#78 - Kim Rose: What Behavior Consulting Can Learn From Nutrition

In this week's interview episode, we're reaching beyond the animal care industry and speaking with Kim Rose, a dually certified diabetes care & education specialist and nutrition support clinician who blends evidenced-based practice with lived experience and cultural inclusivity. There is so much we can learn from other fields when it comes to care of our pets, ourselves, and our clients. 

In this episode, you’re going to hear Emily and Kim talk about:

• Fiber is magical
• How to strike the balance between sustainability and efficacy
• There are many paths up the data collection mountain
• Nutrition, like behavior, is a study of one
• Boundary setting for ourselves and our clients

You can find the full episode show notes here.

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Transcript

[00:00:00] Kim: I love that people allow me, or people invite me, to go on a journey with them. I believe diabetes is a journey. It is a lifelong journey, and they have allowed me to walk the path with them and that, that's how I literally view it in my mind. My mind is such a very picturesque mind, so I view it as walking a path together. Because a diagnosis is intimate, it's vulnerable, sacred, and for me to be a complete stranger that you don't know, but then to trust me, that is, it's, it's quite, I don't have the proper word for it, but it's, it's heartfelt. It's quite heartfelt, it's something that I don't look at lightly. Something that I think about quite often. And I'm just grateful for the opportunity, honestly, because I feel like if I could help one sea turtle that is stuck on the sand, back into the ocean and start swimming, I have made a difference.

[00:00:53] Allie: Welcome to Enrichment for the Real World, the podcast devoted to improving the quality of life of pets and their people through enrichment. We are your hosts, Allie Bender...

[00:01:10] Emily: ...and I'm Emily Strong...

[00:01:12] Allie: ...and we are here to challenge and expand your view of what enrichment is, what enrichment can be, and what enrichment can do for you and the animals in your lives. Let's get started.

Thank you for joining us for today's episode of Enrichment for the Real World, and I want to thank you for rating, reviewing, and subscribing wherever you listen to podcasts.

The voice you heard at the beginning of today's episode was Kim Rose. Kim is a dually certified Diabetes Care and Education Specialist and Nutrition Support Clinician who blends evidence based practice with lived experience and cultural inclusivity. After graduating from Florida State University, Kim volunteered for one year living and working amongst underserved populations in various areas of Alabama.

As a nationally recognized nutrition expert, Kim has been featured in the Huffington Post, Forbes, the New York Times, and numerous magazine and broadcast television outlets. Her inclusive approach and philosophy revolve around making nutrition easy and attainable.

With over a decade of experience, Kim has taught thousands of clients, patients, and their family members how to enjoy the foods they love without compromising their health. She does this by uprooting common food related misconceptions in her private nutrition practice, and empowers her clients to build sustainable and tasty eating patterns for better blood sugar management.

So, Ellen has been raving about Kim for quite a while and I was so excited that Kim agreed to be on the podcast, and to talk about how she approaches nutrition because it's so similar to how we approach behavior. One of the things that, for the professionals listening here, that is really helpful is to learn from other fields because there's so much that we can take away from how they do things, and that makes us better professionals. So, I'm really excited for you to hear this interview with Kim.

In this episode, you're going to hear Emily and Kim talk about: 

·         fiber is magical

·         how to strike the balance between sustainability and efficacy

·         how there are many paths up the data collection mountain

·         nutrition, like behavior, is a study of one, and 

·         boundary setting, for ourselves and our clients.

All right, here it is, today's episode, Kim Rose, What Behavior Consulting Can Learn From Nutrition.

[00:03:34] Emily: Okay. Tell us your name, your pronouns and your pets.

[00:03:38] Kim: So, I'm just tempted to say, do you want my government name? But I go by Kim Rose. My pronouns are she and her. And no, I don't have any domesticated pets, but I like to think that the squirrels outside that come to my back door are my personal pets.

[00:03:56] Emily: I adore that. And if you haven't seen him yet, I wish I could remember his name and I will find out for you, but there's a guy on Instagram who films his, like, relationships with the squirrels in his backyard.

[00:04:10] Kim: I know that that's the type of level that I'm trying to get on, to be honest with you. Like, where they're comfortable climbing up my leg and my arm. I love it.

[00:04:18] Emily: Yes, yeah, those are life goals for sure. That's delightful. Okay, so tell us your story and how you got to where you are.

[00:04:27] Kim: Yeah, so, my story is long, so I'll give you the condensed version. So, I was originally born in Jamaica, and I spent the first few years of my life there. As raised with immigrant parents, you come to the United States and you view the United States as like the land of opportunity.

So, immigrant child has a story where it's like, you're going to be a doctor, you're going to be a lawyer, you're going to be an engineer. In my journey, I realized, well, you know, I'm inclined,  I'm inclined towards the medical community, but I don't want to be a doctor because who wants that stress? No knock to any doctors, of course. It's that we are all united by a few common things and that one common thing, which carries a lot of emotion behind it, is food. So I remember when I was in high school and college, I would always say, “I don't care if you're the queen of England or the president of the United States, we all have to eat,” and food is that common denominator that for me, it breaks down walls. It's intimate. It allows people to get into your life.

So, when I finally went off to college and I learned like, dietitian, nutrition, dietetics, what is that? I realized that that was definitely the path for me. So, I said, you know what, I'm just going to go straight, and become a dietitian because at the time it– Being a dietitian of color was, it wasn't rare or non-existent, but it was just quite unique.

So, I said, that's what I'm going to do, that's what I'm going to be. So, I became a dietitian, and after becoming a dietitian and moving to a little small town in Florida, I realized that, hey, a lot of people are suffering from diabetes. And when I started to look at the statistics and I realized, like, there's 30, over 38 million people in the U. S. alone that have diabetes, I realized that this was the niche that I needed to go into. And that's why I decided to specialize in Type 2 diabetes specifically, as well as prediabetes because I realize food is intimate, and it can also help people to decrease their morbidity and mortality.

[00:06:34] Emily: I love that so much. And I especially love that you came into this with a sort of framework of we all need to eat, and eating is really, really deeply tied to our emotions and our identity, so you can't be cavalier about like, I'm going to come in and change your diet. It's like, we really need to look at the whole person and their reality, their life, to, to have a conversation about how we can change our diet in a way that is going to improve physical health while protecting emotional and behavioral health as well.

So, I love that. I love that. So first I want to fill in our audience regarding how we know you and how we got here today. You are Ellen's dietitian and when she first started working with you, she was like, “Yo! I, I just love Kim so much. I want to share her with the world, like she's got so much to say that was really applicable to our profession, and ourselves, and how we, how we think about behavior change through this lens of enrichment. And so I, I'm, I want to share her, let's get her on the podcast.” 

