People suffering from chronic diseases such as diabetes and accompanying conditions such as hypertension and elevated cholesterol will find help in self-managing these problems from health providers and diabetes educators.
One providing such counsel is Debra Pautz, RN CDE of Calumet Medical Center. She is a certified diabetes educator. Pautz guides diabetic patients in making lifestyle changes and in properly administering their medications. She also assists them in monitoring (testing) their blood sugar, helps them practice healthy and balanced eating, and engage in exercise.
A distinct advantage is that Pautz can and does spend more time with diabetic patients, discussing educational materials, giving patients practical advice on a disease that demands attention for the remainder of one’s life. Education is a key factor in managing this disease, Pautz said,
Patients will find comfort in follow-ups in which Pautz will encourage them to remain constant in making lifestyle changes and in making and keeping scheduled appointments to health providers.
7 million don’t know they have it
There are an estimated 26 million people in the U. S. diagnosed with diabetes and another 7 million who don’t know they are diabetics. There is a growing trend of teenagers being diagnosed with diabetes. All the time we are seeing younger and younger people diagnosed with diabetes. Once uncommon among the young, we now see it all the time and have many children on medication, Pautz said.
There is also a upward trend of people diagnosed as pre-diabetics. Many of those are referred to Pautz by health providers for advice on making lifestyle changes that will help prevent diabetes.
An increasing number of people fall into the category of pre-diabetics. When administering annual physicals, health providers monitor the lab work done and if the numbers are trending upwards, they will be referred to Pautz for help in lifestyle changes, weight loss and dietary changes to forestall diabetes or at least delay it out for a time.
Pautz also works with patients with metabolic syndrome . These people who are overweight individuals, a woman with a waist measurement over 35 inches or a man with a waist size over 40 inches, people with high blood pressure and whose cholesterol numbers need impro ve ment. Metabolic syndrome is a term used for several physical problems that occur at the same time and increase a person’s risk for type 2 diabetes, heart attack and stroke. Nearly 25% of American adults have metabolic syndrome.
A Wisdom Report is regularly shared by health providers and reviewed by Pautz, The report lists diabetic and coronary artery disease patients and tells when their next lab or eye appointment is scheduled, recent lab results and blood pressure readings. If a patient is not on track with these things and their numbers are climbing, Pautz contacts them for a visit. Before they leave. Pautz schedules the patient’s next appointment so they don’t fall through the cracks.
It is not known what precisely causes diabetes but certain risk factors such as being overweight, a family history of the disease, belonging to certain ethnic groups, being over age 45, and being a gestational diabetic can predispose a person to the disease. Cardiac risk factors are associated with diabetes, marked poor vascular circulation, potential for stroke or heart attack. As a registered nurse, Pautz worked in the cardiac department of CMC before embracing her current work, giving her familiarity with these issues. “Every day I use what I learned in cardiac rehab,” she said.
Providers at CMC are wonderful, and very supportive of my role, and readily refer patients to me who are struggling, Pautz said. “I can take the time needed, It is very individualized. Some have an understanding of the disease but others don’t even know what questions to ask, or have inaccurate information about diabetes. Being a certified diabetes educator (CDE) is a convenient thing, otherwise patients would have to travel to the Fox Valley. With a growing number of elderly persons in our community it definitely makes things easier.”
Dietician also helps out
Although Pautz said she gives general nutritional information on matters such as basic carb counting, the different types of fats (choosing mono unsaturated vs. saturated fats), portion sizes, and low sodium referrals are made to a dietician at CMC when certain individuals need a more stringent diet.
A balanced diet is something everyone should be eating, not just the diabetic. So within a family, a special meal should not be cooked for the diabetic and the others. To achieve nutritional meals, Pautz recommends the plate method which governs quantity.
“Portion size is a big problem for many of us. I teach patients easy ways to visualize proper portions by using the palm of their hand as equivalent to three ounces, a tight fist as half a cup, a loose fist as one cup, and cheese the size of one’s thumb . When eating out take home some of it for another meal or use a 10-inch plate at home,” Pautz said.
An occasional treat such as ice cream, a cookie, or dark chocolate allows one to maintain a balanced diet without feeling like a martyr.
Pautz suggests that patients keep a food log, to record the types of things they enjoy eating. She also encourages them to find healthy substitutes. Identifying things that can be swapped with that bag of chips after supper. The log helps one recognize what one is doing well such as giving up soda and eating more fruits and vegetables. Pautz said she individualizes advice as much as she can. If what is suggested is too different from what the patient is accustomed to they will not do it. Questions are asked of the patient such as who does the shopping, what kinds of foods do you like, who prepares the food and what is your usual routine?
It is demonstrated that when healthy foods are kept in the house, children will learn good eating habits. “It does sink in; they do learn it. Involving the children in shopping, in the preparation of the food and setting the table helps them internalize the eating of healthy foods and habits,” she said.
Pautz said perfection is not expected. Patients learn and do their best and make improvements in their diet. When you use up a product at home, next time you go to the grocery store look around for something with more fiber, less salt and sugar. Look at nutrition labels, and in doing that gradually introduce new foods to your family.
Pautz suggests that we not eat the same food all the time. The body can detect the difference between non-saturated fats and saturated fats. Eating a variety of foods, especially those high in fiber, helps bump up your metabolism.
Exercise is a challenge
Pautz said the hardest thing for people, is exercise. On her wish list, Pautz would like a community facility where patients could walk, use exercise equipment and do so safely. One such facility could have hours for women only, offering yoga and Zumba classes. A fitness room at the hospital can only accommodate four persons at a time.
Pautz would also like to see a support group established locally. Fox Valley Technical College, Appleton, has a support group that meets once a month. “I would like to see something like that get off the ground here,” Pautz said.
Seminars for diabetics and their family members are helpful, said Pautz who follows up with a second seminar on nutrition. Support from family members helps manage the disease.
A Healthy Living Cooking School put on by Calumet Medical Center at the Engler Center for the Performing Arts (Chilton High School) was held Monday, April 1. A cooking demonstration with Chef Jason took place along with interactive booths, displays and refreshments.
A self-management workshop titled “Living Well with Diabetes” is a six-week program on Wednesdays which started on April 17. It took at Fox Valley Technical College and might be repeated in the future.
Hosted by the Chilton Alliance Church, a Women’s Break Away took place at the Engler Center for the Performing Arts (Chilton High School) with a number of seminar topics on Saturday, April 20. One of the presenters was Pautz, who talked on preventing and managing diabetes, including diet and exercise, labwork, weight loss, medication and the prevention of complications.