Blessing the Boats | Mindful Monday

With everything going on in the world, I thought today we would move gently into Monday with a poem by Lucille Clifton.

Blessing the Boats

may the tide

that is entering even now

the lip of our understanding

carry you out

beyond the face of fear

may you kiss

the wind then turn from it

certain that it will love you back

may you

open your eyes to water

water waving forever

and may you in your innocence

sail through this to that

~ Lucille Clifton (at St. Mary’s)


Mindfulness and Compassion | A Special Webinar for Diabetes Specialists

View OnDemand FREE Webinar Now

Being a diabetes educator can be challenging. This one-hour presentation by Heather Nielsen, MA, LPC, CHWC will provide diabetes educators with helpful hands-on strategies to incorporate mindfulness and self-compassion into our daily lives and professional practice.  As a counselor and a certified wellness coach, Heather has an abundance of wellness wisdom to share with educators who provide lifesaving diabetes education and support to people living with diabetes.

Objectives:

  • Understand why mindfulness and compassion skills can positively affect both our personal and professional lives-and participant outcomes.
  • Experience several types of mindfulness and compassion practices.
  • Discuss and plan how you can take these tools into your work and personal lives.
  • Gain new resources to use following the workshop.

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Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and Commission on Dietetic Registration (CDR), Provider DI002. Since these programs are approved by the CDR it satisfies the CE requirements for the CDCES regardless of your profession.*  

The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.

“Awe” Walks Improve Well-Being

Looking for awe helps us move from dis-ease to a sense of well-being.

We all know the physical health benefits of walking, but what if we add the intention to experience “awe” during our jaunts?

Researchers divided older subjects, (60 years plus) into 2 different groups. Both groups walked for 15 minutes and logged how they were feeling and thinking about during their walks.

Intentionally Look for Awe

However, the experimental group was asked to walk for 15 minutes in a natural setting and to intentionally look for moments of “awe” during their outings.

In the study, people who took a fresh look at the objects, moments and vistas that surrounded them during brief, weekly walks felt more upbeat and hopeful in general than walkers who did not. The findings are subjective but indicate that awe walks could be a simple way to combat malaise and worry.

Gretchen Reynolds

Examples of “awe” discoveries could include simple things like noticing a frog peeking at you from a nearby pond. Or observing the variety of hues during sunset. Or looking up at the sky through a rainbow of trees.

Awe Moments Improve Well- Being

As expected, the study participants who simply looked for these moments of awe, had an associated improvement in their sense of well being. Overall, the awe walkers felt happier, less upset, and more socially connected than the men and women in the control group.

The Take-Home Message is “Awe” some

As diabetes specialists, we encourage people to walk to help lower glucose, improve balance, and gain muscle mass. By adding this element of awe, we just might be helping people gain enhanced quality of life too.

Life is hard right now and many people are feeling isolated and sorrowful. By taking a fresh look at these little wonders all around us, it reminds us that we are a part of something bigger than ourselves. And in that knowing, that each of us is important, meaningful, and loved.

Happy Monday. Love, Coach Beverly


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Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and Commission on Dietetic Registration (CDR), Provider DI002. Since these programs are approved by the CDR it satisfies the CE requirements for the CDCES regardless of your profession.*  

The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.

Impacts of Healthcare Inequities & How We Can Change Them

As Diabetes Education Specialists and advocates, we see first-hand how healthcare inequalities impact the health of under-resourced communities.

Just as diabetes is systemic, affecting the entire body, so are the disparities in our public and private healthcare systems.

This is not only a result of public policies, healthcare education, medical racism, and medical classism, but also access to nutritious whole foods, stable housing, insurance coverage, and even enough time in the day to focus on one’s health.

Under the COVID-19 pandemic, these disparities have become even more apparent.

“Black and Latino patients are two to three times as likely as white patients to be diagnosed with COVID-19, and more than four times as likely to be hospitalized for it. Black patients are more than twice as likely to die from the virus. They also die from it at younger ages wrote Ezekiel J. Emanuel, Oncologist, bioethicist, and vice provost of the University of Pennsylvania and Risa Lavizzo-Mourey, Professor at the University of Pennsylvania for The Atlantic.

