• Fresh Views

    Going off the beaten path

    From our off the beaten path adventure to  Ireland’s rugged West Coast

    Life throws challenges and every challenge comes with rainbows and lights to conquer it. –  Amit Ray

    With St. Patrick’s Day a few days away, memories of a trip we took to Ireland 4 years ago come flooding back into our minds. We and our husbands, along with two other couples, each of us from a different part of the US, convened for what became a trip of a lifetime.

    While the trip began in Dublin, the real adventure started when we got off the beaten path. When we got away from touristy spots, outside our comfort zone, and took a cross country road trip to the Western rugged coast of Ireland. The picture you see above with the rainbow was taken from the back yard as we were “imprinting” and savoring our last view at the end of the trip. This trip truly turned out to be our proverbial pot of gold at the end of the rainbow.  On this journey not only did we see magnificent castles, abbeys, history galore, sheep galore, glorious green like we’ve never seen, and breathtaking views, we laughed A LOT. We strengthened friendships, we made new lifelong friends in Ireland, but most importantly we learned that when you go off the beaten path (so to speak), good things can happen. You get a different view. You gain a different perspective. You get a different experience. (And yes these experiences are in our gratitude journals and brought us great joy! If you’ve been reading our blogs you’ll know how we embrace expressing gratitude and finding joy in life).

    The majesty of the Cliffs of Moher, County Clare, Ireland

    Reflecting and bringing these experiences back to our practices leads us to ask: What if you went off the beaten path so to speak, and rather than focusing on the things in life when managing diabetes that are NOT going the way you want, instead, focus on the things that ARE going well? In our experience, so often we see that healthcare professionals and those living with diabetes alike, fixate on things that are not as desired – whether its an out of range blood glucose, a high A1C, or frequent hypoglycemia. That can leave you burnt out, and frankly beat down. What if instead you get a whole different experience by taking the road less traveled? Focusing on what you are doing well and how you can achieve or do that more.

    This next week we challenge you (whether you live with diabetes or not) to identify at least 1 thing that’s gone well. Is it possible to repeat what you did to lead to more “positive” experiences and days?

    In closing, returning to the our Irish adventure. The four couples deeply bonded on this trip. We valued the time spent together. It  made us realize we wanted to spend more time together over similar shared experiences. So, we are in fact planning another “off the beaten path” adventure across the South of France this summer. Adventuring through life experiences worked for us. It brings us joy. So we are going to do it again. We are sure to have some new perspectives, new learnings and beautiful views to share with you!

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  • Fresh Views

    Doing things differently: Using solution focused questions to build a therapeutic alliance

    Tami’s photos from the Chihuly glass sculptures exhibit at the Biltmore Estate in Asheville, NC. She did things differently by not only viewing the exhibit in the daylight, but also after dark, and got an entirely different perspective.

    Doing things differently leads to something exceptional. – Anonymous

    Our blog last week focused on being a human first.  There was so much information in that one blog post that we decided to highlight and reinforce a few concepts today. So here we go!

    The strength in a therapeutic alliance

    As you may know, we strongly believe in the concept of a “therapeutic alliance” (which you may also know as the “helping alliance” or the “working alliance”). This alliance refers to the relationship between a healthcare professional and the person with diabetes by which they engage with each other to bring about beneficial change for that person with diabetes. This relationship is a most important component.

    The power of language

    It’s near to impossible to create those connections and build that alliance without focusing on language. Language and word choice is one of the most powerful choices we have. Words can demonstrate respect, empowerment and support or words can shame and blame. Respecting the expertise and experience of the person living with diabetes is essential to develop a strong therapeutic alliance.

    Focusing on solutions, not problems

    You also probably know that we are using solutions focused brief therapy (SFBT) and coaching in our work. SFBT is a questioning approach with conversation focusing on the client’s vision and how he/she identifies potential solutions. The questions asked during the interaction focus on a desired future state, and on what is already working well for that individual in the present. We acknowledge that the client has all the skills necessary to achieve their goals. As we mentioned last week, our goal, through incorporating principles of SFBT and coaching in diabetes care and education, is to change the conversation, the interaction and the experience of the diabetes community to improve health.

    10 questions practitioners can use to build a therapeutic alliance

    If you are a healthcare practitioner, we want to share 10 questions that you might find useful when engaging in discussions with patients or clients to acknowledge and build the therapeutic alliance. These questions reinforce the human side of both parties. They demonstrate that you care about the person sitting with you and that the relationship between you is important. Moreso, the word choices and body language during the interaction can go a long way towards creating a relationship of mutual respect.

