Guest Blog: by Aly J. Yale: Updated on 05.10.19
 
Credit and Debt
 
Home » Guide To Combating Medical Debt
 
Overwhelming medical debt is the No. 1 reason Americans file for bankruptcy. In fact, according to a study out of the City University of New York, 66.5 percent of bankruptcy filings cite medical expenses as a contributing factor.
 
These expenses often stem from unexpected emergency room visits or surgeries, costly bills after life events (the labor of a child, for example), or treatments for fertility or chronic illness. Regardless of their source though, they pose a serious financial burden for the everyday American.
 
Not only can costly medical debt make it difficult to pay household expenses, like rent, utilities and grocery bills, but getting behind on those bills can mean a lower credit score, a constant barrage of calls from collections agencies or, in dire situations, even a filing for bankruptcy.
Are your sky-high medical bills forcing you to consider bankruptcy? This guide can help you find medical bill assistance programs, walk you through the bankruptcy process and help get your credit back in good standing.
 
Dealing with Medical Debt
 
Having a solid emergency fund or Health Savings Account is vital in the event an unexpected medical cost arises. Unfortunately, most people don’t have these funds at their disposal. According to the Federal Reserve, nearly half of all Americans don’t have the cash to cover a $400 emergency expense. And many of those people said they’d need to finance the bill in order to pay it off.
 
If you’re currently without an HSA or flush emergency savings fund, it’s important you take steps to prevent unexpected medical costs where possible. To do this, call doctors and hospitals ahead of time to confirm they’re within your insurance provider’s network. You should also ask about how the charges will be coded at the doctor’s office and connect with your insurer to be sure these are covered expenses.
 
When a medical bill does arrive, take this step-by-step approach to tackle it:

1. Make sure you understand the bill. 
First, is it a bill or an Explanation of Benefits? An Explanation of Benefits (EOB) is simply a statement from your insurance company explaining what medical services were covered (and how much they contributed.) Since you’ll be responsible for any remaining balance past that, you will usually receive an EOB first, and then the actual bill later. That bill should come directly from the provider or hospital system they work for.
 
Second, look at the line-item charges and be sure they’re accurate. If something looks off or says it was not covered by your insurance company, call them up and get the details.

2. Negotiate the debt. 
The best time to try and negotiate your medical costs is before any care has been provided. If you don’t think you can afford the full cost of the services you need, ask early on about reduced costs or some sort of payment plan.
 
Providers may still negotiate with you after the bill is issued. Consider asking for a reduced fee in exchange for paying the bill off ASAP or setting up a repayment plan that spreads your costs across several months or years.
 
Other tactics that might work:

• Offer cash. Credit cards come with fees and cost the provider more to process.
• Ask for insurance rates. Medical providers offer reduced fees for different insurers. See if your doctor will let you pay the reduced rate of one of their insurance clients.
• Do your research. Use the Healthcare Bluebook to gauge the average cost of the care you received. If something doesn’t align with your bill, negotiate to pay only the Bluebook value.

3. Consolidate the debt. 
If your medical debt has started to become overwhelming or you’ve fallen behind on your bills, it’s time to consider consolidation. This combines all your debts into one single account, allowing you to pay just one bill per month, ideally across many months or years.

You can do this by putting the debts on a high-balance credit card or taking out a loan. Keep in mind that even if your credit score has dropped due to your unpaid debts, there are bad credit loans that can help.

4. Consider an income-driven hardship plan. 
Income-driven payment plans are available to Medicaid participants with low income. They function like standard re-payment plans in that they spread your medical debt across smaller monthly payments over time. In some cases, providers may even reduce your debt if you’re on one of these plans. Because of this, you’ll want to consider an income-driven hardship plan immediately — as soon as your medical bills arrive.

Getting Help 

There are many programs and providers that will provide medical assistance for free or for reduced costs to those with financial hardship. The United Way can help connect you with some of these services in your area, or you can look to the National Association of Free & Charitable Clinics or NeedyMeds.org, which details medical assistance programs by state. Many of these programs also offer bill advocacy to help reduce and negotiate existing medical debts.
 