Acknowledging these perforations of care is an important first step towards a more inclusive healthcare system. This reparative practice can result in more positive outcomes and improve the quality of life for many.

Insurance Coverage & Reimbursement Rates

Picture sourced from https://projects.propublica.org/coronavirus-unemployment/

Equal access to healthcare coverage is key.

The economic impacts of the pandemic have widened the gap in insurance coverage. Around 12 million people living in the U.S. lost employer insurance due to the pandemic, with higher unemployment rates for Black and Latino workers (see above graph).

Since the implementation of the Affordable Care Act (ACA) the number of uninsured individuals and families was reduced. However, 15 states opted out of the widening of programs like Medi-Caid under ACA.

For those insured under Medi-Caid, there is still the hurdle of finding a provider that accepts their insurance. This is because many healthcare professionals do not accept Medi-Caid due to low reimbursement rates.

Initially, the ACA increased rates for providers who accepted Medicare and Medi-caid. But they have decreased over time and with that decrease, the number of doctors accepting or even scheduling individuals with Medi-Caid decreased, as well.

“A 2014–15 survey showed that only 68 percent of family-practice physicians accepted new Medicaid patients, while 91 percent accepted those with private insurance,” Ezekiel J. Emanuel and Risa Lavizzo-Mourey.

In addition to raising overall fees for service, implementing a system in which healthcare providers are reimbursed based on health outcomes can be a way to hold us accountable to provide a high level of care, despite factors such as race, gender, sexuality, or class.


Unlearning Medical Biases & Increasing Representation

Medical discrimination is pervasive.

A study conducted earlier in the pandemic found “that doctors were less likely to refer symptomatic Black patients for testing than they were to refer white ones.”

It has also been studied that white medical students and residents rate pain lower for Black people who are experiencing similar symptoms to white people. This bias impacts their care recommendations and the study found lower accuracy of treatment plans for the Black person’s case example.

Educating ourselves on the history of medical racism and classism while engaging in implicit bias training can help us unlearn these inaccurate assumptions.

Representation matters for Healthcare Providers.

Lack of representation often stems from a multitude of factors, such as discriminatory admissions or hiring practices.

An experiment conducted in Oakland found that involving Black doctors in treatment plans reduced the cardiovascular mortality gap by 19% for Black and white men.

Another example of why representation matters are reflected in how commonly medical texts only show white skin tones. Because of this, Malone Mukwende, a 20-year-old medical student is working on a book to show what symptoms look like on darker skin.

Systemic changes begin with each of us.

Educating ourselves on discriminatory medical practices both for healthcare professionals and the people living with diabetes with whom we work with is a great first step to moving towards a more inclusive medical system.

Written by Bryanna Sabourin, our Director of Operations & Customer Happiness


Read more from The Atlantic article by clicking here. For more information on racial disparities in the treatment of pain click here. For Malone Mukwende’s story click here.


Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE!  Sign up below!


AccreditationDiabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and Commission on Dietetic Registration (CDR), Provider DI002. Since these programs are approved by the CDR it satisfies the CE requirements for the CDCES regardless of your profession.*  

The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.

Lainey Koski – Remembering my Friend with a Heart full of Gratitude

It was a beautiful warm evening when I interviewed Lainey Koski in the spring of 2012. Fifteen minutes into our conversation, I was tearing up with joy, because I knew she was exactly the person I didn’t know I needed.

Lainey had just moved to Chico a few weeks earlier to be closer to her grandchildren and answered my ad for an Administrative Assistant.

From our brief interview, a few critical things stood out. She had built a computer from scratch. She was calm and kindhearted, but she had a certain fierceness and determination about her too. She had a wealth of technology and administrative experience. In short, she was the perfect person to become the first full-time employee of my small, but growing, business.

Lainey elevated our customer service by making sure our website platforms were user-friendly and easy to navigate. In addition, she had a certain technological magic that assured our platforms, and Online University was working right on the back-end. Her genuine concern, skills, knowledge, and attention to detail helped move our company to the next level.

Lainey loved calling customers to speak to them directly.

Even when people emailed with questions about the online university or our website, she would pick up the phone and make sure they had a complete understanding and a fantastic experience.

When Lainey first started, I asked her to believe that together, we were going to grow this little company called Diabetes Education Services.

