Diabetes Open Hours: Dealing with a New Diagnosis

0:00 [Music] hello and welcome to diabetes open hours0:05 your live Q&A opportunity with experts in diabetes management and care my name0:10 is Kayla Ranka and I'll be your moderator for today I would like to start by acknowledging that I'm calling0:16 in from Toronto and that I'm located on the traditional indigenous territory of the wendat honi anishnabe and the Miss0:23 sagas of the credit and that Toronto is now home to many diverse First Nations Inuit and matey peoples0:30 as a health focused organization diabetes Canada recognizes that there is systemic racism within and throughout0:37 our institutions and that we have the responsibility and power to create culturally safe and appropriate0:44 environments of care our topic today is dealing with a diabetes diagnosis and is supported with0:51 an unrestricted educational grant from copi and while we have an expert on the0:56 call today this webinar is for educational purposes only the content discussed in this webinar is1:02 not intended to be medical advice and to the extent that medical advice is required you should consult with a1:08 qualified medical professional the information discussed in this webinar cannot replace consultations with a1:14 qualified Healthcare professional to meet your individual medical needs and lastly the views and opinions expressed1:21 in this webinar are those of the speaker and do not necessarily reflect the views or positions of diabetes1:28 Canada having said that today we are very lucky to have Dr Dana Lee Bagley1:33 with us Dr Dana is a registered clinical psychologist in British Columbia Alberta1:39 Ontario and Nova Scotia her registrations include Clinical Psychology Health psychology and1:46 organizational psychology she is the co-founder and chief scientific officer1:51 of the impact me app she has worked for almost 15 years in multidisciplinary1:57 teams on medical Surgical and C Cancer Care Hospital units and conducts research as an assistant professor in2:04 the department of family medicine with a cross appointment in the department of Psychology and Neuroscience at Dal2:10 Housey University and she's an Adjunct professor in the department of psychology at St Mary's University and2:17 if that wasn't enough she is also the author of the book healthy habits suck how to get off the couch and live a2:23 healthy life even if you don't want to and I certainly feel like that's a book we could all definitely use in our lives2:31 before we get started just a few housekeeping things please note this event is being recorded and will be2:37 shared on our website and YouTube channel for on demand viewing any questions or comments that you submit2:43 via the chat function will be visible to other participants during the event but we will not share any names or record of2:49 the chat in the recording we ask that any comments or reactions you share be affirming and positive and we encourage2:56 you to discuss your learnings with your regular healthcare provider prior to making any changes to your3:01 current routine and with that are you ready to get started Dr Dana yes great thank you3:09 for joining us today and for all of you participants feel free to start putting uh your questions into the chat andTime of Diagnosis3:16 while we're waiting um why don't we start with the actual time of diagnosis3:21 so what might some of the emotions that individuals uh may feel when they hear the word diabetes from their healthcare3:27 provider um I'm sure sh probably is one of the top ones on that list yeah we know that people are going3:34 to feel you know a variety of um emotions when they first get diagnosed so that includes things like um shock it3:43 includes things like grief um confusion I think it's helpful for people to know3:48 that there are like grief is a really normal part of getting a diagnosis and3:54 it's grief over a lot of different things right grief is just a reaction to loss and that loss sometimes in includes4:00 your um ideas about the future that might be different now it includes uh potentially a loss of your identity uh4:07 loss of certain roles um that there are changes that will happen kind of throughout your life potentially uh4:13 because of that diagnosis and so that's very common for people to go through some people have heard of like the five4:19 stages of grief I think it's um important to know that there aren't actually five stages of grief and so uh4:27 what's helpful about that model is to recognize there's lots of different um emotions that show up in response to4:33 grief all of those emotions are normal and natural uh but you don't have to go through a set order of stages of grief4:42 to be um coping well with a loss um and and believing that you have to go4:48 through a certain stage you know model actually can lead to complicated grief so just about recognizing there's lots4:54 of different emotions that show up uh we talk about the three ends so notice it4:59 name it and normalize it right so recognizing you're feeling different things um you know naming it it could be5:06 sadness it could be anger it could be numbness it could be um you know a variety of different emotions and that5:12 those are all normal responses to a big change in your life like5:18 this okay great um yeah so so this grieving period we often do hear aboutGrief Management5:23 it and like you mentioned whether it's um due to you know