Book review of A Future With Hope by Carl Armato

A Future with Hope by Carl Armato on Amazon

Carl Armato was diagnosed with type 1 diabetes at just 18-months old in 1966. Immediately thrown into the fire of figuring out diabetes, his family rallied around him and together, they started the journey of fitting good diabetes care into a full, faithful, and active life.

He grew up to become President and CEO of Novant Health, one of America’s largest and most respected healthcare organizations, and that’s a special story. It’s an encouraging and entertaining tale told the pages of A Future With Hope and one that tells the tale of learning to share his story of diabetes.

Refuse, refuse, refuse

Opening the book with a story of talking to a teenager with diabetes just after a presentation, Carl plants the seeds that continue to grow throughout the book.

“…refusing to buy into the notion that I couldn’t be a champion tennis player or an all-star shortstop; refusing to believe I couldn’t fall in love, marry and have a wonderful family; refusing to think I could never be a successful professional, just because of diabetes.” he explains to the teen.

Refuse, refuse, refuse. Can you do that?

Carl S. Armato

Surroundings and support

A central figure in Carl’s story is his father, Lucien Armato. From the early pages of the book, Carl’s family is supportive, but it’s his father’s attitude, understanding, and dedication to Carl’s diabetes care that really shines.

Lucien turned diabetes into a positive for Carl, empowering him to see that having diabetes gave Carl a better understanding of how others with illnesses really felt and that he could be of great service to others because of the compassion diabetes created in him.

Carl points out that we all need a strong support system around us, even if it’s just one or two people, and that we need to support our supporters.

He says that living with diabetes means you are a conqueror inside and your spirit as an overcomer can contribute a lot to the world! I agree with him 100%! I am so proud of and impressed by everyone I know who’s living with diabetes.

I also enjoy how Carl decided that staying tight-lipped about his diabetes deprives him of the opportunity to show others that how successful he can be, even with diabetes!

The power of stories

Chapter eight is titled “Helping Others Find Hope.” There is a line that makes me smile because it’s a lot like the diabetes community online. Carl says “When I talk to people about diabetes, it is clear they want to hear the stories, not just the medical information they hear in a physician’s office.”

It’s my belief that the people listening to Carl value the sense of normalcy that comes from hearing his experiences with diabetes. And thanks to his parents, Carl excels at playing up the possibilities rather than focusing on well-known dangers.

Carl talks about people with diabetes learning by doing, and I couldn’t agree more. He says, “it’s difficult to learn this from a little booklet; everyday life events don’t come at you packaged and succinctly coordinated. You’ve got to be able to account for the curveball that life can throw at you on any given day…”

A world bigger than his own

Carl is using his life experience with diabetes and position at Novant Health to make a huge difference on the general population. Also in chapter eight, he shares that two years ago, Novant Health’s patient data revealed that African-American women with diabetes had a 20 percent greater chance of returning to the emergency room and being readmitted to the hospital than other patients with diabetes. Carl drove change in their practices to make sure they have access to medications and education, and now the increased risk among this group is only 3 percent. That’s just one example of the positive change happening within the system Carl is leading.

His father’s eyes would shine when Carl talked about working in healthcare because of the empathy and understanding diabetes nurtured in Carl. His dad talked of creating delightful places for people to receive care thanks to Carl knowing the experience firsthand. Can you imagine receiving care in somewhere that’s delightful? I love that idea, and thanks to Carl, we’re well on our way.

A Future With Hope is a fun, quick, and inspiring read, and I appreciate the opportunity to learn more about Carl’s story. I look forward to the change he’s making in the world!

Every time I heard a no – No, you can’t play sports. No, you probably won’t be an accountant. No, you can’t pursue your dreams – I tried to listen instead to a yes, from inside me.

Carl S. Armato

Diabetes and Wellbeing by Dr. Jen Nash

Diabetes and Wellbeing by Dr. Jen NashI recently finished reading “Diabetes and Wellbeing” by Dr. Jen Nash, and I really enjoyed it.

Subtitled “Managing the psychological and emotional challenges of diabetes types 1 and 2” Dr. Nash set out to help us find some good ways to deal with the challenges we face dealing with the daily demands of diabetes.

