Wanna Talk To The FDA?

SurveyOn November 3, there will be an unprescendented conversation between the diabetes community and the FDA taking place and YOU can get involved! DiaTribe wants to collect as much feedback from the diabetes community (type 1, type 2, caregiver, whoever) so that they can really know where we stand and what we need from the FDA. This is our chance!

There will be a live webcast from 1-3pm EST so you can listen to the conversation happening between patients, the FDA, and experts from ADA and JDRF. Registration and a finalized agenda for the meeting will be available soon, but save the date!

Head on over to the survey now and answer the questions. They need the answers within the next five days in order to have time to analyze the results before the meeting. I took it and it takes about 5-10 minutes to do. Very easy! No trick questions!

The After

This is the part where I usually start fucking things up.

I’ve lowered my A1C before. A quarter, a half, even a full percent. Now I’ve jumped one and a half percent and all I can think is: “How long will it last?” Because I’ve seen my A1C go down. And I’ve also seen it go up. And down. And then up. And then down.

My A1C rarely stays put and it rarely stays moving in one direction.

I get my A1C done. It’s above where I want it to be. I spend the next three months diligently counting carbs (possibly even lowering my carb count), testing more often, correcting more aggressively, exercising more often, and in general just being a totally bad-ass diabetic. Okay, well I am always a bad-ass diabetic, but this time I’m extra bad-ass. And then I get my A1C. And it’s awesome (eh, awesome-ish). So I think, great, I have it figured out. We’re all good here. Then the days, and the weeks, and the months go on and I start maybe being a little more careless with the carb counting or bolusing early, but I think, well, my A1C was such-and-such, so this one little (::cough::) indiscretion isn’t going to be the end of the world, right? Until I finally make my way back to my endo, get my A1C done, discover it’s crawled back up to where it was six months ago.

And so it goes.

It just pisses me off because I feel like good control is a recipe for diabetes burnout, but if I relax for even a millisecond everything goes to hell anyway.

I need to find a happy medium between being completely obsessive and completely lackadaisical.

My next endo appointment is on December 29th (Merry Christmas to me!), and my main goal for my next A1C is to keep it exactly the same. Well, within reason. Mid-sixes. To do that, I’m trying to focus on a few things:

1) Download my Dexcom receiver and review my graphs every time I change my sensor. I don’t do this enough. I need to do this more, and if I do it every time I change my sensor, that should be somewhere between every 7 to 14 days.

2) Change my goal BG to 90 mg/dl instead of 100 mg/dl. I saw someone recommend this a few months ago and from what I’ve seen in the last two weeks since I did it, it’s pretty helpful. By having just a tiny bit more insulin going in, I think it helps account for any discrepancies in carb counting or in absorption.

3) Not be afraid to make tweaks to my pump settings. I have a bad habit of thinking things will just “fix itself.” Sometimes it does, sometimes it doesn’t. If a pattern emerges, I should fix it, even if I might need to change it back later. It takes less than a minute to change a pump setting. I should be more proactive.

4) Have regular appointments with my CDE. Sometimes patterns don’t always make themselves known to me, or sometimes I don’t realize that by fixing something, I’ve caused another problem somewhere else. After all, our days are cyclical. What you do at one time of day can impact another part of the day. I have an appointment with Jenny for Monday, and I’m hopeful to keep up monthly appointments with her.

 

Do you have any tips for making sure you don’t start slipping back into old habits? 

 

Diabetic Living + TCOYD Recap

This weekend I drove down to Des Moines, Iowa for the TCOYD conference and for a meeting at the offices of Diabetic Living, one of the magazines I write for (I’m in their current Fall 2014 issue!).

When I arrived at the Meredith Corporation (which publishes DL), my editor, Martha, greeted me and showed me some of the behind-the-scenes of how the magazine is put together. We went down to the test kitchens, which is an enormous room that looked like an IKEA showroom. There were about six or eight fully functioning kitchens all in a row. There was a lot going on, including one cook that was making some chicken marsala that will be in next summer’s issue. It smelled so good! I love Indian food.

