Latest / The Healthy Diabetic / #172: Personalized Nutrition & Motherhood - Elizabeth Peshia

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#172: Personalized Nutrition & Motherhood - Elizabeth Peshia · The Healthy Diabetic

• 0:10
  Speaker 1: Music.
• 0:19
  Speaker 2: Coming from you know, 25 years ago, starting with NPH and regular and such a strict diet, Music.
• 0:28
  Speaker 2: It was a set amount of carbs.
• 0:34
  Speaker 2: It was 60 carbs at each meal, 30 carbs, 25, 30 carbs for a snack and you had to have a bedtime snack.
• 0:42
  Speaker 2: Whether I was hungry or not had to have it.
• 0:44
  Speaker 2: I still can't eat graham crackers and peanut butter to this day because that was my snack every night.
• 0:51
  Speaker 2: I still can't eat it.
• 0:51
  Speaker 2: Music.
• 0:58
  Speaker 1: Welcome back to the Healthy Diabetic Podcast.
• 1:02
  Speaker 1: As always, before we get started, please remember that nothing that you hear on this podcast should be considered medical advice or otherwise.
• 1:07
  Speaker 1: Please always consult your medical team before making any changes to your diabetes management.
• 1:13
  Speaker 1: If you haven't done so yet, please make sure to like subscribe to the podcast.
• 1:18
  Speaker 1: If you're listening to the podcast on a platform that allows you to leave a written or five star review, please do so.
• 1:26
  Speaker 1: It really helps the show grow.
• 1:28
  Speaker 1: Again, thank you to all of you who are showing up every single week and listening to these conversations, listening to these episodes, and I also thank you to those of you who are sharing these conversations, sharing these episodes with someone that you know is going to get some really good value out of this.
• 1:44
  Speaker 1: We're all in this journey together, and that's what this podcast is here for to help you by supporting you with good quality conversations and with really good information that you can implement into your diabetes management style.
• 1:58
  Speaker 1: Now, alright, let's get with today's guest.
• 2:03
  Speaker 1: Today, I got to sit down with Elizabeth Pisha.
• 2:05
  Speaker 1: She's a type one diabetic, has been a type one diabetic for 25 years, she's a registered dietitian and she's the mother of four boys.
• 2:13
  Speaker 1: Yes, you heard me right.
• 2:14
  Speaker 1: Four boys, and I'll tell you what.
• 2:16
  Speaker 1: Two is hard enough, and I got two girls Same gender.
• 2:21
  Speaker 1: It's hard enough.
• 2:22
  Speaker 1: I can't imagine three, four, five, six, my goodness, those of you who have multiple kids.
• 2:30
  Speaker 1: Not that two or one is any walk in the park, but those of you who have multiple kids, same gender, different genders, I don't care, you guys are troopers.
• 2:40
  Speaker 1: God bless all of you.
• 2:41
  Speaker 1: Elizabeth is very passionate about helping people with and without diabetes to understand the foods that we eat and empower us to live a healthy lifestyle that's ultimately going to improve our blood sugars and improve our lives.
• 2:59
  Speaker 1: I'm so pumped for you guys to hear this conversation, so, without further ado, let's get with Elizabeth Pisha.
• 3:18
  Speaker 2: All right.
• 3:18
  Speaker 2: Well, I am Elizabeth Pisha and I'm a registered dietitian and I have my masters in clinical nutrition.
• 3:25
  Speaker 2: I've had diabetes for 25 years.
• 3:28
  Speaker 2: I was diagnosed on December 3 1998.
• 3:32
  Speaker 2: So it all kind of jumped out at me this in December, that it's been a quarter of a century, which just sounds crazy.
• 3:41
  Speaker 2: It makes me feel really old.
• 3:43
  Speaker 2: But yeah, it's, it's been that long.
• 3:46
  Speaker 2: I don't remember a whole lot.
• 3:50
  Speaker 2: I was 11 years old.
• 3:51
  Speaker 2: My mom noticed that I was drinking more water and more tired and I had lost about 15 pounds, which could either be a growth spurt during puberty or something serious.
• 4:05
  Speaker 2: And a neighbor made a comment and my mom knew that something was off, went to the doctor, checked my blood sugar and basically went straight to the hospital for three days.
• 4:17
  Speaker 2: And I do remember that a little bit clearer than before.