    1. Thank you for coming in. Tell me what’s been going on. What can I help you with today?
    2. What do you wish to achieve or learn by the end of this session so that you can say you’re glad that you were here?
    3. What is the best way for me to work with you? (For example, do you prefer talking on the phone or text messages?)
    4. So that I can learn more about you, what do you consider your assets and strengths?
    5. Is there anything else you’d like to share that I should know?
    6. When you are at your best, what does that look like? How is that different from the way things are now?
    7. How can you do more of what is making things go well?
    8. If we created a plan, what would you consider a start to your being on the right track? And what else?
    9. What can you take from this session that can help you in the coming weeks?
    10. What will you be doing differently after this visit?

    Here are 3 additional questions that can be used to glean insight and feedback on the interaction:

    1. What feedback would you like to give me about today’s session?
    2. On a scale of 0-10, to what extent did you feel heard, understood, and respected during this session? 0 being you did not feel heard, understood or respected at all.
    3. On a scale of 0-10, to what extent did we talk about and work on the things that are important to you during this session? 0 being not at all.

    If you try incorporating some of these questions, we’d love to hear from you about your experiences and if you felt differently during your client visits. We leave you with 3 things to consider:  

    • Do you feel more present and “conscious” during the visit?
    • Do you feel like a “human” first and a practitioner second?
    • Do you notice that your clients are achieving their goals, and most importantly, are they feeling more confident in their ability to live well while managing their diabetes?

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  • Fresh Views

    Being human first: Perspectives around optimizing healthcare interactions

    Tami and Deb enjoying fresh views in Chicago, finding freedom and joy in life.

    Of course different people fulfill different functions in this world. It cannot be otherwise. As far as intellectual or physical abilities are concerned – knowledge, skills, talents, and energy levels – human beings differ widely. What really matters is not what function you fulfill in this world, but whether you identify with your function to such an extent that it takes you over and becomes a role that you play. When you play roles, you are unconscious.“   – Eckhart Tolle

    Deb’s been listening to an Oprah’s Book Club book on Audible, Eckhart Tolle A New Earth: Awakening to Your Life’s Purpose. While Deb has found the book deep, and a challenging “read”, she’s found that it creates an opportunity to take an introspective look at the way we engage in the world. Tolle believes everyone can find “the freedom and joy of life” if they live in the present moment.

    Deb has also been listening to Oprah’s weekly Super Soul Conversations Podcast to review each chapter of the book, typically while taking her daily walk (and it’s helping a lot to understand and internalize the concepts). During a recent podcast there was discussion between Oprah and Tolle about roles people play and how roles inhibit thinking.  In applying some of Tolle’s principles to our mission and vision here @AFreshPOVforYOU, there was an “a ha” moment for Deb around how the #languagematters movement in healthcare needs to expand to include not just the words we use, but also how we implement person first language. (check out our November blog on why language matters here)  To really put the person (not the “patient”) first, there needs to be a “person” on both sides of the interaction for true person centered care.

    One section of Oprah’s weekly podcast addressed healthcare and how when a healthcare professional “plays the role of healthcare professional”, he or she may become “unconscious” of the fact he or she is a human person while embracing their “healthcare role”. And, that the “patient” across from them is also a person. Something vital is then missing. And as a result, the person (“patient) may end up feeling disconnected and dismissed.

    The discussion brought to mind a recent #DSMA Twitter chat that @AFreshPOVforYou joined a couple of weeks ago. One question asked during the chat was: “How can healthcare practitioners facilitate more empowering or effective communication with patients or vise versa?”  One enlightened participant, the incredible behavioral and data scientist Dr. Chandra Osborn replied, “Be a human first – a practitioner second.”  

    Her reply really struck a chord, and aligns with the closing words in Tolle’s quote above, “When you play roles, you are unconscious.“ Let’s repeat that…..”When you play roles, you are unconscious”. How can there be empowering or effective communication if people are not “present” and if they are “unconscious”?

    Along those lines, We @AFreshPOVforYOU have experienced this first hand.

    Deb’s experience…

    Deb recalls a visit with her daughter to the pediatrician where they never once made eye contact. The doctor typed on the computer the whole time, asking impersonal questions and fulfilling her role. They did not feel like they were part of the conversation.

    Tami’s experience…

    Tami remembers a similar scenario while sitting alongside her mom at hospital discharge following her mom’s knee surgery. The healthcare team was talking all “around” both of them, talking to each other, asking questions, giving a multitude of instructions, rarely looking at them or expressing interest in their point of view or concerns. They did not feel like they were part of the conversation either.

    We’ve heard many similar stories from people with diabetes – how at times the relationship with their healthcare provider was not ideal. Some have stated they cancelled an appointment because they didn’t want to be scolded for an A1C value that was higher than expected. Or because their weight was up a few pounds.