Dr. Nash is a Clinical Psychologist near London, is the founder and director of PositiveDiabetes.com and has lived with type 1 diabetes since she was six years old. She says she went into psychology to figure herself out, but I think it’s something she’s just naturally good and we all got lucky that she found her calling right away. 🙂

Diabetes and Wellbeing covers a really wide range of focus areas. Take a look at some of the areas Dr. Nash covers:

  • Dealing with diagnosis
  • Depression, low mood and burnout
  • Fear, anxiety and worry
  • Food, weight and emotions
  • Relationships
  • Implementing change
  • Managing setbacks

There were many areas that really hit home for me, and many sections of the book where it seemed Dr. Nash could see exactly what was inside my head and already knew many of the things I struggle with. I found myself dog earing page after page, often even scribbling notes in the page margins.

So many pages dog eared!

So many pages dog eared!

One of the biggest takeaways from Diabetes and Wellbeing was a sense of normalcy to struggle with so many of these things. And to have a permission, of sorts, to explore these areas of diabetes that are not talked about enough.

It gave me some tools and resources to explore these areas in my own head, which is something I’m often simply afraid to do, and it also helped equip me to have difficult conversations with my healthcare providers if necessary.

Cognitive Behavioral Therapy for Diabetes

This book takes an explicit Cognitive Behavioral Therapy (CBT) approach to making changes, and that was an approach that was agreed upon between Dr. Nash & her publishers before starting the book. Dr. Nash said that it’s just one of many different approaches that she uses to help people, but you should know before starting that you’ll find only the CBT approach here.

The NHS website does a good job of explaining what CBT is if you are curious to learn more. I know that both Dr. Nash and the resource I offer here for CBT information are both from London, but that’s just a neat coincidence. This type of therapy is used widely around the world.

That’s actually a great transition into something else I’d like to mention. Dr. Nash is from London, so there will be a few “UK’isms” that may catch you off guard. That typically means an extra “u” somewhere (colour vs. color, or behaviour vs behavior, for example), but you might notice other things that don’t quite fit. Wasn’t a big deal for me, but I’d be interested to know if you find other things that just don’t seem right to you as a reader from a different local. I’m sure Dr. Nash would love to know as well.

Resources

Dr. Nash closes Diabetes and Wellbeing with a list of resources, where I was pleasantly surprised to be listed, along with many other greats, as a motivational and support resource. Thank you, Dr. Nash! Very cool! 🙂

Discount Code! Dr. Nash has graciously offered a 20% discount code that you can use to order Diabetes and Wellbeing if you’re interested. Visit www.wiley.com/go/nashdiabeteswellbeing and use code NASH1 when checking out.

Diabetes Hope Conference

I’m also thrilled to share that Dr. Nash is joining us as a panelist for the 2014 Diabetes Hope Conference! Shortly after reading her book and connecting with her via Skype to chat, I asked her to get involved. She will bring an awesome perspective to our panel about the patient/doctor relationship, and I’m very excited to watch it! I hope you can tune in, too.

To learn more and register for your free (virtual) seat, please go to DiabetesHopeConference.com.


Disclosure: Dr. Nash sent me a free copy of Diabetes and Wellbeing, but did not ask me to write about it. I really enjoyed it, found it helpful, and wanted to share it with all of you.

Balancing Diabetes by Kerri Sparling

Balancing_Diabetes_Cover

Balancing Diabetes by Kerri Sparling

Before I talk about how much I enjoyed reading Kerri’s book, I need to disclose that she is a close friend. In general, I’m a fan of all she does. I’m also honored to be mentioned and to have contributed a few quotes in this book. There’s no way I can offer an unbiased review and I want to get that out of the way right up front.

One of Kerri’s many gifts is reflecting praise she is due back onto the community that surrounds her. In a book that takes us through her life with type 1 diabetes, and the many different stages (diagnosis, independent care, friendships, college, work, relationships, pregnancy, parenting, and more) she uses that gift to make a book about her story and search for balance be much more than just about her.

It’s a fascinating look at Kerri’s own experiences with diabetes, which is content worthy of attention all its own. But she’s also added commentary and quotes from nearly forty others.

However this is much more than a collection of stories pulled together to form a book. Kerri shares her thoughts and experiences (both good and bad) in each section, then pulls in additional info from others to either solidify what she’s saying or to offer additional points of view.

“After living with type 1 diabetes for almost three decades, I’ve come to realize that nothing works more efficiently and effectively than a properly functioning pancreas. All my insulin pumps and continuous glucose monitors and exercise can only take me so far. That’s the reality of life with diabetes: it’s not a perfect science, and perfect diabetes management isn’t an achievable goal. (Not to mention, it’s a constantly moving target.)”  — Kerri Sparling, Chapter Nine, Walking the Blood Sugar Tightrope in Balancing Diabetes

It’s easy to fall in love with Kerri’s writing style; it’s full of truth and humor, and presented in a way that you can’t help but relate to. If you like what you find on her blog, Six Until Me, you’ll find that same entertaining style and character here. Kerri is a master at her craft–storytelling with emotion, humor, education, and hope–and it comes through brilliantly in her first book.