And so, I want to be sensitive to medical privacy and HIPAA laws. And so we are being very clear upfront that in discussing this, this was not only, Ellen did not only consent to this discussion, but she specifically requested that we bring you on today and talk about how, how you have positively impacted her life so that we can share how you can help us all think about how we engage with, with food, with teaching, with helping people, all of the things that apply to your profession and ours as well.

So, I just want to start off by saying that. And in talking to Ellen about her experience working with you, she told me that you do an incredible job of making life changes sustainable. And like we just discussed, taking into account the mental and emotional health of the people that you work with, not just their physical health.

And you provide many opportunities to deviate from what might be the most efficient or proven plan, but do so in a safe way for the sake of sustainability and allowing people to actually thrive, not only medically, but also behaviorally so that they don't feel like these nutritional changes that they're making is in some way compromising the rest of their well being, right?

And this is something that we often see people struggling with during a behavior modification program in our field as well, which means that our profession can learn a lot from you. So, how do you identify which of your client's pain points are livable, for lack of a better term, and which ones are significant enough that giving them some compromises is not only kind but necessary? And then I'll tack on another question to that is, which is: how do you strike the balance between sustainable and effective?

[00:09:41] Kim: So that, that was a lot to unpack for sure. So, what I would say in how my clients pain points that are livable, it takes a skill that I honestly did not learn about as a dietitian. And granted, I've been trained for over a decade now, so I'm not sure if they've modified the training in school, that really is about getting to know the client, getting to, getting them to realize that our relationship is not about, I'm your dietitian, I'm here to help you fix your blood sugars.

It's really about getting to know them on a personal level, realizing their likes and dislikes, what pushes their buttons, what doesn't push their buttons. And I always start out and I always let people know, look, I'm going to be annoying. I'm going to be more so like friend that you can talk to instead of this white coat syndrome medical professional because I think a lot of times we, in the medical profession, we look at people as a number and not what is going on mentally, emotionally, physically, spiritually, all the different dimensions that I personally believe in.

In order to figure out what pain points are livable, I get to know them first. And then once I get to know them, what I do is I compare and contrast, well, what is the literature saying? What has, have these randomized double blind control studies shown to be effective for diabetes? And I compare and contrast, well, would this person from what I know about them, want me to really take away that piece of cake? Answer 100 percent of the times is no, because food is emotional, food is identity, food is memories, food is a feeling.

So what I do is I say, okay, well, I know that this person and I'm, I'm going to use Ellen as an example: one of the things that I shared with her is,” I would like you to increase your fiber intake specifically from vegetables.” And her response to me was, “I have a high threshold for fiber.” Because when someone typically increases their fiber intake, they get a lot of gastrointestinal discomfort. And when she told me by getting to know her, well, historically, I don't have that issue. I said, okay, yes, because I know what fiber is going to do. So I got really excited. So for those of you that are listening out there, I just wanted to share with you a snippet. And I don't think I ever told Ellen this, of what fiber actually does in detail. Fiber does a few things, and you have to forgive me, I'm trying to prevent myself from getting overexcited. I get excited about fiber.

[00:12:31] Emily: Do it. Get excited about fiber. I want to hear it. I'm here for it.

[00:12:36] Kim: So, what fiber does. Fiber helps to bring down our blood sugars. That's what I say to everyone as a blanket statement. It helps to manage our blood sugars, but there's a few things it does.

So when we eat fiber, whether that's soluble fiber or insoluble fiber, it goes into our gut, and in our gut we have a community. This community is called the gut microbiome. And it feeds the good guts– the good bacteria in our gut microbiome. And they produce certain byproducts. These byproducts are called acetate, propionate, and butyrate. And these byproducts travel to our brain, they tell our brain to tell our pancreas, create more insulin. They also help for people that are interested, they also help with weight management. They also help to decrease metabolic illnesses.

Another thing that fiber does, and the reason why I say this is because we are living in a society where we're seeing a lot of weight loss medications being pushed on to very unassuming people. But one of these medications, I'm not going to say the name, but the class is called a GLP 1. And a GLP 1 is supposed to suppress your appetite. And that's how people are out here losing weight. But what the fiber does is the fiber in and of itself also produces GLP 1. Very similar to what these weight loss medications are causing to occur in your body, except the weight loss medications, it's like GLP 1 on steroids.

So, when we eat the fiber, we get these, these beneficial byproducts that help with blood sugar management that can help with weight for those people who are interested. I'm not weight focused, I believe health exists in a variety of different bodies, and can help with constipation, can help with a whole maraud of different health issues.

So, that is the long answer to say how do I identify clients' pain points that are livable for lack of better words. So I really get to know them first. So a lot of times when I'm speaking to them, I may ask them personal questions, have a conversation because I'm introverted, but I'm a people person.

The second question that you asked is, giving them some compromises, which really allows them to be kind to themselves. So, when someone is diagnosed with a condition, especially a lifelong condition, they think that they have to travel the straight and narrow path. Especially in the diabetes and prediabetes community, there is a lot of disordered eating and eating disorders, which are not addressed enough. Me personally, that's, that's what I think. So, what I like to do with my clients is let them know that, hey, numbers are just simply information. So, I want them to experiment. I want them to, well, what is your favorite dessert? What is your favorite beverage? Let's go ahead and let's experiment. Let's see what your blood sugars do, how they respond, and let's create a game plan.

A lot of the times it may be them eating, and I'm going to use cake, the whole entire cake. You may need to only eat half of the cake, or, if you eat the cake, maybe pair a protein with it, because pairing does help to moderate blood sugars. So, this is a way that I teach them: your numbers are only information, they're not a reflection of who you are as a person. Numbers are not bad and you can't see it, but I'm throwing up air quotes, and they're not good, they're just simply information on what your body likes, what your body does not like. So there will be times, but not quite often, when I would say to someone, okay, you can order a piece of cake, but let's have half of it today and half of it tomorrow because your body cannot handle the whole thing at one time, and that is being kind to your body. That is not going to overwork your pancreas. That is not going to require a higher medication load for those people that may be on medications. So I let them know that they have to cheer their body on by listening to the cues that their body is telling them.

And then the next question that you, you asked was, “How do you strike the balance between sustainable and effective?” So I always like for my patients to think like me. And that's why a lot of times when people say they want, like, quick fixes and they want meal plans. I don't function like that because meal plans are not sustainable. What if it's your birthday? What if it's a holiday? What if you don't want to cook dinner that night? What are you supposed to do?

So, I typically have my clients work with me for an extended period of time so that they can get aware of the questions - or be aware, rather - of the questions that I would ask. They can be aware of, well, I know Kim is going to ask me, where is my protein at this meal? Where is my fiber at this meal? Where is my carbohydrates at this meal?