    In traditional healthcare people with diabetes are expected to play the role of patient and clinicians play the role of doctor, nurse, dietitian etc.  Yet this type of engagement does not promote healthy communications and relationships. As Tolle recounts, “Authentic human interactions become impossible when you lose yourself in a role.”

    We’ve experienced being on both sides of this equation.  As diabetes educators, we are always striving to improve, but we are not perfect. We’ve made our share of mistakes, but we’ve grown and learned from them. Deb recalls one client she saw years ago that was very frustrated with her because she was following the “assigned content” for the appointment per the prescribed healthcare provider orders, and at the end of the visit the client said, “we didn’t have time for any of my questions!”  That meeting really left an impact on her, she was playing the “role” of a diabetes educator and she never made that mistake again. Fast forward to a more recent experience when she received a call from a healthcare provider who referred his patient to her.  The doctor said, “I’m not quite sure what you did, but Mr. Jones is never satisfied with anything  or anyone, but he could not stop talking about how his appointment with you was the best diabetes visit he’s ever had.”  You know what she did? She started by asking him about his family and recent vacation, and then asked what was going well with his diabetes management?  She was being a human first and he was treated like a person.

    If you follow our blog, you know that we are advocates of solution focused therapy. In the context of solution focused therapy, the client/person with diabetes is viewed as the expert and the most important element is the “therapeutic alliance” between the client and the practitioner.  The relationship is the key to being able to work together. And to build a relationship it requires being present, being conscious of one’s own behaviors, use of language, and body language which all tell a story. We believe it’s critical to enter healthcare exchanges as a human first- not playing a role – with each party recognizing their part in the conversation/interaction as valuable.

    Our goal, through incorporating principles of solutions focused therapy and coaching in diabetes care and education, is to change the conversation, the interaction and the experience of the diabetes community to improve health.  As Eckhart Tolle says, we need to “become conscious of being conscious.”  We need to work as a team, be present in all of our interactions and most of all be human.

    In closing, we leave you with a few thoughts on what you can do when you engage in a healthcare interaction.

    If you are a healthcare provider:

    1. Be human first
    2. Check your ego at the door
    3. Appreciate that the person in front of you is as an expert on their condition
    4. Listen carefully before speaking
    5. When possible, sit on the same side of the table
    6. Understand the burden associated with living with a chronic condition

    If you are a person living with a chronic condition:

    1. Be human first
    2. Actively participate in your medical appointments and your self-management to the best of your ability
    3. Work in partnership with your care team
    4. Be honest about your capabilities

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  • Fresh Views

    Take a pause to gain a fresh perspective

    Photo taken on one of Tami’s pauses

    When life gets crazy, as it often does for us, a strategy that we @AFreshPOVforYOU find particularly useful is taking a pause or break to help clear our minds and gain a fresh perspective. It could be a half hour, an afternoon, a day, or a week. Tami has found that when her mind is jumbled or she’s trying to work out a problem, taking a walk allows her to think, her creative juices to flow, and to gain a fresh perspective. (And sometimes even happen upon a stunning sunset view like the one above captured on a recent walk). Deb enjoys sitting outside in her backyard, enjoying the view of the trees, flowers and clear water in the pool.  Even getting away from our desks and out of the office at lunch brings clarity and new thinking. We’ve found when we’re hit with “writer’s block”, just putting the project away for a day or two allows us to return with a clearer mind, new ideas and new perspective. Clients we’ve worked with have shared a variety of things they do to take a pause – from taking a long run, reading a pleasure book, mowing the yard, or simply sitting and being present in the moment, Taking that pause can change your perspective….much like “turning turtle” can. You can read more about “turning turtle” in our January 30, 2019 blog.

    Have you tried stepping away for a bit when you’re in the midst of a challenge? Maybe you’re struggling with insurance benefits and getting your medication prescription filled, or maybe a co-worker questioned the food you were eating at lunch. (we know that never happens!) Taking a pause may sound counterproductive, but actually it’s not. As you step away, spend a moment acknowledging all the hard work you have done. Remind yourself  what you’ve accomplished or what is going well, even though it may feel like the world is swirling around you.

    The practice of using solutions focused brief therapy (SFBT) encourages the exercise of asking questions when trying to identify solutions. A key premise of SFBT is that the individual is the only person who can understand his or her own needs, strengths and capabilities. The practitioner can facilitate by asking questions. One opportunity to incorporate the practice of asking questions is during these moments when you need to pause and step away.

