Healthy Living in Community
- Written by Jessica Riel
Dino is “on the path of living a life WITH chronic pain and not letting it RUN my life”
When Dino Schnelle retired two years ago, his retirement did not seem to hold the promise of “golden years.” Having suffered hip dysplasia for his entire adult life and then a heart attack in 2011, Dino also left his working life with diabetes and chronic nerve and muscle pain.
“With all these problems and conditions, I felt like my life had been taken away from me,” says Dino.
Dino, now 66, had always led an active life. In the 1980s, he moved to a remodeled one-room schoolhouse in Heath. “I started here as an organic farmer,” says Dino, “growing fresh culinary and medicinal herbs, heirloom vegetables and organizing one of the first Community Supported Agriculture projects in western Franklin County.”
In 1997, Dino took a job with Community Action before becoming the Food Pantry Program coordinator for the Center for Self-Reliance, a position he held for 16 years until his retirement.
His health conditions are what brought on his decision to retire. “Not being able to sit, stand or walk for extended periods of time, not being able to lift or carry large boxes of food, not being able to ‘play’ in my garden or go hiking were all things that restricted my ability to do my job, relax and enjoy the things that were important for me.”
Many people with chronic health conditions feel that, after a diagnosis, they are largely on their own with managing their health, as our modern healthcare system is not built to support the daily management of a long-term condition in the 15 minutes most of us have during a doctor’s visit. Dino was given prescriptions for pain medications and a recommendation to join the YMCA. “Managing my health was now my full-time job,” says Dino.
Last summer, Dino was at the YMCA in Greenfield for a gentle yoga class when he saw a flyer for a free workshop through the Healthy Living Program at LifePath. “Since I did not know anyone who had participated in the workshops, I really was not sure what to expect,” says Dino, but he decided to try it out. “I signed up for the Chronic Pain Self-Management workshop at the Greenfield YMCA in the fall – from late September through November, 2017. I was just hoping to meet others who were struggling with the same problems and looking for practical solutions.”
At the start of the first workshop session, says Dino, his feelings were mixed. “I felt that the reputation of LifePath and my experience working with the organization in the past was one of consistent professionalism, dedication and genuine concern for the people they were working with. I was concerned about the length of the sessions (2 ½ hours each) and was a little intimidated when I saw the ‘workbook’ that was distributed the first session.”
His concerns were understandable. People with chronic pain, as Dino shared, may have difficulty sitting for extended periods of time. Healthy Living workshop peer-leaders, who are also living with chronic health conditions, encourage participants to get up and move around, even to leave the room for a moment as-needed during the sessions to better ensure their comfort.
Fortunately, the heavy workbook turned out to be an invaluable tool. “The workbook laid out in easy detail a wide range of tools and techniques to deal with the ‘limits’ my pain had imposed on me.” Because people who attend the workshop are given the book to keep free of charge, it can also serve as a continued learning resource at home after the sessions have ended.
But on that first workshop day, Dino felt a sense of relief. “It was just a real change to walk into a room of full of people I did not know and NOT have to explain why I was not ‘having a good day’ because of my health problems.”
Surrounded by people from his community who were also trying to manage a life with chronic pain, Dino’s perspective began to shift. “The thing that surprised me about the workshop was the inspiration I got from the other participants, some who were older, some who had struggled with more challenging pain conditions, some who suffered from very different sources and forms of pain. But all of them were demonstrating in their own ways how engaging and facing your pain can empower you.”
Now several months after the six-week workshop ended, thanks to the tools he learned from Healthy Living, Dino says he is “on the path of living a life WITH chronic pain and not letting it RUN my life.”
Healthy Living workshops all have the common practice of teaching people to break their goals down into what Dino calls “simple, easy steps.” Dino reports that “the goal-setting and expectations-management tools have been one of the most important things that I learned, and the exercise and diet tools continue to help me reclaim my life.”
In practice, this means that Dino plans out each day to “maximize my participation in life,” he says, balancing activity with rest so he does not tire himself out to the point of exhaustion. “By planning out my week, I can focus on the priorities in my life of classes and appointments and organizing what I do with whom and when so that I do not suffer the severe ups and downs of over-doing my schedule for a few days and then requiring several more to get my energy back and get my pain back under control. I am now able to attend my gentle yoga and TaiChi classes twice a week, participate in a pain pals support group and am busy in the garden. I maintain my network of friends and, in general, have fewer of those ‘down days’ that are spent on the couch or not being motivated to do all the things I enjoy.”
The workshops include sections on communicating with healthcare providers to make the most of those often short appointments. “Because of the workshop I worked with my health care providers to sensibly reduce some of my pain and blood pressure medications which I felt was only contributing to the ‘woolly-head’ feeling I had from time to time and was one of the things that was reducing my engagement in and enjoyment of my life.”