So at the end of the day, when we work together after two or three months, you're able to say, “Well, I know my body needs protein. I know my body needs carbohydrates. I know my body needs fiber. And Kim doesn't even have to ask me. I want a cupcake, I know what I'm going to do in order for my blood sugars to be much more balanced on that cupcake.” 

So that's how I make it sustainable. I let them in to me, my thought process, because I know at the end of the day, I'm not going to be with you for Thanksgiving, or Christmas, or your 50th birthday party. So, that's how I strike that balance between sustainable and effective.

[00:18:29] Emily: I love that so much because we do something very similar with our clients. Like our goal is not that you are reliant on us for the rest of your pet's life. We want to give you the skills to be able to eventually problem solve for yourself and troubleshoot an issue for yourself. And that's exactly what I'm hearing from you is if I give my clients the knowledge, then they're empowered to go out, and make those decisions even when I'm not there, which to me is the goal, right?

We don't want to have to micromanage our clients. We want them to be empowered to make good choices for themselves. Yeah, that's, that's delightful to me. So, related to that topic. How do you make data collection simple but effective for your clients? Because that was another thing that Ellen talked about.

We also really encourage behavior professionals to help their clients collect data. And we really emphasize that on our, our, our team. So that's, that's something that we share in common. But what we hear from a lot of behavior professionals is, "Oh, my clients would never go for that." And I am, I am sure that you can empathize with that, so how do you do it? How do you make data collection doable for your clients?

[00:19:41] Kim: Yeah. So there's definitely a strategy, and I'm giving away all my trade secrets today. So there's definitely a strategy. So when I first start working with someone, they automatically think, "Oh, have to start tracking, and documenting, and logging." Which we're– in the world we live in, is so overwhelming. We cannot commit to that relationship of documenting, and tracking, and logging initially when you start working with me. So, what I do, I, for the first week or two, I track, I document, I log for you, so as not to overwhelm you. So I have, I have my clients send me pictures of what they're eating.

And the first week, it's simply about, "Okay, well, what times are they eating? What numbers are they getting before and after their meals?" I just want all of that information. And then after that, what I do now is I say, "Okay, well, in your meals, you were a little low on fiber. So what I want you to do is to start documenting your meals in my portal so that it can give a nutrient breakdown."

It breaks down everything: macronutrients - which are your protein, your carbs, your fiber and fat - and also your micronutrients–which are all your vitamins, and minerals that are so important for blood sugar balance. And then what I do is I try to get them excited about the numbers. I try to get them excited to see like, "Okay, great, you did awesome. You did awesome on your protein. This is why protein is important. You're hitting your goals."

And then what I say is, these are our opportunities for improvement. I never call it a failure, I never call it a shortcoming. I call it an opportunity because I'm trying to elicede, or elicit - elicede is not a word - elicit that excitement. So, when they see, oh, well my opportunity for improvement is to decrease my total amount of fat, let me see in my diet from my food log where the fat was coming from. Oh my goodness, I didn't know this cheese has so much fat. Let me find another lower fat cheese. It's really about looking at the data, having them get excited about it, but then also reassuring them that you don't need to do this for the rest of your life. Because once you identify the foods that you do like, the foods that do work for you, you know, okay, I'm going to have– Because typically, we're creatures of habit. We like to eat the same things day in and day out. It may be some variation on the cooking method, or the flavoring, and the seasoning, but if we like chicken, we're going to eat chicken in our diet. If we like beef, we're going to have beef in our diet.

So it's really about having them see that you can continue to use the portal to see your nutrient breakdown of your meals. But if life starts to lifeing and it gets overwhelming. I want you to be aware that poultry works well for you. Eggs work well for you. Wheat bread instead of white bread works well for you. Just to know that information and be able to carry it with them throughout their life.

[00:22:52] Emily: So, what I'm hearing is that you're essentially shaping your client's behavior in a compassionate way, and letting them lead, lead the process or, or tell you when they're ready to go to the next step of data collection.

I love that you start with having them take photos. That never would have occurred to me. Of course, I'm not a dietitian, but I love that you're starting with, okay, this is something that feels easy, and less overwhelming, and less daunting than, than, filling out whole spreadsheets. Do you find that different clients end up preferring to collect and organize and present the information in different ways?

[00:23:34] Kim: Absolutely. And I'm happy that you asked that question because there are clients that I do, or have dealt with, and currently I'm dealing with that do have a lot of disordered eating and eating disorders. So, for me to even introduce them, and this is why I say getting to know them prior is important, to even introduce them into the breakdown of their macro- and micronutrients is going to cause them to spiral. And it's going to cause them to enter into an unsafe space. So, there's some clients that I just strictly use the pictures, while those that don't have a history of disordered eating or eating disorders, I would introduce into the portal. So, it really depends on knowing who is allowing you, I call it a journey, who is allowing you to go on this journey with them. So that's where it comes in, like, who is this person? What is important to them? What are their goals? Long term as well as short term? Just really knowing who they are.

[00:24:29] Emily: Yeah. I think that's so important to know about and care about the learners who are in your care. And not just be thinking about how you can change their behavior, but how you can change their behavior in a way that actually makes them feel supported and, and that they can see their own progress. And I think that we can, we can learn a lot from that in our industry.

So for example I'm very much a spreadsheet person, it just makes sense to me to see, like, it helps me organize the kind of, million directions that my brain goes in to have everything laid out in that kind of orderly way. And so, some of the materials that we use to help our clients track their progress are put out in spreadsheets.

And when, a couple of years ago, my partner was presenting at a conference, and I was in the chat room, supporting the people in chat. And somebody said, “Oh, I could never use this because spreadsheets make me nauseated.” And there were a bunch of people who were like, “Oh, me too. Yeah. I hate spreadsheets. They don't make sense to me. They're overwhelming.”

And I had this moment where I was like– We already do a pretty good job of, of changing or adapting how we let clients do their data collection. But we need to do a better job of communicating that, that that is an option when we're presenting this to colleagues. Because for us, it was like, the spreadsheet is an example of how you could do this. And the way it was being received was, “Well, I can't do spreadsheets, ergo, I can't work with an enrichment framework.” When a concept is new, you may be likely to over-index and kind of throw the baby out with the bathwater. And I was like, I, it was an acute learning moment for me where I was like, “Okay, so what I'm hearing is we need to do a better job upfront of letting people know this is one way that we could do this, but this isn't the only way. There– We can definitely adapt to what makes sense for you. And, and there's lots of different paths up the mountain. And if this one doesn't work for you, we can find another one.”