I found a lot of value from start to finish in the pages of Kerri’s book. Her words, and those of the many contributors, found an easy path right to the core of my life with diabetes. It felt as though our lives as adults living with diabetes shared common traits and a heritage of sorts, which is probably true in many ways. What I value most, however, is the open and comfortable dialogue about being an adult with diabetes – something that is too often forgotten about.

Thank you, Kerri, for bringing that conversation to life.

Freckled Fingertips – Carli J. Visser

Freckled Fingertips I have a stack of books in my office that I’d like to read.  It’s almost as tall as I am.  When Carli sent me her book I wasn’t sure how soon I’d be able to read it.  I made the mistake of cracking it open just before dinner the same day it arrived.

I wasn’t able to put it down until I finished it late that night.

Carli writes with her emotions.  Each of her words are drenched in the deep mental syrup that almost any of us know all too well.  Just as you feel she’s going to take it too far, to over-saturate her work with all of the feelings and hard-fought words, she backs off a little bit and finds that great balance that makes for an enjoyable and moving read.

You won’t find any “how-to” help in this book, nor any of the mechanics of diabetes.  This book is all about Carli growing up and learning to live with type 1 diabetes.  We hear of school, camp, unhelpful doctors, dating, and some general misconceptions.

I ended the book wanting to know more of Carli.  Maybe we can convince her to start a blog!

Carli’s book retails for about $15 on Amazon.com for the paperback, or about $10 for the kindle version.  Carli sent me a review copy at no cost, but didn’t ask me to write (or not write) about it.  She’s created a quality piece of work, and I’m happy to say that I enjoyed it.

I hope you’ll check it out and will enjoy it as much as I did.

Beyond Fingersticks

Thirty years ago I was peeing on test strips to assess my diabetes management (a revolution for those who had to use a chemistry kit).  Within the next few years I was measuring my blood sugar instead of urine, and had machines that spit an actual number at me.  A relevant, actionable number as current as the two minutes it took to do the test.

It was still hard to manage any immediate changes, as the tools available were slow (Regular and NPH Insulin).  It was more about watching trends than making sliding scale adjustments.  Doesn’t the idea of making adjustments at night or first thing in the morning to combat a low or high the next day sound crazy?  But that was the reality of it.  Sort of like having to park a cruise ship at the cabin dock.

As faster insulins hit the shelves, and more sophisticated delivery tools were developed, I started doing more with those blood sugar numbers.  I could be a little more proactive, and make changes to my insulin dose that I would actually see in the next 2-3 hours.  It was a shift in the way I thought about the information I was getting from my blood sugar machine.

We’re ready for another shift.  With continuous glucose monitors maturing and a stronger push for insurance coverage, they will hopefully be commonplace soon.  But the amount of data they spew can be overwhelming.  We need to learn how to cope with so much information.  We need to look… Beyond Fingersticks.

I love Wil, and I’m a fan of all his writing.  It wouldn’t be a fair review if I didn’t disclose that I’m certainly biased here.  I can’t help it!  But now at least you know, right?

Wil quickly builds a house of CGM information.  Foundation, Floor, Walls, and Roof.   Those are, literally, the section titles.  Each section goes on to have chapters like “11. Daily Life“, “12. Travel with CGM“, and “13. Living with, and loving, CGM“.

The book is full of practical, daily-use knowledge, as well as higher level, more philosophical thoughts around this new technology we are using.

As one of the first 30 people in the world using CGM in the real world, Wil has learned more than anyone I know about living with CGM, using it to improve diabetes management, and preventing hypoglycemic unawareness from killing him (scary thought, right?).

What you now hold in your hands is the result of hard work, due diligence, and the artistic skills of a dedicated individual. (from the forward, by Howard Zisser, MD)

Besides all of the great information, I also loved the artwork and quote/phrase choices for each chapter.  They seemed so fitting!


The thing that sticks with me most from the book?  That our blood sugars are chaos.  They are living, moving, fluid, always changing.  Looking at them as a single number does us no good.  Learning to see them differently is one of the many things Wil does well in this book, quite possibly his best work yet.  Buy one, borrow one, steal one (check the library first though!).  If you have a CGM, or are thinking about a CGM, I highly recommend reading this.

