Diabetes Education at Think

We sat down with Think Whole Person Healthcare Diabetes Educator, Mary Jo Burkhardt, RN, BSN, CDE, to talk about her approach to educating her patients who live with diabetes. “I’m all about empowering my patients and instilling pride in them. Here they are, really taking control of their life and body, really taking good care of themselves.” Mary Jo uses an empathetic approach – she knows that everyone likes to eat foods that include carbohydrates – it’s natural to prefer those high-calorie foods (pizza, pasta, burgers, etc.). According to Mary Jo, her job is to individualize nutrition plans that fit into the life of her patients. That requires their honesty and her understanding. “I don’t judge my patients. We work together to create a plan that makes sure they can still eat the foods they love while staying healthy and regulating their blood sugars. When my patients follow our plan and we work together, they’re usually the healthiest eaters on the block.”

Mary Jo’s patient base consists mostly of those living with Type 2 Diabetes. Type 2 is a completely different disease than Type 1. Type 1 is an autoimmune disease in which the body can’t produce insulin, and its symptoms typically begin to appear in children. However, Type 2 Diabetes typically occurs in those 45+ who are overweight and perform little physical activity. The body still makes insulin and the symptoms are less noticeable. Over time, though, the body does make, and exercise is highly recommended to help the body continue to make insulin.

Mary Jo is excited to be part of the Think Whole Person Healthcare family, as many of the services needed by those living with diabetes are all here in one place. Think Whole Person Healthcare has podiatrists, because those living with diabetes worry about their feet due to potential complications with the disease. Think Whole Person Healthcare also has behavioral specialists, Care Coordinators, optometrists, Clinical Pharmacists, dentists and hygienists, and primary care doctors – all who are in-the-know of the patient’s health plan and particular needs, and work together to help the patient manage their health.

Watch the videos below to hear right from Mary Jo, the passionate expert about all things diabetes education and management. Need more information? Don’t hesitate to reach out to Mary Jo directly!

 

 

Here’s an additional note from Mary Jo Burkhardt about living life to the fullest during the holiday season while living with Type 1 and Type 2 Diabetes:

Those living with Type 1 and Type 2 Diabetes can work their favorite holiday foods into their meal plan. I encourage people to be mindful about what they are eating and to be careful to eat their favorite holiday foods only on the holiday itself – in moderation. I also stress the importance of staying on their food plan as many days a year – it’s within their power to stay as healthy as they can! I talk to my patients about how they can handle what can be many holiday parties and still stay pretty close to being on-target for their carbohydrate intake.

We discuss the importance of making sure they are exercising during this food-filled holiday time to help moderate their blood sugars with the benefits that exercise brings. If their diabetes is not in good control, they need to discuss this with their doctor or provider for a particular plan for handling the holidays.

Follow my tips to ensure that you enjoy every moment of the holidays spent with your friends and family. You can do what you love, no matter what, with our help…because Life is for Living.

 


 

Lung Cancer Awareness Month: An Introduction to Smoking Cessation

Krystle Eckhart, PsyD, HSPBehavior changes usually involve five steps. They include the following:

  • Precontemplation: “I’m not ready to change yet.”
  • Contemplation: “I know that I should change but I’m not sure how.”
  • Preparation: “I have begun making small changes.”
  • Action: “I am ready to change now.”
  • Maintenance: “I have changed.”

Smoking cessation follows these stages, too. Throughout Lung Cancer Awareness Month, Think Whole Person Healthcare Integrated Behavioral Health Specialist Krystle Eckhart, PsyD, HSP, is writing a series of articles that will give you quick-hit information related to each stage.

Before we get into the stages, it’s important to know why we’re talking about this in the first place. What are the benefits to quitting smoking? How quick can I get the benefits?

Health benefits:

  • Broken addiction cycle
  • Better circulation
  • Improved taste and smell
  • More energy
  • More efficient/higher functioning immune system
  • Cleaner teeth and mouth
  • Improved sex life – yes!
  • Lower risk of cancer

The benefits of smoking cessation begin shortly after you smoke your last cigarette, regardless of how long you’ve smoked cigarettes.

