects of your life.
  • Marital stress worsens the outcome of a heart attack.

What happens to you when you have a heart attack?

When you develop a heart attack, the blood supply to an area of the heart muscle gets blocked off. Sometimes the blockage may not be a complete blockage and blood can still get by to the heart muscle. This is called ischemia or angina. The classic symptoms of angina are chest pain, chest discomfort, and chest heaviness. Sometimes the pain or discomfort may go down the left arm or into the jaw.

As women we may have what is called ‘atypical symptoms’ like unusual weakness, heartburn, dizziness, etc.

But remember just as I pointed out, some women may not have the classic presentation of a heart attack or angina.

The good news is that if the blood supply is restored at this point, then no permanent damage occurs to the heart muscle.

When the blood vessel to a particular are of the heart remains blocked for a period of time, eventually the heart muscle begins to die off. Sometimes the damage cannot be reversed and the heart muscle dies and it is replaced by scar tissue. Scar tissue reduces the functioning of the heart and eventually causes heart failure and death.

It is important to get to an emergency room as soon as possible if you develop any symptoms suspicious for a heart attack. This is because the sooner you get intervention by a heart specialist to open up the blocked vessels the less the risk of permanent damage to your heart.

What you can start doing today:

  • Become knowledgeable about your risk for heart disease. Even if you do not have a family history of heart disease you can still be at risk!
  • If you smoke then quit. No more excuses! It’s still early in the year and you know you can do it.
    If you are obese or even over 10% of your ideal body weight, then commit to losing weight.
  • Schedule your annual physical and know your numbers! These numbers include- your blood pressure, fasting lipid profile (cholesterol), and blood sugar. If any of these numbers are outside of normal range then take action and work on getting them back to normal.
  • If you have high blood pressure or borderline diabetes or type 2 diabetes, then make sure that you are being treated by the appropriate healthcare professional. Do not ignore this part of your care. Denial only worsens things in the long run.
  • Find ways to cope with stress in your life. Stress is so prevalent that we as humans do not believe they can live a stress free life. It is our perception of stress that matters and what we do to modulate its effects.

Now more than ever we as women need to become more pro-active in our overall health and wellbeing. We need to stop making excuses for poor lifestyle choices. More importantly we need to accept that these lifestyle choices not only shorten our lives, but also the quality of the life that we have left. I’m not sure about you but I want to be health and vibrant into my 90s and beyond!

My mission in creating this blog is to provide a whole person approach to living with type 2 diabetes and other chronic illnesses.

Along those lines, over the next few months, in addition to the release of my updated book, Dr. Eno’s A-Z Guide to Living Powerfully with Type 2 Diabetes’, I will  be rolling out several programs. I look forward to working closely with those who are willing to invest the time and effort to enhance their health and wellbeing.

 

 

How Type 2 Diabetes Can Affect The Skin

diabetesType 2 diabetes affects many organs in the body. The skin is one of the largest organs in the body. There are several skin conditions that can happen just because of diabetes. For the most part very few of these skin conditions are life threatening. More importantly, a lot of these conditions may show up when the blood sugars are not well controlled.

These skin conditions can be very frustrating, especially for women living with diabetes. By knowing about these conditions will allow you to become a more vigilant. It also helps to hasten healing if you should get any one of these.

Acanthosis Nigricans

This skin condition gives the skin the appearance of soft velvety wart like growth. It is usually seen at the back of the neck, the armpits, beneath the breasts, the flexure surface of the elbow.

It is typically seen in those who are  overweight or obese.

There are other conditions that can cause this skin condition, but usually acanthosis nigricans is a warning sign of  insulin resistance. Insulin resistance can eventually lead to diabetes.

I take the time to point this out to my patients. Especially patients who do not have diabetes. This is a great time to start making lifestyle changes.

Scleroderma diabeticorum

This is a skin condition that causes the skin of the back and the upper neck to become very thick.

The treatment for this is to get the blood sugars well controlled.

Lotions can be applied that will help to soften the skin.