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Then we went to the Photo department. I saw the Prop room, which has just about every kind of dish, glass and servingware you could imagine! The room was huge. Then we went over and saw some of the photo shoots going on, including a feature on some healthy desserts. We taste tested a brownie with mint creme filling and it was pretty good! Martha says that they taste test every recipe that goes into each issue, which not every magazine does. She also explained that when they do the photo shoot, they photograph the precise serving amount you should have. It’s very technical!

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On Saturday, I went to the TCOYD conference at the Iowa Events Center. A few DOC favorites were there, but there were also a couple missing faces because of the fires in Chicago that delayed flights. So sad. But it was still a good conference!

Here are some key take-aways:

“There’s never been a better time to have diabetes” – Dr. Steve Edelman 

There was a heavier emphasis on type 2 diabetes than at some other D conferences I go to. Dr. Edelman shared that:

- Any drop in your A1C will reduce the risk of complications. It’s not a sprint, it’s a marathon.

- It’s never too late to take control of your diabetes by putting diabetes high on your priority list.

- The gene for obesity may be linked to the gene for type 2 diabetes.

- Your therapy may change over time. Even if you do everything right, your therapy may change. It’s not that you’re failing, that’s the progression of type 2.

- It’s important to get regular eye screenings and kidney labs done, because symptoms of those complications aren’t felt until it’s severe.

Change Your Mind, Change Your Diabetes – Dr. Bill Polonsky 

  • No shame, no blame. Some people believe the reason they have diabetes or not good diabetes, is because they are bad. That is scientifically not true. genetic link and often invisible environmental factors. even when we look at numbers attached to weight or when we check BGs. we must remember it’s just a number. no good or bad numbers, just information. we give too much power to these numbers, to give self-worth as human beings. “it’s just a number.”
  • Remember the good news. With good care, the odds are good that you can live a long and healthy life with diabetes.
    • 1978: more than 30% with severe vision loss, 38% with nephropathy, 10% amputations
    • 2009 – 1% severe vision loss, 1% amputation, 6% nephropathy.
    • There is a normal life expectancy for type 2 PWDs compared with the general population when you have good care.

Sir William Osler says, “To live a long and healthy life, develop a chronic disease and take care of it.”

  • Make sure that you have concrete and reasonable diabetes care goals.
    • Focus on the important stuff. Not everything is equally important. “bang for your buck list.” Being on the right medication and taking it is the biggest bang.
    • Give yourself a break. You can’t be perfect and you don’t need to be.
      • Take a diabetes vacation, just plan it ahead. how can you give yourself a little break in a way that is restorative. it’s people who take unsafe vacations like ignoring the disease for 20 years. Talk about it with HCP to get a little break and get what you need.
  • You don’t have to do diabetes alone.
    • Find people who will root for you and help your loved ones help you. Have conversations with loved ones who are supporting your efforts, but sometimes you might have people who are giving you too much support. They all mean well but you end up working against each other. They are always coming from a place of love and caring but they may not know what to do. Because they love you, they are never going to stop. You have to distract them, give them something clear of how they can help.
  • Develop a sense of humor.

CGM: Revolutionizing Diabetes Care – Dr. Jeremy Pettus and Kelly Rawlings

- According to new studies, the Dexcom really is more accurate than Medtronic

- However, Medtronic is an integrated system and the 530G has the Low Glucose Suspend, both of which could be very useful for some people.

- Dr. Pettus suggests that in the future, rate of change arrows will play a bigger role. If your blood sugar is 200 mg/dl and rising, you might need more insulin than if you were 200 mg/dl and dropping. He said that at first we’ll learn to do it manually, and then later it will be automatic.

- Dr. Pettus, who has type 1, boluses off his CGM almost all the time. (Not sure I could be that brave!)

- One patient of his uses the Earthquake app on his iPhone to make the alarms louder!

Diabetes Criminals and Diabetes Police – Bill Polonsky and Steve Edelman

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This was a session where patients and healthcare providers had a chance to air their grievances.

- Patients shared that providers are often: not interested, don’t listen, give bad advice, and aren’t empathic.

- Providers shared that patients often: don’t come prepared, stop taking medications without consulting with their doctor, won’t spend the time to get educated, feel like they are working harder on their diabetes than the patient.

- Edelman and Polonsky shared that: patients should come prepared with a short agenda to maximize efficiency with time, show appreciation for what their doctors do, and understand that providers went into the field to help people but they are under a lot of stress.