Eyecare
Sight for Students
EyeCare America
Vision USA
New Eyes for the Needy
Mission Cataract

Dental
Donated Dental Services (DDS)

Prescriptions
RX Assist
Partnership for Prescription Assistance
The Assistance Fund
Good Days from CDF
Patient Access Network Foundation

Hearing loss
Hearing Loss Association of America
HIKE Fund

Medical equipment
GoodHealthwill
Rehab Equipment Exchange

Prenatal care
US Department of Health and Human Services / 1-800-311-BABY
Healthy Start
Planned Parenthood

Other forms of assistance you might want to consider include:

Medical bill advocates. 
A medical bill advocate is a person who works independently of any insurance agency or healthcare provider. They work on your behalf to analyze your medical bills and negotiate them directly with providers and hospital systems. They usually come at a fee (a percentage of the amount they save you, in most cases). Popular options for medical bill advocates include the National Association of Healthcare Advocacy Consultants and the Alliance of Claims Assistance Professionals.

Help from family and friends. 
You can also ask loved ones for assistance. If you’re not comfortable asking directly, consider setting up a campaign on a crowdfunding platform like GoFundMe or PlumFund.
 
If you still can’t pay your medical bills
 
Despite all these sources of help, you might still be unable to pay your medical bills — and you wouldn’t be alone. Medical bills are one of the most commonly collected on debts in America. According to the Kaiser Family Foundation, 52 percent of debt collection actions in our country contain some form of medical bill.
 
Unfortunately, if you’re unable to pay your medical expenses, this likely means you’ll have collections agencies at your door as well. This isn’t just annoying, but it can have a serious impact on your credit score, too. Having a single debt in collections can ding your credit by 100 points or more.

Dealing with Collections Agencies 
If you’re dealing with debt collectors, make sure you know your rights.  
You should also record every call you have with a collector and get other communications in writing if possible. If you ever feel your rights are violated, consider enlisting an attorney to represent you.

Filing for Bankruptcy 
In the event you’re unable to negotiate or settle your medical bills, filing for bankruptcy may be your only financial option. And the sooner you file, the better. Bankruptcies stay on your record for seven years, and they can have a significant impact on your financial options during that time period. The quicker you’re able to file, the quicker you can get on the road to recovery, financially speaking. In medical debt cases, Chapter 7 bankruptcy is often the best route to take. This allows you to wipe medical bills and other unsecured debts clean, while still keeping the majority of your property and assets intact.
 
Recovering Your Credit

After you’ve filed for bankruptcy and eliminated your medical debt, you’ll need to work hard to get your credit back in good standing. That means paying your bills on time, every time, and avoiding big purchases or risky new debts. You also might consider:

• Securing a 0% interest credit card. This will help you build up credit without costing you lots in interest.
• Taking out a personal loan. Use a personal loan to cover everyday expenses and pay it back over time.
• Use a secured card. Visit your bank and inquire about a secured card. It requires an up-front cash deposit, but it can be a great way to boost your credit if you’re unable to secure a card or loan elsewhere. Some banks also offer credit-builder loans you can consider.
• Become an authorized user on a loved one’s account. Have a friend, spouse or family member with great credit? See if they’re willing to let you be an authorized user on their card or bank account.

 
Finally, just give it time. It takes a while to build credit, and even more when your credit has taken a major hit. Pay your bills on time, avoid expensive new debts and commit to long-term fiscal responsibility, and your credit will recover in no time.
 
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It’s another one of those days. You stayed up late working on a project knowing full well that if you did, you’d receive what was coming to you.
 
The pay you’d receive isn’t something you earn at work like overtime pay. It’s also not the pay you’d receive by way of complements and the words, “job well done.”
 
The “reward” I’m talking about can’t be taken to the bank to save up to spend on something you really want. The “reward” due to you would be how your body reacts to work those long hours. To be more specific, it would come in the form of a pain flare-up.
 
A pain flare-up can come in the form of muscle spasms, deep bone pain, loss of strength, inability to function on a daily basis and the guilt that would follow knowing that you had caused harm to your body.
 
But don’t stay put in guilt mode. Sometimes we have to do what we have to do. Life expects us to sometimes step up to the plate and give it our best shot. Our team is counting on us. All the bases are loaded and we’re up to bat. We can’t just put down the bat and run away. Right?
 