So, that– For me, it's a little bit of a different– That experience was a little bit different of a story because I– That was a learning lesson for how to communicate with colleagues, but do you find that with clients where at first blush, they see something that you're asking them to do and they're like, “Well, I guess I can't do this because that, that way doesn't work for me”?

[00:27:00] Kim: Yeah. Yes, they do. Definitely. It's, it's so funny that you mentioned that because a former client and I, we were actually laughing about it the other day. She was like, “Kim, when I started working with you initially, I was so upset every day. I was upset. And, but at the end of it all, I see, and I understand now why you were doing that.”

You're absolutely right. Letting our clients know upfront, like, there's a variety of different ways to do this. And then also, two, catering and letting them know like, “Hey, we can modify this to fit into your busy lifestyle or your way of doing things.” It doesn't have to be cut and dry, black and white. There are many areas of gray that we can definitely track this data.

[00:27:43] Emily: Yeah, I love that. So when you are working with clients and you're helping them figure out what's the best way to do it for them, and they don't immediately know, right? So if somebody says, "Oh, spreadsheets make me nervous." And I asked them, “Okay, what feels better to you?” Sometimes people don't know the answer to that question. So how do you help your clients figure out what would be ideal for them when they don't know the answer already?

[00:28:11] Kim: Everyone has a different learning style. And that's what, I really feel in dietetics, we should have some, some counseling skills. Like, we do address motivational interviewing, and things of that nature, but I do feel like we need a little more deeper clinical counseling skills. So, there are some people that I work with, and I am their security blanket and that is okay. Because pre diabetes and type 2 diabetes is scary, it's a big bad monster that you did not allow in your life. And it can have the potential to cause a lot of harm if you allow it. So, it's really about knowing, like if, when I say to them, “I would like you to start documenting,” some people say, “Yeah, no problem.” Or some people say, “No, I'm not going to do that. I want to continue to send you my pictures,” and then I say, okay. I, I don't push it because I realized if I push the scenario with them, that is going to ruin my relationship. That is going to ruin my, their reception to what I'm saying.

So what I do, I start letting them know, well, I'm documenting for you, and I see on this meal, you didn't get enough fiber or you didn't get enough, a lot of people are surprised when I say you're not getting enough protein. They're like, how in the world am I not getting enough protein? And then they were like, “Well, many grams did I get?” And then I would say, “You know what? Let me take a picture for you, from what I documented in the portal, that you can see exactly what I'm seeing, and then our next meeting we can talk about it.”

So, when they see the graph - because there's a numerical collection and then there's a graph - they would say, “There's no way on Tuesday that I did not get enough of X, Y, Z,” and then that's how I start to excite interest in the documentation. Then they would say, okay, well, maybe it's not as bad, quote unquote, as I thought it was. This data is quite interesting. And then I say, okay, how about this? One meal. One meal a day, you choose - breakfast, lunch, or dinner - you go into the portal and you put it in there. And I want it to be the meal that you think is your weakest link.

Then when they put the meal in there and they realize, I'm like, “Well, I knew that dinner was never your weakest link, it's lunch.” They're like, “Okay, well, let me document lunch.” And then they say, “Wow, this is interesting information.” So, it's really about not even, you can't even change the data, it's changing their mindset around the data points to let them know this is what's going to help you, it's not going to hurt you. It's not a reflection of your character as a person. This diabetes or prediabetes, yes, it's big, and bad, and scary, but it's just like a teddy bear. It's just like a puppy. It's cute. And you can really modify the numbers through your food choices. So, just letting them realize they have the power, all you need to do is to document, and to look at the data points, and make the adjustments from there.

[00:31:18] Emily: Yeah, and it's really funny how your body tells you when you get it right. And, and I think that is one thing that's surprised me about my own journey is that I, I didn't realize I– I have some workaholic tendencies. I have multiple health issues, which means I'm always feeling some level of discomfort.

I tend to get very lost in my head about what I have to do, and so when I worked with a dietitian and she had me do a food log, I was expecting her to come back and tell me, “You– you're eating way too much,” because I'm overweight, and I've always struggled with my weight, and so that's what I assumed.

 And then she came back and she was like, “Wow, you, you, you hit 1,100 calories twice in a month. Like, you need to eat more.” And I was like, “What do you mean eat more? Like, how could I eat more?” Like, I don't– I could– I was like trying to wrap my head around what that would look like. Cause I already felt like I ate too much and it was, timing of when I– There, there was a lot. As you know, it's not a simple answer, it's, it's a journey, like you said. But what was interesting is after having gone on that journey, I started, like, eating meals that actually worked better for my body.

And afterwards I would feel it, “Oh! This is, this is what feeling nourished feels like! This feels incredible! Oh! I didn't, I didn't realize what I– that I was just in this constant level of feeling undernourished or malnourished because I didn't have a point of reference for what it feels like to, to be nourished by a meal.”

And, and so that was a really profound learning experience for me to be like, okay, so even– Because I'm not a dietitian, I had a limited view in my head of what my options were, and I thought I had quote unquote, tried everything. And, I didn't– Nothing felt good, or nothing seemed sustainable, or nothing worked over the long run, whatever.

And then my dietitian opened me up to opportunities that I didn't even know that, that, that were possible. And when we found the right thing for my body, and we got it right, my body told me, you got it right. You nailed it. This is it. This is what it should look like. So, I think that was just a really profound– And you have to find the person who can help you go on that journey with you and help you. And then when you get it right, your body will tell you when, when you get it.

[00:33:38] Kim: Our body definitely does give us cues into what it likes, and what it doesn't like. And one of the, the things that I always ask people is, I ask them a few questions related to like how their body feels, so I always work up to the point of I want your body to know how it feels when your blood sugar is high, and for everyone it's different. I've had people tell me that they feel like they're buzzed, or they're hot, or they get sweaty, they, they, they can't think properly, or they're having like this excessive thirst. So, I want your body to recognize your high blood sugars, and your low blood sugars because we have to be in tune with these things in order so that we can have better blood sugar balance.

[00:34:19] Emily: Yeah, for sure. And, and having said that, having just said your body tells you when, when you get it right, that's also a little bit of an overstatement because one of the things that we, that Ellen was sharing with us about her journey that we realized, like, wow, this has so many parallels to our own profession, was when you were helping her to track, like what, not just what foods her body needs, but what time of day her body can best, best metabolize those nutrients. And of all things - when she told Allie and I this story, we, our jaws hit the floor - of all things, broccoli at night was, was causing her blood sugar to spike. Is that correct?

[00:35:02] Kim: Yeah, it was, it was just really odd because like when we think of vegetables, vegetables are healthy. And in the community that I typically deal with, I'm always trying to push vegetables because we just simply don't get enough vegetables in our diet. What a lot of people don't realize is that some vegetables also have a carbohydrate attached to them - well, all vegetables have some carbohydrates - and for, for some reason, Ellen's body just did not like that broccoli. I don't know why, but it did not like it.