• 4:24
  Speaker 2: No one else in my family has type one diabetes, which I think is much more common to hear that now than what people expect, but I did have like a flu, a virus, pretty, pretty soon before my diagnosis, which that's really the only thing that makes sense to me, that that triggered that.
• 4:47
  Speaker 2: So, yeah, spent three, three days in the hospital and went home with NPH and regular and started counting carbohydrates and everything that goes along with that and then about a maybe a year later I started hemalogue and then about a year later went on to a pump.
• 5:11
  Speaker 2: So this was around, you know, around the year 2000.
• 5:15
  Speaker 2: And my doctor was really good about getting me right on whatever was coming out, whatever was new and the thing to do.
• 5:23
  Speaker 2: I've been on the pump since then and, yeah, I when CGMs came out and I don't remember when they first came out, but I got mine in 2007 or 2008.
• 5:41
  Speaker 2: Which one started on Medtronics because I was using their pump, hated it.
• 5:46
  Speaker 2: Yeah, totally honest.
• 5:50
  Speaker 1: So how many people?
• 5:50
  Speaker 1: I mean I?
• 5:51
  Speaker 1: That's the first one I started on, like, my first was Medtronic.
• 5:55
  Speaker 2: Yeah, I mean, there wasn't at that point, there wasn't another option.
• 5:58
  Speaker 2: Then, pretty soon after, there was then Dexcom.
• 6:02
  Speaker 2: But yeah, hated it and really what I hear people kind of saying now isn't too different from my experience.
• 6:09
  Speaker 2: You know what was that?
• 6:12
  Speaker 2: 15, almost 15 years?
• 6:13
  Speaker 1: ago.
• 6:14
  Speaker 2: So, um, yeah, now I'm using Dexcom.
• 6:17
  Speaker 2: Switch to Omnipod and Dexcom about maybe 12 years ago.
• 6:22
  Speaker 1: Okay.
• 6:24
  Speaker 2: And I've never turned back.
• 6:26
  Speaker 2: It was just night and day.
• 6:27
  Speaker 2: Love my Dexcom, never, never turned back.
• 6:31
  Speaker 2: And yeah, I mean here.
• 6:36
  Speaker 2: Here we are now with all the other pump options and I love all the tech.
• 6:45
  Speaker 2: All the new tech is just very cool, coming from you know, 25 years ago, starting with NPH and regular and such a strict diet.
• 6:55
  Speaker 2: You know you hear about strict diabetic diets.
• 6:58
  Speaker 2: Yeah, and it kind of come from that time period, which isn't so much the case anymore.
• 7:04
  Speaker 1: So yeah, I can't wait to dive into that with you, being a dietitian, and what your thoughts are, because I have my own personal thoughts about the restrictive part of that, that concept and that foundational thing and I think that we're even hearing that from doctors today like a diabetes diet, especially for type twos, and it's just.
• 7:26
  Speaker 1: It's a sad thing and world that we're living in right now with that is having to be in that space, and it's one of those things that I just I think that we're in this space where technology is incredible and it's just getting better and better every single year, and thinking about like being able to be in this space where technology is so good, why are we holding on to old things that we thought that work?
• 8:02
  Speaker 2: Yeah.
• 8:03
  Speaker 1: You know we're not proactive enough to being able to change with the times.
• 8:07
  Speaker 2: Yeah, a lot of times that education of how to eat and give insulin is not caught up to where tech is.
• 8:17
  Speaker 1: Yeah, yeah, so it's a.
• 8:19
  Speaker 1: That's a very interesting piece, and even thinking about what you're talking about when you were first diagnosed, when you're on NPH and like doing.
• 8:28
  Speaker 2: I mean I can't imagine that.
• 8:30
  Speaker 1: I can't imagine that.
• 8:32
  Speaker 2: You had to.
• 8:32
  Speaker 2: It was it was a set amount of carbs.
• 8:35
  Speaker 2: It was 60 carbs at each meal, 30 carbs, 25, 30 carbs for a snack, and you had to have a bedtime snack.
• 8:43
  Speaker 2: Whether I was hungry or not, had to have it.
• 8:46
  Speaker 2: I still can't eat graham crackers and peanut butter to this day because that was my snack every night.
• 8:51
  Speaker 2: I still can't eat it.
• 8:53
  Speaker 2: And but you had to because that was your set dose and it was.
• 8:59
  Speaker 2: It would kick in half an hour later and you had to eat.
