Getting organized is always one of the top New Year’s resolutions. But keeping track of everything that goes along with diabetes can feel like an uphill battle. This week, easy and actionable advice from Susan Weiner, the author of The Complete Diabetes Organizer.

Susan is the 2015 AADE Diabetes Educator of the Year, a registered dietician-nutritionist and certified diabetes educator.

Plus, in our new Now You Know segment, a look at the origins of the Apple Watch’s potential to monitor glucose.

And Stacey’s new year’s resolution is to hear more of YOU in the show this year. If you have a diaversary, special event, fundraiser or just want to toot your own horn or sing someone else’s praises, speak up!! Use this Speakpipe link to send your audio (you can re-record as many times as you like).

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4:10 Interview with Susan Weiner

38:40 “Now You Know” – Apple Watch info/discussion

43:40 Send us your audio!

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Interview transcription:

Susan Weiner is an award winning registered dietitian-nutritionist and certified diabetes educator. She is the 2015 AADE Diabetes Educator of the Year and the recipient of the 2016 Dare to Dream Award from the Diabetes Research Institute Foundation. Susan is the author of The Complete Diabetes Organizer. She is a highly sort after national and international speaker and has authored dozens of articles on diabetes, wellness and nutrition.

Susan, thanks so much for joining me and Happy New Year. 

Thank you Stacey. I’m so excited to be here and happy and healthy New Year to you and your listeners as well.

Thank you so much. You know, it’s funny. I was so excited to talk to you because after 11 years now of type 1 in my house and my husband has type 2. We have stuff everywhere. You know, we try to stay organized and I have my cabinet and then we have a bag in another bag and then but there’s stuff everywhere. And then it’s the routine and the doctor’s appointments. So I know you’re going to fix me and everything’s going to be good today. 

How do you start? It seems overwhelming when you have to do as much as you have to do for diabetes. 

Oh, you hit the nail on the head. I start off my presentations by telling participants that we don’t do diabetes perfect and we don’t do organizing perfect. So start with one small piece that can help your day and your diabetes day go a little bit more smoothly. Maybe that has to do with the supplies that you need when you leave the house in the morning. Maybe it has to do with preparing what you need for the next day the night before. We can talk about a few of those little things throughout our discussion today, but just start very small. Any one little thing that you want to do is going to go a long way.

When you’re starting out, how do you even know what to pick? How do we start?

I like starting in the kitchen. Maybe that’s my registered dietitian hat speaking. We ask people to prepare healthy meals and they have the education in so many circumstances. They know how to carb count. They know more about portion control, what’s healthy and what’s not. So why aren’t they doing it? Could it be that they can’t see their countertops? Or that everything is so jumbled up in the refrigerator or pantry?

Start by stepping out of your kitchen for a moment and looking in. See what you want to tackle first. Choose one small space; maybe it’s the countertops. Let’s start there. If it’s overly cluttered with newspapers and maybe bills that you have to pay or doodads that you put on throughout the day and people just left around. Start by decluttering there. Decluttering gives you such a fantastic sense of accomplishment. You can find what you need when you declutter. The second piece in the kitchen, which is so helpful, is move things out that you’re not using day-to-day. If you still have your Christmas china out in the kitchen, and it’s already January, it’s time to reassign that to a different place in your home. So you can get to your usual pots and pans and wares that you need for day-to-day meal preparation to make it that much easier for you. So start with decluttering one small area of your home and the kitchen, as the hub of the home, is usually the best place to start.

That’s a great point about the kitchen because my husband and I did that a couple years ago. He loves the kitchen and he likes stuff – he likes the mixer and the coffee stuff that he has. We had to figure out what really needs to stay out and what we can move so we can see the countertop.

Absolutely true. I use the acronym SPACE. Space starts with S for sorting. Sort what different things in the kitchen what you’re using every day. If you have two coffee makers, you want to use one and get rid of one right? To make more space start by sorting. P is for purge. Donate, get rid of the stuff that’s chipped or broken or that you’re not using. A is for assign. Move things to where you need them to be in the kitchen or into another place in the home. C is for containerize. Put things into clear containers because “clear is king.” You can see through them and know what you have. And then E is just for continuing the efforts of maintaining whatever strategy you’re using. So these little acronyms help us realize how to organize and really how to stay with it. How to equalize the system.