And we, we tried this broccoli numerous times, and every time she had broccoli with dinner, specifically, her numbers just jumped, and it's not the first time I'm seeing it. I noticed that some of my clients, their body would do well with black beans, but not garbanzos, or their body would do well with oil, but not canola. It was, it's so interesting. It's so interesting, the, the dynamics and the interplay of our blood sugars and our overall metabolism health. It's so interesting.

[00:36:12] Emily: It really is. And it's such an important message that, there's not– Nothing is a panacea, and you can't just take this formulaic approach to like, “Well, I need to follow this diet to get these results,” or whatever, that everybody is different. It took me a very long time to figure out that for me, I have a phytic acid sensitivity, and so I have to be really careful about the phytic acids that I consume. So legumes are, are really tricky for me, and, and my body tells me when I, when I didn't get it right, but I, it took me forever to figure that out because it's such a very specific thing that is hard to separate out when you are not working with a dietitian, and you don't know how to, to parse things apart.

So, so yeah, it's interesting that, even though, yes, we should listen to our body. Yes, it tells us when we get it right. Also, sometimes it takes a lot of trial and eval with the guidance of an expert to find, to fine tune those little details of our diet that our body has feelings about. Like me having phytic acids that haven't been soaked at least 24 hours, or Ellen can't have broccoli after like 2 p. m. or whatever, like those are, those are the things that you're only going to find out with guidance.

[00:37:33] Kim: And you know, I'm, I'm very happy that you say that because I don't, I don't want to jump the gun, but I'm, I'm on TikToK and I see, I intentionally do things on TikToK to get people to start having conversations. Like, I always would say, “Let me know your opinion,” or I would say something controversial, and I know I'm going to start, like, a debate war in my comment section.

And I see so many people in there saying, well, I did, I use this herb or I use this food medicinally and this was the result that my body gave me, and it's a positive result because of xyz. And you're right earlier it definitely was an overstatement because our body is going to respond, it is going to respond but we also have to, you know, definitely work with the health professional, or a professional in another space to know what's going on. Like I remember sending Ellen a video because I'm thinking about getting a dog, it's very emotional for me. But anyway, I sent her a video, I think it was a German Shepherd and the German Shepherd was in the backseat with a crying baby, and I could not differentiate if the German Shepherd was annoyed or tired. And I'm like, well, the German Shepherd is in the backseat with the baby, this is quote unquote, very, I wouldn't say aggressive, aggressive is not the correct. But it's a, it's a large dog. Let me just say that. It's a large dog. And she said, “Oh, no, he's not upset. He's sleepy.” I, I could not tell that. I would think, “Oh, we got to move the baby from the back seat. Baby can't be there. The baby's crying. The baby's annoying him.” You're absolutely, right. Working with a health professional or any type of professional, like in the enrichment space that you guys are in, can clue you in into what is happening, what this means. This response may be a good thing, may be a bad thing, may be a neutral thing, maybe you need to pay attention to it more, maybe you don't. So it, it really all depends.

[00:39:30] Emily: Yeah. I think that's a great analogy that, just because we have a body doesn't mean that we're a dietitian, and we know how to, how to listen to the very specific details of what our body is telling us, and just because people own pets doesn't mean that they know the, the really specific nuanced communication that, that pets are, are communicating. So yeah, it's a, it's a good parallel. I love that.

And I, and I'm going to switch topics, but along the same vein, I hear a lot of, “Well, we can use just this over the counter supplement, or this nutraceutical, or whatever, and you can just get it, you don't have to worry about a doctor, or a dietitian, or whatever, or a nutritionist. And it'll solve XYZ problems, and it's safe because it's natural,” and, and that's very common to get that advice, the internet is full of that. And I also honor the intentions of, there are a lot of good reasons that people try to do that, like accessibility, which is a beautiful intention, or wanting to share what worked for them because trying to be generous of spirit and say, “This helped me and I want to help you.”

So I'm, I'm definitely honoring the intentions of that advice, but along the same lines of, sometimes you shouldn't eat broccoli after 6 PM, or you really should only eat beans if they've been soaked for 24 hours or whatever, we also need to be careful about just being cavalier about recommending natural supplements, nutraceuticals, over the counter stuff.

And one of the, I think the mantras that was drilled into me when I was just a little baby vet tech was, “If it can have an effect, it can have a side effect.” And I think that is, is really, really salient to this conversation because just because it's natural doesn't mean that it's inherently safe or you can be cavalier about how you take those supplements, or give them to your pets.

And Ellen told me to ask you about spearmint tea and estrogen driven breast cancer, which was an example of this concept that she learned from you and it blew her mind. So, I would love to hear you speak more on that topic, and how can we as lay people and consumers engage with natural medicine, herbal remedies, and over the counter supplements in a way that is safe and thoughtful?

[00:41:48] Kim: Absolutely. So, I will answer the last question before I answer the spearmint tea and estrogen driven breast cancer. So, this is, this comes with such a duality for me to speak about because of my history. I, born in Jamaica, came to the, to Florida at a very young age, basically raised in South Florida–which, if anyone has ever been to South Florida, it's the Caribbean of the United States. You have your pockets of Cuban, and Haitian, Jamaican, Trinidadian, Puerto Rican, Mexican, so forth, so I just, I just love it. And in that, those communities, herbs are utilized a lot. A lot. They, they're utilized not only for health benefits, but mental, behavioral, spiritual, so forth and so on.

But I've come to the realization that even in community, there is an overuse of herbs that I have seen really hurt people. So, you're absolutely right in saying that if it can have an effect, it can definitely have a side effect. So, herbs in and of themselves are not regulated. That means if there's an over the counter herb that stays, quote unquote, it can help with decreasing mood swings, for instance, or your blood sugar, really look at it through, like, as a grain of salt, unless you are working with a professional.

Because there has not been a lot of research shown that it is effective, and then on top of that, what effect is it going to have on your kidneys as well as your liver? Like, I know that there is, like, a cost benefit analysis to everything. At the same time, are you getting your labs tested to realize, hey, is your kidney functioning normally? Is your liver functioning normally? Is your blood sugar, in this case, that's what we're talking about, positively being impacted. So, it's really about weighing everything out, and I definitely think as lay people and consumers, we do want more of, like a cost effective means, and there's also a deep history of distrust in the medical system. Which it's another topic for another time, but what I would say is, definitely work with a professional.