Lainey was such a great sport. For the first year of working together, we were squeezed into a 10×10 bedroom with 2 desks, our products, a packing station, and my treadmill desk. In addition, my boys, who were 7 and 10 at the time, were frequent visitors. And then there were the two dogs and two cats, who contributed to the overall experience of working in a home-based- office.

Through all the commotion and chaos, Lainey was gracious and understanding. She provided helpful insights on parenting and had a lot of wisdom to share on canning, gardening, and jam making. She shared stories about her adventurous parents, who, with all the kids in tow, traveled extensively plus created a family band.

But it was when she spoke of her grandchildren, that her whole face and being beamed with joy. She would share funny and heartwarming stories about sleepovers with Grandma and their special outings together. Over time, I was fortunate enough to become friends with her daughter, son-in-law, grandchildren, sisters, and husband. My life is richer and better because of knowing Lainey and by extension, her wonderful family.

We worked hard together and had fun too!

In January 2012, Lainey and I conjured up a plan to do a virtual walk across the country to the Banting Museum (where insulin was discovered) in Ontario, Canada. We wanted to make it in time to celebrate World Diabetes Day on November 14th. We both got pedometers and started tracking our daily steps. The Banting Museum was 2,642 miles away. We set a goal of each of us walking at least 50 miles a week, for a combined total of 400 miles a month. We plotted our journey on maps, made virtual stops at all kinds of fun places, and shared our walking path on our Facebook posts and in our monthly newsletter.

We made it to Canada in time to virtually celebrate with the Banting Folk and we continued our U.S virtual tour back home. To this day, I am still walking at least 50 miles a week to continue this tradition that Lainey and I started over 8 years ago.

Finally, in early 2013, we broke ground on our new office. Lainey and I had so much fun picking out paint colors, countertops, and designing our product storage area and packing station.

Lainey is pictured here donning a hard hat in a photoshoot that I had to coax her into doing. She was shy and humble, but with a little encouragement, she was game for almost anything.

To this day, when I look around the beautiful office design and layout, I am reminded of all of Lainey’s ideas and contributions as we created our dream working space.

Early in 2015, Lainey announced that she and her husband Willie would be moving to a homestead near her parents, where she could plant a garden, raise goats, and reconnect with the land.

I didn’t want to see her go, but I was so appreciative of how much she had improved my business and set me up for ongoing success. And, of course, I was joyful that she was moving to live her dream. We agreed that she would continue to provide tech consulting services and help keep our Medication PocketCards up-to-date and posted on our website and CDCES Coach app. Just a few months ago, Lainey helped to design and publish our first Glucagon Emergency Medication PocketCard.

Sadly, Lainey unexpectedly passed away on September 12, 2020. She was young at heart, vibrant, and living her life just as she wanted, on her ranch near her family and connected to the earth, all the way through.

This post is my opportunity to share my profound sorrow and grief of losing such a wonderful human and dear friend way too soon. Many of you reading this might have met or talked to Lainey along the way, and I know that like me, you were blessed for having known her.

But even more important, this is my note of joy and celebration for having the great honor of working with, dreaming with, and loving Lainey Koski as a friend, colleague, role model, and teacher.

Thank you Lainey and know that your light shines on in all the lives you have touched, including mine!

Lainey and I host our Office Grand Opening Party

Ruth Bader Ginsburg – A Note of Appreciation from a Diabetes Nurse

Today, let’s celebrate Supreme Court Justice Ruth Bader Ginsburg and consider the impact of her legacy on our lives.

In spite of a tough childhood filled with loss and numerous obstacles through her adult life, Ruth Bader Ginsberg (RBG) persevered and became a champion for equality. She believed that equal justice under the law should be applied to every single American, regardless of gender.

As a woman-owned business, I owe a debt of gratitude to this trailblazer. She demonstrated through her actions, that women are equally capable of taking leadership roles, running organizations, and being change agents.

She provides wisdom and guidance for diabetes specialists and advocates.

“Fight for the things that you care about, but do it in a way that will lead others to join you.” – RBG

As a Diabetes Care and Education Specialist for over twenty years, I have personally witnessed the positive changes our community has championed. From making sure recommendations are based on evidence to changing our approach from a compliance model to person-centered education. We have advocated for Medicare Coverage for the Diabetes Prevention Program and won approval.

