Dr. Manuel Serrano-Gil | 1
INDEX I. Buds and hollows Expert Patient ...............................................................................................3 II. Expert Patient Movement ........................................................................................................5 III. Expert Patient Movement Obesity/Diabetes...........................................................................7 IV. The magic effect of support ..................................................................................................13
Dr. Manuel Serrano-Gil | 2
I. Buds and hollows Expert Patient Society is a puzzle. The objective is to complete the puzzle, the social cohesion. Each one of us is a piece with buds and holes. Buds are our ability to help others. Holes are our need to be helped. Help can be replaced by support, care, cherish, love.
Newborns, aged people and sick people, are pieces with many holes.
However, they are both necessary and valuable. Without these pieces there would be no puzzle.
Dr. Manuel Serrano-Gil | 3
When two pieces merge together, they both grow and new buds emerge. The more unions, the bud becomes a branch and suddenly you realize you are in a tree. The expert patient is the one who helps others while let himself be helped. To take care of others is to take care of oneself.
Dr. Manuel Serrano-Gil | 4
II. Expert Patient Movement To take care of ourselves, we need help. In 2006, I introduced the term “Expert Patient” in Spain. But somehow it has spread the idea that the expert patient is "Superman", some kind of almighty person. But Superman does not exist. Or the "encyclopaedia" patient, who "knows" a lot. But the information is not enough. We have several diets at home, or we can just search for them on Google but we do not follow them. We know we should exercise and take our medication, etc. But we just don´t do it. To know is not the key here; the key is to WANT and to ACHIEVE. The expert patient is the ONE WHO LETS OTHERS HELP HIM AND HELPS OTHERS IN RETURN. To say: "Yes I want", and "Yes I can". This is not my own saying, but the World Health Organization´s one, concerning the Support to Self-care as the key to chronic patients´ care.
Dr. Manuel Serrano-Gil | 5
With the health professionals’ support, in addition to families and groups, you get the will and the power to achieve. Support groups, led by expert patients, and supervised by health institutions, are the 21st-century medicine´s revolution.
Dr. Manuel Serrano-Gil | 6
III. Expert Patient Movement Obesity/Diabetes If you suffer from diabetes and obesity and overweight, you can greatly improve your disease, and not need as much medication. Change your mind. It is not a matter of weight losing but changing your behaviour. For any purpose concerning health or life, there are three steps: KNOWING, WANTING and ACHIEVING. "Knowing" is not an issue, how many Google-diets are there in your house drawers? And in the event of a doubt, we can always reach a doctor or a nutritionist. Additionally, the question is not the kind of diet. I´ll explain it with an example: If you lose a kilogram, next week, we will give you 1000 Euros; if you lose two kilograms, you´ll get 2000 Euros; and if you lose four kilos, then it will be 4000 Euros.
Dr. Manuel Serrano-Gil | 7
"Say no more. I do not need to know about the diet. I´ll not even drink water". Moral: "We would do it for money but not for our health". The problem is not knowing but wanting. It is about changing our will, to get our motivation at least by 7 over 10, being 10 the 4000 Euros prize. Write down your reasons to lose weight, for instance: “Because I want to take off this 20-kilograms backpack I am carrying. My heart, my engine, is overloaded"
"Because I want to improve my health, my diabetes, my bone pain, etc" "Because I want to look and feel better, etc" Keep that little piece of paper on your night stand and check it frequently. Dr. Manuel Serrano-Gil | 8
If you don´t change your mind, when you reach (for example) 70 kilograms after having lost 20 you will say: "70 or 71? Whatever, I'm fine" And the next week ... "72 or 73? This shirt still big for me" ... and so on, until you reach 90 kilograms. To change your mind is to HAVE A "MAGIC" NUMBER: "I am a 70 Kilograms person". And so, if you gain an extra kilogram, you will think this way: "71, I'm fine, but I'm a 70kilogram person, so I'm going to lose it" To know, to want and to ACHIEVE "I have tried so many times and I cannot" However: you have achieved so many other things in life: a job, a family, etc. By seeing other people like you who have achieved it and who are dedicated to helping you, the expert patients, you will say: "If they can, I can too" The foremost impulse, even more than those 4000 Euros, is to do it for "someone" instead for "something". Dr. Manuel Serrano-Gil | 9