Timeline after last cigarette:

  • 20 minutes: Heart rate and blood pressure drop.
  • Temperature of hands and feet increase to normal.
  • 8 hours: Carbon monoxide levels in blood return to normal. Blood oxygen level increases to normal
  • 24 hours: Chance of heart attack decreases
  • 48 hours: Nerve endings start re-growing therefore ability to smell and taste is enhanced
  • 2 weeks – 3 months: Risk of heart attack drops. Circulation improves and lung function increases up to 30 percent
  • 1 – 9 months: Coughing, sinus congestion, and shortness of breath decrease. Ability to fight lung infection increases. Overall energy levels rise
  • 1 year: Excess risk of heart disease is cut in half
  • 5 years: Stroke risk is that of a person who has never smoked
  • 10 years: Risk of lung cancer is that of a person who has never smoked. Risk of developing other cancers (e.g., mouth, throat, esophagus, bladder, kidney, pancreas) also reduce significantly
  • 15 years: Risk of coronary heart disease is that of a person who has never smoked

Think Whole Person Healthcare’s Krystle Eckhart will be back with three more articles covering the five stages of smoking cessation. Share these articles with your loved ones to spread awareness for Lung Cancer Awareness and the stages of smoking cessation!

 


 

An Introduction to Smoking Cessation – Stages One and Two: Precontemplation and Contemplation

Hello, there! My name is Krystle Eckhart, PsyD, HSP. I’m Think Whole Person Healthcare’s Integrated Behavioral Health Specialist. I’m excited to share with you this series of quick overviews about one of my areas of specialty – smoking cessation. You can learn more about me at the end of this article! First, let’s talk about the five stages of smoking cessation.

With smoking cessation, like most behavior changes, you will likely find yourself going through these stages:

  • Precontemplation: “I’m not ready to quit smoking yet.”
  • Contemplation: “I know that I should quit but I’m not sure how to do it.”
  • Preparation: “I have cut down the number of cigarettes I smoke per day.”
  • Action: “I am ready to quit smoking now.”
  • Maintenance: “I have quit smoking.”

 

In this article, we’re talking about Stages One and Two: Pre-contemplation and Contemplation.

Stage One: Pre-contemplation

During the Precontemplation Stage, it can be helpful to gather smoking cessation resources and information to help gain the motivation to quit. Now is a good time to identify your support network (e.g., those people and resources who encourage you to quit and help support you during the process) and determine your top reasons to change your behavior (e.g., motivated to quit due to impact on health, financial cost, negative impact on work or important relationships, etc.).

We talked about the health benefits of smoking cessation and the health benefits timeline after the last cigarette in part one. Go back to that blog to find fodder for motivation. As stated above, finding these motivations will help you move from Precontemplation to Contemplation.

 

Stage Two: Contemplation

It’s important to continue to gather information about smoking cessation resources to continue to find the motivation to quit. To increase success, it’s also important to develop an understanding of your triggers – the “why” part of smoking. This is a great stepping stone for the “how to stop” part. We can then find healthy alternatives to triggers and use them for proactive coping strategies.

 

Here are some common triggers for smoking:

  • Nicotine cravings
  • Need to handle something/keep hands busy
  • Needing an energy boost
  • Thinking/concentration
  • Feeling down, stressed or angry
  • Boredom
  • Wanting a reward
  • Social situations
  • Drinking coffee
  • Drinking alcohol
  • Driving/riding in a vehicle
  • Reading or watching television
  • Talking on the phone
  • After meals/when you feel too full
  • First thing in the morning

What comes to mind right away as alternatives? Can you identify what kind of things make you feel bored, down, or unfocused? Are there strategies you can think of right away that can help you avoid feelings or situations that make you reach for a cigarette? It can be hard to think of them right away – you have a lifestyle that you like, right? That’s where I come in. We can make a plan that fits into your life.

Stay tuned for the next article about Stage Three: Preparation. Share this article with your loved ones to spread awareness for smoking cessation and Lung Cancer Awareness Month.

 

About Me

I am a clinical psychologist by training and I work as a Primary Care Behavioral Health Consultant (BHC) at Think Whole Person Healthcare. That means I work with our Primary Care Providers to help them address concerns about their patients’ habits/behaviors or emotional health and how it affects their overall well-being. Common referrals include diet, physical activity, life transitions, coping with situational stressors, behavioral problems, or adjusting to new diagnosis. If you’d like to see if my expertise can benefit your health, please speak with your Think Whole Person Healthcare primary doctor.