Vitiligo

In vitiligo, the skin loses it’s pigment and causes white patches. Vitiligo is an autoimmune disease. Vitiligo is more common in type 1 diabetes. It is very important to use a sunscreen, to reduce the risk of developing skin cancer.

Vitiligo is treated with skin lightening creams to try to even out the appearance. Some people even attempt to tattoo back in pigment into the white areas.

Eruptive Xanthomatosis

These are lumpy yellow deposits of fat beneath the skin. It is usually an indication that cholesterol and triglyceride levels are high.

Once blood sugars and the cholesterol are better controlled then these may disappear.

Digital Sclerosis

Tight waxy skin on the back of hands, the toes and also the forehead. This condition happens more commonly in people with type 1 diabetes and can cause the hands to become stiff.

Just as in most of the other skin conditions we have discussed thus far, the treatment is to normalize the blood sugars.

Disseminated Granuloma Annulare

Raised oval patches that are either skin colored or red or brown. They usually occur on parts of the body away from the trunk such as the legs or the ears.

In addition to controlling the blood sugars, there are several ways to treat this condition. So please be sure to see your healthcare provider.

Diabetic Blisters (Bullosis Diabeticorum)

These blisters may be large but are usually large and look like burns. They are not painful. They can occur on the fingers, feet, and hands and even sometimes on the forearms.

The treatment is to get the blood sugars within control. They heal by themselves within a few weeks. It’s important to keep them clean.

Necrobiosis lipoidica diabeticorum

This is caused by fat and collagen accumulating beneath the skin. Most times these lesions happen on the legs. The overlying skin then gets thin and can break down easily especially when exposed to injury. It can also get itchy.

It is important to see your primary care physician especially if the lesions break open as it may take a longer time to heal.

Allergic reactions

Allergic reactions that can cause rashes and bumps can also occur in type 2 diabetes. It is even possible to develop an allergic reaction to a particular type of insulin. So be very observant and if this happens inform your physician.

Bacterial infections

These can happen especially when blood sugars are not well controlled. The common culprit is staphylococcus aureus. This can cause boils, folliculitis or impetigo. There is a particular strain of Staphylococcus called MRSA (Methicillin Resistant Staphylococcus Aureus).

It is very important to treat MRSA early and promptly. So be sure to bring any boils to the attention of your physician.

Fungal Infections

These are usually caused by candida (yeast) organisms. Women with borderline or full-blown diabetes may also be at risk of vaginal candidiasis. Fungi can affect various body parts. For instance between the toes it can cause athlete’s foot. It is very important to make sure that the webs between the toes are kept dry to prevent athlete’s foot, as this could become an entry point for bacterial infections. Fungi can also infect the toenails causing the nails to become dark and discolored. This is called onychomycosis. In the groin it can cause a jock itch.

There is a potentially fatal fungal infection that is very common in diabetes called Mucormycosis. This fungus invades the nasal passage and then can spread to the eye and brain.

If you have a ‘sinus infection’ that does not seem to be getting better, especially associated with eye pain, and fever should be evaluated immediately by a physician.

It is important to get evaluated and treated for these skin conditions. Your healthcare provider may refer you to a dermatologist. This is a doctor who specializes in skin diseases.

As you can see from this article, in addition to treating these skin diseases, it is also important to get the sugars under good control.

As with any other complication associated with diabetes, I like to emphasize the importance of prevention rather than treatment.

You may be experiencing difficulty getting your blood sugars under control. Do not despair. It starts with your mindset. You have control over how you choose to live with a chronic illness.

To learn more about this click here to download a free copy of the first three chapters of my upcoming book.

Be persistent. Stay the course.

To your Health and Wellbeing,

Today’s Health Awareness Topic: The relationship between your emotions and diabetes symptoms

 

 

 

 

People living with diabetes  may experience a wide range of emotions on a day-to-day basis. These emotions may range from initial anger, resentment, disbelief, and even denial. At times these emotions can be very intense. Sometimes these negative emotions are inappropriately directed at the healthcare provider who gave the bad news of the diagnosis.