Not all is lost though. There are things you can do to quench the flames of a pain flare-up before the fire gets out of control when you must push yourself at work or home. Here are a few:
 

1. Distraction – Find something that takes all of your attention and that you enjoy. I’m not talking about adding another job on your “to do” list.
2. Humor – Find a collection of funny stories or jokes and read a few pages. Or, put on a funny movie. Choose something that will give you something to laugh about for at least twenty minutes.
3. Prayer and meditating on God’s word – If you enjoy reading your Bible, find a few selections that talk about becoming calm because you know God’s in control, or read a few of the Psalms. Then, after you’ve finished, think about what you read and how you can apply it to your life.
4. Call someone – Often hearing a friend’s voice alone is enough to lift your spirits. Be sure to ask them about what’s going on in their life and not just talk about your current flare-up. It will strengthen your friendship and enable you to take your eyes off yourself for a bit.
5. Ask to be held – There is power in the sensation of touch. It can be a simple squeeze of the hand, but when someone holds you in their arms you can feel their compassion circling around you. It can also give you the strength you need to keep going.
6. Change your position to one more comfortable – Whether this means standing up and walking around if you’ve been sitting for some time; or, if you’re in bed, moving from laying on one side of your body to the other.
7. Take a soaking body or foot bath in Epson salts or use heat and ice – These modalities will help provide pain relief as well as loosen tight muscles.

 
These are are just some of the ways that I use to help me make it through a difficult pain day. Painpathways.org, in their article, “Preventing and Recovering from … Overdoing It!” provides us with several ways to cope with a pain flare-up. One is to, “schedule a rest period mid-morning and mid-afternoon. A half-hour is usually effective, but some people take an hour or longer.” Another way is to, “do light stretching and petting your dog.” Animals can make a big impact on how you feel on the outside as well as the inside.
 
Though going through a pain flare-up can seem all consuming, with the right knowledge, help from coping skills and the support of others, you can get through the flare-up easier and faster than you may have thought you could.
 
In addition, take a look at the Bible verse above. Sometimes we may indeed feel guilty that we caused another pain flare-up, but God is ready to comfort you and speak kindly. He knows the price you’ve paid, and will wrap his arms around you, hold you and tell you that you’ll get through the pain together.

So you’ve been praying about an assignment, working your hardest to complete the task and provide the most accurate research.
 
You want to do well at your job so that you can be in line for a promotion. You work all day and into the evening thinking of nothing but your job. Finally, you’re done.
 
And to your great surprise, it mets your boss’ expectations. He even smiles at you. But what do you do?
 

• Do you go home and celebrate with your family?
• Do you take one of those vacation days to just give your brain a break?
• Do you take the time to thank other people at work for their assistance?

 
No. You’re right back to square one thinking about the next assignment. That vision of your boss smiling at you spurns you on. Now, this may seem like a really good thing, and sometimes it is, but there can be serious consequences if you suffer from chronic pain. But, you don’t care about that right now. Well, maybe you don’t think of the consequences at all.
 
So you keep working all day and into the night the next day to try and get more praise from your boss. It’s a good sign of a hard worker to make sure you do everything to the best of your ability. However, if you’re not careful, your life will be only one assignment blended into the next one.
 
Your goal in this scenario is to please someone else. Is this to be your only goal? I’m not saying that we should be selfish and point the finger at ourselves and taunt our fellow coworkers about what “we” did.
 
I’m talking about a healthy acknowledgement that you did a good job, and it brought you pleasure to know you completed the task.
 

1. Take a breath and enjoy the moment.
2. Think through all the hard work you put in.
3. Thank those who helped you along the way.
4. Share with your family how thankful you are that they believe in you.
5. Be pleased with yourself and all the hard work you did.
6. Allow others to praise you for a job well done.
7. Remember how you thought at the beginning that there was no way you’d be able to do this job, but you persevered.

 
It’s okay to recognize your accomplishments and tell yourself that you did a good job.  And it’s also okay to receive praise from others. It’s not always selfish. A healthy self-esteem can go a long way to carry you through difficult assignments at work and stressful situations in other areas of your life.
 