 


 

An Introduction to Smoking Cessation – Stage Three: Preparation

Hello, there! My name is Krystle Eckhart, PsyD, HSP. I’m Think Whole Person Healthcare’s Integrated Behavioral Health Specialist. I’m excited to share with you this series of quick overviews about one of my areas of specialty – smoking cessation. You can learn more about me at the end of this article! First, let’s talk about the five stages of smoking cessation.

With smoking cessation, like most behavior changes, you will likely find yourself going through these stages:

  • Precontemplation: “I’m not ready to quit smoking yet.”
  • Contemplation: “I know that I should quit but I’m not sure how to do it.”
  • Preparation: “I have cut down the number of cigarettes I smoke per day.”
  • Action: “I am ready to quit smoking now.”
  • Maintenance: “I have quit smoking.”

In this article, we’re talking about Stage Three: Preparation. If you missed my previous article about the first two stages of smoking cessation, go back and read it before you continue! (step 1 & 2)

 

Stage Three: Preparation

Quitting smoking “cold turkey” may work for some people, but research suggests that taking steps to gradually reduce cigarette use and engaging in preparation tasks help people be successful with sustained smoking cessation. Remember, everyone has different ways of quitting, so what may work for you might not be the same for someone else. Use the list below as a starting point and remember to talk with your Think Whole Person Healthcare primary doctor for additional information and support. (Need a primary doctor? Become a patient today.)

 

Here are some ideas for how to can prepare for smoking cessation:

  • Set a quit date. Perform the tips of your choice below to prepare yourself for that date.
  • Hold your cigarette in your opposite hand.
  • Switch to less favorable brand of cigarettes.
  • Delay (use another skill or strategy to assist in distraction, such as chewing gum, taking a brief walk, deep breathing, etc.). Gradually increase delay. Remember ­– smoking isn’t the only thing that will relieve the urge to smoke. Patience will, too – the urge WILL pass!
    • 5 minute time out: Each time you have desire to smoke, wait 5 minutes before reaching for cigarette.
    • Postpone first cigarette of the day by one hour.
  • Smoke only the cigarettes you want intentionally — catch yourself before mindlessly smoking cigarette out of habit or boredom or while distracted with television, etc.
  • Refrain from emptying ashtrays (as a reminder for how many you have had).
  • Put cigarettes in an unfamiliar/inconvenient location.
  • Watch yourself smoke in a mirror.
  • Stop buying cigarettes in bulk. Buy only one pack at a time.
  • Make smoking unpleasant (e.g., by yourself, outside, not while talking on phone).
  • Eliminate places where you smoke (e.g., only smoke outside, put cigarettes in trunk of car while driving).
  • Smoke only part of the cigarette.
  • Smoke only on odd or even hours of the day.
  • Smoke one less cigarette each day/identify the cigarettes that are the ‘easiest’ to give up.
  • Avoid high-risk triggers if possible. Practice deep breathing, progressive muscle relaxation techniques or 5 senses grounding instead.
  • Discuss nicotine replacement therapies with your primary doctor.
  • Find support groups (local, over phone, or online).
  • Discard smoking paraphernalia (dispose of lighters, ashtrays, etc.).
  • Clean smoking areas (e.g., wash curtains, air out cushions, detail car upholstery).

That’s about 20 tips to prepare you for Stage Four: Action. Surely, there are at least a few that can work for you! Which tips do you like the best?

Stay tuned for the next and final article covering Stages Four and Five: Action and Maintenance. If you missed my previous article about Stages One and Two, go back and read it now. Share this article with your loved ones to spread awareness for smoking cessation and Lung Cancer Awareness Month.

 

 

About Me

I’m Think Whole Person Healthcare’s Integrated Behavioral Health Specialist. I am a clinical psychologist by training and I work as a Primary Care Behavioral Health Consultant (BHC) at Think Whole Person Healthcare. That means I work with the Think Whole Person Healthcare Primary Care Providers to help them address concerns about their patients’ habits/behaviors or emotional health and how it affects their overall well-being. Common referrals include diet, physical activity, life transitions, coping with situational stressors, behavioral problems, or adjusting to new diagnosis. If you’d like to see if my expertise can benefit your health, please speak with your Think Whole Person Healthcare primary doctor.