    Here are 3 questions to consider to help guide your thinking and help gain perspective:

    1. Compliment yourself on your current efforts.  What would you say to yourself?
    2. What good intentions did you have when you started out today?
    3. What is the most important quality you have and use when you are under stress or pressure and how can you leverage that now?

    Asking yourself these questions when your mind is calm, and you are not distracted can help remind you of the resources you have within you and re-focus on your strengths.

    We often find that the more challenging the season in life, the more often we need to pause. It’s an important part of self-care. Sometimes just stepping away from a situation for awhile helps to bring a fresh perspective.

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  • Fresh Views

    Spare a Rose, Save a Child Today!

    The past few years we’ve requested no roses on Valentine’s day and instead asked our husbands to make donations to the Spare a rose, save a child campaign, a program of Life for a Child.

    What is this all about?

    If you are reading this blog, you probably know us and this program. But just in case….Life for a Child is a charity that helps diabetes programs in countries that do not have insulin and other diabetes supplies needed for young people living with type 1 diabetes to, …..well live!  The vision seems so simple….no child should die of diabetes. Yet the scary reality is they do..

    How can you help?

    Spare a rose, save a child is pretty easy. Instead of a dozen roses, ask your special someone to only buy you 11 roses, and then donate $5, the cost of that one rose! One rose can provide life saving medicine and supplies for a full month for one child. Better yet, forgo the dozen roses all together and you can save a life for a whole year! Now that is a Valentine’s day gift to remember.

    Several other people have written blogs this month to raise awareness of this life changing program. For just a sampling of the advocacy taking place this month, check out Renza’s blog Diabetogenic here and Stephen’s blog Happy Medium here.

    Since we post our blog on Wednesdays and today is February 13th, we thought this would be a good last minute reminder that you don’t need to run to the store to make a meaningful difference tomorrow, just click and donate here and #SpareaRose.

    Reflecting on our recent blog on Gratitude, this Valentine’s day we are grateful for our diabetes community and want to give back. And since we learned that practicing gratitude can decrease stress and anxiety by activating the areas in the brain that release feel-good hormones serotonin and dopamine, this is really a gift that actually gives back to us!   

    Happy Valentine’s Day to all!

    Deb and Tami

  • Fresh Views

    It’s time to flourish with diabetes!: An interview with Riva Greenberg and Boudewijn Bertsch about this new world view

    Over the past few months through this blog we’ve shared some thoughts, insights and innovative approaches around living well with diabetes and creating possibilities, opportunities, and a vision for the future. Through several projects we’ve been working on we became familiar with the like-minded work of Riva Greenberg and Boudewijn Bertsch and their Flourishing Approach to living well with diabetes. So, we connected and shared ideas. We thought our readers would be interested in Riva’s and Boudewijn’s Flourishing Approach, and they were gracious enough to share their time and thoughts with us.

    Riva Greenberg and Boudewijn Bertsch.
    Photo credit: Mathias Loevgreen Bojesen

    1. Tell us about the core principles of the Flourishing Approach to living with diabetes, and how it differs from the traditional Healthy Coping approach.

    Riva (and Boudewijn): I find it interesting that we call the conventional approach to diabetes management, “Healthy Coping.” That’s truly a mixed metaphor. For people with diabetes, coping does not translate positively. Their association with coping is a sense of just getting by or struggle.

    The Flourishing Approach that we designed and have shared with thousands of health professionals around the world, is a paradigm shift and a new world-view, which I will explain.

    Our conventional approach takes a machine-view of the body and, while most health professionals don’t realize it, causes us to see and treat people like machines. The approach grew out of acute care, however in acute care, you can repair, heal or cure someone. Here machine values make sense.

    Modern medicine adopted the values of the Industrial Revolution: accuracy, precision, perfection, standards, linearity, cause and effect. These remarkably advanced medical tests and technologies. Unfortunately, they do not foster what people need to live well with a chronic illness – adaptability, growth, healing and developing resilience. Nor do they inspire the tissue of self-care – connection, confidence and commitment.

    Seeing people with diabetes as machines we see defects. In contrast, the Flourishing Approach (FA) sees a person with diabetes as a biological organism. As such we see they are now in a new state, redesigned, not disabled but differently-abled. From this orientation, the Approach brings no  judgment and the direction, rather than fixing, is to promote growth and wellness as living organisms are designed for.

    The Flourishing Approach also, unlike the conventional approach, sees diabetes as a complex condition and the person with it operating in a complex world. As such, you cannot apply cause and effect thinking. We cannot say, “Do this and that will happen,” there is too much complexity.

    Nor can we apply accuracy and precision to blood sugar management. Telling a person with diabetes that they can “control” their blood sugar is not only untrue, it sets them up for failure. Instead, we need to nurture and equip individuals to help influence their blood sugar and respond appropriately.

