LifeNotes :: Travis Hiland

After responding to Linda’s post “The Doctor said Celiac is very rare” here:
http://forums.about.com/n/pfx/forum.aspx?nav=messages&webtag=ab-celiac&tid=24
about her frustration at how uninformed the medical community is to Celiac Disease, gluten-intolerance, and malabsorbtion issues, I thought I should post just one of my experiences with the issue.

Nine months ago, my wife was diagnosed with Celiac Sprue. Needless to say, this long overdue diagnosis (12yrs) finally provided the missing link to many chronic symptoms, including extremely severe iron-deficiency anemia, which countless inept physicians either failed to address or chose to ignore, commonly and obsurdly attributing her “severe” and chronic anemia to her normal menstrual cycles, usually with a single swift stroke of their magical diagnostic wands!

Sorry to digress…

Once her Celiac related malabsorbtion condition was diagnosed by our thoughtful and tenacious Nurse Practitioner, IV Iron Therapy was prescribed to help my wife on the road to recovery from years of iron-deficiency. However, due to critical mistakes made by the hospital pharmacy and the nurse on duty in the infusion lab, my wife nearly lost her life.

Iron with Dextran base was prescribed, which is the only iron-base formula that requires a test dose on 1st exposure due to the risk of anaphylactic shock and systemic failure.

The test dose was supposed to be 25mg DILUTED in 50-100 mL of NS and infused (DRIPPED) over 15-20 minutes. The test dose given my wife was NOT diluted and was injected directly into my wife’s IV site, and therefore directly into the bloodstream. In the meantime, the remaining full dose in raw, undiluted form was being drawn up for injection into IV site. All contrary to my understanding of the intended prescription!

I told the nurses to STOP, DO NOT administer anything else until I made confirmations, then I was immediately on the phone to doctor’s office.

Within seconds of receiving the test dose my wife began to experience an escalation of frightening symptoms: First, an immediate sharp pin-prick itching all over her body, then fierce abdominal cramps, followed by a severe tightening of her chest with respiratory distress, before she finally went unconscious. All this transpired within just a few minutes of injection, all without the recommended anaphylaxis management kit on hand in the infusion lab. My wife was rushed to the ER, where she thankfully regained consciousness and was further stabilized.

Two weeks later, we tried again, this time changing the iron formula to a “gluconate-base” (Brand name: Ferrlecit). This second dose was diluted and infused over 5 hours/day for 8 days WITHOUT incident.

PLEASE, remember that credentials are NOT licenses for omniscience. DO NOT take your doctor or hospital or pharmacy at face value. Please require them to check and double check the prescription and its administration. PLEASE DO NOT be intimidated by your doctors and nurses, ASK QUESTIONS until you are comfortable and satisfied with the answers and DO NOT allow your practitioner to EVER dismiss your concerns.

Travis Hiland - www.travishiland.com

As discussed in earlier posts, Celiac Disease is probably the most underdiagnosed and misdiagnosed conditions in the U.S. Outside the U.S., especially Europe are much more advanced in their understanding and earlier diagnosis of the disease. In fact, physicians outside the U.S. commonaly screen chidlren every five years as a matter practice. They know that Celiac is one of the most common genetic conditions in the world.

Celiac is a malabsorbtion condition, or a disease that prevents the body from absorbing vital and basic nutrients, i.e., proteins, carbohydrates, fats, vitamins, minerals, and in some cases, water and bile salts. If Celiac disease is left untreated, damage to the small bowel may be chronic and life-threatening, leading to associated disorders, both nutritional and immune-related, and an increased risk of intestinal lymphomas and other GI malignancies.
One of the basic nutrients pre-diagnosed Celiacs are not absorbing is calcium and Vitamin D and other nutrients required to maintain a strong enamel and strong bones. It is therefore common for Celiacs to have dental problems. My wife’s dental problems were a source of great pain and frustration to her, especially because she is obsessive about her oral hygiene. She brushes her teeth and flosses religiously, yet she made twice the trips to the dentist than thre rest of the family combined. The dentists could only surmize that her teeth were “soft”, an unfortunate genetic anomoly that she would have to live with. Once again, if the dentists had only been aware of the very common celiac symptom of weak or “soft” teeth, they could helped lead my wife to an earlier diagnosis, and saved not only future dental bills, but countless amounts of emotional and physicial fatigue and pain as a result of living with the pre-diagnosed condition.

