"She's very sweet, how she talks about your diabetes in class. She's mentioned your efforts to walk and eat healthier, but she's concerned about you."
I nod in appreciation as my daughter's kindergarten teacher pats my back, offering an empathetic "hang in there."
These days find me reflecting a lot on my journey with diabetes. I keep thinking in particular about last New Year's, when I posted a piece in this forum, saying my resolution "is to be here for my kid." I vowed to once and for all (a) lose the weight; (b) exercise every day; (c) check my blood 3 times a day; and (d) get off diabetes pills forever.
And now, a year later, I have begun injecting insulin. What happened?
Like many determined folks each January 1st, I got off to a fine start on my resolution. For a few months, I was making smart nutritional choices and taking nightly walks, even in the rain. Some pounds came off, and diabetes numbers moved in a healthier direction.
It was a real mental struggle for me, though. I remember sitting at a diner with a friend one night, trying not to drool on her burger and shake or steal a few fries. "You're being so good!" she observed. I sipped my tea (after a balanced meal) and thought: "Hang on, you can do this." But I worried about how long my good behavior was going to last.
Sure enough, my efforts to meet my big goals soon became inconsistent: a missed walk here (Too tired! Too cold!), a calorie-bomb snack there (Just this once!) After two straight weeks of "failure days," I read myself the riot act for being weak. Notably, the speech left me depressed, not motivated. My diabetes related efforts ground to a halt.
Then came the day when I met my doctor to review recent blood lab results. I had anticipated poor numbers, but not a new directive to start injecting insulin. In that moment, it felt like the floor fell out from beneath my feet.
"But I'll...I'll do better this time--" I heard myself stammer, the panic in my voice rising. My normally soft-spoken, defer-to-the-patient doctor was suddenly quite firm. "I wouldn't be practicing good medicine if I let these numbers continue," he emphasized.
We talked about other contributing factors to my diabetes (genetics and polycystic ovarian syndrome, which contributes to insulin resistance), but I couldn't escape the conclusion that I had hit rock bottom because of one factor: me.
I cried for two days straight, then took the walk-of-shame to a former diabetes counselor's office for instructions on injecting insulin. I can tell you this: nothing made my "motivation switch" roar back to life faster than sticking that first needle into my belly.
"This is GO time!" I told the counselor. "No more excuses, time to change everything I am doing wrong!" She patiently listened as I laid out my big game plan for major dietary changes, daily workouts with a new gym membership, rigorous blood monitoring, maybe even a juice cleanse to start.
Thank god for my diabetes counselor, a wise, patient woman who understands the complex physical and emotional issues raised by diabetes. She helped me see the fundamental flaws behind my resolutions, and gave me ways to reconsider them as well:
Resolution flaw no. 1: Aiming for leaps versus baby steps.
As the counselor emphasized, if you suddenly vow to cut out all carbs, sugar and fats from your diet and exist only on kale juice and salad, this is a "food leap" with very high odds of failing.
Reconsidered resolution: Take baby steps, particularly in the beginning. Work on one small, "even-I-can-manage-that" goal to start. Examples: Swap that large, sugary coffee drink you buy each day for a smaller version, hold the whipping cream. Allow yourself a favorite food, but eat it on smaller plate. And if you will "absolutely die without chocolate" (I think I may have said that), feel the joy I felt when my counselor said "then enjoy one small dark chocolate after dinner." (Yes, it has health benefits, too.) Diabetics have to focus on moderation (baby steps as we rethink our plates) versus deprivation.
Baby steps logic applies to exercise, too. If you're leading a sedentary life now, start with a daily half hour walk, not a marathon race or a vow to pump iron at the gym seven days a week.
We may think baby steps are too slow and represent too little an effort. But if baby steps can help you: a) feel more motivated to try; b) feel less deprived; and c) achieve small, incremental movement towards a goal, you may well experience greater success in the long run.
Resolution flaw 2: People bail after a fail.
A typical misstep for many of us with health resolutions comes when we "mess up." The scale went up. We fell off a wagon and snuck a cigarette/candy bar/drink, etc. We then launch headfirst into the "I-blew-my-resolution-so-it's-over" death spiral.
Reconsidered resolution: First, drop the failure speech. It clearly isn't motivational. Second, if you ate the hot fudge sundae or skipped the gym today, move on. If you need to reflect on why you did what you did, great. But recognize that the earth won't stop moving because you had a sundae, and neither should you. Think "clean slate" tomorrow, because each day really is a new day.
As I wrap up my first month of 2013, I'll be very frank. I'm still not used to the nightly injections and I still hope for a day I am needle-free. Every single day remains a challenge for me around food and exercise. But my weight and blood readings are moving slowly in the right direction. I can accept needles may be part of my life now, even if I get healthier. And I have an amazing husband and daughter supporting me as I strive for a more realistic approach to my life with diabetes. It sounds like this:
I'm on a long road with a great view, but lots of pot holes and detours. So when I fall -- and I will -- I'll just have to get up and keep walking. Baby steps.
When she isn't walking or looking for healthier muffin recipes to bake with her daughter, Diana Dull Akers is a freelance writer and social researcher, living in the San Francisco Bay Area.