To do a mind-shifting you need to be an expert patient: let others help you, and help others. It is very challenging to do it just by yourself. Look for someone. Ask for your doctor´s help, or your family ´s, friends´, or self-help groups. Help others. Do it for "someone". Sign up for a volunteer group. Now you already know that the key factor to lose weight is to change your mind, to want and to be able to do it. And this can be achieved with social support: let yourself be helped and help others. Allow me to talk about this. If you are suffering from diabetes or obesity, your problem is that the pancreas, so-called the "sugar burning oven", is not working as it should be. The ingested sugar does not burn and gets transformed into accumulate fat. To lose weight this oven must be fixed, and the fat removed from the belly. And how is this done? Well, simple. Deliver less sugar to the oven, so it rests a bit. Sugar is the body's gasoline. When we exercise we need sugar. If the organism does not find sugar, he will look for the required energy at the fat layers and loses weight. Dr. Manuel Serrano-Gil | 10
If we exercise sugar disappears first, and then we burn fat. Best sugars can be found in fruits, and even better ones, in vegetables. There was a patient who took 15 medlars a day. "The fruit is good," he used to say. And of course, he did not lose any weight. He took too much sugar. He was not told: "Medlars are forbidden" instead, he was told: "How many medlars do you need to feel satisfied?" And he said: "I think I can manage myself with four". And just one week later he found himself two kilograms lighter. In other words, it is like a custom-made suit. Thinking about the most influential sugars. For example, if instead of half a loaf a day, you take just a quarter and you see that each day you lose 200 grams, it means you will lose one kilogram each five days. And how about if you gain 500 grams during the following weekend? No big deal, it will be two kilograms a month. This way you get to know your own body. You have the "key" of your own health. Weighing yourself will not be any more "let´s see if I won the lottery", on the contrary, you will be able to estimate how much it will be depending on the sugars, the exercise you have done, and other factors, such as fluid retention, etc.
Dr. Manuel Serrano-Gil | 11
There are no forbidden foods. If you have a slice of bread in your hand, no one will prevent you from eating it. Isn’t it so? The main difference is that when we say "I can´t eat bread", we don't like it. But when we say, "Yes, we can eat bread, but we don't want to" sounds much better and we can live with that. So you will think: "It's worth not eating this bread and losing 200 grams" Meaning, "yes, it is hard enough but it's worth doing this small sacrifice". Fat is on the menu? Yes, but it must be considered that the loss weight will be slower because you have to burn the ingested fat in addition to the one yet in your body. How about proteins? The proteins ingestion must be adequate, so that when we lose weight, we do not lose muscle mass, making us look sick. Where are the proteins? In meat, fish, and in all kinds of cans: mackerel, tuna, mussels, cockles, sardines, razor-shell, octopus, seafood, etc. These are some generic tips. To lose weight, it is necessary to be followed-up by a healthcare professional. Losing weight can also adversely affect our health. You should discuss with your doctor about the decisions you have made by reading the previous text, to check if they are the right ones. Dr. Manuel Serrano-Gil | 12
IV. The magic effect of support
Why some people take care of themselves and others does not? Why some people suffering an incurable disease use to answer "I'm fine" when they are asked how they feel, while others who have a perfect body, however, say "I'm not fine"? Health is the entire bio-psycho-social well-being. In other words, health is not only the cholesterol or the mind. The social component is the big forgotten one, and perhaps the most important one. Once I told to an obese patient: “You have to lose weight", and his answer was: "My problem is not to lose weight, but being unemployed" Dr. Manuel Serrano-Gil | 13
you?".
A relative's death, a problem on the job, or above all, "feeling alone" even if member of a large family, make us answer "I am not doing well" when we are asked, "How are
How do you manage to say “I'm fine” despite having a serious illness? You will be able to say "fine" if you have an answer to the question "Who helps me?" To help Help, support, care, love. Mothers often ask their children “Who loves you?” As Goethe says: “It strengthens more knowing oneself loved than knowing oneself strong” If you answer "Bad" or "Regular", it's not big deal. That’s the starting point. On the other hand, if you answer "Fine", you will not look for help because you'll think you don't need it. For example, obese chronic patients happen to feel as the anorexic but the other way around: they consider themselves "good" even if they weigh 120 kilograms. They should clean their glasses and look again: "I'm not so good or I could be better" Dr. Manuel Serrano-Gil | 14
Many chronic patients are resigned to having a bad time, but if they allow themselves to be helped, even feeling fine, they can feel even better. We live in a type of society where it is usually considered that "you worth as much as you have". If you do not have money, health, beauty or youth, you are worth less than others.