So, here is another call to share information with your dentist about how Celiac is a very common cause of dental problems, and should be shared with their patients as a possible condition. It is so very easy to have their MD order a blood test to screen for the specific Antibodies related to the disease. Peace of mind can come even by ruling out the possibility.

Travis Hiland -www.travishiland.com

I would like to re-affirm any motion carried forward on this forum that Celiac is not so rare afterall.

I believe most Celiacs can attest to the lack of understanding and underrecognition of Celiac Sprue in the U.S. medical community. My wife was finally, officially diagnosed nine months ago, after the 12 years of symptoms, the severest of which manifesting during the final 6 years before diagnosis.

Research shows that Celiac is probably the most underdiagnosed condition in the U.S and affects more people than Crohn’s disease, cystic fibrosis, multiple sclerosis, and Parkinson’s disease combined. Yet 97 percent of the people with celiac go undiagnosed. Incidently, outside the U.S., Celiac disease is recognized as one of the most common genetic conditions in the world!

Nancy, astutely referenced the conclusions made by the 2004 National Institute of Health Consensus Conference on Celiac Disease, which were validations of a study conducted by the University of Maryland’s Center for Celiac Research (CFCR). One conclusion, as you mention, is that 1 out of 133 people in the U.S. (3,000,000 people) are at risk for celiac disease. Also very revealing, is the associative risk amongst immediate family members.

Celiac disease is known to occur in 5-15 % of children and siblings of those with the disease. The results of one study indicate that one out of 22 first-degree relatives of a celiac have the disease as well. While other studies show that immediate family members have up to 30% chance of carrying the genetic markers for celiac. In 70% of identical twins, both twins have the disease. It is recommended therefore that both first and second degree relatives of a celiac be tested as well. And finally, since Celiac Disease is an autoimmune disease, it is suggested that people living with other autoimmune disorders, like Diabetes, Addison’s disease, Rheumatoid arthritis, Lupus, MS, Grave’s disease, and Hashimoto’s thyroiditis, should be tested as well.

It behooves anyone at all affected by Celiac, including family members, to become overnight spokespeople for the disorder. The medical community at large in this country are grossly misinformed and underinformed about the symptoms, the risk factors, the genetic predispositions, and ultimately how easy it is look for markers in a simple blood test. Learn as much as you can about the disease here: www.celiac.org and www.celiac.com, and share your story with as many as will listen. You may be able to inspire professionals and friends alike, and shorten someone’s time to diagnosis and healing, which is currently averaging about 11 years! Imagine what is must be like to have to wait 11 years before you hear that you are not crazy afterall, you really were sick, but no one understood. For my wife, it was 12 years, and symptoms had to escalate to life threatening levels before diagnosis was ultimately reached.

Travis Hiland - www.travishiland.com

Values-Based Selling techniques enable advisers and selling agents how to understand and use their client’s values to gain their trust and help them make more intelligent choices about their personal and professional goals. The application is equally effective for recruiting and selection. Managers typically ask me two questions:

1. Can I use the values conversation to build the same high-trust relationships with our employees that agents achieve using the values conversation with clients?

2. Will understanding a prospective employee’s values help me determine if they are more likely to succeed?

The answer to both questions is yes.

Understanding an employee’s emotional reasons for wanting to be successful can be very helpful in determining the most effective ways to motivate that employee to pay the price of success. His/her values reveal these emotional reasons. You have to know what these reasons are before they can be effectively used. You may recall Pete Sampras’ emotional tennis match against Jim Courier at the 1995 Australian Open. Sampras was down 2 sets to 0 when a fan yelled out, “C’mon Pete, do it for your coach!” The fan was referring to Sampras’ coach, Tim Gullickson, who had recently suffered a stroke and couldn’t be at the match. Pete dug deep within, actually crying during the match, and somehow pulled off a 3 set come-back to beat Jim Courier. It’s a match that will go down in tennis history. That fan knew what to say to strike a very motivating emotional cord in Pete Sampras. If that fan had not known about Tim Gullickson’s situation he could not have attempted to use it to inspire Pete Sampras. You can’t use a motivator you do not know exists. Understanding your employee’s values will give you a powerful tool to influence their activity.

