Monadnock Family Services
Keene, NH

As written by Gail Williams, Project Director, In SHAPE

Between a Rock and a Hard Place

A large man came through the office door, 6’1”, red faced, round bellied, eyes on the floor ahead of him. I took out my folder of forms and invited Bob to sit down. While I wrote his date of birth and address, the shy eyes lifted, and the quivering voice said, “My doctor told me I’m going to die if I don’t get my blood sugar under control.”

This is often the way it happens. Between the lines of “critical information” the real story comes out. The story of desperation, fear, confusion—the story of the rock and the hard place. The rock is the illness of the brain that cause apathy, difficulty communicating, and difficulty defining reality. The rock is also the psychiatric medications required to settle the mind into smoother functioning. The hard place is the damaging side effects of those medications on the body: the weight gain, decreased energy, forgetfulness, and a heightened feeling of physical hunger.

So here’s Bob, 54 years old struggling for 35 years with schizophrenia, and 15 years with diabetes. He spends most of his time alone in his tiny apartment, when he is not at his part-time job. He spends lots of time searching the Internet for comfort and connection on various religious sites. He sees a case-manager every two weeks for an hour and visits his mother once a week. Bob knows he needs to make some changes to lose excess weight and regulate his blood sugar; inactivity and isolation have put him on the brink of needing daily insulin injections.

In SHAPE provides Bob with a YMCA membership that he would not be able to afford on his own, and with a health mentor, Jake, who will help him make a plan for regular exercise and changes in eating habits. Jake asks, “How about using your computer to look up some low-carbohydrate food options?” Jake also recommends that Bob meet him at the YMCA three times a week to walk on the treadmill and do some light weightlifting.

Bob takes his mentor’s suggestions and begins to look forward to their regular workouts. “It helps to have someone else to focus on so I don’t feel so self-conscious and alone,” he tells us.

Bob embraces the In SHAPE program in other ways, too. He attends cooking demonstrations, meets with a dietician, and follows up with the program nurse after a surgery. For all of these efforts and changes Bob is recognized at the regular In SHAPE celebrations. All participants are invited to the celebration to enjoy a healthy lunch, try an activity like line dancing or nutrition jeopardy, and to be commended for their efforts in changing habits.

Jake tells the group that Bob comes faithfully to exercise each week and that he is increasing his time and speed on the treadmill, and that he is beginning to shed some pounds. When the group cheers and gives him a round of applause, Bob appears younger, stronger more present. He is inspired to keep struggling out from under all the hard places he has had to navigate.

Six months later Bob has lost 34 pounds. He loves that he has more energy and spends less time alone. He loves the sense of pride and accomplishment when his doctor says, “Your blood sugar is down and more stable than it has been in years. Good work.” Bob still carries the heavy rock of his illness, but the hard place is less confining now that he takes a more active role in managing his health. And now he does not have to do it alone.

Graduates 2007 | Project's Graduate Report | Project's Information Page