• 9:03
  Speaker 2: So yeah, thank goodness it's not like that anymore.
• 9:08
  Speaker 2: We're so much more free to skip that.
• 9:15
  Speaker 1: I'm curious too this this comes from the, the coach and trainer and the fitness person in me it were were were you using fitness or were using exercise to help manage blood sugars, or is it more like hey, we have this regimented eating schedule and this regimented insulin schedule.
• 9:36
  Speaker 2: Yeah, that's a good question.
• 9:37
  Speaker 2: I I played soccer, I played sports, but at that time I was on the pump once.
• 9:44
  Speaker 2: I so that did change, change that change that, change the game a lot, yeah, plan, yeah.
• 9:52
  Speaker 2: So you know, when I was 11, 12, just doing shots and I was just playing outside doing kids stuff.
• 10:01
  Speaker 2: So I don't remember any specific Exercise Protocol or anything that I was yeah, specifically with that.
• 10:13
  Speaker 1: Yeah, it's just an interesting thing for me all the time when I think about, you know, the I hate to say the ancient times Of diabetes, right where there wasn't all this technology.
• 10:25
  Speaker 1: We didn't have cgms.
• 10:26
  Speaker 1: We, you know, we had in pH or we had, you know, you know, long-acting.
• 10:30
  Speaker 1: When that's what I started on as long acting into that in 2007, at the age of 25, that's what I had to start on and he started me on long acting, you know, and it wasn't even actually long acting, it was more of a 70 30 split and oh, wow.
• 10:45
  Speaker 1: Yeah, so that's what.
• 10:46
  Speaker 2: I started on a 70 30.
• 10:48
  Speaker 2: Oh, interesting.
• 10:50
  Speaker 2: Yeah, cuz that's.
• 10:51
  Speaker 2: I mean that's hard.
• 10:52
  Speaker 2: There's kind of more rules with that too, because you've got it.
• 10:56
  Speaker 2: Yeah, that's, yeah it was.
• 10:59
  Speaker 2: It was pretty challenging and yeah it was like.
• 11:02
  Speaker 1: I've talked about it in lengths on this show.
• 11:05
  Speaker 1: I've talked about it in lengths on on speaking, in speaking engagements and on social media.
• 11:11
  Speaker 1: It's like it is one of these like missions and passions for me, because I Didn't have that support.
• 11:19
  Speaker 1: I talked to so many people that go to the hospital for three days.
• 11:22
  Speaker 1: I've talked to people that were diagnosed at the age of eight or ten or younger and they were in the hospital for five days, getting educated, going through all this amazing stuff and and it's like part of me is like man I wish I would have had that because maybe I wouldn't have been denial in denial about the condition for three straight years.
• 11:41
  Speaker 2: Yeah.
• 11:41
  Speaker 1: I literally had no one.
• 11:43
  Speaker 1: Yeah, I had my parents.
• 11:44
  Speaker 1: Like my dad was like very, very into it.
• 11:47
  Speaker 1: He's a researcher at Ohio State, he was on the JTF board, but it just wasn't the same.
• 11:54
  Speaker 2: No, one to compare stories to, and yeah, yeah yeah yeah, yeah, I think, also being diagnosed as an adult, even a young adult.
• 12:03
  Speaker 2: Back and to that was it 2005 there wasn't as much we.
• 12:11
  Speaker 2: They didn't know back then that Adults can get it as often as as they are in this diagnosis and I could go down that that rabbit hole Podcast to.
• 12:21
  Speaker 1: But I love that.
• 12:24
  Speaker 2: Um that's a fun rabbit hole though I know um, yeah, so that 70, 30 kind of probably was.
• 12:33
  Speaker 2: Oh, it's not juvenile diabetes, so yeah, yeah education.
• 12:40
  Speaker 2: I don't know, yeah, I don't.
• 12:41
  Speaker 2: There's a big gap there.
• 12:43
  Speaker 2: I think, one thing, but there's like there was a gap.
• 12:46
  Speaker 1: Yeah, there's a.
• 12:47
  Speaker 1: There's a big gap there and and I hope I hope that it has caught up because it was.
• 12:53
  Speaker 1: I was diagnosed with my family practitioner Amazing, amazing doctor he's.
• 12:59
  Speaker 1: He was incredible, the best you know GP I ever had but they just wasn't knowledgeable.