“Diabetes Rising” by Dan Hurley

I first heard of Dan Hurley and his book, “Diabetes Rising“, over at Amy’s site (Diabetes Mine).

She did a two part interview about a year ago (Part 1, Part 2), and there was something about what Dan said that pulled at my emotions.

He says about his approach to the book:

… Even with this best medical advice, I feel that
the ‘just try harder’ approach is not going to work for a lot of people.
If you’re very educated, motivated, and have a good attitude, you can
kind of stumble your way through it. But obviously tons and tons of
people don’t have all those attributes… something else is needed to help
them.

How many times have you felt you needed to “just try harder?”  Or worse yet, been told you “just need to try harder?”  I feel that way almost all the time!  Yet I’m always mentally exhausted from it all.  Try harder?

After Amy’s interviews the book fell off my radar.  The book wasn’t available for order at that time, and my attention span just didn’t last.

While down in Florida for the Roche Summit and CWD Friends For Life Conference, Lili and her husband told me they bought a copy of his book at his booth.  I said “wait – you mean he’s HERE?” and made a dash for the booth.  It was weird for me to say “Hi Dan, Uh… I’m a big fan, but haven’t actually read your book yet…”

I told him that I had seen the interviews on Amy’s site and they had really piqued my interest.  He was extremely pleasant.  We chatted for a minute, he signed my book, then I grabbed a picture with him.

"Dan Hurley - Diabetes Rising"

I wasn’t sure I’d like the book.  I figured with a name like “Diabetes Rising” it would be all about type 2 diabetes and the panic the world is in.  That wasn’t the case at all.  There was a lot about both type 1 and type 2 diabetes.  Dan is a very scholarly looking fellow, complete with a bow-tie and all, which set me up to expect a very dry and technical book.  When I got to the title of the first chapter, “Pissing Evil”, I smirked a bit and had a feeling that I would enjoy Dan’s style.

There were a couple of paragraphs that just shouted to my soul, and I
asked Dan for permission to quote them here.

The Computer Cure – The Quest for an Artificial Pancreas
In Chapter 10, Dan covers some information about his experiences being connected to an artificial pancreas for a day.  He’s talking with Marc Breton, PhD, the systems engineer who was designing the software to control the artificial pancreas.  Dan asked Marc “why, from his perspective as a programmer, is controlling blood sugar so maddeningly complicated even though it involves just two variables, insulin and sugar level?”  Marc came up with an almost perfect metaphor to explain it (italics mine):

The glucose you measure with a continuous monitor was accurate fifteen minutes ago.  The insulin you take does not start acting for twenty minutes, has a peak of action around forty-five minutes, and it continues to act for up to three hours.  So you are acting on out-of-date data, and you’re using a mode of action that will only kick in much later on.  It’s like you’re driving a car down a winding road — but you aren’t able to see that the road turned until you are fifteen yards past it, and turning the wheel will have no effect for two hundred yards more. If you’re driving a car like that, you’d better have a good map.

Two sections later in Chapter 10, Dan is now hooked up to a closed-loop trial system:

At 11:07 P.M., watching Seinfeld, I had a sudden urge to go running down the hall, skipping and yelling, in celebration of not having to worry about my insulin and sugar levels — of being, for one night only, magically freed of my diabetes.  And then I felt myself close to tears, thinking what a pain in the ass, and how phenomenally distracting, it is to be constantly worrying about my goddamn sugars, instead of focusing on my work and my family and my friends and my life.

I found myself near tears just from reading that – but am admittedly a softy when it comes to the emotional prices we all pay living with diabetes.  There was plenty of other great writing before and after chapter 10, of course, but these two quotes really pulled me.

I really enjoyed reading Dan’s book.  His writing style entertained me, and spoke to me beyond the words on the page.  There’s a certain wisdom that comes from living a long time with something like diabetes, and I got a lot of that from everything Dan shared.

Newly Dx Week: Think Like A Pancreas

A bunch of years back I spent some time working at an ISP (Internet Service Provider).  I had the opportunity to take a bunch of training courses. One of my favorite courses was called “Think Like A Router”, and it was the class that finally got through to me.  It was the class that made the light bulb “pop” on for me.  All of a sudden I was able to make sense out of so many things that were confusing me at work.

When I ran into a diabetes related book with a similar title I was excited!  Even with my high expectations, the book did not disappoint.  In fact, it exceeded my expectations and taught me many things.

Cover for Think Like a PancreasGary Scheiner lives our life.  He has type 1 diabetes (funny story in the book – he was diagnosed in Sugarland, TX.  No joke.)  A Certified Diabetes Educator and an exercise physiologist, he runs Integrated Diabetes Services in Wynnewood, PA.