Inc.com posts the article, “3 Reasons Celebrating Your Many Accomplishments is Critical to Your Success,” describes how you can recognize what you’ve accomplished and benefits from doing so. An example is, “The act of celebrating changes your physiology by releasing endorphins inside your body and you feel incredible,” and, “Celebrating with colleagues and business partners tightens your network.”
 
Did you, also, know that God likes to acknowledge your accomplishments as well? Take a look at the Bible verse above. Here you read of God praising his servants by telling them that they did the job well done. So do it. Tell yourself that you did a good joy and remember it’s okay to receive praise from others as well.

It’s another one of those days. The sun may be shining outside, but inside your heart it’s a cloudy day.
 
You tire from the day-in day-out struggle with pain or an illness. Sometimes you do better than other times, but there are many days that you feel hatred toward your own body.
 
It’s like as if it’s an entity unto itself. It screams at you, “You think you’re in control of your life, but you’re not. I’m in control! I’ll decide what you can or can’t do today. I’m the one who can turn your day upside down.”
 
But you push yourself even though the screams inside haven’t calmed down. Anger is about to spill all over your day, while pain is right behind with fists pounding down the door to your heart.
 
You try to go about your day smiling at people in line at the grocery store or saying pleasant “hellos” to fellow coworkers. However, what’s inside will eventually find its way outside.
 

• You start saying mean things about that slow grocery clerk inside your head. You can’t believe their incompetence.
• Then you make it to work with only a few minutes to spare and think really dark thoughts about how you hate your job and everyone who works with you.
• You sit and try to do your work, but pain is pounding harder and anger won’t go away.
• You get up to retrieve something from the fax machine and you stumble and almost run into your boss.
• Then, just as you’re about to sit down at your cubicle a coworker walks up to you. “Oh, no.” You think. “Please don’t let this be another assignment I have to finish today. I just can’t handle one more thing.”

 
Your coworker gently places her hand on your shoulder and says, “I can tell you’re having the start of another bad pain day.” You feel anger swelling inside of you and then embarrassment.
 
Living with chronic pain and illness can steal much of your life. And it can indeed feel like it’s taking over your life, but it doesn’t have to. You’ll find some ways to look deeply at anger on lasvegasrecovery.com website in their article, “Anger, Resentment and How They Affect Chronic Pain.” The article provides some hands on ways to identify what you’re feeling and then tips on how to deal with the anger. It also discusses how resentment is related to anger in that anger is about the present, whereas resentment relates to the past.
 
Back to your coworker:
 
“I don’t think you know this, but I deal with chronic pain too,” they say. “It’s not an easy road to walk on, but I found that when you have even one person in your corner the anger that’s just beneath the surface dissolves into gratefulness for someone who understands.” Then your worker says they will pray extra hard for you today, and you find your anger just went out the door and a softened heart takes its place.
 
You see, God knows you. He sees that all of your anger has turned your heart of flesh into a heart of stone. But he is able to use people like your coworker to help heal your heart. Chronic pain may continue to spill all over your day, yet you may begin to feel less hatred of your body, and a renewed spirit which can see that there’s hope your day won’t have to be destroyed by the pain you face.

I’ve been doing well for some time now when dealing with anxiety, but lately, pain plagues me around every corner and out pops the anxiety.
                                           
Anxiety and chronic pain create a repeating cycle:
 

• Your pain level increases and you become anxious trying to figure out what you did to end up in a pain flare-up.
• Your pain level increases again and anxiety increases as you wonder how to get out of it.
• Then your increased anxiety in turn creates more pain.
• You begin to withdraw. It takes too much emotional energy to be around other people.
• You become more anxious because you don’t want to let other people down.
• Your pain level increases again and you wonder what other people truly think of you.

 
It’s not that you want to pretend to be something you’re not, but that you want to look like you’re doing better for the sake of those who care about you. So, you become anxious about this, too.
 
But hang in there. There’s hope. Not everyone can handle what you’re going through, but there are those who can.
 
Build yourself a life raft by placing a few individuals around you who can help encourage you to be who you are. Even if that means you’re in an anxiety free fall down the rapids, your friends will help you. These people will pick up your life raft’s oars and help direct you towards a peaceful inlet.
 