- They told providers that no one asks to have diabetes, so we need to be careful not to blame patients. Guilt does not create motivation.

Keynote speaker – Joe Piscatella (a motivational speaker and author on living healthy)

- Stress is a major reason why people don’t take care of their health, because they are stressed out and don’t feel they have the time.

- Major causes of stress:

  • Multitasking
  • Anger and hostility
  • Depression
  • Constant connection

- No such thing as stress reduction, but you can learn to manage stress. You learn to manage diet and exercise better.

  • Deep breathing (in through the nose, stomach out, hold it, out through the mouth for 5 beats)
  • Dxercise – the most important element: regularity by getting a partner
  • Perspective — it’s the way we view an event that makes it stressful or not stressful.

Joe shared that he had coronary bypass surgery at age 32 and was diagnosed with an aggressive cardiac heart disease. His doctor told him that he should continue on living the way he was, because there was no hope! He would likely not see his children, then 4 and 6, graduated high school. But his wife believed that he should do whatever he could to live a healthier, longer life.

She said, “You can’t change the cards you’re dealt, but you can change the way you play them.” 

Now Joe is in his seventies, and has seen his children graduate high school, college, grad school and law school and has four grandchildren! Now that’s the power of positive thinking and healthy living!

One Week As A PWD

Awhile back, I learned about Michelle Litchman — a nurse practitioner specializing in diabetes in Salt Lake City — and her Fakeabetes Challenge. The Fakeabetes Challenge is a one week challenge where a non-PWD who works in healthcare attempts to live like a PWD by wearing the gear, testing blood sugar, and counting carbohydrates. It’s not a precise replication of the real experiences of a PWD, because they don’t have to deal with the physical feelings of highs or lows, but it’s a pretty good approximation.

I was partnered with Amy Reeder, an RD and CDE, who wore an Omnipod demo pump, tested her BG, counted carbs and reported what she was doing to me so that I could give her feedback on what it might be like if she really had diabetes.

We started randomly on a Wednesday afternoon when I texted her that she had diabetes.

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Over the next week, she would text me when she tested for a meal and I usually texted back with a slightly different BG reading than what she had. Obviously, being a non-PWD, her blood sugars were pretty perfect. 80s and 90s pretty much all the time, although a couple times she was in the low 100s. One time, just before going on a walk, she was 58 mg/dl! All on her own! I was super surprised, not realizing that a non-PWD could get that low. Obviously she didn’t feel it the same way we would, but it was still interesting to see that there was some variation in her blood sugar.

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It was kind of fun randomly texting her with high and low blood sugars, especially since at first she would go on walks or hikes without changing her bolus at the previous meal. It took a couple times before she caught on that she needed to do things differently!

For me, I think I was most surprised at how often I think about diabetes! Obviously I think about it a great deal, but I think a lot of it is woven into my day to day thoughts. It so fluid, whereas working with Amy meant stopping and thinking, “Should I text Amy about this high or low blood sugar?” I realized in texting her several times a day about what was going on that I really do think about diabetes a lot! It’s kind of insane the amount of brainpower that goes into managing diabetes. Sometimes I wonder what I would do if I didn’t have to think about diabetes all the time…

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I didn’t always text her what was happening to me because I wanted her experience to make sense for her lifestyle — going high or low because of what I was doing didn’t make sense and wouldn’t give an accurate depiction of diabetes. We are all different! So I based most of my texts off of what would likely happen to me if I was doing what she said she was doing, such as her food or her activity level. Sometimes she’d eat things — like granola — that would shoot me high, so I reflected that at her next meal. And I would change her blood sugars depending on the intensity of her exercise. Her hikes and bike rides dropped her low, whereas a short walk with the dog didn’t drop her very much. It’s all context! And nothing is ever the same!

Overall I thought it was a really interesting and obviously rewarding experience helping someone learn more about the nitty-gritty of diabetes management and how it’s not always so easy to remember to do everything and do it right. You can read about Amy’s experience here!

God’s Country

I wanted to be prepared. I didn’t want to go to my appointment with lofty expectations, so this morning I downloaded my Dexcom to see what the latest numbers said. The 14 day average was 154 mg/dl. The 30 day average was 166 mg/dl. Both of those numbers indicated that my A1C would be somewhere in the lows 7s. Better, but not quite all the way to where I’d hoped it would be.