    The core principles in the Flourishing Approach are based on human sciences, neuroscience, biology and social sciences and according insights like we need to feel safe to function at our best. “Best practices,” culled from the masses pale against individualized “emergent practices.” The FA helps people explore their own solutions; we don’t impose standards based on averages.

    As an orientation the Flourishing Approach: 1) is relationship-centered, both practitioner and person with diabetes bring their mutual strengths, expertise and ideas together, 2) explores the patient’s context 3) uses open conversations where solutions emerge 4) is positively focused, looking for what’s working and 5) aims to achieve what’s wanted, better health, not what’s to be avoided, complications.

    2. The work we @AFreshPOVforYou are doing is centered around the solutions focused brief therapy approach. How does that align with the Flourishing approach?

    Riva (and Boudewijn): The Flourishing Approach is based on several sciences that explain how we operate as a biological organism. Solution focused brief therapy (SFBT) is one of these theories. But it’s important to understand the FA is not just a set of tools, but a different paradigm. One can use SFBT within the conventional treatment approach. For instance, we can ask patients positively-focused questions yet still assume the mantle of the expert who has the answers.

    The FA is based on Systems and Complexity theory, that we operate within systems – home, family, work, community, culture, country, and that diabetes is complex and medical sociologist Aaron Antonovsky’s ‘Sense of Coherence’ and Dr. Stephen Porges’ Polyvagal Theory.

    Porges identified a third autonomic nervous system (ANS) in addition to the sympathetic and parasympathetic. He calls it the social engagement system. In this state we are most open, flexible, creative, adaptive and push forward confidently into the world. But to be in this state we must feel safe. So, I ask practitioners when I present at conferences, “What do you do to help your patients feel safe?” They have never thought of it before. The FA being relationship-centered, not patient-centered, heightens safety.

    3. How can readers learn more about the Flourishing Approach?

    Riva (and Boudewijn): The Approach appears in two issues of the Academy of Nutrition and Dietetics, peer-reviewed journal, “On the Cutting Edge,” The Flourishing Treatment Approach: A Strengths-based Model Informed by How People Create Health and A Flourishing Approach to Mental Health in Patients With Diabetes.

    4. Would you share an impactful story/experience surrounding the Flourishing Approach.

    Riva (and Boudewijn): In January 2014 we spent three weeks sharing the Approach with the medical staff of Jnana Sanjeevini Diabetes Center in Bangalore, India. One day a dietitian came up to me. She told me she’d followed our teaching and asked her patient what he was doing well and what he’d like to try next. The whole visit, she said, was light and filled with laughter and he left excited. Normally, she said, she’d try to push him to do what she thought he should, he’d leave downhearted and nothing would change.

    We also have a diabetes nurse from Steno Diabetes Center in Denmark, where I’ve done a lot of training, tell me her patients are changing behaviors more easily, and she is happier in her work using the Approach.

    5. What one thing would you like readers to know?

    Riva (and Boudewijn): I don’t discount today’s conventional approach. It works for some. My aim is to expand health professionals’ repertoire and people with diabetes’ possibilities by using a human-, not machine-, based approach.

    We’ve had numerous innovations in diabetes medicine, tools and technologies, in software and hardware. Yet no innovation in treating patients. The Flourishing Approach is an innovation in this essential aspect we all but ignore, heart-ware.

    I’ve presented the Flourishing Approach at diabetes conferences around the world – the ADA and AADE annual conferences, the Charles H. Best Diabetes Center in Canada, and at conferences in Israel, Sydney and Singapore. I have also presented the Flourishing idea to device and pharma companies. This December I’ll be presenting it at the International Diabetes Federation World Congress in Busan, Korea.

    If anyone is interested in a presentation on the Flourishing Approach and/or workshop, where I teach a few tools from the Approach, they can contact me at riva@diabetesbydesign.com.

    Thank you Riva and Boudewijn for your encouraging solutions focused approach to flourishing with diabetes!

    To learn more, here are links to Riva’s Books: Diabetes Do’s & How-To’s; 50 Diabetes Myths That Can Ruin Your Life; The ABCs of Loving Yourself With Diabetes Here’s the link to Riva’s Blog: diabetesstories.com

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  • Fresh Views

    “Turning Turtle”: Seeing life from a different point of view

    Dubai, UAE following the IDF Congress, December 2017

    Last week’s blog post focused on developing a practice of gratitude – being grateful for the little, everyday things (and big things too), especially when challenged with the burden of a chronic condition that may sometimes make finding joy in life a struggle.  