In the spirit of RBG, we are taking a leadership role in promoting CV disease reduction and bringing technology and resources to underserved communities. We realize the importance of equitable diabetes care delivery and are raising awareness of the social determinants of health. We are breaking down barriers and lifting people up.

We have done all this through careful study, collaboration, research, kindness, and compassion.

Just like RBG, our Diabetes Community realizes we are in it for the long haul and big changes take time.

“Real change, enduring change, happens one step at a time.” – RBG

This determined woman instigated a revolution of thought and legislation. Not overnight, but with slow, methodical determination and intelligence and we are forever indebted to her.

Thank you, Ruth Bader Ginsburg. Even though you have passed, your fire burns brightly.

Coach Beverly

Earth Blessing

Today’s blog provides a moment to pause and acknowledge the pain that the earth and many of us are experiencing from fires, the pandemic and intense weather events. I want to share this blessing with our community and let you know that you are important and treasured.
With affection, Coach Beverly

We Hold the Earth

We hold our brothers and sisters who suffer from fires, illness, extreme weather events and droughts.

We hold all species that suffer.

We hold world leaders to make decisions that support healing of the planet and all its inhabitants.

We pray that the web of life may be mended through courageous actions starting today.

We pray for social justice, empathy and awakening to help our already suffering earth community.

We pray that love and wisdom might inspire my actions and our actions as communities. . .

so that we may, with integrity, look into the eyes of brothers and sisters and all beings and truthfully say, we are doing our part to care for them and the future of the children.

May love transform us and our world with new steps toward life.

Adapted from Innovation Institute Earth Day Blessing

3 Things I’ve Learned While Speaking Spanish

On Fridays, I get to provide diabetes care at a local clinic where about half of the people I see are Spanish-speaking only. We do have wonderful interpreters, but I have a strong desire to communicate directly with my clients and really understand what they are saying, in their language.

My Spanish is getting better, but I keep giving myself permission to appreciate where I am now, with the belief that even at my age, I can keep improving.

Learning Spanish Isn’t Easy

Coach Beverly (1987) pictured holding bowl filled with honey and sugar, which was used to treat bedsores in the clinic. It worked remarkably well.

I took a few years of high school Spanish, but never really had a grasp on the language until I signed up to move to a small pueblo in Mexico, in 1987, to volunteer as a rural healthcare worker.

I lived with a local family and helped with daily chores in addition to providing services in the clinic. As part of the “Projecto Projimo”, I helped with everything from cleaning bathrooms to dressing wounds as pictured here. I also attended classes daily in Spanish, to become a “Promotora de Salud”, a community health worker.

Along with learning Spanish, I have gained some other valuable insights that I would like to share.

1. I’ve learned how to be still and listen

For the first few months I lived in Mexico, my Spanish was so bad I was reluctant to talk and embarrass myself.

Instead I did a lot of careful listening and observing.

As with anyone acquiring a new language, my brain was looking for patterns and listening for frequently used words. I studied cognates and learned about sentence structure and common phrases in my textbook, “Donde No Hay Doctor – Where There is No Doctor”, which I would read every night before passing out from mental exhaustion.

This is the book I read at night which taught me a lot of Spanish.

By the third month of living within this new community, I was able to understand most of the questions being asked and respond with rudimentary sentences. Sometimes I could even conjugate in the past tense. That was 30 years ago.

Now, working in the clinic, I have had to dust off my Spanish language skills, that have been languishing in the recesses of my brain for almost three decades. I have committed myself to expanding my Spanish vocabulary and improving my ability to communicate in ways that are meaningful.

When I meet with our Spanish-speaking clients in my current clinic, to fully understand what they are saying, I have to dedicate my whole being to hearing their diabetes stories.

It all starts with listening.

I am completely present to capture all the words they are saying coupled with their body gestures. Sometimes I get so enraptured in everything they are saying, then when they stop, I forget to ask the next question.

In that silence, we have a moment of understanding and togetherness that goes beyond language.

2. The most important phrase to learn

The funny thing is, in spite of knowing lots of diabetes phrases in Spanish and the names of dozens of fruits and vegetables, plus most of the body parts and medical conditions, there is still one phrase that I need to say with each new person I meet.