 


 

An Introduction to Smoking Cessation – Stages Four and Five: Action and Maintenance

Hello, there! My name is Krystle Eckhart, PsyD, HSP. I’m Think Whole Person Healthcare’s Integrated Behavioral Health Specialist. I’m excited to share with you the final article in my series about smoking cessation. Before we get into specifics on stages four and five, let’s first talk about all five stages of smoking cessation.

With smoking cessation, like most behavior changes, you will likely find yourself going through these stages:

  • Precontemplation: “I’m not ready to quit smoking yet.”
  • Contemplation: “I know that I should quit but I’m not sure how to do it.”
  • Preparation: “I have cut down the number of cigarettes I smoke per day.”
  • Action: “I am ready to quit smoking now.”
  • Maintenance: “I have quit smoking.”

 

In this article, we’re talking about Stages Four and Five: Action and Maintenance. If you missed my previous articles about the other three stages of smoking cessation, make sure you go back and read them before you continue! (Intro, Stages One & Two, Stage Three).

 

Stages Four and Five: Action and Maintenance

When you reach your “stop smoking” date, be prepared for feelings of withdrawal in the first days. Not all people will go through the same withdrawal symptoms or the same intensity of symptoms. For many people, the most intense symptoms will lessen 3-4 days after quitting. Most physical withdrawal symptoms should be gone within 7-10 days. It is important to know what to expect and to develop a plan for ways to cope with these symptoms.

Common symptoms include:

  • Intense cravings
  • Mood swings, irritability
  • Anxiety, tension, restlessness
  • Difficulty concentrating
  • Trouble sleeping
  • Coughing/dry mouth
  • Headaches, dizziness
  • GI upset (constipation, nausea)
  • Increased appetite
  • Feeling down/sad

Strategies for coping with withdrawal:

  • Nicotine Replacement Therapies (NRT) (e.g., lozenges, gums, patches, Chantix, Wellbutrin, etc.)
  • Visualize surfing the urge waves
  • Delay
  • Distractions
  • Deep breathing/progressive muscle relaxation/5 senses grounding and meditation techniques
  • Drink water!
  • Connect with support person
  • Re-engage in leisure activities or try new hobbies
  • Take walks
  • Physical activity (e.g., weight lifting, stretching, yoga, dance, etc.)
  • Reduce alcohol and/or caffeine
  • Engage in healthy sleep hygiene
  • Take warm baths/shower
  • Eat low-sugar hard candy (to prevent throat dryness)
  • Eat foods higher in fiber (e.g., whole-grains, fruits and vegetables)
  • Brush teeth after eating
  • Smile at yourself in the mirror
  • Find humor
  • Express yourself creatively (e.g., journal, draw, play musical instrument, sing, etc.)
  • Have compassion for yourself if you slip up. Learn from the slip up rather than criticizing yourself. Review motivation list and reach out to support network and/or primary care team for additional resources and support.

 

That’s it! This completes my quick overview of the five stages to smoking cessation. If you missed my previous articles about the other three stages of smoking cessation, make sure you go back and read them! (Intro, Stages One & Two, Stage Three).

 

Please share this article with your loved ones to spread awareness for smoking cessation and Lung Cancer Awareness Month. If you need more assistance and information about smoking cessation, please speak with your Think Whole Person Healthcare primary doctor, or become a patient at Think Whole Person Healthcare today. That way, your Think primary doctor can determine if I’m the right fit for you, or they can refer you to other resources you can use to help you quit smoking. Get out there, exercise, explore, and use those powerful lungs of yours…because Life is for Living!

 

 


 

Stress Awareness Month

Written by Meghan Herek, Think Mental Health Therapist

Stress Awareness Month is a helpful tool for us to bring attention to the stress people may live with year-round, and helps remind us of tools we can use to better manage stress. This Stress Awareness Month, we’re focusing on the benefits of talk therapy.

 

Who is talk therapy “for”?

Talk therapy is for everyone. There are many assumptions about who talk therapy is for, and it is for everyone. Many of us struggle with stress, anger, and in some cases, anxiety and depression. No life is void of triggers. Talk therapy teaches you techniques you can use to manage the things – internal and external – that ignite your stressors. Plus, you absolutely deserve to have someone who is there for only you. So, yes – talk therapy is for everyone!