There have been numerous people that have told me, “I cannot afford to work with a dietitian in the food and nutrition space,” but you will be so surprised the number of dietitians that do offer pro bono services. I offer pro bono services, especially for someone that may be disadvantaged financially, or even dietitians in your area that may really be cost effective. A lot of people think working with a dietitian, or working with a health professional is going to be an arm and a leg when it's really not. There are some people out there who do want to see the good of mankind to, to really flourish. So that's, that's what I have to say related to that, take everything with a grain of salt, unless you are working with a health professional that is able to help you monitor everything appropriately, because numbers don't lie. Labs don't lie. Blood sugars don't lie. They tell you what's going on.

In regards to the spearmint tea as well as the estrogen driven cancer: so I, I, if I remember correctly, had Ellen try, and she may have to correct me on this, because there's a few people I have on spearmint tea, so I'm trying to figure out which story is which story. But I'll just give you the history of it. So, for individuals that have a specific condition and the condition is called Polycystic Ovarian Syndrome, there are different types of polycystic or PCOS, so some people that have PCOS, their testosterone tends to be a little higher than normal. And, and we don't want the testosterone to be elevated, so the spearmint tea comes into play because it helps to decrease the androgens. Because sometimes the androgens can cause your blood sugar levels to be elevated. Another thing, so that, that's the whole ordeal with the spearmint tea and PCOS, which can cause a negative impact on your blood sugars.

In regards to the estrogen driven cancers, this one is, how do I say, it's a, it's I think it's important for everyone to know, and it doesn't matter what chromosomes there are, simply because cancer as a whole is increasing as a nation. So my focus, I know Ellen specifically, I would just really try to maximize fruits and vegetables with her because I know they have antioxidants. Antioxidants prevent free radical destruction of the cells. Antioxidants, aka, phytochemicals, they have phytochemicals as well. They help to prevent cancer proliferation. So, when someone says to you or, your doctor - cause your doctor knows this as well, but not on the level that dietitians know - eat more fruits and vegetables. When I tell someone that I want them to see the Star Wars opening scene flying through my mind, and all the medical conditions written in white, that I know that these antioxidants and phytochemicals are going to address. So it's not– For me, it's like, okay, yeah, I say the blanket statement, but my mind is like a Star Wars and it's flying, and I'm, I'm addressing all of these variety of different health issues. So, that is the story behind that.

[00:47:21] Emily: Yeah, it's really fascinating because I'm a big tea drinker. This, what you're seeing behind me is my tea wall. I have, I'm now up to 190 teas. And it never, I don't think about– When I'm drinking tea, I'm not thinking about health ramifications, but I do have spearmint tea on, in my collection. And also I do have PCOS, and I had, it never occurred to me, that there would be a ramification for, for drinking spearmint tea because I have PCOS. So, now that's something that I have to go look into and think about because that is, that it is, it is, it is something that it never would have occurred to me until you connected those dots for me.

So, and I think the message here, y'all, is don't feel paranoid about everything that you eat and drink. That's not, that's not the point here. But be aware that just because it's natural doesn't mean that it's automatically just safe, and if, if you are having some kind of health struggle, or emotional, or behavioral struggle, or even like you said, if like there is a long and storied history across, across multiple traditions from around the world of, of using natural medicine to address spiritual health, right? So, we have to acknowledge that as a valid use of those as well. That doesn't mean that there, you can do it in a cavalier way. There's a reason that you seek guidance in, in those– in how you approach those natural supplements and medications, right?

[00:48:58] Kim: Exactly. Yeah. It's those, especially the herbs. I find it's, it's so ingrained in, in identity as well. So, I can give a perfect story: that I used to work in the hospital setting. I live very close to a Seminole Indian Reservation. So, this is my favorite story to tell, I get so excited. So, there was one day I got a consult from the cardiologist to go to the ICU and to see someone that came in the hospital for diabetes, and they had uncontrolled diabetes. And when I'm reading through their history and physical, I realized this is a Seminole Indian chief. And I said to myself, "Oh my goodness, Kim, don't faint. You're going to meet a chief." Like if you don't know, if there's one thing you should know about me, I am a super fan of Native Americans, super fan. Simply their history, their resilience, I'm a super fan.

So like, I'm trying, I'm trying like, "Okay, Kim, calm down. What, what do you need to know?" When they're in their history that they use herbs and okay, looking at the medication list, these are the diabetes medications, but I don't know the herbs. So, the first thing that's on my mind is, well, what are the herbs? Do they have an interaction with the food that he's consuming? Maybe they're decreasing the effectiveness of the medications. So I, I need to help him.

I went in there, I had on my Superman cape and I'm like, I'm going to help you because I know a little bit from the reading, from documentaries about Seminole Indians. So, I went in there, and the family was there and, I do what I normally do. Try to disarm, sit on the bed, laugh, tell stories, let them know like, "Oh my goodness, you guys are celebrities in my eyes."

And so, I started speaking to the chief, who was the patient, and it was so interesting because, and it's all this time like his wife is talking to me, she's doing the majority of the talking. His daughter is in there, his grandchildren are in there, and they're, we're, we're vibing well, I feel like I'm a part of the family. And I turn my attention to him and I start asking him about his diet and his health and, he's, speaking well and enjoying, and I said to him, what medications he's taking for his diabetes.

And I should note that there is a nurse in the room, and this nurse is his nurse from the reservation. And he tells me the list of prescribed medications. And then I said, "Oh, okay. And you're taking them as prescribed." And he said, yeah. And then I said, well, what about any herbs?

And he said, “Yeah, my, my shaman gave me some herbs to take,” and then I said, “Okay, well, what are the herbs?” And he looks at me, his family looks away, and he ignores me, and then he changes the topic, and he's speaking to me again, like, okay, and then I'm like, “Oh,” and I'm here processing like, maybe, maybe he didn't hear me, maybe I'm mumbling. Maybe I'm speaking too low. Let me ask again.

And he looks at me again, dead in my eyes, and I'm like, “Okay, he's heard me this time.” And his family, who was engaged, looks away. And I'm saying to myself, what is going on? I'm not getting it. I'm not reading the room. Read the room, Kim. I'm just like, what's going on here?

So I ask again, Emily, I ask again. And that time, the nurse from the reservation says, “Kim, can I talk to you outside the room?” And I said, “Yeah, absolutely. Absolutely.” And she says, “You're disrespecting him.” And I said, “How, what do you mean? I'm like, there's no way we're rapping good.” She says, “You keep asking him about something that is sacred. You will never know. That is sacred between him and his shaman. Not even his family knows the concoction of herbs his shaman has given him because it is sacred.” And in my mind, I felt so bad, Emily, but it's, it's a learning experience, and opportunity that shows me in certain cultures, natural medicine, herbal medicine is very sacred, and I am an outsider, and I cannot touch that. So that's not to say, “Oh, everyone should just go to the store and say that their herbs are sacred,” but in certain cultures, it definitely is. So, yeah, just wanted to share that.