Being diagnosed and living with type 2 diabetes does not have to be a stressful experience. Consider that contrary to popular opinion, being ‘stressed out’ does not have to be part of living with any chronic illness including type 2 diabetes.

It is predictable that over time, your emotions will wax and wane. Some days you may feel more upbeat than other days. Rest assured that you are OK. One of the first things that I do with my patients and clients is to work on getting those emotions out in the open so that we can deal with them at the outset.

You have the power to choose how your emotions impact your overall health and well being.

This is especially important if these emotions are not empowering. We all have the power to choose how our emotions impact us. I know this may sound so cliché. But really and truly this is one of the times that you get to choose and that choice directly impacts your blood sugar control. Living with diabetes is a prime example where having the power of choice impacts your overall health and blood sugar levels.

If you are constantly stressed out and angry then it’s predictable that it may be more challenging to get your blood sugars within normal range.

Stress causes the release of hormones in the body. The stress hormones are called adrenaline, noradrenaline and cortisol. These hormones help to prepare the body for ‘fight or flight’. One way that they prepare us for ‘fight or flight’ is by increasing the production of glucose from the liver stores. This is a normal stress response.

However, when you have diabetes, the last thing that you need is more sugar in your blood stream. Your body is already not able to handle the glucose that it has already!

Research has been performed on the effects of a positive mood on our overall health and well-being. On a chemical level, being happy helps to reduce stress hormones. It enhances the release of endorphins and natural serotonin both of which enhances our emotional state and enhances our well-being. If you have a positive and optimistic mindset, then you will feel more empowered in finding ways to better control your blood sugars.

The first step to living an empowered life with diabetes is to get those emotions out in the open. The next step is to deal with these emotions.

It can be challenging for healthcare providers to be able to address all the emotional concerns of our patients  living with a chronic illness. There is no  doubt the 15-minute ‘double-booked’ appointment slot may not help us to connect with our patients and understand how they are actually experiencing their disease but this discussion is important. Be certain to speak to your healthcare provider if you are feeling stressed out or overwhelmed.

Over time some people living with diabetes may begin to experience what is known as diabetes distress.  Diabetes distress is not true depression. Some patients may need the support of talk therapy. It may be helpful to work with a health coach or a psychologist.

As a professional life coach and a physician my stand is for patients and clients living with type 2 diabetes or any chronic illness to experience a vibrant wholesome life.

It is what motivated me create this platform as a way to empower women living with diabetes.

By empowering women, we empower our communities and eventually the planet.

One of the most important things to do is to deal with your mindset and your perception of living with diabetes.

In the first three chapters of the soon to be released updated version of my  book, ‘Dr. Eno’s A-Z  Guide to Living Powerfully with Diabetes’ I write about what I can best describe as the ‘ABCs of a positive mindset’.

They are:

  • A-Acceptance
  • B-Belief
  • C- Commitment to change

Yes you have the power to choose whichever way it goes. Remain committed to how your health and well-being even on days that you may not feel your best.

To take a FREE peek of the first three chapters my upcoming book, click here.

To your Health & Well-being,

Five Physical Symptoms Women Should Never Ignore

Type 2 Diabetes

As women, it is not unusual that we may ignore our health and wellbeing. For women living with a chronic illness such as borderline or type 2 diabetes, it is important to make our overall health and wellbeing our number one priority.

I have seen female patients who have ignored symptoms that later turned out to be very serious.

In this article I outline five common symptoms that should never be ignored. This is because contrary to ‘popular wisdom’ these symptoms may be a sign of more serious illness.

Rule of thumb is that if you experience any of these symptoms for more than a few weeks then it is time to schedule an appointment to see your healthcare provider.

1-Persistent Heartburn

Heartburn is a common complaint. It is also called ‘indigestion’, or ‘reflux’. It is caused when stomach acid moves back up the swallowing tube (called the esophagus).

There are many things that can cause heartburn. Some of the common reasons include certain foods such as spices, tomatoes. Caffeine intake, emotional stress and fat around the abdomen (abdominal obesity) are also causes of heartburn.

One uncommon symptom that may mimic heartburn but is something more serious is a heart attack!