• 13:05
  Speaker 1: They weren't knowledgeable about the condition, of what was going on, and it was.
• 13:09
  Speaker 1: I went in with Almost no symptoms your excessive urination in thirst is my only symptoms and I only recognized it because I was.
• 13:17
  Speaker 1: I went to our summer house in New York on a 12-hour trip and had to stop every 45 minutes to use the restroom on the way up there and the way back 12-hour trip.
• 13:27
  Speaker 1: So something was going on.
• 13:29
  Speaker 1: So it's the only reason I went to go see him.
• 13:30
  Speaker 1: And they tested my blood sugar three or four times.
• 13:34
  Speaker 1: It was over 450.
• 13:35
  Speaker 1: I felt like a million bucks and they just they were so Baffled.
• 13:40
  Speaker 1: Yeah they gave me a 70 30 split, gave me a glucose monitor, said here, take 12 units at night, 12 units in the morning.
• 13:46
  Speaker 1: We'll see you back in a couple weeks.
• 13:47
  Speaker 1: And that was it.
• 13:48
  Speaker 1: It wasn't all.
• 13:49
  Speaker 1: Your over 450.
• 13:50
  Speaker 1: You probably need to go to the emergency room.
• 13:52
  Speaker 1: It was how.
• 13:53
  Speaker 1: Just take this so it, and I've heard multiple stories like that.
• 13:59
  Speaker 1: Yeah, yeah, yeah, no, there's too many yeah so but I, just I, I, I hope that the in at least in the GP world, we're getting better.
• 14:08
  Speaker 1: I believe we are, and and I think the other interesting piece when I hear people that were diagnosed 2000 and you know before it's the thought process of being able to have multiple days in the hospital, not just they, not just 24, 48 hours to get you to your blood sugars regulator, to get them back to where they're supposed to be.
• 14:35
  Speaker 2: But it's it's constant feedback, it's constant education, it's constant like this is what this is, is what this is and my my under chronologist and his One of his nurses came in multiple times over those days With the education.
• 14:53
  Speaker 2: My first shot that I ever gave was actually in my under chronologist arm.
• 14:58
  Speaker 2: It was a some.
• 14:59
  Speaker 2: He filled a shot with saline, yeah.
• 15:01
  Speaker 2: So there's stories of, oh, I'm gonna give a shot in an orange, like nope, I gave my first shot in my doctor's arm.
• 15:08
  Speaker 2: That's awesome.
• 15:09
  Speaker 2: They made it so.
• 15:10
  Speaker 2: They were wonderful.
• 15:11
  Speaker 2: I Credit them with so much of who I am today.
• 15:16
  Speaker 2: They won't take the credit for it, but I give it to them.
• 15:20
  Speaker 2: All the time yeah and because of that, like that memory sticks out and okay, this isn't scary if I can jab this Doctors arm.
• 15:30
  Speaker 1: Yeah.
• 15:31
  Speaker 2: I can, I can do it, so that made a huge difference.
• 15:35
  Speaker 1: What was you know growing up and Going through all that?
• 15:40
  Speaker 1: What?
• 15:41
  Speaker 1: What do you think was the biggest Impactful thing that you learned, or you have learned from diabetes?
• 15:47
  Speaker 1: No matter whatever that is, whether it's support, whether it's some type of educational thing, whether it's a management style, you've learned.
• 15:55
  Speaker 1: Whatever it might be, what is the biggest impactful thing that you've learned?
• 15:58
  Speaker 2: Well, my kind of going back to what I was just saying about that, my under chronologist and the team that he has, um I, they were phenomenal from in the hospital I remember and my mom clearly remembers them telling us that Having type 1 diabetes was not gonna stop me from doing anything.
• 16:20
  Speaker 2: It's just gonna take a little bit more planning than someone who doesn't have diabetes.
• 16:25
  Speaker 2: And that really stuck with my mom and it has stuck with me.
• 16:30
  Speaker 2: I mean, that's the the attitude that they had at every single Appointment that I had.
• 16:37
  Speaker 2: Oh, you want to go to two-week summer camp, let's figure it out, let's do it.
• 16:41
  Speaker 2: Oh, you're gonna Go camping for five days, we can figure that out and do that, we are gonna.
• 16:50
  Speaker 2: You know, whatever it is, whatever came up, it was okay.