    Along those lines, this week we are continuing our discussion on gratitude from a slightly different view……. when things are “turning turtle”, or in other words turned upside down! What are we talking about? You may have seen the recently released movie Mary Poppins Returns. One of the movie’s songs beautifully sung by Meryl Streep is called “Turning Turtle”. If you haven’t heard it, click on the link and check it out!

    The song opens with these  lyrics:

    Turning turtle? What exactly does that mean?

    It means my whole world goes flippity flop like a turtle on its back.

    And I don’t know my up from my down, my east from my west,

    My topsy from my bottomsy…

    By definition, “turning turtle” is to capsize or turn upside down. (For example, during the accident, the car turned turtle). A turtle on its back is helpless and disoriented. It can’t move. It isn’t safe or protected by its shell. It may seem stuck, without options or an evident solution to being trapped on it’s back. Or are there options? The song lyrics go on to say:

    …It’s good to get a different point of view

    You see, when the world turns upside down,

    The best thing is turn right along with it.

    When the world turns upside down so to speak, an opportunity is presented to gain a fresh point of view. And when a situation may seem challenging, being able to bring forth opportunities for gratitude may need that twist – that upside down view. This song is a great exercise in seeing the world through a different lense and creating a different point of view. And in turn, rather than focusing on the “problem”, instead focusing on “solutions” that could work (especially if similar solutions that worked in the past can be applied here). In illustration, a friend with diabetes shared this story that might help us think about the “turning turtle” concept applied to life with diabetes:

    She was traveling out of the country and had recently changed insulin pumps.  By mistake, she packed her old infusion sets, that worked with her old pump. When she was preparing to change her pump,  site realized what had happened. Fortunately she packed enough insulin pens as back up and had those with her to use for the remainder of the trip. When the trip was over she actually felt like she had been on a vacation from her pump.  She never dreamed of stopping the pump – she felt like she would be flat on her back without it, like the turtle. But, she actually found some joy and gratitude in not being attached to her pump for a week, and at the same time gained a new sense of appreciation when she returned home and was able to connect to the pump again. She was pleased with herself for being prepared.  She commented that she always brings extra supplies but has never needed them before. This “problem” had a solution readily available because of her constant effort to be prepared. And her trip might have been ruined had she focused on the fact that she couldn’t wear her pump, but instead she chose to be thankful she had insulin pens available and experienced a different week of diabetes management that then gave her a little more resilience when she was ready to start the pump again.  

    Returning to the song…it goes on to close out:

    When you change the view from where you stood

    The things you view will change for good

    I never thought of things that way

    She never thought of things that way

    Now Wednesdays are my favorite days

    …I have changed. To be exact, I love the fact

    The world is turning turtle, turtle, turtle

    When you next find yourself in a “turning turtle” situation, we encourage you to reflect on the  following:

    • What new point of view is in front of you to be embraced?
    • How can you leverage past successful solutions in this situation?
    • What can you acknowledge gratitude for?

    And like the closing song lyrics, now Wednesdays are our favorite days too since that’s when we share a new blog post each week! Until next Wednesday!

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  • Fresh Views

    What are you grateful for today? 5 strategies to develop daily gratitude habits

    Gratitude makes sense of our past, brings peace for today, and creates a vision for tomorrow – Melody Beattie

    Do you think about gratitude during your daily routine? Is it a habit you practice? Deb was recently on vacation and needed some self-care so decided to get a massage.  When she was checking into the spa they showed her three smooth stones, each with one of these words on it: Hope, Love and Gratitude.When asked to choose one emotion that she wanted to focus on during the massage, she chose Gratitude. While laying face down during the massage, a smaller stone was placed below her face so she could see and reflect on the word “Gratitude” during the massage, and to help her think about being grateful. (You see that stone in the photo above) This fresh view and experience created a new desire to be more thoughtful and intentional about being grateful for what is and what she has.

    What do you think about when you see or hear the word ‘gratitude”? The simple definition is “a feeling of thankful appreciation for favors or benefits received; thankfulness.”  But the practice of gratitude means so much more.

    According to the American Heart Association several clinical trials show that engaging in a practice of gratitude can lower blood pressure and help the immune system. “Grateful people engage in more exercise, have better dietary behaviors, are less likely to smoke and abuse alcohol, and have higher rates of medication (taking)”. Several studies suggest that gratitude can decrease stress and anxiety by activating the areas in the brain that the release feel-good hormones serotonin and dopamine.