[00:53:12] Emily: That, yeah. That is such a great story to, to help us be aware of cultural differences that we may not be aware of and, and that we take for granted and the ways in which food, and, and herbs, and the things that we consume aren't just things that we consume. It's not just feeding our body. There are deep cultural and emotional ties to what we eat, why we eat it, and how we eat it or drink, consume, I should say, consume, and if you come in and try to make changes without having a deeper understanding of that culture, it can, it can get us into trouble, right? And I think that's such a potent lesson, because it never would have occurred to me either, that in some cultures, the herbs that your shaman gives you are sacred, and secret, and just between you and your shaman.

But now that you said that, I'm like, oh, that does make a lot of sense because there is a lot of, of confidentiality between a spiritual advisor and the person that they serve, right? So, so yeah, okay. I guess now that you're saying that, yes, that makes sense. And also I too would have been the person being like, am I, am I not communicating? Are you not hearing me? Like what's happening here? Why are you not answering my question? I don't understand it. Yeah.

So that goes back to how do you, that goes back to that compromise that we talked about at the beginning of our, of our conversation is like, okay, well, if I'm not allowed to have access to the herbs that you're taking, I want to respect your culture, and your privacy, and that private relationship that you have, and also how can I work around this? Right? So, yeah, that's, that is fascinating. I, I'm, I'm interested to hear, obviously we're not going to violate anybody's medical privacy, but just in general, were you able to help him and navigate that even without knowing what those herbs were?

[00:55:07] Kim: Yes, I was. So, after I stopped talking about the herbs, I just focused on food, and I found one area of opportunity. So, like a lot of times when someone has a diagnosis, in this case, diabetes, they think that they have to create a complete overhaul, when it can just be something very simple. I discovered in his diet, he was drinking an excessive amount of regular soda. So, the compromise is you like soda, I'm not going to take it away, I'm not the food police, can we switch to diet? He said, absolutely. No problem. And that was that.

[00:55:38] Emily: Nice. One of the biggest changes for me that blew my mind is, I always had been told, like, you don't exercise at least an hour after you eat, and so I was exercising at, whatever time of day made sense for me. And most recently, the dietitian that I'm working with had me, because I am not pre diabetic– We're just all divulging our medical histories on this podcast. Welcome, Kim. I've told people many times, I have no filter. I just talk about everything. But so for me, I'm not pre diabetic, I don't have diabetes, but because I have PCOS, we carefully monitor my A1C, and the moment that it started to climb, even within the normal range, my doctor was like, we're going to start, we're going to get you on a medication because we don't want you to become pre diabetic.

And then, so my dietitian had me start exercising immediately after eating, and when she explained why about how, like. with insulin resistance, your cells don't necessarily know how to store energy, it made perfect sense, but it would have never occurred to me to do it, and it made such a huge difference in how I feel exercising immediately after meals, instead of just doing it at arbitrary times. And I'm not even, I haven't exercised more, but I feel so much better now just from that one simple change of like when not, you don't have to increase your exercise, but change when you do it. It made a huge difference for me.

[00:57:00] Kim: Oh, I'm very happy that your dietitian was able to help you with that. I mean, It, it works wonders.

[00:57:06] Emily: I just noticed how long we've been talking. Time flies when you're having fun. So I'll, I'll move on. Let me see, okay. So, I'm going to now really shift gears and I want to ask you how you as someone who works in a helping profession, and you've worked in a hospital setting, what are some boundaries that you have put in place for yourself and, or what are boundaries that you encourage clients to put in place to maintain their peace and health?

[00:57:32] Kim: So, one of the biggest boundaries that I've realized is mental health. To me, health begins in the mind, and I get an inclination that someone may be distressed, because there is something called diabetes distress. And this distress can occur from, by definition, diabetes distress is the stress that happens in life when you have to nurture, and monitor your blood sugars, and get eight, seven to eight hours of sleep, and make sure that you're exercising, make sure you're taking your medications on time. But I like to take diabetes distress and I like to extend it to mean any stress that occurs in life that really causes a mental upset and it derails you.

So, one thing that I always try like to encourage my clients to identify is where are their stress points coming from? And after identifying the stress points, where are areas in their life, that they can really minimize that stress. So if that stress is coming from a friend, that's not really a friend, what do you really need to talk to that friend and then cause mental turmoil? Because when you cause that mental turmoil, you're going to let go of cortisol, and cortisol is going to cause your blood sugar levels to be elevated. Or if you have, you have no boundaries, you're a people pleaser, you're carrying a lot of that stress internally. So, I like them to realize that, " Hey, you have to set up some boundaries for your personal success."

Something that I do for my personal– because you know, I deal with a lot of people, I deal with a lot of minds, and at the end of the day, the news is stressful for me. I don't want to know what other– cause to me, the news is so, it's crafted in such a way to elicit a response from you, an emotional response. So, I personally don't watch the news, by any means. I don't watch it.

Another thing that I do as well that helps me to sit out and take time back, besides feeding my squirrels that come to my back door, - they're bougie, they like cherries currently. - I spend a lot of time in nature. I do. I spend a lot of time just watching birds, watching the squirrels, watching my garden snakes, even though I'm terrified of snakes. I just spend a lot of time in nature watching them, and realizing how life for them is, they don't go to the grocery store and buy anything, they don't prick their blood– their finger to monitor their blood sugar.

My friend's cat had diabetes, and she's all stressed out and I'm looking at the cat, and the cat is living its best life. So I, I like to, and this is part of why I want to get a dog, I'm letting you into it. I think animals and nature teach us more about slowing down, looking at the little things, being joyful in the moment, instead of worrying yourself, which can have a detrimental effect to your mental, and physical health.

[01:00:24] Emily: Yeah, I, I resonate deeply with that because for me, I, the only way that I consume news is I have a subscription to AP News Alerts, and I like that because AP is a least biased publication. So, they don't tend to use a lot of inflammatory language, and I can just skim the title to sort of get an update about what's happening in the world without having to read anything that's going to be really triggering for me. So, I have more agency over whether or not I click on a story to learn more about it, or I'm just mentally clocking progress in different areas of world events, right?

And, but I've gotten off completely off of social media for the same reason that you don't watch news because that's where a lot of the kind of emotionally charged language that's, there's no accountability to it, and there's no critical thinking skills, and that's just really, really distressing to me.

So, yeah, I've, I, I try to avoid social media as much as possible for the same reason. So, that's a really good, um, boundary to set is what are the things that are really, really upsetting to you that are going to really drain your cup and how can you limit exposure to those? And what are the things that are going to fill your cup, like nature, and animals, and, and getting a dog. Getting doggos are, are great. They're, they're fabulous. Okay. So what are our observable goals and actionable items that people can take away from this discussion?

