By Stefanie Sacks, MS, CNS, CDN
I have a client, let’s call her Lucy (I just love that name!), who has Diabetes Type II (DMII). And that is only a part of her picture...
When a person comes to me, I have to look at their entire health “landscape,” including (but not limited to) clinical diagnosis, symptoms and medications (and who comprises their current “care team” be it doctors or other health practitioners); I look at their family health history; their relationship with food from a behavioral perspective; what they eat; their food likes and dislikes; what they need and want to accomplish by working with me; and most importantly I need to understand what they are truly willing to do and able to do so I can help set them up for success.
Lucy is a vibrant, loving, and incredibly optimistic woman, whose “suffering” struck a deep chord with me for many reasons. After listening to her story, I wanted to do anything and everything I could to help her. Calling on my personal experiences (and professional ones), I felt that she had been gravely misguided in much of her “care."
In a nutshell, Lucy lived most of her teens and twenties on and off antibiotics due to recurring strep throat, then a horrible bout with Lyme disease. What followed? The DMII diagnosis in her mid-30’s, and what defined the next 10 years of her life — medication for diabetes; terrible acid reflux; rapid weight gain; failed attempts at weight loss; the emotional challenges that go along with living with chronic illness (let alone life); a pancreas that is ceasing to work (meaning she now has insulin dependent diabetes — Type I); and a medical team who told her that gastric bypass surgery could be her only “solution” for care.
As Lucy was highly motivated and ready to use diet, exercise, and more alternative approaches to her care (meaning the idea that meds and surgery weren’t the ONLY option), it was clear what I needed to do to help her:
- Get her on an overall diabetes supportive diet. While she was managing her blood sugar through food to some extent, she needed to do a much better job.
- Get her on a candida diet — because of Lucy’s long history of antibiotic use, she most likely has an overgrowth of bad bacteria (candida) in her gut. This is thought to be a contributor to chronic illness; reclaiming her gut health could help her overall picture.
- Teach her how to make healthier food choices (a.k.a Shopping Education)
- Encourage her to “get moving” with exercise
- Help her complement her team of medical doctors with those who are more open-minded to alternative care. When working with complex (and often not-so-complex) clinical cases, I always collaborate with integrative practitioners, whether a registered dietitian (a nutritionist who is clinically trained) or doctor.
- Most importantly, give her some much needed love and support
Lucy is amazing — she followed the program I created for her, exercised, and started trusting her care to other medical practitioners. She started losing considerable weight and was feeling great!
But a couple of weeks ago, she developed moderate to acute abdominal pain. While she wanted to brush the pain off as a stomach virus, after conferring with a colleague, I encouraged her to call her doctor for immediate care. This was out of my league! She did, and thank goodness for that — she had an inflamed gallbladder (cholecystitis) and she very well may need gallbladder surgery. Based on guidance from her doctor, I modified her program to a “plain foods diet” — easily digestible, refined foods. The only catch: while this diet is supportive of the cholecystitis, it is contra-indicated for diabetes.
Even with this kink in the road, Lucy remains positive and is ready to get back on track as soon as possible. The big question — If she was eating so healthfully, why did she develop this complication? The answer — There is no simple response, but we do know it wasn’t the healthy diet she started eating. Chronic illness is very complicated and there will always be roadblocks. It boils down to how to manage those obstacles, and whom you choose to handle them with. With the uncertainty inherent in illness, it is important to have a support system that you are certain about.
My work has humbled me over the years. If there is one thing I know best — it’s that I know what I know, and know what I don’t know. A person’s care should always be a collaboration among practitioners.
Stefanie Sacks, MS, CNS, CDN is a Culinary Nutritionist, author, radio show host, educator, speaker, and consultant. She works hands-on with individuals and groups in transition to a healthier way of eating. Sacks has been studying food and healing for 30 years, has her Masters of Science in nutrition education from Columbia University, is a Certified Nutrition Specialist, Certified Dietitian Nutritionist and is a graduate of The Natural Gourmet Institute for Health and Culinary Arts. Stefanie’s weekly Stirring the Pot Blog goes hand in hand with her weekly Stirring the Pot Radio Show on Hamptons NPR, WPPB 88.3FM. The show focuses on food, cooking, nutrition, and health. Her book, What the Fork Are You Eating? (Tarcher/Penguin Random House) is set for release January 1, 2015. She has contributed to several books, and is a sought-after guest expert on local and national programs. Her print and online media contributions are extensive from Harper’s Bazaar, O Magazine and Teen Vogue to The Huffington Post and Healthy Eats by The Food Network.