So how can your friends help you move towards peace of mind when you’re in pain? Awaremeditationapp.com lists specific ways they can help in their article, “How Your Friends Add to Your Peace in Life.” First, friends can make your immune system stronger. But this isn’t talking about your social media circle, but people who you can spend time with in person. Also, friends can help reduce stress, help with depression, and prevent anxiety. They help ease feelings of loneliness which is among the biggest causes of disconnection and anxiety.
 
Now that you have friends who are helping you build your life raft and directing you towards a peaceful inlet, it’s time to have an anchor ready.
 
That anchor is our faith and hope in God. Knowing, really knowing, he will keep you from drifting further downstream can begin to finalize breaking free from the cycle of chronic pain and anxiety.

Many times disbelief and cruel opinions surround us when we have multiple health conditions.
 
They question us:

• Who told you that you have this much wrong with you? Are you sure you’re not just exaggerating or can it be that you’re faking your pain?
• I know lots of people who have physical pain and other problems and they seem to be able to hold down a job. Why can’t you work?
• You shouldn’t be collecting any Social Security at your age even if it is Social Security Disability. Are you just trying to take advantage of the system? Do you feel “entitled” to the benefits?
• And why did you give up your car? Who told you that you couldn’t drive anymore? So what if you have double vision and trouble with your peripheral vision. Park far away and if you mess up and park crooked no one will care. There. That takes care of that excuse.

 
Out comes the measuring spoon; no, out comes the ladle as you’re covered with a cloak of shame and guilt. But what these naysayers are missing is that you are doing the best that you can do in the situation that you’re in. Try to find comfort in those few words, “I’m doing the best I can do.”
 
You are not a failure. You are not faking your pain. You are not just exaggerating. Every day you’re suffering, yet you walk through your day. Every day you fight giving up, but you don’t. And, you’re the only person who has to believe that you’re not just making excuses for yourself.
 
Having multiple health conditions not only affects the opinions others have of us, but we can also begin to doubt ourselves. Reverehealth.com, in their article, “6 Tips to Self-Manage Multiple Chronic Conditions,” provides ways to help us cope. One of their suggestions is to consider behavioral health counseling. People with chronic conditions are more likely to experience depression, but the opposite is also true: people with depression are more likely to develop chronic conditions. Also, keep track of your symptoms and progress. You may find using a paper journal helpful, but there are also apps that can help such as mymedicalinfoapp.com, medisafeapp.com, and sympleapp.com.
 
And remember, don’t let others’ disbelief that you battle multiple health conditions cause you to wear a cloak of shame. Job was a man in the Bible who had suffered multiple tragedies in his life including a chronic health condition. He felt abandoned by his relatives and closest friends because they believed it was Job’s fault. It wasn’t. God helped Job see that he would never forsake him, and in the end, his life was blessed. God knows that you’re not “faking” your health conditions. He will walk with you through the chastisement of others and will hold you together.

It’s another one of those days. You stayed up late working on a project knowing full well that if you did, you’d receive what was coming to you.
 
The pay you’d receive isn’t something you earn at work like overtime pay. It’s also not the pay you’d receive by way of complements and the words, “job well done.”
 
The “reward” I’m talking about can’t be taken to the bank to save up to spend on something you really want. The “reward” due to you would be how your body reacts to work those long hours. To be more specific, it would come in the form of a pain flare-up.
 
A pain flare-up can come in the form of muscle spasms, deep bone pain, loss of strength, inability to function on a daily basis and the guilt that would follow knowing that you had caused harm to your body.
 
But don’t stay put in guilt mode. Sometimes we have to do what we have to do. Life expects us to sometimes step up to the plate and give it our best shot. Our team is counting on us. All the bases are loaded and we’re up to bat. We can’t just put down the bat and run away. Right?
 