things changing rapidly or potentially even worry about5:30 their family and now their family history has changed with the diagnosis of a a chronic medical condition as well5:36 um so do you are there specific tactics that people can use maybe to get through5:44 that time of grief and move on to you know the management stage of of a new5:49 diagnosis yeah so one of the main things we do work on with people um with a chronic disease which you know starts a5:57 diagnosis um is a term we call psychological flexibility and that's like your ability to have like a large6:03 behavioral repertoire meaning you could do lots of different things and it's really important for people experiencing6:08 a chronic disease to figure out how to be value driven instead of goal driven so our culture talks a lot about being6:14 goal driven and you know those are achievements you want to do they're outcomes that you want to have happened6:20 but we don't always control those right they're often controlled by lots of different things not just our own6:26 efforts being value driven is about how you want to show up as a human so it's not about what you want to get from the6:32 world it's about what you want to contribute to the world so whether you want to contribute creativity or kindness or compassion it's about how6:38 you want to show up and if we can um move to being value driven it gives us a6:45 much larger opportunity to do things that matter to us it's quite likely that there are things that will have to6:51 change in your life about um what you can do and but that doesn't mean you6:56 can't have a meaningful life you can for sure have a mean meaningful life it's just going to look different and frankly7:02 that's true for all humans as we grow up right it very rarely looks the way we thought it was going to look and so that7:07 psychological flexibility about being able and willing to um express your values in a different way so for example7:16 you know um perhaps uh it was a part of your role was to like make meals for7:21 everybody right and now some of the meals that you make are things that you're not supposed to eat because of your diagnosis right so we're trying to7:28 find you another way to care about your loved ones that might involve different meals or different activities but it's7:34 still an expression of your care and affection for them and so that's something that we are trying to work on7:40 with people is to be have more options for how to express your values we can always find them and the key is uh your7:47 willingness to have it look different and feel different than how you thought it was going to look or7:52 feel wow I I love that that actually spoke to me um incredibly as you know aSelfblame7:57 mom and and someone who car cares for my family via food and I can imagine that um that's a big change for people8:04 especially with a diabetes diagnosis um you know learning you have a chronic medical condition um can be8:11 hard to accept um and uh depending on how you move through that stage8:17 sometimes people move into a period of self-blame so um why did this happen to8:23 me how could I have prevented it um can you speak to that feeling a little bit and and you know some tactics maybe to8:30 help people again deal with that concept of of self-blame Y so you know we all8:36 want to recognize that we live in an environment in like you know North America that absolutely does not is not8:43 conducive to health it's not conducive to health behaviors it encourages unhealthy behaviors it's actually8:49 incredibly difficult to to do like to maintain healthy behaviors in our culture our environment just does not8:55 support that and it it's not a neutral environment it actually supports um unhealthy habits right so what we talk9:02 about this as like a compassionate reality check which is like certainly there are things that that you've done9:09 and that you could continue to do that will impact your um condition and you want to be aware of those and you want9:14 to work on those as much as possible because they you know are under your control but there's a whole bunch of9:19 other factors that lead to these diagnoses that are absolutely out of our control right there are um different9:25 rates of diabetes depending on um different like economic classes right there's differences in terms of um9:32 different um ethnicities there's differences in terms of like where you live for example uh whether rates are9:39 higher in you know one country versus another country none of those are things that we chose right we don't choose9:45 where we're born we don't choose what era we're born in we don't choose whether we're male or female and all of9:50 those things also impact our health so it's kind of a terrible thing that our culture has done to act like if you just9:57 believe in your dreams anything is possible because it sort of conveys that you have some unlimited control over10:03 your body and if you had just tried harder you could have stopped this from happening right but most of us are10:09 facing an uphill battle when it comes to health and there are all a whole bunch of factors that influence that but we10:14 actually have no control over and so we're balancing the two things which is uh there's a whole bunch of this that10:21 isn't your fault and it's your responsibility right so there's a bunch of things that you can do to help your10:27 condition and even when you're