    Research discussed in the Jan/Feb, 2019 issue of Diabetes Self-Management also shows that positive psychological states such as gratitude are associated with improved physical health in people with diabetes, improved sleep, and increased self esteem. While the relationship is not fully understood, positive emotions such as expressing gratitude, are linked to healthier lifestyle choices. And healthy lifestyle choices including healthy eating and being active are in turn linked to overall health.

    How can you get started with gratitude?

    Here are 5 strategies to help develop daily gratitude habits:

    1. Have gratitude reminders. These are simple cues to remind you to focus on gratitude daily. Maybe it’s an alarm on your phone, a bracelet or wristband, a photo, a magnet even a post it note. And with that reminder, pause, take a breath and focus on being grateful in that moment.
    2. Keep a gratitude journal. We both have found this to be a good personal practice to express gratitude more readily and find things to be more grateful for. Some log entries in their journal weekly, and others daily. Our personal goal is to identify at least 3 things daily for which we’re grateful. Tami numbers her entries and is working toward 1000 things for which she’s grateful. Some things are big (Entry #622 – Protection through a tornadic storm). Some things are small (Entry #1- Sun and warmth on my shoulders). While the goal is to write in the journal daily, sometimes life happens and weeks may go by without an entry, but we pick right back up with our entries.
    3. Start a gratitude box. Keeping a box (jar, album, folder, or whatever works for you) filled with notes, pictures, and moments you are grateful for can bring a boost when needed. Tami keeps a folder on her desk and a file on her computer filled with nice notes and photos, as well as  an album on her phone of messages and moments she’s grateful for to refer back to when she needs a reminder. Deb has a bulletin board in her office that displays happy memories in photos, ticket stubs, quotes, flyers etc. that she can look at during working at any time.
    4. Voice or write down one (two, or three) good things that happened in your day. On the homefront, this is a gratitude practice Tami has used with her son over the years. In the days when she would take and pick him up from school, she found that the drive time was a good time to learn about his day. That conversation always began with these words, “Tell me something good that happened today.” He knew he needed to answer that, acknowledging something good, before talking about the challenges of the day.
    5. Use gratitude apps. There are a number of apps with a range of capabilities including sending reminders, sharing uplifting thoughts, and organizing memories for which you are grateful. Deb has been struggling with back pain from a chronic disc problem and was at a place where no position brought relief, not sitting, standing or lying down. It was getting challenging to think clearly and work. She began using the Calm app, decided to take the Calm masterclass in gratitude, and use their 7 days of gratitude meditation. The process has helped her to find daily items to be grateful for during a time when it was challenging to not be engrossed in the pain.

    Here are 3 other things Deb has learned  through this experience:

    Learning #1 – When you have a chronic condition that is challenging you, think about ways to appreciate and focus on what you do have and what is working for you.

    Learning #2 – Try not to compare yourself and what you may be dealing with to others. While the grass might look greener on the other side of the fence, we never truly know what others are going through.  

    Learning #3 – Trying to simply look at what is right in front of you and be present in the moment.

    Maybe you employ one of these strategies. Or several.

    Here are 3 tips to help maintain your gratitude practice once you get started:

    • Find a daily time to practice gratitude and try to be consistent. Maybe it’s when you get up in the morning. Maybe it’s before you go to bed at night. Maybe it’s when you’re exercising.
    • Write what you feel. Don’t censor it.  
    • Refrain from making the list repetitive. Be specific finding new ways to approach gratitude.

    We’ll continue our discussion on gratitude next week from a slightly different view……. when things turn upside down! Read our post next week and find out!

  • Fresh Views

    Hello world! A Fresh POV may change your life

    We started our blog in November 2018, just a couple of months ago, and thought we would re-share our first post in the new year for those of you who might not know who we are. Please subscribe to our email list and we’ll let you know when new blogs are published!

    Deb and Tami in Italy enjoying the view!

    Thanks for checking out our new blog “A Fresh POV for You”!  Join us as we focus on Possibilities, Opportunities and creating a Vision (POV) for the future, based on strengths and leveraging positive learnings from past experiences.

    Who are we?

    We are healthcare professionals and diabetes specialists passionate about positivity and empowering people with diabetes to live life to the fullest! Deborah is a nurse. Tami is a dietitian. We both have spent our entire careers partnering with those living with diabetes to leave a positive imprint.

    We are also speakers, authors, wives, moms, adventurers, and avid travelers always in search of the next fresh and magnificent view. (You see one of those stunning views in this photo, looking out over a vineyard in Italy). You’ll learn more about us and some of our adventures over time.

    What is our focus?

    Simply put, our goal is to inspire those living with diabetes, or at risk for diabetes to design a life that has a personal sense of balance, is realistic and fun. A life that works for them. It goes without saying that managing diabetes is complex and burdensome. The constant focus on problems can make it even harder. We are passionate about turning the focus to abilities and possibilities. What will be different and new instead of what will NOT happen anymore?  What is desired instead of what is NOT wanted? Let’s learn from each other!  