• 16:53
  Speaker 2: You know how much insulin do you need to take you it with you?
• 16:56
  Speaker 2: What snacks should you bring?
• 16:58
  Speaker 2: Here's some strategies to try.
• 17:00
  Speaker 2: You can do it.
• 17:01
  Speaker 2: And Just that belief from day one, I think, their belief in me, like they believed that.
• 17:12
  Speaker 2: I could do it and I believed them.
• 17:16
  Speaker 2: So I think that also helps because I was going right into my teenage years too and I mean it was hard in school being the I went to a small school and I was the one who was like checking her blood sugar and eating snacks and it felt, you know, I felt weird, but I never went through like a rebellious time with my diabetes, where I, you know, was making up numbers and not giving myself insulin.
• 17:46
  Speaker 2: I was motivated to do that because I knew my parents and my healthcare team believed in me, and not that I didn't want to let them down, but I was like, okay, like I can do this, why wouldn't I do it?
• 18:03
  Speaker 1: You know, a feeling.
• 18:03
  Speaker 1: Yeah, that's awesome.
• 18:06
  Speaker 2: You know, back even when I was a teenager, talking to people.
• 18:11
  Speaker 2: I was told then that I was really good at helping others and explaining to other people with diabetes and helping them through some of just what you have to do and giving tips and that kind of thing, and that was really the first spark in my mind that I wanted to be a diabetes educator.
• 18:31
  Speaker 2: I'm not one yet Got the first step.
• 18:34
  Speaker 2: I'm a registered dietitian.
• 18:36
  Speaker 2: Who knows what'll happen next?
• 18:38
  Speaker 2: But ultimately this is what I have been wanting to do since I was a teenager and that spark has always been there.
• 18:47
  Speaker 2: So, and I don't think I could have done that without having a healthcare team that supported me and believed in me.
• 18:56
  Speaker 1: Yeah, that's awesome.
• 18:57
  Speaker 1: I love that because it's one of those things it's like when you figure out at a young age what you want to do and you hold on to that and you ride that all the way through.
• 19:11
  Speaker 1: You know a lot of young kids.
• 19:13
  Speaker 1: They'll have multiple things that they're like oh I want to do this, I want to do this, I want to do this.
• 19:17
  Speaker 1: This sounds really cool, but when you hold on to something like that, it's super powerful and you're doing it.
• 19:26
  Speaker 2: I'm 36 and it finally happened, so I mean lots of things had to happen before that.
• 19:33
  Speaker 2: I've got four kids and got married right after I graduated with my nutrition degree, and it just took another eight, nine years to finally get here.
• 19:48
  Speaker 2: So it's been quite the long road, but it was what it was supposed to be.
• 19:58
  Speaker 1: Exactly, exactly.
• 19:59
  Speaker 1: So let's go into this.
• 20:03
  Speaker 1: Then your philosophy with food right, I think this is super powerful.
• 20:11
  Speaker 1: I want to go into this part and then we'll circle back, because I do want to ask you about your pregnancies and how that went, because I know a lot of young women, a lot of women that are thinking about it or have gone through it really like those types of conversations because they're sort of powerful.
• 20:28
  Speaker 1: So we'll come back to that.
• 20:29
  Speaker 1: But I'd love just to dive into your coaching philosophy with food.
• 20:34
  Speaker 1: What are the things that really jazzes you up when you think about food and coaching people?
• 20:41
  Speaker 2: Yeah.
• 20:41
  Speaker 2: So I'm all about meeting people where they are at.
• 20:46
  Speaker 2: I don't like whole diet overhauls.
• 20:49
  Speaker 2: It just doesn't work, it's not fun, nobody really wants to do that and we all know that it doesn't work.
• 20:57
  Speaker 2: So I like to meet people.
• 21:01
  Speaker 2: What is their situation in life, what is going on in their life, and meeting them there and figuring out it's not just about food figuring out what is going on in their life that's causing trouble with getting this food in their diet.
• 21:25
  Speaker 2: Or I mean pre-bolusing is like that's like my number one.
• 21:33
  Speaker 1: Yeah, with diabetics yeah.
• 21:35
  Speaker 2: I struggle with it.
• 21:36
  Speaker 2: I feel like every time I go to the doctor I know I gotta be better about pre-bolusing, but what are the things that are making that hard to do and going that route and just connecting on an emotional level?