“No es su culpa” orIt’s not your fault.

When people share their diabetes stories with me, it feels like there is an invisible burden they are carrying on their backs. This burden is reflected in tears or embarrassment for elevated blood sugars. For many, that burden is best described as shame.

They somehow believe it is their fault they have diabetes.

I reassure them, that diabetes is not their fault. It is a complex interplay between genetics, environment, access to healthy foods, stress, inequities, body weight, and age.

Each one of us knows people who don’t eat healthfully, have extra weight and don’t exercise, who never get diabetes.

Let’s help people let go of the shame so they can move toward engaging in self-care that improves their sense of self and well-being.

Let’s remind them that they are worth it!

3. Offer Grace to those learning English

The outstanding thing I so appreciate is the grace that my Spanish-speaking clients show me.

So many times I can’t remember a vocabulary word, or I will say a phrase in a funny way. There are moments where I stumble and feel bad that I don’t have the ability to accurately express what I am thinking.

No one has ever made me feel bad about my mistakes. They are respectful and just politely ask, “Mande?”, letting me know that they did not understand what I was trying to communicate.

They are simply grateful that I am trying to communicate in their language.

It reminds me to be patient with people who are trying to acquire the English language. Let’s acknowledge the courage it takes to tackle a language that you did not grow up speaking. Let’s offer them grace and the opportunity to practice speaking this new language.

We can also let them know they are safe to make mistakes with us.

Gracias! Coach Beverly


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Figs and Drunken Fig Jam. Happy Monday

Our treasured fig tree

On my 40th birthday, I was gifted a Mission Fig tree that was no taller than my 5″ 7″ self.

The tree loved her new home and grew quickly, spreading out her limbs and gifting us with buckets of sweet fig fruit within a few years.

She is a strong and sturdy tree. My teenagers do pull-ups on her limbs and she has survived all kinds of weather events.

She rebounded after an intense wind storm, where her largest limb snapped off. Overburdened with figs, her trunk broke in half one season. We worried she wouldn’t make it, but that summer she produced even more figs.

When we were planning to build my office eight years ago, the architects told us our fig tree would need to be cut down to make room.

We altered our building plan and moved the location of my office to make room our beloved fig tree.

As a gesture of gratitude, our tree has blessed us with fig “over-abundance” year after year.

With my office doors open in the summer, I hear the birds fighting for the juiciest figs that thrive on her crown. During work breaks, we go outside, stand in her shade and search for the plumpest and biggest figs to eat on the spot and later to bake and top with a dab of goat cheese.

To extend our fig enjoyment through winter and beyond, we collected over 7 lbs of figs and made 9 jars of buttery fig jam.

With virtual coaching from my Aunt Hedy in Canada, I cut up 7 pounds of figs, added some sugar, fresh lemon juice and a generous cup of brandy. I cooked on low for at least four hours to blend flavors and reduce the jam to the perfect thickness. The brandy adds a smokey, caramel flavor to the jam, that my family loves. However, it also tastes great without it.

Here is the recipe for fig jam that I modified by cutting the sugar by one – half and then adding it back as needed for thickening.

Drunken Fig Jam (Coach Beverly’s modified recipe)
You can easily google a recipe with more detailed instructions, but here is the basic idea.

  • 4 pounds of figs cut into quarters
  • 2.5 cups of sugar
  • 1/2 to 3/4 cups of brandy
  • Lemon juice to taste (about 1 squeezed).

Put all of the above into a thick pot and mix. Let sit for an hour, stirring occasionally. Then put on a low heat and let simmer for 4-6 hours to reduce to desired thickness. You may need to add a little more sugar for thickening and lemon juice for the right balance of sweet and “lemonyness”.

Then put into sterilized jars and follow usual canning procedures. I always save one jar as a refrigerator jam that we can start enjoying right away.

With all that is going on in the world, I wanted to write a post that is life affirming and voices my gratefulness for the generosity of nature and my fig tree in particular.

Coach Beverly


Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE!  Sign up below!


AccreditationDiabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and Commission on Dietetic Registration (CDR), Provider DI002. Since these programs are approved by the CDR it satisfies the CE requirements for the CDCES regardless of your profession.*  

The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.