Wellness coaches target women's heart health

BY ROBIN ERB
FREE PRESS MEDICAL WRITER

Grief and stress can be vicious, sneaking up and pressing in on you when you least expect it.

Lori Uyttebroeck went from joking -- "I tell everyone I'm a 46-year-old jobless widow with no income" -- to tearful in the time it took her to try to apologize for it.

"I'm sorry. I didn't mean to. ... It's just that I once thought nothing could be worse than losing my job. Then my husband, he was diagnosed with pancreatic cancer."

Francisco Salazar -- a man who faxed her poetry at work and was forever trying to concoct the best chili and soup recipes -- was diagnosed just before Christmas 2008. He was gone by July.

For Uyttebroeck, a former administrative assistant with a rental car company, eating became mindless and exercise dwindled.

She credits a personal cardiac coach, Peggy Manchester, for helping her drop more than 30 pounds and, just as importantly, find a bit of tranquility in a life that had careened off-course.

A mix of life coach, personal trainer and counselor, health and wellness coaches like Manchester, 44, of Dearborn, help clients forge better health habits one small step at a time.

"You can't believe how many times she called and I was on the edge," said Uyttebroeck of Rockwood. "I had no control over anything, but Peggy reassured me: 'Give it time, and you'll get back on track.' "

A new mindset

It's tough to say how many coaches there are in the United States. It's a mostly unregulated industry and no one tracks the numbers. But a growing focus on wellness coaching marks a major shift in health care, said Ewa Matuszewski, CEO of Medical Network One. The Rochester-based physicians group has a Chronic Care Travel Team -- dietitians, diabetes educators, exercise physiologists, nurses and wellness coaches -- that meets with chronically ill patients.

"Physicians practices are moving from the 'I' approach to the 'we' approach," Matuszewski said. "It's not enough to dictate. You have to work with a patient and provide them direction, but also find out how willing they are to change. We're talking self-efficacy."

International Coach Federation, which claims more than 16,800 members worldwide, says the industry is growing overall -- whether in executive, leadership, life or business coaching. However, those who list health and wellness coaching as their specialty is still small -- an estimated 1% of the federation's members.

For those with certain chronic conditions, Blue Cross Blue Shield is covering the $75 per half-hour sessions with a wellness coach, Matuszewski said.

But about 25% of the time, clients who want to get their health under control shell out the cost out-of-pocket, said Margaret Moore, codirector of the Institute of Coaching at the Belmont, Mass.-based McLean Hospital, a Harvard Medical School affiliate that is helping develop a national curriculum for coaching -- bringing standards, research and credibility to the profession.

Those who choose to pay often are working women in their 40s and 50s who are feeling stretched to the brink, said Moore, whose company, Wellcoaches, began in 2000 and now trains more than 1,000 coaches a year.

Taking charge

Oakwood Healthcare, based in Dearborn, has teamed up with Ford Motor Co. Fund & Community Services in a five-year study into women's heart health using wellness coaches with specialties in cardiac care.

The 400 metro Detroit women involved are at risk for heart disease. Half are assigned one of three personal cardiac coaches and can choose exercise classes, nutrition programs and stress-management seminars. The other half are not.

All of the women are assessed periodically -- weight, body mass index, blood tests -- to see if there is a measurable difference between those who make lifestyle changes and those who do not. Ultimately, study leaders are trying to understand the best way to improve women's heart health.

And though the clinical numbers aren't in yet -- the first participants don't complete their part of the study until this spring -- there's anecdotal evidence that such coaching might be one way to help clients wrest control of their lives again.

"Women don't practice good self-care. They're wonderful caretakers for the rest of their family. It could be their parents, it could be their kids. A lot of women are taking care of their grandkids," said Carla Schneider, one of the cardiac coaches in the study. "To get those women to practice good self-care so they can be good caretakers is important."

In fact, even the study's coaches were "astounded" by how much stress their clients faced, Schneider said.

In addition to caring for their own children or grandchildren, many were caregivers for parents or siblings, had suffered recent deaths of loved ones, bouts with serious disease and job losses.

"So it was pretty hard to say, 'I want you to go out and exercise five times a week, 30 minutes a day, and I want you to eat healthy,' " Schneider said.

Moore, at the Institute of Coaching, has seen it over and over again: "You're stressed out so you eat badly. You don't sleep. You don't exercise. It's one tangled knot and you have to look at that in a holistic way. I don't mean a New Age-y, flaky way. But what is causing what and where do I start untangling it?"

And that's when a coach and client take the first baby steps together -- identifying stress triggers and major health issues, then moving into a plan that's realistic -- and "realistic" is the key -- for each woman.

Sure, there are exercise routines or nutritional goals.

But often it's also helping an overwhelmed client get control of clutter, going grocery shopping to offer insights into food choices, or even helping knock down mental roadblocks.

"It has a lot to do with your mental state. You don't know how bad you're feeling until you're feeling well," said Toni Yanowski, 59, a school bus driver from Brownstown Township, another study participant.

She knew about exercise and nutrition. But fast food drive-throughs helped break the boredom of long hours driving a taxi van and a school bus, and the resulting extra weight fed frustration. A bout with breast cancer sent her further off-course, and she quickly gained 40 pounds.

It was her coach, Schneider, who first saw the tell-tale blood-sugar numbers: Yanowski had also developed diabetes.

Schneider has since helped her develop a better eating plan. And Yanowski no longer sees the elliptical machine and treadmill in her windowless basement as chores to avoid; she instead drives to a brightly lit gym to Jazzercize with her daughter, burning off stress and pounds to the tunes of Madonna and Lady Gaga.

Feeling better

For Uyttebroeck, memories of her husband bring on fast tears.

But she finds catharsis in yoga and belly dancing and BOSU exercise classes. She's down about 30 pounds and is fitting into sizes she hadn't seen in years.

But one of her biggest victories has been in something that no one else would notice. Panicking at her unraveling life last year, she had begun obsessing over the numbers that had been creeping upward on her bathroom scale.

Manchester challenged her to put the scale aside for two weeks.

That was months ago. It's still tucked under a credenza in the hallway. Uyttebroeck said the numbers are now secondary to how she feels.

"I tell everyone that we all have grooves in life," she said. "I'm in the process of cutting new ones."