The reason values are so powerful for building trust in any relationship, especially that of leader and employee, is because trust is built on a foundation of understanding. Values provide a deep, meaningful understanding of another human being. Simply expecting an employee to perform for a stated goal is proven to not work. Values are the reasons why the goals are important. Understand your employee’s values then help him / her fulfill them and you will build an unbreakable bond of trust. The values conversation will help you demonstrate that you care about your employees as people as much as you care about their production. Have you ever told your employees, “people don’t care how much you know until they know how much you care”? What about you? Do your employees believe you care? Prospective employees want to work for, and will perform better for, leaders who truly care.

Trust begins in the recruiting interview and must be nurtured throughout the life of the manager / employee relationship. The following are real answers I received during a values conversation with an established financial consultant named Brian. These same values responses could have easily occurred during a recruiting interview.

The opening comments from the manager are a good way to open the values conversation.

Manager: “One of the things we do at Acme, Ltd is to be sure to only hire people who are serious about being successful. This is very rewarding, but very challenging business and some people are clearly more serious about success than others. Are you serious about being successful?”

Brian: “Absolutely!”

Manager: “What’s important about success to you?”

Brian: “Making money. Enough to buy the sailboat I want.”

Manager: “What’s important about making money and having that boat to you?”

Brian: “Freedom. Freedom from some things so I have the freedom to do others.”

Manager: “When you think about having this freedom, “What’s important about that freedom to you?”

Brian: “Time.” (In a very reflective expression and tone — emotional shift)

Manager: “Oh, so ‘time’ is very important. What’s important about time to you?”

Brian: “Having time for personal growth. Using my time for myself instead of for others.” (Lots of emotion so I can tell I’m getting close to the top of his values hierarchy.)

Manager: “That’s interesting. What’s important about personal growth so you can use your time for yourself instead of for others?”

Brian: “It indicates that I’ve arrived!”

Manager: “Wow. It indicates you have arrived. Can you imagine what that would be like?”

Brian: “Right now!”

Could you tell the difference between Brian’s values and goals?

Goals are tangible things the prospective employee wants to do and have. Values are intangible. Values are about being. The old school would have you focus on the sailboat as a ‘hot button’. The old school would have you asking what kind of sailboat? How big? How much? By when? The manager might think to himself / herself, “I’ve got them now! That boat is going to be expensive to buy and expensive to maintain. If they really want it their going to have be at least MDRT to get it!” We’ve all worked with employees who find it a lot easier to change or lower their goals than to do whatever it takes to achieve them. But values don’t go away. You either do what it takes to satisfy them or lead an unfulfilled life. Very powerful. The boat isn’t it. The house isn’t it. The nice car isn’t it. Even the family isn’t really it. It’s the values, the personal emotional reasons behind the goals that make the difference.
Engaging in the values conversation in the beginning of a recruiting interview will create very positive feelings between you and the prospective agent. This bond of trust paves the way for you to tell them the truth about what it really takes to make it as a life insurance agent / financial advisor. As they begin to understand how this business may be a path toward achieving their goals and fulfilling their values you have the opportunity to have an equally candid conversation about whether or not they really have what it takes to be successful.

Is it possible that one reason there is such an apparent lack of trust between employees and managers is because the wrong person did the selling in the interview? Many employees were sold on the benefits of the insurance business and never really knew what it was going to take to be successful. Make the interview an interview, not a sales pitch for an insurance career. For the few people who really have what it takes there is no other career choice that will get them where they want to be. Stop selling and let your candidates discover for themselves how this business is the best path to achieve their goals and fulfill their values.

Can you determine if a candidate will be successful based on their values?

There are no absolutes, but you can definitely get some clues. Some of these clues are tangible. Some of these clues you will intuit. Clearly, one of the common traits shared by top-producers is their thirst for knowledge.

Knowledge
Top-producers love to learn and grow. For example, a workshop was recently held for a Chicago sales agency. The first person to invest in the workshop training tapes was the 78 year-young top-producer in the agency, Mel Barnes. There is no better indicator of a person’s commitment to their own success than their willingness to invest in themselves. If your candidate values growth and learning it will come out during the values conversation. If you were to simply ask, “Do you value growth and learning?” anyone who ever got a few tips on how to interview well knows the ‘right’ answer to that question. The values conversation will bring out the truth naturally.