[01:01:56] Kim: Well, the first one I want them to realize is food is not the enemy. Food is to nourish your body. Food is supposed to be fun. So, that cake example I used earlier, a piece of cake is okay to eat. Some of the best times of my life was when I had a piece of cake. Birthday parties, anniversaries, achieving a milestone. So food, no matter what form it comes, it is to provide either nourishment or some type of positive emotion that releases the endorphins so that you're happy. Happiness in this society is, is quite needed and I find that food is a vehicle to elicit happiness. Another thing that I want people to take away from this discussion is, do not think to yourself that you don't need to see a dietitian.

A dietitian is simply here to help you maximize your current state of health and wellbeing, even if you think you are a person that is relatively healthy. Hey, try to see if you can see a dietitian. If you have benefits, try to tap into your benefits to see if you can see a dietitian. If you don't have benefits, try to see if a dietitian will work pro bono.

I believe that everyone should see a dietitian at least once in their life to really give them insight into certain things because the health of the nation, the health of the world in general-- I won't bring the statistics to light, but It can definitely be improved, for sure. I would say those are the main two things, the main two observable goals, and action plans to take away.

[01:03:33] Emily: I love it. Yes. Food is not the enemy. It's connection. Like you said, connection to our culture, and to our past, and to the people in our lives, social, and everything. Yeah. Okay, so at the end of every interview, I like to ask people the same set of questions, and the first one of those is, what is one thing that you wish people knew about either this topic, your profession, or enrichment, you get to choose.

[01:04:00] Kim: The topic: don't be afraid of diabetes. It is a condition that can be properly managed, and it is not a death sentence, it is not anything bad. it's just a modification to really help you to live your best life possible.

[01:04:17] Emily: Yeah. And I will say that I think for me personally, my biggest fear of, of becoming diabetic is just the pharmaceutical companies, and their exploitative prices of things like insulin. And and that's a valid fear that, that people have, and also working with a dietitian can be a way to mitigate having to have that battle with, with pharmaceutical companies. So, dietitian: the way to go. Okay. So what is one thing you would love to see improved in your field?

[01:04:50] Kim: I would say the counseling. I feel we get a lot of training on food, and nutrition, and the components, and the vitamins, and the minerals, and the byproducts, so forth and so on. But a lot of times we don't get - and again, I don't know if the field has changed, but I'm just going off of what I see - we don't get enough counseling on, these are people with different experiences, different cultures, different lived experiences, and they process the world differently. So, someone prescribing a medication may come off as helpful, while someone prescribing a medication may come off as hurtful. Telling you this is what you should be eating and what you should be in your diet may come off as helpful, while someone telling you the exact same thing may come off as you're the food police and you want me to die from a diet of eating cardboard and sadness. And the reason I say this is I had an uncle in his late 50s early 60s was diagnosed, and then well he was diagnosed in his like 30s 40s, and then because they told him to eat cardboard and sadness, he died of diabetes related complications, but what was not understood was his lived experience with diabetes. So, love people to understand psyche of it all, and I feel that dietitians need more training to understand how people compartmentalize and process information.

[01:06:12] Emily: Definitely. And I will add to that, that from a behavioral perspective, when you set a goal or set expectations too high for clients, and they have a learning history of being punished for not meeting expectations, even if you yourself have not attempted to punish their behavior, they can still start avoiding you, and not telling the truth, because they're, they're in that situation where expectations are too high for them, and they assume that you will be upset with them or shame them or something. And so, they, they become furtive. And so that's one thing that I've had to really learn is not expecting a client to, to be honest with me about how uncomfortable my expectations are for them. Because in– Past Me would be like, “Well, why didn't you just tell me? I would have been happy to, to, to work with you on that.”

But, if they're learning history is that when they tell people that they get severely punished for it, then, then my question of why didn't you just tell me is completely inappropriate. Because I can't expect them to have known that, so learning anytime you're working with clients in any kind of emotionally fraught situation - like changing their diet or, or, their health, or working through really emotional behavior issues - be very, very sure, that you're giving them a realistic and attainable goal for them so that they don't have to have that internal conflict about whether or not to be honest with you about the fact that they can't reach the goals that you're setting.

And I think– My sister is a nurse and she has had similar stories to you where they had clients who were just rapidly decompensating, and a lot of her co-workers were just shaming them like, “How, how could you do this to yourself? How could you let it get this bad?” And when my sister would go in and ask them, it, the answer was, “I lack the social support to do what you're asking me to do, and I knew that if I came in and told you that, I would be shamed exactly as I'm being shamed now.” So, I think that's a lesson that we all can learn. Any of us who work in a kind of caregiving or health care profession, all can learn that exact lesson that you, that you talked about is making it, making it doable for your, for your clients.

What do you love about what you do?

[01:08:34] Kim: I love that people allow me, or people invite me to go on a journey with them. I believe diabetes is a journey. It is a lifelong journey, and they have allowed me to walk the path with them and that, that's how I literally view it in my mind. My mind is such a very picturesque mind, so I view it as walking a path together. Because a diagnosis is intimate, it's vulnerable, sacred, and for me to be a complete stranger that you don't know, but then to trust me, that is, it's, it's quite, I don't have the proper word for it, but it's, it's heartfelt. It's quite heartfelt. It's something that I don't look at lightly. Something that I think about quite often. And I'm just grateful for the opportunity, honestly, because I feel like if I could help one sea turtle that is stuck on the sand, back into the ocean and start swimming, I have made a difference.

[01:09:28] Emily: Well, thank you so much for joining me. I've really appreciated getting to speak with you and I, I definitely understand why Ellen has been so thrilled to work with you. It has, it has been a delight.

[01:09:42] Kim: Well, thank you so much for having me. I enjoyed our conversations as well.

[01:09:45] Allie: Okay, what did I tell you? There's so much that we can learn from other fields and I absolutely love Kim's emphasis on a relationship-first approach to helping her clients and how she looks at their entire lived experience to support them through their journey.

It's so similar to how we approach behavior, and it's really cool to see how that looks in a different field. Next week, we'll be talking about: if it can have an effect, it can have a side effect.

Thank you for listening. You can find us at petharmonytraining.com and @petharmonytraining on Facebook and Instagram, and also @petharmonypro on Instagram for those of you who are behavior professionals. As always links to everything we discussed in this episode are in the show notes and a reminder to please rate, review and subscribe wherever you listen to podcasts. A special thank you to Ellen Yoakum for editing this episode. Our intro music is from Penguin Music on Pixabay.

Thank you for listening and happy training.