Not all is lost though. There are things you can do to quench the flames of a pain flare-up before the fire gets out of control when you must push yourself at work or home. Here are a few:

1. Distraction – Find something that takes all of your attention and that you enjoy. I’m not talking about adding another job on your “to do” list.
2. Humor – Find a collection of funny stories or jokes and read a few pages. Or, put on a funny movie. Choose something that will give you something to laugh about for at least twenty minutes.
3. Prayer and meditating on God’s word – If you enjoy reading your Bible, find a few selections that talk about becoming calm because you know God’s in control, or read a few of the Psalms. Then, after you’ve finished, think about what you read and how you can apply it to your life.
4. Call someone – Often hearing a friend’s voice alone is enough to lift your spirits. Be sure to ask them about what’s going on in their life and not just talk about your current flare-up. It will strengthen your friendship and enable you to take your eyes off yourself for a bit.
5. Ask to be held – There is power in the sensation of touch. It can be a simple squeeze of the hand, but when someone holds you in their arms you can feel their compassion circling around you. It can also give you the strength you need to keep going.
6. Change your position to one more comfortable – Whether this means standing up and walking around if you’ve been sitting for some time; or, if you’re in bed, moving from laying on one side of your body to the other.
7. Take a soaking body or foot bath in Epson salts or use heat and ice – These modalities will help provide pain relief as well as loosen tight muscles.

 
These are are just some of the ways that I use to help me make it through a difficult pain day. Painpathways.org, in their article, “Preventing and Recovering from … Overdoing It!” provides us with several ways to cope with a pain flare-up. One is to, “schedule a rest period mid-morning and mid-afternoon. A half-hour is usually effective, but some people take an hour or longer.” Another way is to, “do light stretching and petting your dog.” Animals can make a big impact on how you feel on the outside as well as the inside.
 
Though going through a pain flare-up can seem all consuming, with the right knowledge, help from coping skills and the support of others, you can get through the flare-up easier and faster than you may have thought you could.
 
In addition, take a look at the Bible verse above. Sometimes we may indeed feel guilty that we caused another pain flare-up, but God is ready to comfort you and speak kindly. He knows the price you’ve paid, and will wrap his arms around you, hold you and tell you that you’ll get through the pain together.

When walking the road of pain, we come upon those we know. We stop and look deeply into their eyes. Just beneath the surface, lays a mix of frustration along with sympathy.
 
They want to see us:
 

• Not suffering.
• Not hurting.
• Not sad.
• Not wanting to live with this.
• Not ready to give up.

 
It’s hard for them when we can’t seem to find relief. So what do we do?
 

1. Sit down with them and talk about other things in our lives, not just the pain.
2. Show them that we’re more than just a disability.
3. Find a way to lift their burdens – Make them laugh. Lighten their load. Show them we can help them sometimes.
4. Go for a walk together if you can. – If you can’t walk, suggest that you take a drive out into the country to just get away for a bit.
5. Most of all, listen to their story. Because sometimes, they’re going through agony and pain, too.

 
We all carry pain around with us, as we walk down the road of life. Let’s sit down together and share openly what’s going on. Let’s be there for each other and try to understand what we’re each walking through. Because when we help someone else:
 

• Our suffering lessens.
• We stop hurting.
• Our sadness turns to joy.
• We see we can live through this.
• We’re not ready to give up.

 
Also, our suffering can be used to help others. Here are some ideas from yourfamilyexpert.com in their article, “The Secret Way Suffering Helps Us to Help Others.” One way is when we’ve made a bad choice in the past we can lift a voice of warning against addition, abuse, impulsiveness, crime, and a variety of other choices, speaking from experience and influencing others to avoid our mistakes. Also, our pain helps us to be more compassionate and tenderhearted towards others who suffer, which in turn leads to some of the most joyous and satisfying relationships of our lives.
 
Take a look at the Bible verse above. In this we see the good that can come from our suffering. For when we receive comfort from God, we can share that comfort with others. We don’t have to reach out to someone empty handed. No matter how much we are hurting, there’s someone who is reaching out their hands with hope of finding someone who will take the time and reach out to them. Let’s take our sorrows and turn them into stepping stones of comfort and renewal.

When living with chronic pain, at what cost does my saying “yes” bring when being asked to do something?
 
If you constantly push your needs down inside you where no one can see them, and say, “Yes,” to whatever someone is asking you to do, how does that make you feel?
 