This was my second attempt at finding an endocrinologist in Minneapolis. Although the first endo put me on Victoza, which has been working swimmingly, I didn’t mesh as well as I’d like. Another local D-friend, who just gave birth to her first baby, recommended her endo so I decided to give it a try.

I was very anxious when I arrived at the clinic because I really wanted it to go well with the doctor and I wanted a good A1c. On top of that, I had left my insurance card at home, and I was nervous the receptionist was going to lecture me or give me a hard time. But she was actually very nice about it and it worked out just fine. I had to wait quite awhile for the nurse to come get me, but she was also very nice. She didn’t ask me any silly questions about my diabetes, which was a relief.

My blood pressure was taken, and it was surprisingly on the low side. I had expected it to be a little higher because of the appointment but I was taking a lot deep breaths! She took the blood sample for the A1C and my Dexcom and PDM to download the data. Unfortunately their Dexcom system wasn’t working, but I wasn’t too bothered this time because my last sensor was a little on the wonky side and I didn’t think it would have been that valuable anyway.

Eventually the endo arrived, and she was very cheerful and smiley. We started off talking about where I was from, what I did, school, my previous work at DiabetesMine, my blog, that sort of thing. We started talking about my management, and then she realized that the nurse hadn’t brought back my A1C reading, so she went off to get that.

“It’s 6.6. Are you cold in here?” she said when she returned, adjusting the thermostat.

I couldn’t believe it. No, really, I couldn’t believe it.

“Wait, what?”

“It’s 6.6.”

“Really?”

“Yeah.”

“You’re sure?”

“Yes.”

“Wow… Are you sure your machine is accurate?”

She laughed. “Yes, it’s very accurate. It’s calibrated every day.”

“I’ve never been below 7% before…”

“Well, welcome to God’s country!”

I just about fell out of my chair. My A1C in June was 8%. Today, 6.6%. That’s a drop of 1.4%! Holy crap!

Of course, I attribute most of this to Victoza. I don’t know why it took me so long to start using it! Be ye not so stupid! Having Victoza has smoothed out a lot of my postprandial spikes, and I think that was the biggest reason why my A1C dropped so much. I also think it has made me more sensitive to corrections, so I don’t stay high for as long. I don’t really have any proof of this, but it’s a theory.

I also know that working with Jenny at Integrated Diabetes played a huge part in it. Even with Victoza, I still struggled with getting my rates settled. There were a lot of adjustments in the beginning, and I’m still making a lot of adjustments. As I lose weight and as my activity increases, my insulin needs change too. Sometimes it’s hard to keep up!

However, because I’m working with Jenny, the endo and I didn’t talk that much about my blood sugars. Jenny helps with a lot of my little tweaks, and lately things have seemed okay. Sure, there are a few highs and lows, but nothing that screams trend.

We did talk a lot about pregnancy and diabetes. She explained how their system works, and that since I don’t already have an ob-gyn, it would be good to have one in their network of clinics. She gave me a couple names of providers who she think would be good for me, which was super helpful. I hate having to find a doctor!

We also talked about my previous labs showing low thyroid and low Vitamin D. She decided that it would just be best to get new lab work done because it’s been over a year. I’m also getting tested again for celiac. It’s been a couple of years and from what I’ve heard, it’s good to get tested regularly for it because it can appear suddenly.

victory_cat_by_oman96-d3kzkd2I felt very comfortable with this endo. There weren’t any warning bells as far as anything she said, and she was very nice and personable. She reminded me a lot of my New York endocrinologist, who I saw for six years. Despite having diabetes for 20 years, I’ve only had a handful of endocrinologists and the whole process of finding a new doctor is something I completely dread. I can definitely see myself walking through a pregnancy having her on my diabetes team. I’m really glad the second time was the charm!

Of course, pregnancy is not exactly right around the corner. We’re thinking it’s probably about a year away, maybe a little more. But having an A1C of 6.6% makes the whole becoming a mom thing seem a lot more real. For so long it’s been something that was in the far off future, because I didn’t know how or when I could ever get an A1C below 7%. Especially last fall when my A1C climbed from 7.2% to 7.7%, I felt like it was impossible. I was never going to figure it out. And now that I’m here, it’s like wow. This is really going to happen!