Dino has even been able to share what he has learned to help someone else: his 87-year-old mother. Immediately following the workshop’s end Dino spent three weeks with his mother after she was released for a 12-day hospital stay for blood clots in her legs. “Upon reviewing the workbook with her, we were able to find exercises that we both could do that would help her build up the strength she had lost in her arms and legs,” says Dino. “She has had a full recovery, and we continue to inspire, support and challenge each other as we get ready to celebrate her 88th birthday!”
- Written by Andi Waisman, Healthy Living Program Manager
Be gentle & forgiving with yourself to change behaviors
I have worked in public health my whole life, reaching people with many different health challenges who are in various stages of changing some behavior. Some people have been challenged to change their risky sexual behavior, their smoking behavior, their drug use behavior, their relationship behavior, their parenting behavior and so on. Most recently, I have the privilege to work with individuals with chronic conditions who are hoping to play a more active role in managing them.
Though millions of us Americans are living with a chronic illness that could be helped by some lifestyle changes, we all find it difficult to change our behaviors. Those of us who have tried to quit smoking, change bad eating habits, increase our exercise, stop risky behaviors as well as those researching change know how difficult behavior change can be. We have learned that people changing their behaviors, regardless of what the behavior is, move slowly through various stages from intention to long-term success. We stop and start. We relapse. We progress. And that’s okay – it’s part of the process.
Research has shown that by making some lifestyle changes, we can significantly affect our health and our quality of life – and those same researchers have identified the factors that influence us to move through the stages to success. Sometimes, just giving people basic information will be enough to move them along the process of change. Sometimes people begin to think about changing when they realize that their behavior has an effect on the people they care about. Sometimes, the act of making and expressing a commitment to a new behavior is what people need to move them forward. Sometimes the work to support someone changing is the work of building confidence, helping them believe that they can be successful and change their negative internal messages to messages of confidence.
Our Healthy Living workshops at LifePath help you use these tools. We serve people who want to get their appetite back, find ways to cook for just one person, manage symptoms, manage their diabetes through diet and exercise, eat more vegetables and add more grain to their diet, fight all kinds of illnesses. They want to get strong enough and have enough balance to get on a bus, to walk their dogs, and to hike in the woods on rough terrain. Our students want to learn how to accomplish their daily activities (gardening, spring cleaning, paperwork) again while managing their chronic pain. We grow confidence in people by asking them to break things down in more doable chunks and by giving information. We teach our students to create confidence-building statements, to find creative ways to integrate physical activity into our lives, and to support each other to solve problems. We make commitments each week to tackle a small, achievable goal and share ideas about issues that concern us.
For me, it was a bout with cancer that pushed me to finally quit smoking. For two of our Healthy Eating students, it was the act of monitoring their eating habits daily, realizing how their eating contributed to their diabetes problems, that helped them to integrate more healthy eating habits into their life. For several of our chronic pain students, just getting information from a peer who also suffers from pain is what it took for them to become open to trying the strategies we teach.
We stop and start. We relapse. We progress. We are grateful to be walking together.
Click here to learn more about Healthy Living or call 413-773-5555 or 978-544-2259.
- Written by Jessica Riel
With Dr. Norbert Goldfield, Chronic Disease Self-Management helps “heal across the divides”
When someone is diagnosed with a chronic disease, oftentimes they may feel a wide range of responses: a sense of frustration and loss; relief from having an answer about what’s been doing on; bewilderment about what to do next. To manage their new condition, they will likely have many questions and try to seek answers, but they may not know where to look.
Dr. Norbert Goldfield understands. A physician for nearly 40 years, he has treated patients around the world, from right here in the Pioneer Valley at a practice in Springfield to refugees in Hong Kong. “Patients should see me as their assistant,” says Dr. Goldfield, someone who is there “to empower them.”
One resource for finding your own way to manage a chronic illness is the Healthy Living Program, offered locally through LifePath and developed by researchers at Stanford. The Chronic Disease Self-Management Program (CDSMP) is one of the five workshops offered at LifePath.
Dr. Goldfield knows Dr. Kate Lorig, one of the creators of CDSMP, and was familiar with the program. As an internist, he found the program to be organized, systemized, validated scientifically, and, most importantly, useful for working with patients who are dealing with their own or a loved one’s chronic illnesses.
“We know that it makes a difference in terms of chronic disease control,” says Dr. Goldfield. “The more the person is self-confident and knowledgeable, the great the chronic disease control.”
In 2016, Dr. Goldfield signed up to become a workshop leader and master trainer. In addition to offering the workshop locally, his intention was to bring the program to the other side of the world.
Healing Across the Divides, which seeks to use community-based interventions to improve the health of marginalized people living in Israel and the West Bank. There, he trained 15 community members from five communities as Healthy Living leaders. Workshops have now helped approximately 1,000 participants, mainly women who are marginalized, have a chronic illness, and are low-income. Because women often direct the health-related behaviors of their families and support networks, they in turn can have a powerful impact on their local communities.In 2004, Dr. Goldfield founded a nonprofit organization,
Dr. Goldfield hopes that the West Bank participants can someday get together with their Israeli counterparts and see their similarities and differences.