• “We both have next weekend off, why don’t we take a trip to the coast? The weather is supposed to be beautiful, and you know how I love to get out my surfboard. Now don’t give me those eyes. I know you have pain sometimes, but you can do this. It can’t be that hard.” (You know just the drive makes your back go into spasms, but you don’t want to make your husband mad. So you go, and spend the next three days after you get home in sheer agony.)
• “It’s the first of the month. Let’s drive to Chico and shop at that new Walmart store. You know the one I’m talking about. The one that’s the size of three football fields. I know you say you can’t walk that much, but you can do this for me, can’t you? We’ll save a bundle, and we always come home with bargains.” (You know all that walking is going to make the bone spurs in your heel scream at you, but you do want to save money. You’ll save now, but you’ll pay for it with the inability to simply walk around the house.)
• “Hey, Honey,” I just got a call from Ed. He said the new bowling alley is open. He wants us to join him and his wife, Bob and his wife and team up for a match. You know it takes six to play. I know you say that you can’t bowl anymore because it hurts too much to swing the ball back. We’ll find you a real, light ball, like the ones kids use and it shouldn’t be a problem then, right? (Bowling? You’ve got to be kidding me! You know if you bowl, you won’t be able to move your right arm for the rest of the week. But you don’t want to disappoint your husband, so you go.)

 
So you see what happens? When you’re not being honest and say, “Yes,” when you want to say, “No,” you risk a break down. Your body says, “Enough!”
 
What are some things that you can do to change not only the outcome of a conversation with someone, but help maintain good relationships?
 
Here’s one idea – There’s strength in the words, “Let me think about it,” and, “I’ll get back to you as soon as I can.” It doesn’t mean that you’re going to excuse yourself from helping others. It just means that taking a few minutes or hours to sort through their request is okay.
 
Creakyjoints.org has some other ideas in their article, “Here’s Some Much Needed Advice for Saying No to Plans When You Have a Chronic Illness (Without Feeling Totally Lame). One of their suggestions is to have an elevator speech ready. Don’t be caught off guard when well-meaning friends and family bombard you with questions or try to guilt you to attend a gather. Try a narrative like this, “I know I look fine on the outside but my joints hurt so much I can barely move. Sometimes I feel exhausted. This is a real medical condition, and I need your support.”
 
When faced with a situation that you know you can’t say, “Yes,” to try to be prepared ahead of time in your mind what you can say to decline when you aren’t able to fulfill someone’s request. Even the Bible verse above says to not try to convince someone why you have to say, “No.” Just let your “Yes” be yes and your “No” be no. There’s freedom in sticking to your boundaries. Then, when you are having a good day, your friends and family will appreciate your company all the more.

“Pass the sugar,” someone says. The sugar is passed and two teaspoons are slipped into a cup of tea. No problem, for most people. But for those who have diabetes, it can be a dangerous choice.
 
Diabetes, or diabetes mellitus, is a chronic disease in which your blood sugar levels (glucose) are too high. What you eat provides glucose for your body. Insulin, a hormone, helps glucose filter into your body and provide energy. Sometimes, with diabetes, your pancreas doesn’t produce enough insulin, and sometimes none at all. This is true of Type 1 diabetes. Whereas, in Type 2 diabetes, the way your body processes glucose fails to do so correctly.
 
In both types of diabetes, this is why you can’t just slip those two teaspoons of sugar into your tea.
 
There are other types of diabetes, such as prediabetes where the blood sugar is too high but not to the point of being in the diabetic range, and gestational diabetes which can occur during pregnancy where the mother’s glucose levels are too high.
 
Depending on the kind of diabetes and the level of severity, it can be treated by diet alone, prescription drugs or shots.
 
Speaking of diet, so what types of foods are good for a diabetic and which should be avoided? Webmd.com, in their article, “Best and Worst Foods for Diabetes,” gives us some suggestions. Some foods listed are starches which include the best to be whole grains such brown rice, oatmeal, quinoa, millet, or amaranth while avoiding processed grains such as white rice and white flour. Raw or steamed vegetables are a good choice such as plain frozen vegetables, kale, spinach, and arugula. Avoid canned vegetables with lots of added sodium, vegetable cooked with lots of butter, cheese or sauce. Read the article to find the complete list of recommended foods.
 
Understanding diabetes, how it affects your body and how food choices can go a long way in helping stabilize blood glucose levels. Always check with your doctor or a nutritionist before making changes to your diet.
 
Also, one of the keys to healthy eating is mentioned in the Bible verse above. Even back then, it was recognized that too much sugar, in this case honey, could make you sick. This is important to consider for those who’ve been diagnosed with diabetes and for those of us who are trying to prevent it.