 

Cool Kids

imagesHave you heard the Echosmith song “Cool Kids”? I love that song. I feel like it captures a lot of my feelings when it comes to, well, life. I think most of us have at one point or another felt like everyone else had it together, knew what they were doing, had everything they wanted and what we wanted.

Over the last couple of days, the Cool Kids conversation has resurfaced yet again. It happens. It’s happened before. It’ll happen again. But every time it happens I do feel a sense of obligation to write a little bit about it in hopes that maybe it will shed some light.

I’m not disagreeing and saying there aren’t Cool Kids in the DOC. There definitely are. But there are some nuances to how this all developed and I have a unique insight into the story.

When the first diabetes pharma company wanted to get together with us, immediately people started criticizing those of us who went. I really didn’t have a clear sense of how the invite list was selected, but I knew it had a lot to do with recommendations, readership, and familiarity with the diabetes space. It’s probably why it seems like most of us know each other, because when we’re asked who to recommend, we tend to recommend the people we know.

A few more companies held summits, and yes, most of the people who went to them were the same people. I don’t know if this was intentional, but I imagine it was. Especially when some of the summits held in subsequent years were designed to follow-up on previous summits, there was bound to be repeat attendees.

While all this was going on, I started working for a PR agency. I worked on the digital media team and I was responsible for creating a number of blogger media lists. The number one thing my clients wanted to know was how much traffic does this blogger get? Now I’m sure when it comes to diabetes there’s more to it. I think companies also want to invite bloggers who can speak to issues like advocacy and technology and intelligently contribute to the conversation. You had to be a thought leader. You had to be influential. You had to speak and write well.

There aren’t as many summits now. A few, but they just aren’t as often, but there are some new projects being developed and those have very well-known names attached to them. They are the Cool Kids.

There’s a reason for this.

The Cool Kids are professionals. Above anything else you have to realize that the people who become frequent speakers and who are paid to do anything in this field are professionals. They treat this as if it is their job because in most cases, it actually is. It’s not a hobby. It’s not something they do while watching The Daily Show (although I’m sure sometimes they do). It’s not something they squeeze in after dinner and before tucking their kids into bed or when they happen to have a really terrible D day (although they do it then, too). This is something they do all the freaking time.

And I know this because I used to be a professional, working as an assistant editor at DiabetesMine. When something is your job — especially something that has a rather entrepreneurial bent to it — you’re going to spend a lot of time finding ways to get paid. You’re going to do a lot of networking. There will be a lot of queries, pitches, follow-ups, phone calls, and lunches. There are going to be a lot of assignments and 1099s. And for a few — for a very select and gifted few — this is sustainable. This is what they do and they do it because they are good at doing it.

Now there are other bloggers or tweeters or whatever you want to call them, and you might be thinking, Well, what about that person. That person is probably footing their own bill. They are probably saving a ton of money, or maybe going into debt (I don’t know, we don’t get that personal at the bar). They might be on scholarship. There are a number of scholarships provided by the Diabetes Advocates and Children with Diabetes to attend their conferences. Some professional conferences will give free press badges to bloggers. There are a lot of “This is our vacation this year” that happens. There’s a lot of room sharing (we’re all family, remember?). There’s a lot of budgeting.

I don’t blame people for being jealous. I’m jealous, too. It’s been a long time since I’ve been invited to speak on a panel or attend a summit. But I also want people to understand that the people you are jealous of also work their asses off for this and it’s not an accident that things are the way they are. This happens in almost every blogging niche — from fashion to home design to food to other chronic diseases. There are people who dedicate themselves just a little bit more to doing what they are doing and they become more well-known, and companies take notice of that. It does not mean that people who aren’t more well-known are somehow worse or not appreciated.

So how do you become a Cool Kid? I don’t think there’s a hard and fast answer but I do have some suggestions based on nearly ten years (oh God…) of experience.

1) Be yourself. Your voice is wonderful all on its own and you don’t need to imitate anyone else for the sake of “fitting in.” We like the rabble-rousers, the table-shakers, the feet-stompers.