doing everything right your condition can still be Progressive it can still go up10:33 and down it doesn't mean what you're doing doesn't count doesn't matter it just means that there are some parts of10:39 our bodies we don't have control over and we live in an environment that does not help us make good choices so I once10:46 uh you know once worked with this woman who was um diagnosed with breast cancer in her 40s so I know it's a different10:51 diagnosis but kind of relates to the same idea which um you know and she just run a marathon or something like that so10:57 she was like super healthy and she was so angry right that she'd gotten this um diagnosis when she um was so healthy and11:04 she was like all my healthy habits were for nothing but we don't know that maybe she was destined to get um breast cancer11:11 in her 20s and all of her healthy habits delayed the progression until her 40s11:17 right she was definitely going to go through chemo a lot better because she was healthier the rest of her body was healthier and so there's some parts of11:23 our bodies we don't have control over we can't directly you know um change them11:28 and so you want to control the things you do have control which is your behaviors and there are lots of behaviors that will make your condition11:35 better or worse and at the same time there are parts that even when you're doing everything right you won't have11:40 control over it so getting into that shame cycle typically isn't good for people it usually like goes down a a11:47 path that actually doesn't help you make good choices it doesn't help you live a meaningful life and so we just want to11:53 recognize that again you can use our three ends of notice it name it normalize it of course it's normal to11:59 feel that way is it really going to help me if I let this be in charge of my day right and chances are it's not and so12:06 then go do something that's value driven go do something that matters to you go take care of yourself in some way and12:12 some you know easy kind of thing that you can do to remind yourself that it's an and not a but right that you can do12:19 things that influence your condition and you should and you can be doing everything right and your condition can12:25 still progress that's a great um thought and also a fantastic segue into the nextOrganizing12:32 question so you know espe specifically with a diabetes diagnosis there's a lot12:38 of things that end up needing to change um changes to the diet changes to your12:43 physical activity um treatment plans medication schedules blood sugar checks12:49 and uh all of those details take up a number of sort of points throughout a12:55 day and um for some that additional routine might be a little overwhelming13:00 so are there ways to organize or even um wrap one's mind around fitting in all13:07 these points of a treatment plan throughout the day knowing that again to your point of um value based and and13:13 moving forward through doing something positive for yourself um is now critical to one's life and well-being yeah so we13:21 try to get people to attach a value driven reason for change for making13:26 those changes a lot of people will try to make those changes um based on kind13:31 of a fear model right I don't want to have the bad outcomes that people have told me will happen with diabetes I13:38 don't want to go blind I don't want to you know um have problems with my feet and so it becomes driven by distress and13:45 that can get you going at the start but it will never keep you going because people humans don't like being in13:51 distress so if you've attached all of those healthy behaviors to distress or13:56 something bad happening to you that's what become linked in your mind right it's not a positive thing it's this14:02 dangerous thing that you're trying to prevent and so values are always about moving towards something that matters not about getting away from something14:08 bad and so um Health we actually describe as not a value it's a means to14:13 an end what will the health allow you to do so if uh being healthy gives you more energy you know if taking care of your14:20 diabetes makes you more stable or reliable if it helps you uh you know do your job better right those are the14:27 things we're looking for not even just like well I could live longer okay well if you live longer what14:33 are you going to use those extra years for why does it matter to be here on the planet and managing diabetes in14:39 particular there are things that will impact your well-being on a daily basis right so managing your blood sugars um14:45 will help you think more clearly it'll help you be more productive it'll help you be more reliable and so what matters14:52 to you and who who and what are the things that are important to you that you want to be more reliable for that you want to have a more clear head Ed14:59 you know ability to think and to be productive right whether that's your family your relationships your work it's15:04 going to help you on a day-to-day basis show up as the person you want to be and so connect it to those things that are15:10 meaningful important to you not a distress model of change the second part is you know if we think about that we15:17 have sort of a certain capacity like a battery right and that battery will get um drained and there's things that like15:24 use up that battery if you suddenly need to add in a whole