That Purge one is really hard for me. I sometimes need to call my sister or my husband. To just confirm that it’s okay to donate or throw something out. Sometimes I know it’s junk! Why do we hang onto stuff? 

If you haven’t used an appliance in about a year, that’s the gold standard that I use, get rid of it. It’s the same thing with clothing that you’re holding onto forever. And, Stacey, so many people are in need. If you want to donate to a Goodwill store or your church or a synagogue, people can definitely use what you’re not using. But tossing it and that feeling of openness that’s going to help you feel more accomplished and less cluttered is going to help you stay organized, stay focused and really stay motivated.

When I thought about diabetes organization, my first thought is the cabinet with the supplies. I’m a cluttered person. I don’t mind piles and things like that. It’s kind of embarrassing to say I’m not the neatest person in the world. But, whenever we get a new shipment, I try to go through the “the cabinet” and get rid of old stuff or organize. How can we tackle that diabetes cabinet or even create a space because a lot of people don’t have a whole cabinet to dedicate to it.

I ask people to think like a library. And for people who haven’t been in a library in a while, a library is that place with the big hard books that you get to read that you don’t have to read on a different type of technology or device. In a library things are put together that are alike. So cookbooks might be in one section, and children’s books will be in another section, and romance novels in another section. So you can find what you’re looking for easier.

Diabetes supplies can be grouped together so that you can find what you need more easily. If you don’t have an entire shelf or shelf space for it, you can get a clear plastic container or even a couple of stackable containers. You want to use vertical space not horizontal space. Horizontal space spreads out but vertical space that stacks up helps you find what you need in a jiffy. And on the top put a little label, it could be with a piece of masking tape that you write on so, you know exactly what’s in there and what the expiration dates are. And, Stacey, if you’re finding that things are a little bit cluttered, maybe in your extra storage supplies, extra batteries, or things of that nature, go through it. Slim it down keep what you need toss what you don’t or we use the word before, purge. Purge what you don’t need. It will help streamline  what you need so you can find it easier.

There’s just so much stuff especially with pumping. I’ve seen a lot of people use an over-the-door shoe organizers. It’s clear and I think that’s great. But I don’t like to take everything out of the boxes. I feel like it’s better to keep it in the box. Do you have a stance on that?

I think it depends on what it is. When I do diabetes organizing talks, I bring the clear plastic shoe bag with me to show people what it looks like. That’s one of my props, because I like to show that you can put into the shoe bag either individual supplies or even carb counted snacks. Kids who are trying to help to get more involved in their diabetes management, so they can feel empowered, can re-put things in the clear plastic slots so that you can see it. I think that that’s really a good idea.

But again, every tool, tip, and strategy has to work for the individual. If you like to keep things in the box, the only issue that I have with that, is do you know when the box is empty? It’s great, if you’re traveling to keep the box because it has the, might have the prescription on it, may help help you get through traveling easier, shows the expiration date. But if you use the last supply from that box and the box is empty when you reach for it, then that’s an issue. So when you take something out of the box or it’s becoming emptier mark on it, say one left, two left, whatever’s in there so that you can see it from the outside. Remember that “clear is king.” So in a clear plastic container, you can see what’s in it. But if the box is not clear, mark what’s in it on the outside so you can see what’s inside.

There’s nothing worse than opening that box of insets and there’s nothing in it! When you have teenagers, they do that with food all the time. They put back the potato chips with nothing in the bag or the milk has a drop left in it. 

Exactly, teenagers or significant others or spouses that seems happen across the board. Absolutely true.

One of the points you make about organization is about health records and doctor appointments. I wasn’t thinking of it that way. Can you talk a little bit about why that’s important?

It’s so overwhelming, diabetes overwhelmus, which was a term coined by the late great. Dr. Richard Rubin. And diabetes overwhelmus encompasses all that we need to do, all day long, without a day off without a moment off, when you have diabetes. That includes keeping up with provider or clinician appointments and everything that has to do around your health records. Even though you can have electronic health records and everything is now sent through portals, your medical paperwork is not always carried through and there are errors and mistakes. So, I always ask people to write down their questions either pen to paper or to put it on an electronic device, whatever works best for you. That helps to take the remembering out of remembering. When you write something down, it takes the remembering out of remembering.

