Beyond Existing
A Coaching Framework for Living with Chronic Illness
Rick Ivone Jr. (USA)
I have lived with Type 1 diabetes for more than three decades. I have sat across from more endocrinologists, diabetic educators, and specialists than I care to remember. Most were highly skilled. They knew their craft and asked all the right clinical questions.
What’s your current A1c
Are you tracking your total macro intakes
Adjusting insulin based on your CGM readings
Those questions really do matter. They keep people alive, and I am grateful for all of them. But they are not the questions that determine whether someone keeps showing up for their life over the long haul.
The question that really matters sits much quieter.
How are you actually doing inside all of this?
That is the question that is rarely, if ever, asked. And when it is not asked, something truly essential gets missed. Not clinically, but humanly.
That gap, between what systems deliver and what a person actually needs, is where this work truly begins. Diabetes is not a condition that comes and goes. It is quietly unrelenting and constant. It is with you every hour of every day, for the rest of your life. For coaches, this gap invites a disciplined question: how do we support clients whose lives are shaped by realities that cannot be solved, only integrated?
Because Existing is Not Living
There is a difference between existing with a chronic condition and living with one. While diabetes is my lived experience, the same dynamic appears across many chronic conditions.
This is not about effort. It is not about discipline. It is not about compliance. It is a difference in orientation, shaping everything that follows.
Existing is a survival posture. Life becomes organised around managing metrics, obligation, and the pressure of getting everything right. Setbacks are internalised quickly. A difficult week becomes evidence of personal failure. Energy is spent maintaining stability rather than building anything beyond it.
Many are doing exactly what they have been taught. They are engaged. They are responsible. They are also exhausted and disconnected from their own lives.
Living with it becomes something else entirely. The condition does not become easier. The demands do not go away. What changes is their relationship to it.
Constraints are acknowledged without surrender. Engagement becomes guided by values rather than fear. Difficulty becomes information to work with, not a judgment to carry.
This is the shift from management to meaning. And this changes how a condition is carried over a lifetime.
The Weight Most People Do Not See
Most who don’t live with diabetes picture it as a few moments in the day. The blood test in the morning. The shot before lunch. The decision about dessert.
A person with diabetes makes hundreds of decisions every day, and almost all of them carry real consequences. Every meal is a calculation. Every walk, every meeting, every stressful conversation, every hour of sleep. Even rest has math attached to it. The decisions never stop. There is no off switch. No day off.
And almost none of this is visible. From across a table, a person with diabetes looks like they are eating lunch, going for a run, sitting in a meeting, doing whatever everyone else is doing. From the inside, they are doing all of that while also working a second invisible job. Tracking. Adjusting. Calculating. Watching. The exhaustion this creates is not the exhaustion of one demanding life. It is the exhaustion of carrying two of them, every day, for the rest of your life.
This is the weight no one sees.
You are always working, whether you decide to do the work or not. The disease is always working on you.
And it is what the right kind of support must meet.
Why the Current Model Falls Short
This is not a critique of the medical system. It is essential. It saves lives. It has saved mine.
But essential is not the same as sufficient.
Source: iCN Issue 54 (Coaching Practice & Innovation); page 55
About Rick Ivone Jr.
Rick Ivone Jr. is an executive transformational coach with over thirty years of experience guiding leaders, entrepreneurs, and high-performing professionals. He is the Founder of Life Studios, LLC, a practice built on the principle that “Existing is Not Living”. He is the developer of the Face-Shift-Live framework, a human-centred coaching model supporting identity-integrated, values-driven change. Living with Type 1 diabetes for more than three decades, Rick brings his lived experience into a disciplined coaching practice, helping clients move from managing their condition to fully engaging in their lives. Connect with Rick @ rickivone.com or linkedin.com/in/rickivonejr.