 The heart sits in the chest wall directly above the stomach and is separated by the diaphragm. The diaphragm is a muscle that separates the chest from the abdomen. It is very important in breathing. If you have a heart attack that affects the bottom of the heart that sits on the diaphragm part, it may mimic the symptoms of heartburn.

How do you know it’s not heartburn?

 If you have never experienced heartburn before and right out of the blue you begin to experience this more frequently -this is a strong clue! Also if you break out in a sweat, feel your heart racing or have nausea or vomiting. Another thing to observe is if you don’t recall anything that you may have eaten that could be causing you to feel this way.

Rule of thumb when it comes to heartburn that you cannot explain, get checked out immediately. This is especially important if you have a family history of heart disease

 

2-Frequent vaginal yeast infections

A common reason for vaginal itching is a yeast infection called candida albicans. Candida is not sexually transmitted. It can cause a rash on the labia, itching and also a thick vaginal discharge that looks like cottage cheese.

There are many reasons why a woman may get yeast infections. This may include wearing tight underwear, stress, antibiotics, and hormonal contraceptives to name a few.

However frequent candida infections may be a hidden sign of diabetes mellitus. Yeast love sugar; the candida spores usually live in the digestive tract, but diabetes mellitus affects that acidity of the vagina and this way promotes the growth of yeast.

Rule of thumb, if you have frequent yeast infections more than 2 -3 times a year, then inform your healthcare provider. A simple fasting blood sugar is a great screening tool to find out if you have borderline or type 2 diabetes.

 

3-A constant dry cough

Have you ever met people who constantly have a cough and short of breath? Perhaps you or someone you know may have even gone to your doctor and been told that you have ‘allergies’. The fact is that this may be a sign of a serious lung disease called sarcoidosis.

The medical profession does not really know what causes sarcoidosis. It is common between the ages of 20 and 40 years old and can affect both men and women. It is three to four times more common in black people. If you have a family member with sarcoidosis then this increases the probability of another family member having it.

Sarcoidosis can progress from a very mild illness to a very serious illness.

Rule of thumb if you have a cough especially with shortness of breath and chest pain that persists for more than a month then I recommend that you schedule a visit with your healthcare provider.

4-A facial rash that won’t go away

 Do you have a red rash around your nose and cheeks that gets worse in the summer? This could be a disease called systemic lupus erythematosus –‘lupus’ for short.

Once again this is one of those illnesses that we in the medical community really can’t pin down a definite cause for. We do know that it is an autoimmune disease. This means that the body forms compounds that literally fight itself breaking it down. These are called antibodies. Because it is an autoimmune disease it can affect literally any organ in the body. This is why it can be a challenge to diagnose.

Lupus is more common in women and recently there have been campaigns to increase the public awareness of this disease.

Rule of thumb if you have a rash with an outline that looks like the wings of a butterfly over your nose and cheeks, gets worse in the sunlight and just does not seem to go away, see your healthcare provider to get blood tests for lupus.

 Lupus can show up in many ways, for more information click here

5-Constant Fatigue

Now this is a tough one. I mean as women we are built to be resilient, right?. We are super mommies, caregivers, professional women, working women. We burn the candle at both ends trying to meet each and every obligation thrust upon us. So naturally we will become fatigued right?

Well here are some additional clues that that fatigue may be a sign of something more:

 

  •        Weight gain
  •        Constipation
  •        Feeling cold even in warm weather
  •        Growing fuzzy fine hair on your skin
  •        Dry brittle skin and nails
  •        A feeling of depression

      

These symptoms may be due to a low active thyroid called hypothyroidism. The thyroid gland produces a hormone that is responsible for maintaining our metabolism. Hypothyroidism becomes more common in women over the age of fifty.

Rule of thumb- if you are experiencing constant fatigue that you can’t explain then you can get a simple test called TSH from your primary care provider.

Well I hope that you find this information helpful. Always remember it’s better to be safe than sorry. By tuning in to the wisdom of our bodies we can live more fulfilling lives.

Remember an ounce of prevention is worth a pound of cure.

 

To your health and wellbeing

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