Then I like to ask, what is one date that we all have to observe in this country? It might not be a holiday that we like but one date that we all observe in this country is April 15th – tax day. So, I use that as a point of reference for your medical paperwork or bills or unpaid bills or unpaid insurance claims or issues. Use last year’s April 15 as a reference point and as a current point after April 15th of this year. And everything that’s reference that can be old insurance policies flex spending plans, maybe old lab work, whatever it is, old logs, you can keep that in reference. The previous year of reference, a lot of people like to keep in a binder because they still like to touch it. They like to look at the paper. Then after, you can scanned that into your computer. The current documents can be kept, again scanned in, but also in a current binder so that you can bring it with you to medical appointments and actually show it or reference it while you’re with the physician, while you’re with your healthcare provider. So I really like that. It helps to keep you organized but it also reduces that diabetes overwhelmus feeling that you may have when there’s so much you have to do. Finances are truly a big issue.

Yes. There is so much to do. Even, as you said, with electronic records, a lot of us do like the paper. I like a printout even with just account numbers and passwords. Stereotypical here, but many moms run the household or wives run the household for banking, and doctors’ appointments, and all that stuff. I have four people in this house, three of whom have a chronic condition, everyone with different multiple doctors and keeping up is difficult.

It’s very overwhelming and anything we can do to reduce that stress will help. That stress will absolutely affect your diabetes, and your chronic condition, and your ability to cope. So everything that, when we get rid of some of the things that take up our precious minutes, then we have more time for want-tos. Want-tos which may have nothing to do with diabetes or any chronic health condition. So by streamlining these things and giving us peace of mind, I have everything in my hand when I go to the doctor’s appointment and sure you have it on scan, you have it on back up. But you look also more serious when you go into that clinician appointment with everything lined up. You’re better prepared on the phone when you finally get in touch with a representative if it’s in front of you on paper. You can take notes and thumb through it. It’s very important for follow up that way.

We talked about the kitchen and I want to go back to this. We talked about countertops and organizing supplies, but we never talked about the actual food. Do you do you organize your food? 

It’s a great idea to organize your food shopping and your food the way that you need it to be organized so that it works for you. Everybody has different levels of organization, but if you keep a shopping list, whether it’s pen to paper or you use an app or you do it on the notes section of your phone, you’re more likely to buy the supplies you need to prepare your healthy meals. You also don’t double purchase which can really break your budget. When you’re preparing a healthy recipe and you’re looking for one of those ingredients and you can’t find it, that’s an issue if you don’t buy what you need to have.

When you come home and unpack your groceries, ask yourself if you’re unpacking for fit or for use? Think about if you’ve ever taken out a can of beans or a can of tuna fish or some veggies that you’re buying and you shove them in. Either to the refrigerator or you fit them in to the black hole in the back of the pantry. If that happens, you’re never going to find it and you’re going to wind up duplicate purchasing it. It makes a lot more sense to buy a few, or to set up your pantry, so you can find things. Maybe you need a lazy Susan in your refrigerator or your pantry so you can find things. Or taking all your seasonings and spices and putting them on a tiered rack, so you can see what you have. It makes sense to explore more vertical space. Stacking things together in clear containers that are labeled so you can see what you have.

Also, look at tossing what might be expired, tossing things that are duplicate purchases that you don’t need, take an inventory, and see what you do need. We also tend to purchase things that are in our prime real estate, which is the area between our shoulders and our knees. That’s what you reach for a first that’s prime market space in the supermarket. By the way, Stacey, there are 45,000 different items in a typical supermarket. So, we want to go in with a list and get what we need. But even in your pantry keeping things that you need most often right in front of you in that space between your shoulders and your knees is so great because you could find what you need really quickly. And keep the things that you want to eat less often, maybe the less healthy items that are sometimes foods, on a high shelf where you can’t get to them as often. All these little practical tricks will help make things so much easier for diabetes management.

How did you get into all of this? Were you organizing your pantry as a little kid? 

No, no (laughs).  I’ve been a registered dietitian and certified diabetes educator for 28 years, and I’m very clinically and classically trained. I was looking at the people that I work with who have diabetes and other chronic conditions and people who were trying to maintain and lose weight and I was really listening. I’m a very good listener and trying to see where they are in their journey, there was still something missing. Then one night my very dear friend Leslie Josel who is an organizing guru and a very famous professional organizer, called me and said, ‘You know tonight I’m going to be on the TV show as the organizer “Hoarding Buried Alive.” So I tuned in. It’s a great show and I tuned in and I’m watching her take this man, he happened to have been an Elvis impersonator in Brooklyn, and I’m watching this man who also had chronic health conditions who was feeling completely overwhelmed in his existence. And by Leslie taking very small steps, very small tools, tips, and strategies that worked for him one small step at a time. So he felt accomplished in what he was doing. A light bulb went off in my head and I said, why can’t we take these strategies and make them specific for lifestyle change for people with diabetes. Because 99% of diabetes management is self-management.