bunch of health behavior15:29 it's going to use some of that battery and time in your day and so we have to actually start thinking about what am I15:35 going to give up what am I going to give to somebody else what am I not going to do to make space for these Health15:41 behaviors because they take both time and energy right um they again will help15:47 you do the things that matter think about the things that anyone could do versus the things that only you can do15:52 if anyone could do them could someone else do them for you then do they really require you to do can you save your15:58 battery for the things that are most important to you right and managing your uh diabetes will always help you show up16:05 as the person you want to be not in the future but today right now right to the people and the things that matter to you16:11 but you need to find that time by giving up other things in your life so that you have time because it actually takes you16:17 know time and energy to properly manage diabetes and so if the whole plan is I'm16:23 just going to add it on to what I currently do it's not a good strategy because most of us don't have extra hours in the day so you have to figure16:30 out what you're going to give up what you're going to delegate what you're going to not do in order to have time to16:35 manage diabetes sound advice for everyone really um quite frankly um butDepression16:42 especially for those with the additional um uh stress of sort of a chronic16:49 medical condition so we talked a bit about you know the normal feelings anger uh shock numbness kind of um things that16:57 you would naturally feel following a diagnosis but we also know that depression um is about twice as common17:03 in people with diabetes so um maybe you could share some um things to look out17:10 for um in particular with depression and what might indicate the need to get a17:16 little extra help yeah so we know that um some of these um you know mental17:21 health conditions are higher in people with chronic disease and that's in part because it's stressful to live with a17:27 chronic condition um another part that um we want people to recognize also is17:33 um diabetes distress and diabetes distress is symptoms of depression symptoms of anxiety symptoms of17:40 irritability but that are about the illness right so they're about the emotional burden of the illness the17:45 regimen stress um how it impacts your interpersonal relationships and that's17:50 almost like 50% of people with diabetes will experience those kinds of diabetes distress and so it's actually very17:57 normative and so the people who are more likely to experience depression have had a history of depression prior to18:04 diabetes um and then their risk increases when you have a chronic condition almost everybody can18:10 experience diabetes distress because it's actually a normal response to this new stressor in your life and so um I18:18 generally say that when you feel stuck that's a good time to get help like when you feel stuck in depression when you18:23 feel stuck in anxiety uh when it's taking over your life when it's making the decisions about what to do instead18:30 of you then that's a good time to get help uh it's important for people both18:35 to get help about depression but also about diabetes distress because standard treatments for depression will not take18:42 into account the fact that you have this chronic condition that is generating a huge amount of stress in your life that18:47 you can't make go away right it's not a you know in classic therapy they look18:52 for like a distortion and you know overestimation of risk or you know perceptions of feeling hopeless about18:58 the future but some of that actually is uh entirely normative when you're facing19:04 a chronic condition that will you know potentially impair the rest of your life or at least have an impact on your life19:10 and so we want people to recognize that treating diabetes to stress requires19:16 recognition of this stressor in your life right um that it's using up some battery and it's important to think19:22 about and you know has a variable Progressive course sometimes for people and uh and that's typically a different19:29 intervention than what people get when they get um treatment for major depressive disorder for example or an19:34 anxiety disorder and so um you know both can be helpful if you have both but also19:41 you know we should probably have more services for diabetes distress embedded within Diabetes Care not something19:47 separate that you go to mental health clinic to go get that treated it should be integrated into Diabetes19:55 Care yes I agree and and um the concept of self- advocacy is also an importantStress and Distress20:01 one I'm just going to pause for a second and encourage any participants to post questions in the chat and our digital20:08 man manager will get those over to us um but back on to the topic of stress and20:14 distress um do you have any tips for recharging or letting go of that stress when you're dealing with um a diabetes20:21 diagnosis so we talk about that there's like three main forms of coping so one form of coping is problem Focus scoping20:28 and this is very effective when you can get rid of the stressor right so um so20:34 for example lots of us go through our work life using problem Focus coping there's an email you have to send20:39 there's a paper you have to write those