The patient with a chronic disease (obesity, diabetes, pain, depression, cancer), is told: “Bad luck!” which is equivalent to: "you worth less". What is "magic" about the help? It´s the effect of each and every volunteering: When someone dedicates time to another person, and he does it for free, he is saying: "You worth it", “not for what you have but for who you are”. We only devote time to what is valuable to us. If we have a plant at home, we take care of it. The patient finds himself as a "Chinese vase". In other words, something we cherish every day because it is priceless.
Dr. Manuel Serrano-Gil | 15
If I am worthy I start moving on, I turn on the car´s engine: it's worth taking care of me. Also, I'm not alone, I have help. This help´s magical effect befalls naturally in a family where the key factor is not "having" but "being": being a father or mother, son or daughter, husband or wife. And it also occurs with friends and support groups. First, allow yourself to be helped. Open the fuel tank and let the gas flows in. You cannot give what you do not have. And then help others, which is the other side of one's health. The patient who helps others helps himself. It's a boomerang effect. With social support, the chronic patient changes his mood and say: Yes, I worth it. Yes, I want. And yes, I can. And when he is asked about how he is doing, he will reply: I'm fine, even if I bear an incurable disease. The health´s door opens outwards. We need you, to be helped and to help others. Here comes the telephone image: If I call my parents' house, when they say "hello" I must just say, "It's me". No further explanation is required.
Dr. Manuel Serrano-Gil | 16
If I miss-dial, someone would think I'm crazy. I? Who am I? So, there is no me without you. Without you we are nobody. How do we perceive other people, as things or as persons? Are they a paper or a music sheet? A piece of paper is only good for one-time use. With a music sheet we can create something new together, music, timeless music. Pieces of the puzzle to which I can connect and grow together. From time to time, some injuries can occur within the pieces of that puzzle causing the pieces to separate. Forgiveness is like a rubber that erases those wounds re-connecting the pieces. Knowing yourself forgiven and learning to forgive helps you to feel better, by getting rid of the poison we carry inside. The more pieces attached to us, the easier will be to take care of our health. An isolated piece does not make sense. Two cards can hold each other.
Dr. Manuel Serrano-Gil | 17
There are people who help others for what they are and not for what they have. And they expect nothing in return. Once a lady asked an expert patient: "Why do you help others for free at the supporting groups? Are you from planet Mars?” And the expert patient said: “No lady, I'm not a Martian; I'm a Murcian” (from Murcia/Spain) Martians are a myth. Murcians do exist. From Murcia, Spain. Volunteering. The expert patient is not some kind of superman with a perfect body. It is better to call him the "beautiful" patient. A mother will never call her child "fat". Instead, she will say "my child is beautiful". And it's beautiful to see some people, even if they have a little tummy, helping others for free. The expert patient is like a new pill. It provides health. And without side effects. He is the socially-committed patient. He is not only seeking to improve his own health, but to build a healthier society/community. The complete puzzle.
Dr. Manuel Serrano-Gil | 18
Complete the puzzle
Buds and gaps
Two pieces merge together, new buds emerge
buds, a branch, a tree
Pieces with many holes
baby: many holes
aged people: many holes
Sick people: many holes
Let others help you. Help others in return
Superman does not exist
Encyclopaedia patient
Support for wanting and achieving
Change your mind
Knowing, wanting, achieving
Many diets in Google
The health professional has the book
Keep paper in your night stand
The 20 kg backpack
4000 euros example
Write down your reasons
Dr. Manuel Serrano-Gil | 19
The heart, the engine, overloaded
Oven is broken because fat
Fruits, vegetables: best sugars
Magic number: Who am I?
“If they can, I can too”
Pancreas: “the burning sugar oven”
Sugar is the body´s gasoline
Exercise sugar disappear
Custom made suit
The key of your own health
Who helps me?
Obesity as anorexia but other way around
Volunteer effect: “You worth it”
Plant we take care of it
Chines vase: we spend our time: it has a value
First open the fuel tanks: let others helpyou
Boomerang effect of helping others: we help our selves
Repair the oven: fat removed from belly
15 medlars example
Proteins Slice of bread on the hand
Clean your glasses
I I have a value, I turn on the car´s engine
Dr. Manuel Serrano-Gil | 20
Telephone example: “Its me”
There is no me without you
Forgiveness: get rid of the poison
Paper or music sheet?
Two cards hold each otherr
Music is something new, timeless
Martians are a mith. Murcian doe exist
Expert patient: new pill
Dr. Manuel Serrano-Gil | 21
Forgiveness a rubber to reconnect pieces
Beautiful patient: little tummy, but heaping others for free