Really is, it’s unbelievable. So an episode of Hoarders is what led us to this, huh? 

Susan: So I’m going to make you laugh. It’s called, “Hoarding Buried Alive” because we don’t say someone is a hoarder the same way that we stay away from calling somebody a diabetic, rather than a person with diabetes. That’s personal preference, but I was schooled on that as well.

Well, I appreciate that. Words are important. 

Yes, as a matter of fact, there is a new paper that’s just come out between AADA and ADA on language and diabetes and it doesn’t apply to everyone but it does address the sensitivity that some people have for language. For example a person may not want to be referred to as a diabetic but a person with diabetes. Not to test your blood sugar, but to check your blood glucose. Not to use the words control and compliance but rather influence. So language is very, very important and helpful in education.

I agree 100% and I actually try very hard to use the words the way you just laid them out. It’s really been quite an education. I don’t really mind if someone says, oh your son’s a diabetic. But it just doesn’t sound right to me. It’s more like, he’s got diabetes. He’s a person with diabetes, but it’s not offensive to me. When you start talking about this from a healthcare perspective, though, the wording is so important. So I’m glad you brought that up.

We’re speaking in January and this time of year we’re all a little overwhelmed. We’ve made these resolutions. Maybe we’ve bitten off more than we can chew. You were talking about starting small with the man who was a hoarder. Can you bring some of that advice to us?

Take a step back and look at what your goals are. Not your healthcare provider goals, not your spouse’s or significant others goals. Your goals and what you want to do. Pick one goal and be smart about it. And then break it down into a step. What doesn’t work is when you speak to your provider and they say lose weight or exercise more. That vague goal is so overwhelming and when someone says eat healthy, I don’t even know what that means. It has to be a lot more specific.

Ifone of your goals is, for example to exercise more that that is an umbrella goal. Break it down into a small accomplishable step. So take out your schedule for the week and say, you know, I can probably fit in 20 minutes of walking with my neighbor who loves to walk at 6:30 in the morning before work. If you’re not a morning walker I could fit in at six o’clock in the night after work or during lunch with a co-worker. And then circle it in, put it in your phone as an appointment. Really as an appointment. Set yourself up for success by the night before because morning minutes are completely precious, especially when you have diabetes. And I have a lot of organizing tips for that as well for the mornings. Lay out your clothes the night before, your sneakers, your socks, your hat, your sunscreen, whatever you need so that you just accomplished one or two times a week walking. And that will be something checked off your calendar that you did.

The gym is certainly not for everybody. The treadmill is certainly not for everybody. It could be dance. It can be walking, but schedule it in as a small appointment and that’s really where you start. And as a certified diabetes educator, I work very diligently to listen to the people I see in my office, to hear where they are on their journey, when we set up these goals. So that they don’t feel overwhelmed and they don’t look in the rearview mirror to see what they didn’t accomplish. We work on what they can do, what they can accomplish with the limitations of time, and maybe physicality. There may be certain things that they can or cannot do. But I really suggest only taking on one goal at a time.

You mentioned mornings and people with diabetes. Can you give us a couple of tips? 

Of course! I love to set things to music. So whether it’s a child, a teenager, adult, or an older adult find three songs three to four songs, and put them on a playlist that you wake up to in the morning. Songs that you love, not that a parent loves or a spouse loves. Songs that you know that you love in the morning. When the first song comes on as your wake up song, that’s the time that you’re waking up and you’re checking your CGM or your blood sugar. You know, you’re enjoying the song, you know when the songs going to end. You know how much time that gives you. By the time the second song starts, you’re moving to your second activity. Maybe that’s going into the bathroom and grooming doing whatever you need to do. Whether that’s taking your insulin or medications or whatever adjustments you need and so forth. By the time it’s the third song you’re getting dressed. You’re moving forward. And by the way, there’s no moving back. This moving forward to room to room in the morning so that you learn to stay organized and just go forward in the morning. Music is an amazing brain booster.

