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Personal Health Check-up
  By Nicole Johnson, MA, MPH

Spring feels like it is getting ready to spring.  I bet most of us wish it had already sprung.  This time of year is always my favorite.  It is a time of birth, growth, future planning and playing.  I enjoy every aspect of spring.  Recently, gardening has been a focus at my home.  We are learning much about planting, pruning, and process.  My 3-year-old is enthralled.  Nearly every day we check on our flowers and measure how much they have grown.  It makes me nostalgic about the little girl I am teaching and how fast she too is growing.  This week, while watering the plants, I started to think about growth and diabetes.  Those thoughts lead me to consider a personal health check-up.  How am I growing in my care?  How is my knowledge expanding as my experience broadens?  How am I cleaning out the old and implementing the new to make sure my care and practice are relevant?  Have you thought about these things?  Maybe this notion could be a version of spring-cleaning for your diabetes.

If we were to do a personal check up, where should we begin? 

That is a tough question to answer.  I often find success approaching things in a systematic manner.  With that in mind, let’s start with some general health questions and then move to a systematic approach of our every day life with diabetes. 

The first questions on most personal health check-ups relate to smoking.  Do you smoke?  Why do you smoke?  How often do you smoke?  Have you tried to stop smoking?  Do you want to stop smoking?

If you smoke, you should do everything you can to stop.  It is well proven in scientific literature that smoking is dangerous and a risky behavior. 

Next, if you have diabetes, do you test your blood sugar?  How often do you test?  When do you test?  Is there anything that keeps you from testing? 

These questions help establish the basics about your pattern and personal approach to living with your chronic disease.  If you don’t test, start!  If you test infrequently or inconsistently, talk with your healthcare professionals about new strategies.  Knowledge of glucose levels, patterns and trends is essential to success with diabetes.

Now, do you exercise?   How often do you exercise?  When do you exercise?  Do you enjoy exercising?  What exercises do you enjoy?  What is most challenging about exercise in your personal scenario?

These are always tough questions to answer.  Exercise is often the most challenging personal health behavior.  It takes time and effort, qualities that are often scarce in our schedules.  However, we know from diabetes research that exercise is crucial to good diabetes management.  Exercise can come in all different forms.  It doesn’t have to be intense, it doesn’t have to in large time blocks, it simply must happen.  If this is a stumbling block in your health check-up, I encourage you to think about how you can strategize and implement small steps to modify your approach to exercise.

The next general assessment or inventory relates to food.  Argh!  I can hear the sighs now.  I understand and am with you.  Food management, preparation and modification are major challenges.  I struggle with this daily!  What are you eating?  Do you eat 5 fruits and vegetables a day?  Do you eat three balanced meals a day?  Do you eat snacks?  Do you skip meals?

These general questions will reveal plenty about your habits.  For diabetes to be optimally managed, one must have a level of culinary consistency.  That means, eating at nearly the same time each day, balancing all meals, incorporating fresh produce and planning.  Does it seem unreasonable or overwhelming?  I know at times it can.   This is my major impediment to care.  I don’t plan my meals well and often get in patterns that lack the proper balance and nutrition proportion.

So, from my perspective, those are the big general categorical questions in starting a health check-up or health assessment.  However, it is important to recognize that true diabetes mastery requires a detailed approach to personal care. 

With that philosophy in mind, let’s look at our daily routine and see if there are places that need to be cleaned up a little.

A good place to start with the assessment is a diabetes journal.  A record of actions, activities, meals, times, etc. will show so much.  It will also be an invaluable resource for your next meeting with your healthcare team.

The journal doesn’t have to be fancy.  Any kind of notebook will work.  Start with your earliest actions…what time do you wake up, what is your blood sugar, what did you eat for breakfast, what medication did you take, how did you feel? 

After the starting questions, consider your daily routine and chart your activities and actions for several days.  Once you get information, you can then begin to spring clean.  You will probably find that you are like most people, you eat far more than you think and you exercise far less than you wish you should.  You will also detect patterns of laziness and even hormone fluctuations.  The best diabetes patient has a good knowledge of how their body works.  (I am trying to restart my efforts of creating a diabetes journal.) I know the process seems, even feels daunting.  Start slow and build up to your ideal. 

Eventually, an ideal record would have listings and logs of blood sugar readings, food intake, medication delivery, emotional health, exercise and health professional visits/encounters.    Don’t forget to include lab reports in your book as well. 

Once you have your data, you will be completely prepared to take your diabetes care to a new level.  Your check-up will reveal opportunities for growth.  Maybe you need new types of treatment, maybe it is a new perspective on life with diabetes, or maybe you need support. 

So, if you are thinking that you are doing just fine with you diabetes care, I encourage you to still check yourself.  Think about exercise and the philosophy of plateauing.  Even the best and most successful routines lose their effectiveness over time.

We all should take advantage of the opportunity to grow in this growing season.  What are you going to do?

Nicole Johnson, MA, MPH, Miss America 1999, is an international diabetes advocate. She travels extensively promoting awareness, prevention, and early detection of the condition she has shared for fifteen years. She has written four books including her autobiography, Living with Diabetes. Nicole serves on numerous advisory boards including the National Institutes of Health (NIH) Council of Public Representatives, the Florida Governor's Diabetes Advisory Council and the Tampa Bay chapters of the American Diabetes Association and the Juvenile Diabetes Research Foundation. She is also a past national board member for the American Diabetes Association. Over the last nine years, Nicole has helped raise approximately $20 million for diabetes research and programs.

Learn more at www.nicolejohnson.com

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