The goal of this book is to help you learn to “successfully master the art and science of matching insulin to the body’s ever-changing needs”.  Gary’s book covers TONS of stuff that the “diabetes 101” books either don’t cover at all, or skim over so quickly that it can’t make sense.

Even though Gary dives into some of the very necessary “nitty-gritty” detail that living on insulin requires, it is not dry and hard to understand.  Skillfully constructed sections and topics pull you through the book without making you work on it.  You will no doubt learn many different things, and also refer back to the book over and over again.

In a section appropriately titled “Adjusting to the Real World”, Gary was the first person to discuss the possibility that caffeine can raise your blood sugar.  It was something that I suspected for a long time, but could never find any usable information on.  And here it is in black and white in Gary’s book.

I highly recommend this book.  If you don’t want to buy it, at least go get it from the library.  It will be well worth the late fees.  Also, go check out the Integrated Diabetes Services website. Gary and his team there have a lot of resources available.  Their newsletter is fabulous.

Gary runs a unique practice because he leverages the internet and telephone to work with patients all over the world.  It’s really very cool.  While I have not had the opportunity to work with him directly (yet), he is one I would trust unconditionally to manage my diabetes.

During my time at Cozmo I got to meet Gary, which was a really neat experience for me.  Gary was in the office to participate in a meeting for the Cozmo Advisory Board, and our Marketing Manager brought him over to my desk for some computer help.  When I looked up and saw who was at my desk, my jaw dropped!  After the initial shock, I shook Gary’s hand and then grabbed my “Think Like A Pancreas” book for an autograph.

He wrote “Scott, keep your chin up & your sugars down, Gary Scheiner”.  I love that line.  It says so much about our lives with diabetes, doesn’t it?  Over the next few years I was able to hang out with Gary and/or listen to him speak another three or four times.  He’s a really good guy that knows his stuff with diabetes.  And even better than knowing his stuff with diabetes, he is able to use that knowledge to help others with their diabetes.

“Keep your chin up & your sugars down.”

Newly Dx Week: The Born-Again Diabetic & Taming The Tiger

Like Amylia, I was diagnosed young.  At five years old I didn’t know anything about what was going on, and at 34 years old now, I honestly don’t remember much about things that far back.

I can only imagine the shock of being diagnosed with diabetes.  I can only guess at what types of things would make that diagnosis easier to cope with, either for the one diagnosed or for parents of young kids diagnosed.    Here are my first two guesses.

I know that using “The Born-Again Diabetic” phrase for Newly Diagnosed Week is a little strange, but despite the title, this is my very first recommendation for those recently diagnosed with diabetes.

Cover for "The Born Again Diabetic" book

I posted about Wil’s book when it first came out back in February.  What makes this book so special is Wil’s talent for visualization and for writing that keeps you engaged at every sentence and able to understand everything that he’s trying to tell you.

Wil also speaks from a rare perspective of being in the medical profession AND living with type 1 diabetes. He knows what he’s talking about.  And he knows how it is “in the trenches”.   I love this book.  And the author is a pretty good guy too (but that’s not why I love the book).

Cover for "Taming the Tiger"This book also has a little brother, if you are a bit put-off by the idea of a couple hundred (though very quick and easy) pages (very understandable if you are dealing with the diagnosis).  Wil thought about that too, and worked to put together an even smaller and easier to digest book.  As he says “Just what you need in the here-and-now”, and “it has just the basics in plain English”, and “Just what you need to get started.  And nothing more”.

This book can be read in 30 minutes or less, and has Wil’s same flare for straight to the point information presented in a way that you will understand and remember.  That is a perfect combination for those newly diagnosed.

It is small enough to fit in the back pocket of a pair of jeans, and is less than 85 pages (not including acknowledgments, etc). In the title pages of the book it says “It’s going to be Ok, you’re going to be Ok”.

Those are just the words you need to hear when you think your world is falling apart.

Artwork That Resonates


Book cover for "One Lump or Two?"
Sometimes you find something that just rings through on your very first glance.

Sometimes you find nice packages of these things that seem made just for you.

Sometimes you get lucky and they show up on your doorstep.

Sometimes your friends find them too (Amy T, Lee Ann, & Chris).

One of the cartoons from the book illustrating a late night low blood sugar feast.

If you have type one diabetes, and that image doesn’t hit you, check your pulse (or blood sugar).

Thank you Haidee, for being so great (and please forgive me for taking SO LONG)!