are technically like solvable stressors if you work harder at it you can you20:45 know um get rid of that stressor of course in Modern Life something's always there to take its place right but in20:51 theory they're solvable stressors um that strategy often is helpful when you20:57 think about health behaviors about trying harder about health behaviors but it doesn't by definition your diabetes21:04 can't be fixed or made to go away right and so we actually need a different type of coping called emotion Focus coping21:11 and emotion Focus coping is helpful um when the stressor can't be eliminated and it's about dealing with the emotions21:18 that show up as a result of a stressor that can't be removed and so um that's21:24 an important skill to develop when you have a chronic condition because by defition it's not going away it's21:29 something we have to continuously manage and um lots of people don't have21:34 that skill set because it's not one we really teach well in our culture we focus so much on problem Focus coping21:40 and trying to apply problem Focus coping to your chronic disease will actually in some cases make you feel worse because21:46 you're trying so hard and it's still not doing what you want it to do it doesn't mean that your um efforts don't matter21:52 or don't count but it's just that there's some aspects of our bodies we don't have direct control over and so uh21:58 we need to help people learn those emotion focused coping skills the third form of coping is relationship focused22:03 coping that's about managing and maintaining relationships during times of stress and so we're often trying to22:10 help people expand their coping toolbox with emotion focused coping and22:15 relationship focused coping uh because those are necessary to deal with a chronic22:24 disease I forgot I was on mute you think I've learned by now um okay soBurnout22:32 burnout um definitely you know stress distress um the treatment plans for22:38 managing diabetes can be very real for both people living with diabetes as well22:43 as their care providers um in terms of just getting to that point where it's22:49 too much so um how can individuals deal with this burnout related to chronic22:55 disease management um and optimally obviously in a in a positive way yeah so23:01 I mean we actually know that in general everyone's really burnt out like any statistic that you look at um basically23:09 uh looks sees that the rates of uh burnout are increasing basically for everybody right this is um a bigger23:17 concern when you have a chronic disease because there's an extra Demand on your battery right the chronic disease is23:22 using up some of your battery and so you have less battery to play with and so this is one of like the main things we23:28 work on with people across the Spectrum um is managing burnout one of the things we want to23:34 think about is that that battery um you know that that energy is a fixed amount and it's it's like a battery so we will23:40 use it up so you want to think about recharging activities right a recharging activity is something that makes you23:46 feel more energetic at the end than when you started so it's not necessarily the same thing as a healthy habit right if23:52 going for a walk makes you feel angry and irritated then it's not a recharging activity even if it's a healthy habit it23:58 so some of the ones I've heard people share are things like drumming gardening cuddling with a pet right and they're24:05 really we're looking for opportunities for Joy opportunities for things that make you smile and so we want to think24:10 about recharging that battery and again on a daily basis like think of how often you charge your cell phone if you have a24:16 chronic disease it means that that part of that battery is being used for your chronic disease and so you have less24:22 battery to play with and again in our culture we kind of act like if you just try harder you can do more but it's a24:28 fixed amount and so if it's a fixed amount you want to think about if I'm spending it on this then you know means24:34 you can't spend it on that right we can't just plan to have more and more energy and so thinking about where are24:40 you spending your battery is that how you want to spend your battery what things are draining your battery what24:45 things are charging your battery everyone has things in their lives that are just drains sometimes people but24:51 sometimes activities right that are just drains on your battery and we just need to take that into account but we want to24:56 make time for the charges we want to make time for opportunities you know for Joy for opportunities to smile um and to25:03 really think about that battery management um it becomes a big deal in chronic disease when we talk about25:09 pacing so pacing is about recognizing uh how much energy you have25:14 and matching your activities to that and so what often people will kind of do is wake up and decide like how am I feeling25:21 today and that sort of decides what they can get done or not get done but when you do it that way you're at the mercy25:26 of your illness right it's the illness deciding what you get to do that day pacing is about deciding how much25:32 activity you can do even on a bad day and keeping the activity level constant even if your condition is going up and25:39 down um and so it actually makes us feel more empowered because it doesn't matter how we