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Why One Size Does Not Fit All
Posted on October 15, 2012 by Miki Peer
This week we are going to focus on ‘why one size does not fit all’ or how a single ‘treatment plan’ can be realized in totally different ways by different people. By highlighting the important factors that influence how we manage our health we can show that there are several ways to tackle similar goals. Let’s take for example two people recently diagnosed with Type 2 Diabetes: Tim, a 35 year old man, and Sonia, a 65 year old woman. Tim is overweight, but otherwise healthy, and about to become a father for the first time. Sonia is also overweight, a smoker, taking several medications daily, and recently retired. Both are told by their doctor that they need to monitor and improve their diet, exercise regularly and monitor their blood sugar. Tim and Sonia are given similar diagnoses and treatment plans but the context of their lives is quite different. Let’s see what worked for Tim and Sonia in terms of managing their diabetes. For Tim his motivation for better health was his family, particularly the up-coming birth of his first child. A major barrier for Tim in managing his health was his highly-demanding job, so he enlisted the help and collaboration of his pregnant wife who was also motivated to stay healthy. Together they researched diet tips and recipes online, and over time discovered healthy dishes that they both enjoy. Tim made a habit of keeping healthy snacks at hand (in his briefcase, in his desk at work, in the car) so he could stick to healthy eating even if he needed to work late. Tim found that he had time for exercise by combining some of his activities – for example, he does a mild work-out, rather than sitting on the couch, while watching his favorite weekly TV show. After about two months, Tim found he was starting to slip back into his old unhealthy habits. Through talking with his wife, he discovered the source was extra stress at work; Tim was letting stress be his excuse for not taking care of himself. He realized that his health was more important than his work and that these two elements need to be balanced in his life. While this remains somewhat of a struggle for Tim, by making diabetes management a priority in his life and enlisting social support (via his wife) he found that changing his lifestyle and diet was manageable. For Sonia, her diagnosis felt like a burden because she was already having difficulties managing her other health issues (i.e., being overweight and quitting smoking). Sonia started having trouble sleeping and feeling tired all the time so she went to her family doctor who suggested that Sonia might be depressed and recommended a type of antidepressant that has been shown to also help people quit smoking. Sonia began taking the antidepressant and by her follow-up appointment, six weeks later, Sonia was feeling more energetic, sleeping better, and had even cut her smoking down. This really encouraged Sonia to begin tackling some of her other health issues. She decided to learn more about her health conditions, in this way Sonia learned about diabetes and began to feel more confident in her ability to control and manage her health. She learned about proper portion sizes and the importance of keeping a diary of food and blood sugar levels. Sonia also learned some useful tips specific to older persons such as writing a list of all her medications (including dosages and instructions) to bring to her doctors’ appointments. By talking more often to her pharmacist Sonia realized that a pharmacist can be a very helpful part of a healthcare ‘team’. Her pharmacist printed Sonia’s medication-related information in a larger font and took the time to help Sonia find the right products for checking her blood sugar. Sonia now understands more about her health and, with the help of her local library, family doctor, and pharmacist she developed the confidence and skills to manage her diabetes.