Fire in their eyes.
Engaging candidates in the values conversation will teach you to focus more on the emotion in the answers than the responses themselves. Can you feel how badly they want it? Is there fire in their eyes? When you challenge their level of commitment to really do what it takes do they respond calmly or is their an emotional “I’ll show you” reaction. If they can’t convince you how badly they want to fulfill their values in life how are they ever going to convince anyone to give them their money? The few people who will truly do what it takes to fulfill their values, versus the many who will regret they didn’t, have an intensity when they discuss what’s important to them which you will easily detect as you gain experience with this process.

Evidence.
Once you get the verbal response to the “What’s important about success to you?” question, look for evidence in their life, which is consistent with their values. Some people might talk about accomplishment like it’s really important, yet have zero evidence that they have ever accomplished anything. We all know employees who look like a million, talk a great game, but never amount to anything. Don’t rely on the values alone. Get evidence.

As you implement the values conversation as a regular part of your selection interview certain patterns will emerge that will help you make more intelligent choices about who to hire and who to avoid. There are no absolutes, but the candidate who trusts you and has a burning desire to fulfill their values is far more likely to succeed.
________________________________________
Weaker sales employees try to just satisfy needs. Better sales employees help people get what they want and desire. The best producers help their clients fulfill their values in life through the purchase of their products and services. Values fulfillment is to selling in the 90s what needs satisfaction was in the 70s. It’s difficult to be on the cutting edge if you are using 20-30 year old strategies. Use the values questioning of “Values-based Planning” to help employees and selling agents achieve higher levels of success.

Would you like an example of how this works during a recruiting interview?

Manager: “We’re only looking for people who are serious about being successful. My job is to differentiate between the people who say they want to succeed at high levels and the people who are willing to pay the price. Everybody claims to want to be successful. How serious are you about being successful?

Recruit: “Very serious.”

Manager: “Help me understand, what’s important about success to you?”

Recruit: “Making money. Enough money to buy the sailboat I want.”

Manager: “What’s important about making money and having that boat to you?” (Notice we did not get into a conversation about sailing!)

Recruit: “Freedom. Freedom from some things so I have the freedom to do others.”

Manager: “When you think about having this freedom, what’s important about that freedom to you?”

Recruit: “Time.” (In a very reflective expression and tone — emotional shift.)

Manager: “Oh, so ‘time’ is very important. What’s important about time to you?”

Recruit: “Having time for personal growth. Using my time for myself instead of for others.” (Lots of emotion so I can tell I’m getting close to the top.)

Manager: “When you sum it up, what’s important about personal growth so you use your time for yourself instead of for others, to you?”

Recruit: “It indicates that I’ve arrived!”

Manager: “Wow. It indicates you have arrived. Is there anything more important than the feeling you have arrived?”

Recruit: “Nothing more important.”

Manager: “Suppose we put together a strategy to help you have the type of success which will get you the money so you can have your boat and, more importantly, that will lead to the type of freedom which will give you the time to have the personal growth which allows you to do things for yourself instead of responding to what others want so you can feel like you have “arrived’. Is that the kind of plan you could get committed to?”

Recruit: “Absolutely!”

You have now created the same kind of impression in the mind of your prospective agent that you are going to expect him/her to create with their prospective clients. A good relationship between a manager and an agent should be exactly the same as a good relationship between an agent and his/her clients. So shouldn’t the exact same strategies be used to cultivate these relationships? The manager / agent relationship must be based on trust. Trust that you care more about helping them succeed for their reasons, not just for the override. If there is not a high level of this kind of trust it is very unlikely that the agent will execute the plan you develop, even though it benefits them. Part of your job is to keep the employees focused on why (the emotional reasons) they are enduring the pain required to succeed in their career, especially if it’s a selling career.

Understanding their values will help you present the plan (and consistently hold them to it) in their terms, for their emotional reasons (their values). After all, how can an agent trust that you are interested in helping them succeed for their reasons if you don’t even know what their reasons are? Add values questioning to your interview and you will develop a relationship far superior than you may be currently achieving. Isn’t that how you get what’s important to you! Have fun.

Travis Hiland