feel today we can do this amount25:46 of activity and so it makes us more reliable more dependable you don't have to cancel things as often but you're25:52 often having to um you know it it's less than what you would like it to be right right and so again deciding what you25:59 want to spend your battery on that's most valuable and often the hardest part of pacing is actually holding back on a26:05 good day right so people you know have a good day and they're like oh who knows when I'm going to have another good day I better do everything but then they26:11 overdo it uh and then they kind of pay for it for a few days right and so holding back on a good day when you feel26:18 good saving the battery for tomorrow is actually a key skill in pacing and so um26:24 we also talk about adding extra batteries to the system right when you have a chronic disease a really important skill is learning to26:31 ask for and accept help um and because you have less battery because of your chronic disease so we often need to add26:37 more batteries meaning we need friends and family your your health care providers can be part of you know that26:44 Village of support it could be Community groups it could be your church it could be work friends but you're going to need26:51 some extra batteries and so you know our culture again kind of our dominant Western culture kind of says that um26:57 it's bad to depend on other people but actually that's the highest like functioning human is someone who is27:03 connected to a village who is part of you know feels connected to Safe trusting other people and so the27:10 opposite of Independence isn't dependence it's connection right and so27:15 it's and we often you know feel lonely the loneliness epidemic right um and27:21 that's partly because we've overemphasized Independence and we're sacrificing connection as a result and27:27 so figuring out how to ask for and accept help means how do you add extra batteries to the system and sometimes27:33 people are glad to help you right sometimes it's actually way more difficult to watch someone you care27:38 about not accept help right and watch them struggle when they're refusing your help it's not a zero sum game sometimes27:45 both people feel better when you accept help from somebody else yes yeah that Circle of support is27:51 so important in so many ways um including uh when you have diabetes um27:57 if someone is finding things overwhelming um are there places where28:03 they can go for further help or to find support yes so you know we know that um28:09 basically there's not enough mental health providers for the need right now right um whether we're talking about um28:17 mental health support for people with chronic disease or for other you know just living in our crazy world we live28:23 in now right um so there's not enough um resources for that and so we often are28:28 you know um looking to how we can create scalable options to help people access28:34 you know more care and so those are some of the things that we work on um in our company is how can we offer better28:40 access to um science-based information right more scalable um that's like high28:46 quality information that people that can help people and so there are some of28:51 those options now emerging sort of like online tools as well as you know um28:57 mobile app tools uh we have one that's working on burnout but we will eventually be adding courses on chronic29:04 disease as well as special you know add-on modules for diabetes and heart29:09 disease and other um chronic conditions um and we try to embed the science of behavior change into those um apps so29:17 that it's actually helping you on a daily basis support the difficult you know um behaviors of being healthy uh29:24 there are you know online resources through government of Canada sometimes your provincial government you know29:30 again has um opted into uh you know mobile or Technology Solutions for uh29:37 mental health and so looking into those as options for extra help if you are working you might have an employee29:44 assistance program that you could access um so like wellness together is a government based one that um people can29:51 access for mental health support and then Community groups uh patient advocacy groups like diabetes Canada29:58 those kinds of groups as well because it really helps to have connection with other people who get it right who know30:04 what you're going through um that really can help us cope as well no that's great and um Dr DanaFeedback30:11 provided some links to a few um uh30:16 organizations and the impact me app that um our digital manager will pop into the30:21 chat for you so I don't see any more questions coming in um so maybe will we30:27 will wrap this up but before I ask you one last question um we're going to pop30:34 a brief evaluation into the chat if you could kindly take a minute to provide us with some feedback so we can continue to30:40 learn grow and better meet your needs that would be great um also if you have30:46 any ideas on future topics feel free to pop those in the chat as well we're always open to uh ideas on how to meet30:53 the needs of our uh group of um people living with diabetes so the last30:59 question is really generic and just wondering if we haven't covered something in particular or if you have31:04 any parting words of wisdoms regarding a new diagnosis um so in the chat we also IElevator Pitch31:12 