    Why did we start this blog?

    Since November is Diabetes Awareness month there’s no better time than now to let you in on our new adventure in diabetes that’s been in the works behind the scenes for some time.  

    Getting to know us personally, beyond professionally is important. We believe in the concept of a “therapeutic alliance”- which means that the relationship between health care professionals and people with diabetes is the most important component.  

    Awhile back, we discovered an approach called Solutions Focused Brief Therapy. It resonated with us because of the focus on possibilities, opportunities, and creating a vision for the future.  How about applying this to diabetes?  We  look forward to sharing with you as we learn more!

    Then we joined together to craft content for two recently released brief videos focusing on the use of empowering language in diabetes. Language that puts the person with diabetes, their needs and their values first, thus moving away from language that judges, blames and shames. These videos are based on the language position paper published by the American Diabetes Association and American Association of Diabetes Educators. (You can check out the paper and the videos here and on our blog homepage). Over the months that we worked on the video project we had many soul searching discussions about how diabetes care and education needs to evolve and innovate.

    And thus was born A Fresh POV for You! If you are someone who feels challenged and overwhelmed with aspects of life with diabetes – or someone who just wants to learn more about our creative approach – follow our blog as we begin to share more about our exciting new adventure over the next few months. We have lots of creative ideas and ways we hope to engage in innovative diabetes services! Our goal is to create programs and services that resonate and make sense for people living with diabetes.

    Follow us on Twitter and Instagram @AFreshPOVforYou.  

  • Fresh Views

    Make New Year’s Solutions rather than Resolutions

    With the new day comes new strength and new thoughts – Eleanor Roosevelt

    New Year’s Eve Fireworks

    With the start of the new year, many find themselves reflecting on the past year, re-evaluating life, and pondering what “resolutions” they will set for the new year.  New year’s resolutions often focus on “stopping” doing certain things and starting to make changes. Many resolutions revolve around trying to be healthier in some way.  Yet evidence shows that about 80% of people fail to stick to their New Year’s resolutions longer than six weeks.  That means by the time the Valentine’s Day rolls around, many have abandoned their desire to change. Often resolutions are attempts to find ways to solve problems.

    What if, instead of making New Year’s Resolutions which require change and “fixing”  problems (and change is hard!) – you focus instead on making New Year’s Solutions?

    Who doesn’t like a solution after all? One way to identify solutions is to focus on things that have gone well in the past, and pinpoint how you can do more of that (rather than trying to change).

    As you reflect on the past year, here are 5 questions to ask yourself and guide your thinking:

    • What went well for you in 2018?
    • What did you feel happy about?
    • What behaviors helped you feel successful and were doable?
    • How can you do more that?
    • Instead of thinking about “problems”, how can you reframe your thinking into positive “opportunities” and solutions? (Reframing a situation, idea, or belief can bring a fresh perspective. You can read more about this in our January 2, 2019 post.)

    Here’s an example from Deb…

    I am  a fan of Starbucks Mochas. As 2018 opened, I was getting a Mocha most every day. I also like Starbucks lattes. And the latte has fewer calories. So I started ordering the latte more often. I also discovered I didn’t really need a grande but was satisfied with a tall, so I now order a tall most days. When you add up the calories over the course of a year, that’s a significant savings! (Now on some days when I  really need a pick me up I may decide on a Mocha or splurge on a grande, but it’s no longer the routine). I leveraged something that was going well, and did more of it. It was doable. I closed out 2018 happy about this solution.

    Here’s an example from Tami…

    One of my favorite ways to get physical activity is to walk in the neighborhood after a long work day. I especially like this in the fall and during the holidays with all of the decorations and twinkling lights providing a fresh view to take in while meeting my step goal and unwinding from the day. The past few months I’ve battled a foot injury that has made walking my usual routes impossible some days. Rather than focusing on the “I can’t”,  I’ve turned and focused on what I CAN do. By reframing my thoughts, I find myself thinking, “ I can do this. I am not lazy. I am rebuilding my endurance step by step. I am grateful I am able to do half of my usual walk, it’s better than none.” And I’m really grateful for the days I’ve been able to complete my routine route! I’ve focused on keeping the habit going. Focusing on what I CAN DO and what is going well, rather than fixating on what I can’t accomplish. By reframing the situation, my resulting emotions are feeling confident, in control, and hopeful.

    So as we look with excitement to 2019, join us in making New Year’s Solutions and resolving to do more of  things that we do well!

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