By the time the fourth song comes on, you’re already dressed and ready to leave the house. Where by the way, you have what’s called a launching pad. A launching pad is where you have your diabetes supply bag and anything else you need to have in the morning, aside from what’s in the refrigerator that you might need to bring that’s already set up and ready to go. So you don’t forget anything. And the reason is that morning minutes are really precious. Evening time, we tend to have a few minutes extra to make sure we have everything to go for the next day. I love doing this with children and teenagers or people who feel a little bit scattered because it takes so much stress off. That you don’t have to think about things in the morning because it’s set for you the night before. So using music as that brain booster to help you calmly get through your morning routine with all that we have to do with diabetes in the morning and setting up what you need to take for the day on the launching pad are two great pieces of advice that anyone can do anyone can do.

So can I ask, what are your songs? Is that okay to ask?

Absolutely! I’m a big Carole King fan. I saw Beautiful on Broadway too, I just love Carole King. So I wake up to the first song, “I Feel The Earth Move.” So that’s one that I really love in the morning and then I go to, I also love jazz. I love New Orleans jazz. So, I like that it as the middle songs and then as I’m leaving, I actually like some Justin Timberlake tunes and I changed those over time because that speeds me up at the end of when I’m leaving in the morning.

One other thing, I love to suggest too, for precious morning time is to use an analog clock rather than a digital clock. Because an analog clock shows the sweep of time. You see time move on an analog clock and there’s nothing wrong with putting an analog clock in every room of the house for a teenager. The bedroom, the bathroom, and the kitchen, or the workout room, whatever room that it’s in, because they can see time moving rather than just looking at it digitally on a phone which does not have the same impact.

Before I let you go, Susan, one of the things that comes up a lot, in those of us who are, let’s face it lucky enough to have pumps and CGMs, is some extra stress that can come along. Technology is really racing forward, but there are extra supplies and things to think about.

It’s overwhelming at times and it’s difficult to keep up with at times because some people feel left behind if they’re not using the latest technology. If what you are currently using is working for you and you feel comfortable with it, you feel in range. It works for you with your physical activity. It works with you emotionally because you feel comfortable with it. It’s staying on the way that it’s supposed to be and you have the supplies you need, then stay with it unless there’s a problem with it for the time being. That’s really the greatest advice I can give. It can sometimes be more stressful, if you’re reading posts on social media, especially of people who might be doing something different. Of course, if there’s a way that you think it can better your diabetes care and management definitely look into it and not to be complacent about it. But if you are really comfortable and it’s working for you, don’t be over challenged by what other people are doing. This is your diabetes life. Not somebody else’s.

That is such great advice because I look around sometimes and think I should be doing that or maybe that could help Benny, but what was it you said earlier? Diabetes overwhelmus?  

Using a phrase from the late, great Dr. Richard Rubin; he coined the term diabetes overwhelmus referring to the anxiety and the amount of work that needs to be done every day just to keep up with your diabetes management.

Thank you Susan. I know, for me, acknowledging that this isn’t easy can sometimes make me feel better about being overwhelmed if that makes sense. I’ll admit I have a lot of guilt; I feel like I should be doing a better job.

Exactly Stacey. Everything that we’re talking about diabetes educators, clinicians, physicians, endocrinologist, pcps pediatricians, it’s so helpful to take a step back be in a non judgement zone and to listen to what the person is telling you or what they’re not saying. Not use yes or no questions when you’re talking to the person with diabetes and or their family, but you watch what they’re saying and what they’re not saying maybe learn a little bit more about motivational interviewing techniques, open-ended questions. And that’s sometimes hard to do when we’re trying to share a lot of information, but by golly that has helped me help so many other people just by learning how to listen. I listen, this is funny, I listen by sitting on my hands because I talk with my hands. So if I’m sitting on my hands, I think it’s difficult for me to speak. So that’s my little technique that I use.

(Laughs) I totally understand that. Susan! Tthank you so much for joining me. I really appreciate it. And of course, we’ll link up all the information to your book and to your website because there’s really just so much good stuff there. Thank you so much. 

Absolutely. Thank you so much for having me. It was my pleasure.

Susan’s Book: The Complete Diabetes Organizer and her other publications can be found on her website:  http://susanweinernutrition.com

 

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