think provided information about a research study that we're doing that lots of people might be eligible for and so it's about Wellness um for uh people31:19 living with chronic disease and so you can actually access a program for free for the 12we program that includes31:26 psychology support or as well as other supports um if you are you know interested in participating in the31:32 research so that's also available the last part I'll just talk about is um having an elevator pitch about your31:38 illness um or your condition so an elevator pitch is you know if you only had the length of an elevator ride to31:44 give somebody information that's kind of what an elevator pitch is about and so it's helpful you know when you have a31:49 new diagnosis or you go into a new environment to have an elevator pitch about your condition you don't actually31:55 have to give the diagnosis right uh sometimes what's more meaningful is to give the symptoms that might impact that32:02 environment so for example in your workplace you don't necessarily have to say I have diabetes but you could say I32:08 have a health condition that sometimes means I need to take more breaks or I need to manage my diet differently right32:15 um because those are the things that might impact your workday for example right um and then you can always you32:21 know end the conversation meaning that people might ask you more questions and you can simply say um you know that's32:27 all I'd like to share for now but thanks so much for your concern right it's a lovely way to end it thanks so much for32:32 your concern right uh people often will give you all kinds of tips and suggestions you should do this you should do that and often you know32:39 they're not appropriate for you or they're not the nuanced things that individuals need and again you just32:44 thank them for their concern and go about your day we don't have to get into arguments with them about you know32:50 whether that's an appropriate like course of action or not um but it's helpful if you have a chronic condition32:56 to let people know because it will probably impact you it might impact your relationships it might impact how you33:02 show up and you want people to attribute your behavior to your health condition and not that you don't care about things33:08 or it's not important in lots of workplaces there are accommodations if people need to provide if you have a33:14 health condition uh which can help you manage your um illness better um often33:20 you know planning for more breaks planning for time off can be helpful um33:26 rather than kind of waiting for it to be a crisis and then having to go off and so those are things that you can have33:31 conversations with your workplace uh to talk about those things um and uh and33:37 again and then having an elevator pitch with everybody else that you talk to so again you don't you don't have to give33:42 them all the details you don't even have to give them the diagnosis but just to let them know that you have a health condition that like impacts you or33:49 impacts you know um your daily behaviors or things like that so that they understand that there's a reason for33:54 your behavior and sometimes you have to remind people that even your loved ones right they'll forget about you know the34:01 condition and not because they don't care about you right just sometimes you need to remind them and then sometimes34:06 we need to give permission to people to not talk about it right it's okay to not talk about it sometimes they always want34:11 to talk about it sometimes they'll forget to talk about it and so we just have to communicate more um and and34:17 describe what's happening and be okay with that because um they're not things that we kind of um are good at at34:25 managing and so we we need some extra help with that sometimes yeah that's that's great advice and also I think tooOutro34:32 the the more we talk about it and the more it is open and out there the less stigmas associated with it as well which34:39 I know um is a whole other topic for another day um okay well no more questions34:46 coming in so I guess we've come to the end of our time um thank you for taking34:51 time out of your busy schedules to join us today um taking time for ourselves and our personal care care is never easy34:58 but so important and um definitely worth it uh in the long run if you haven't35:04 filled in the evaluation please consider doing so now the link can be found in the chat and with that a a big thank you35:12 uh to Dr Dana Our Guest expert today I know I learned a lot and I'm sure you did as well um there was a lot of great35:20 advice in there for um just healthy living in general um without the35:26 generosity of your time Dr Dana our open hours would not be possible so thank you again and thanks everyone for joining us35:33 today on Facebook live open hours runs the last week of every other month with a different topic and guest expert so be35:40 sure to follow us on social or visit the website regularly for updates to learn more and stay up toate on Diabetes35:47 Canada's work and resources you can visit our website at35:55 dibs.com ledin and the platform formally known as Twitter you can also call our36:02 info team at 1 1800 Banting that's 1 1800b n TI n or email info@36:19 diabetes.com and guest for our next conversation and with that thank you36:25 have a great day and we'll see you36:32 again