 

Why use talk therapy?

If you never talk about your issues, you won’t gain another perspective, create more understanding about the whys and whats of your triggers, nor will you learn tools to overcome them. Closing your thoughts and emotions may even cause you to see the world in a more negative way. Your mind and body are strongly connected. Have you ever noticed your muscles tighten when you’re worried about something, or get a headache? Your mind controls everything. It’s important to keep your mind healthy, and you can with the help of talk therapy.

 

How often should you go to talk therapy?

Even one to two appointments a month can do wonders for your mental state. You can use real, stressful situations to practice the tools we talk about in our sessions. During our sessions, we discuss those situations, what you did, your successes, and areas to improve. It’s so healthy for your mind to talk about what’s going on inside it! Mind your mental health and come see me. Because Life is for Living!


 

Feeling SAD?

Seasonal Affective Disorder is depression that affects many people in the dark, cold months. It seems this Nebraska winter has been especially brutal, which doesn’t particularity help. When the blossoms of Spring come about, your mood may become lighter and happier – just like the trees and grass, newly healthy and green!

 

Why does SAD happen?

Scientists don’t exactly know the causes of SAD, but one thought is that the lack of sunlight during fall and winter months causes your brain to make less serotonin, which helps makes you feel happy. This fluctuation of your normal serotonin level can make you sad, sluggish, moody and irritable.

Lack of sunlight also causes an increase of melatonin, a hormone that makes you feel sleepy. This increase may cause you to feel consistently sleepy, versus just at night, and possibly unmotivated and agitated.

 

What can you do about SAD?

There are several things you can do to help yourself, like exercising, taking antidepressants or trying a SAD lamp to replicate the sun’s light. Your best option, though, is to speak with your Primary Care Provider to come up with a plan to combat SAD that’s personalized to your specific needs and symptoms.

 


 

Am I A Caregiver?

Written by Jenn Black, Care Coordination Manager, Think Whole Person Healthcare

 

What is considered “caregiving”?

There are many kinds of caregivers. Physicians, nurses and care coordinators are all caregivers. There is a special kind of caregiver, too. Some caregivers care for their loved ones, and are typically children and spouses. If that’s you, you’ll want to keep reading.

 

At what point does a caregiver become a caregiver?

It’s a complicated thing to define. As your loved one ages, they have a harder time getting to the store or running an errand, and might reach out to you for help. Or, your loved one might have a chronic condition, and that typically means they’ll need help managing their healthcare.

As your loved one continues to age, your responsibilities likely increase. Somewhere along the line, you’ll likely become a caregiver.

 

How do caregivers support their loved ones while also maintaining boundaries?

Being a caregiver is a complicated role to fill. Often, you have your own responsibilities and even families to care for. You want to be there for everyone, but you don’t want to burn yourself out.

First, it is important to educate yourself on your loved one’s condition. This will help you be there for them, because you’ll know what they need. More importantly, however, you’ll learn if something they need is something you can’t do on your own (for example, lifting someone to help them use the restroom). Knowing your boundaries and asking for help will help eliminate stress when certain tasks become daunting.

It’s important that you respect the emotions of your loved one, but it’s just as important to recognize and verbalize your own emotions – and to expect understanding and compassion. Please don’t pretend that you can do everything and be everything for everyone! It’s not personal, just impossible!!

 

Where should caregivers go for help?

Think has an excellent Care Coordination program that eliminates most of your work coordinating, managing medications, and the back-and-forth with multiple doctors. It’s actually quite incredible. When you sign up for the program, you’re paired with a personal pharmacist, care coordinator, and if you’re not yet a patient at Think, your best-fitting physician and their nursing staff. These roles create a team who monitor, communicate, and plan around your loved one’s healthcare. Can you imagine that without Think, you’d be doing all that by yourself? It’s a great solution to manage your loved one’s health, and YOUR sanity. Think About It…and if you decide it could be the right fit for you and your family, then fill out this form to get more information and to get started.

There are other great resources available for caregivers. Family Caregiver Alliance, for example, has a wealth of knowledge that will answer your preliminary questions.