Back here in the Valley, Dr. Goldfield believes that other medical practitioners could benefit from enrolling in Healthy Living Leader Trainings as well. “I also believe in lay leadership.” Anyone can learn to become a workshop co-facilitator, and patients can also encourage their doctors to make referrals to the program. “Most people would like to feel better,” says Dr. Goldfield. “This can help.”
Dr. Goldfield will continue doing what he can to make a difference. “My hope,” he says, “is that I can be helpful in other ways that will lead to improved health for a least one more person with a chronic illness.”
To learn more about the Healthy Living Program, enroll in a workshop, or become a volunteer leader, click here or call us at 413-773-5555 or 978-544-2259.
- Written by Jessica Riel
Mike’s review: “I was surprised at the powerful effect that changing my diet had”
Small changes can have a powerful effect on your life. Just ask Mike.
Mike hadn’t been feeling completely himself. “I had tingling in my feet and I was having it a lot,” he says. Wanting to see if a free community workshop would help, he signed up to take a Healthy Eating workshop from LifePath’s Healthy Living Program. The six-week workshop focuses on how food and exercise can help change a person’s health for the better or prevent a health condition from developing or getting worse.
Mike was surprised when the changes he was making started to impact how he was feeling. “Physically, I felt better. After I started the course, at some point I noticed that my feet were no longer tingling. I watched what I ate, and the tingling stopped.”
The program book, says Mike, “had a lot of good information and helped me chart my daily eating and intake habits. I would look up what I ate, and the detailed information about amounts on the charts helped me tweak what I was eating.”
Mike also appreciated being in the workshop with others who were in a similar place. “The weekly commitment and action planning that means you had to be accountable to the group the next week,” says Mike. “It would be easy to sit around the house and say, ‘Let’s start tomorrow.’ But knowing that I had to go back in a week and face the instructors committed me to doing something.”
After taking the workshop, Mike feels better about how his life is going. “The course changed me by giving the motivation to exercise and watch what I ate. It informed me about what I should be eating and how much. And all for free! Thank you, LifePath!”
Healthy Living workshops are “evidence-based,” which means they are proven to work, and are led by local volunteers in communities across Franklin County and the North Quabbin. Workshops are small, and people who attend interact with and support each other. They are open to people with chronic (long-term) health conditions and their caregivers and loved ones.
In addition to Healthy Eating, workshops offered by Healthy Living cover topics like:
- Managing chronic health conditions
- Managing chronic pain
- Managing diabetes
- Improving balance and preventing falls
- Written by Andi Waisman, Healthy Living Program Manager
Workshops for a growing population of people with chronic illnesses right here your town
LifePath has been providing evidence-based self-management workshops for people living with chronic disease since 2011. We are part of a 20-year-old national movement, started at Stanford University developed to help patients with chronic illnesses manage their symptoms and make needed lifestyle changes.
Our workshops are for people who have arthritis, diabetes, heart disease, balance challenges, COPD, chronic mental health conditions or any other chronic condition and who:
- struggle with fatigue, pain, fatigue, difficult emotions
- sometimes feel alone in the challenges they face
- need to change their eating habits
- need more exercise
- feel overwhelmed with taking care of their own health along with all their other responsibilities
- know they need to make changes but aren’t quite sure how
Here is how some local folks felt before attending a Healthy Living workshop:
“I knew I needed to change my lifestyle,” says Gary Reagan, who attended a Healthy Eating workshop. “I was overweight and a borderline diabetic. I have had a stint put in and my doctor was really concerned.”
"I used to want to be in bed almost the whole day, wanting to lie there and not really participate,” says Elayna Haase, who joined a Chronic Pain workshop this past spring.
Research says that if these people take a self-management workshop, they and their physicians report better physical and emotional health, greater energy/reduced fatigue, more exercise, improvement in medical compliance and communication with their provider, and have fewer visits to their doctor’s office or to the emergency room.
What makes these workshops work is that they provide helpful information about exercises, healthy eating and the skills of relaxation, problem solving, and reading food labels. The workshop provides non-judgmental support for your goals; each person develops an action plan and is accountable to their peers.
Here is how our people who’ve taken the workshops describe their gains:
“The course changed me by giving the motivation to exercise and watch what I ate and informed me about what I should be eating and how much. I noticed a physical change,” says Mike, who completed a Healthy Eating workshop.
“This year when I am not able to go out and be as physically involved I used to be, it was especially helpful to develop a network of peers.”
“[There] are still days where the pain is overwhelming. But it is a lot less overwhelming than it has ever been. I feel like I can function a lot better. I can’t believe the difference. My body is never gonna be pain free; I haven’t been in the wheelchair since the group.”
We in the Healthy Living Program have our work cut out for us. Over the past ten years, the national population 65 and over increased by 30% and is projected to more than double in 2060; 90.7% of those people live with one or more chronic diseases and 73.1% live with two or more. Our hope is to reach as many of this population as possible with a message of hope and empowerment.
The Healthy Living Program is funded in part by a grant from Baystate Franklin Medical Center as well as other sources; this generosity enables us to offer our workshops free of charge to community participants.