2) Engage. I can’t say enough on this point. Participate in DSMA on Wednesdays. Leave comments on as many blogs as you can. Share links to relevant posts on Facebook. Follow people on Twitter and respond to whoever says something that you think is interesting. Offer to guest post. Send queries to the editors of some of your favorite diabetes blogs. Contact the Communications teams of your favorite Pharma companies. No one knows you’re there until you say something. On the Internet, you are invisible until you share your voice.

3) Save your money. If going to conferences really is that important to you, then you need to save your money or apply for scholarships. It’s that simple. I wish it was easier. It isn’t. I don’t work for a diabetes company anymore, and I foot my own bill. I’m heading to Des Moines next Wednesday. Who’s paying? I am. I’m driving for four hours. Staying in a cheap hotel that I got for $50 on Priceline. You have to work for things you want. Of course, going to a conference won’t automatically make you a cool kid (none of this will, actually).

4) Give. The “famous” people with diabetes? They didn’t try to be famous. But they had something to give. They had an idea and they wanted to share it. It took guts. It took time. It took a lot of support. But there are some pretty fantabulously awesome things that have been created in our community. That’s what gets recognized. But it’s also hard. It’s hard to come up with a brilliant project and so this shouldn’t be your focus. Which brings me to my last point.

5) Relax. Whatever your vision is for what the Cool Kids have, it’s probably not as great as you think. Or maybe it is. But my point is that if you spend your time angry, or sad, or miserable about this Cool Kids stuff, you’re going to miss out on some really wonderful opportunities in the Diabetes Online Community. There is a lot going on at a national level, but there are also JDRF and ADA events, there are meet-ups and support groups. It sometimes takes time to connect with people in your community, but with five million type 1 PWDs and 30 million PWDs in general, trust me, someone is near you.

I’m also a bit of a diabetes matchmaker, so if you’re looking to get plugged in, send me an email. Chances are I know a guy. Or girl.

Being cool? It’s cool. But being connected is even better. And thankfully, you do not need to be cool to do that.

Getting a Handle On Food, Fitness & Type 2 Diabetes

The American Diabetes Association is famous for the Tour de Cure bike series, and now they have launched a new series just for women! The first ride is this Saturday, September 13 in Southern California, and the next one will be on Sunday, October 26 in Northern California. Their goal is to get more women on bikes while also supporting the ADA’s movement to Stop Diabetes. 

Sharon Steele is the Chair of the 2014 Northern California event. Her mother and several members of her mother’s family have type 2 diabetes, and with her increased risk, Sharon set out to reduce her weight and achieve an active lifestyle in hopes of preventing type 2 diabetes. Sharon has already lost 93 lbs and is just 20 pounds shy of her goal weight. Wow! 

 

A Guest Post by Sharon Steele  

Sharon Womens Series 2013My mother was diagnosed with type 2 diabetes in the mid-90s. Both of her parents had type 2 along with several of her siblings. I have watched her struggle with complications of the disease, including hypertension, neuropathy and vision loss.

I realized that being obese increased my own risk for developing type 2, so I set out to reduce my weight and achieve an active lifestyle. I know I am not necessarily doomed to develop diabetes simply because it is prevalent in my family.

I am now 93 pounds lighter and within 20 pounds of my goal. How did I get there? It’s been a long, up-and-down road for me—almost 20 years.

It started with a food addiction

Like many people, I struggle with an addiction to sugary foods. I often joke that it’s my “drug of choice,” usually in the form of cookies. During stressful times, I would secretly binge on cookies, donuts, pies and so on.

My first major weight gain was when I was pregnant with my daughter in 1994, at age 26. This was the first time my weight surpassed the 200-pound mark. I went from 160 to 210 pounds, despite my vegan lifestyle. Though I lost a good amount of the weight after her birth, a stressful period in 1997 sent me on a lemon meringue pie binge. All-natural pies from Whole Foods still pack on the pounds! I could eat an entire 9-inch pie in one sitting! In no time I was back in the 200+ pound club.

Tired of carrying the extra weight, in 1999 I began taking cardio-kickboxing classes. Within six months I dropped below my pre-pregnancy weight, into the mid-150s. I maintained this weight through healthy eating and an active lifestyle for a couple of years.

I got married in 2001 and soon became pregnant with my son. I gained a whopping 60 pounds during that pregnancy due to an insatiable craving for steak. (Yes, I went from being vegan with my first pregnancy to a ravenous carnivore in my second.) I otherwise ate healthfully, but steak has a lot of calories and fat. My son was a big baby –10 lb. 3 oz.–so I instantly dropped from 220 to 185 when he was born. However, I gained 20 pounds back while I was nursing him. I learned firsthand about the often-overlooked calories in juices and other sugary beverages. I was drinking juice like water, racking up calories AND pounds.

I managed to get things under control and was working my weight back down—but then 2003 happened, bringing two life-changing events. First, I lost my job as an independent contract technology trainer and consultant, and I was ineligible for unemployment. A few months later, my husband told me he no longer wanted to be married. BOOM! Two days later, I learned I was pregnant; however, that ended in miscarriage in the ninth week. BOOM again!

After the miscarriage, I worked feverishly to lose the excess weight. I was at the gym at 5:30 a.m. five days a week, hoping to regain my husband’s attention. Within just a few months I was back to the mid-150s. However, despite all my efforts to save my marriage, I finally realized divorce was imminent.

My divorce was filed in the summer of 2004, kicking off a binge that sent my weight soaring to heights I had never known. I stopped weighing myself once the scale read 262 pounds. Though I appeared to hold it all together, inside I felt ugly, unlovable and ashamed of what I had allowed my body to become. But God, by His mercy and grace, had a purpose for me.

Embracing my dream of a career in fitness…

But get this: I’m now a fitness instructor! I first taught a fitness class in 1986, when I was 19 years old, but I really did not know what I was doing. I quickly withdrew, figuring I was no good at it.

Fast-forward 20 years. In June 2010 I weighed 195 pounds, having just completed the P90X program. More importantly, that is when I became licensed to teach Zumba® Fitness. My first classes launched the Saturday after Thanksgiving with my local parks and recreation department.

In the months between getting licensed and starting my classes I managed to get back up to 232 pounds (this time, I blamed Starbucks). I wanted to add more classes to my schedule but, as you might imagine, it can be a challenge for an overweight/obese fitness instructor to be taken seriously by club managers. After being turned down a couple times, I got my first break. I did a 30-minute demo and nailed it. The students loved it and I was offered my first club job.

It was a great experience, but eventually I decided to take my classes directly to the community as an independent instructor. That’s just what feels right to me. The growth of my classes and the people I have met over these last two years have been true blessings.

How did I FINALLY get the weight off?

I have learned that physical activity is vitally important to overall health, for weight loss and so much more. I had the exercise piece locked down.

It was more a matter of getting a handle on what (and how much) I was putting in my mouth. What worked for me was completely abstaining from refined sugar and flour and embracing fresh, whole foods, including lean proteins, healthy fats, vegetables, fruit and whole grains. (Except wheat; I learned I have sensitivity to it and my body responded very positively when I removed it from my diet.)

I won’t pretend that I don’t get sucked into the feasting of the holiday season, like a lot of people. I’ll pick up a few pounds, but I know how to get back on a healthy eating regimen to lose it and maintain a healthy weight going forward.

My message

With my story I hope to encourage others who may have similar struggles. Start where you are. It does not matter what you weigh now; what matters is knowing your goals and taking that first step. Some struggles will always be there; you need to learn to manage and navigate them. I know that I cannot be handed an entire box of cookies and expected to eat only one. Just give me one cookie and hide the box (in another building!).

Why I ride 

 I am passionate about raising awareness about diabetes and its complications. Thanks to the American Diabetes Association’s Tour de Cure®, I have developed a love for cycling. I am even in the process of becoming a certified cycling instructor and cycling coach! Now there’s the Tour de Cure Women’s Series, which gives women a chance to ride in sisterhood to celebrate all those who live with diabetes.

In 2013 I rode the Tour de Cure Napa Valley (50 miles) and the inaugural Tour de Cure Women’s Series in Santa Barbara (67 miles). This year, I am taking on my first full century ride in the Tour de Cure Napa Valley and serving as the volunteer chair for the Tour de Cure Women’s Series in Northern California.

I’m taking the ride of my life! I count every moment, every tear, every struggle and every triumph as a blessing. If you live in California, I hope to see you out there for the Women’s Series!