• 21:53
  Speaker 2: Nobody likes to be told what to eat, so what do you want to eat?
• 21:57
  Speaker 2: Let's make that work for you.
• 22:01
  Speaker 2: I don't like taking out foods or insisting that someone eat a food.
• 22:07
  Speaker 2: What are the foods that you eat?
• 22:10
  Speaker 2: What is your favorite breakfast?
• 22:12
  Speaker 2: Let's make that work for you, and whatever.
• 22:14
  Speaker 1: yeah, I love that, because it's one of those things that we think about what are you eating, and we're not here to restrict that type of food.
• 22:25
  Speaker 1: I think about pizza for people.
• 22:27
  Speaker 1: Pizza is one thing that people love to eat.
• 22:29
  Speaker 1: So I always think about two different things when I think of food.
• 22:34
  Speaker 1: It's one what does the person actually want, which is what you're saying, it's perfect.
• 22:40
  Speaker 1: And then I also think what is the quality of that food, and can we improve that in whatever way we need to, and is this a situation where we need to improve it?
• 22:50
  Speaker 1: So I think about pizza.
• 22:52
  Speaker 1: People just love pizza.
• 22:54
  Speaker 1: I love pizza.
• 22:54
  Speaker 1: I eat it probably once a week, but I'm not going to constantly go eat cauliflower crust pizza.
• 23:01
  Speaker 1: I'm going to sometimes indulge myself into some pizza, real pizza yeah, Real pizza right.
• 23:07
  Speaker 1: I like cauliflower crust pizza but it doesn't fill me up for the 10 sizes that they have and the carbs really aren't that different.
• 23:15
  Speaker 1: There you go, right.
• 23:17
  Speaker 1: Yeah, yeah, I'm figuring it out.
• 23:19
  Speaker 2: There's so many different strategies for dosage.
• 23:22
  Speaker 1: Yeah.
• 23:23
  Speaker 2: Like, let's figure it out.
• 23:24
  Speaker 2: It's empowering to figure that out and be like hey, I had a bunch of pizza last night and I wasn't sky high all night, Cool.
• 23:33
  Speaker 2: I couldn't do it.
• 23:34
  Speaker 2: But figuring things out from that perspective and bringing diabetes into it specifically like diabetes is unique and you can really, when you try to describe it, even do another diabetic.
• 23:51
  Speaker 2: It's the constantness of it and the 24-stage.
• 23:54
  Speaker 2: It's the constantness of it and the 24-7.
• 23:59
  Speaker 2: And it's more than just living with it 24-7.
• 24:03
  Speaker 2: It's the constant.
• 24:04
  Speaker 2: It's always in the background, decision making, and it's hard to put into words that feeling.
• 24:10
  Speaker 2: But whenever you talk to another diabetic they nod and say, yep, I know exactly what you're talking about and that emotional.
• 24:19
  Speaker 2: It doesn't have anything to do with your blood sugars, it's just that emotional toll of living with that every single day, every single hour, minute, second.
• 24:29
  Speaker 2: It's so it's hard to work through that and it can really hold you back from pre-bolusing or from trying to figure out dosing for pizza or it can really be one of the big roadblocks in getting better blood sugars and I think Specifically us having diabetes ourselves.
• 25:00
  Speaker 2: It's just really special to be able to completely have that empathy with the patient, with the person that you're working with, and they know that, you know that they know exactly what that feels like and then you can really get through to even just talking it out, having someone to talk to can kind of start to break down that barrier and make it feel a little bit more motivated to have a little bit more balanced breakfast.
• 25:33
  Speaker 2: Or try pizza and try figuring out pizza, because that can be really overwhelming, or whatever.
• 25:43
  Speaker 2: The thing is that.
• 25:44
  Speaker 2: The change is that you want to make.
• 25:46
  Speaker 1: Yeah, I'm interested too because, as we're having this conversation, I think back to my values with coaching and my own personal values and food values, and I'm curious what is your thoughts on this concept of understanding what your relationship with food is?
• 26:09
  Speaker 1: Because I know for me, when I talk to people about food and about nutrition and about eating and their habits, that's like the very first place I go to, even when I'm talking to a diabetic, and we're not even talking about food.
• 26:23
  Speaker 1: We're talking about two specific things what is your relationship with yourself and your diabetes, and then what is your relationship with food.
• 26:28
  Speaker 1: So I'm interested to know what are your thoughts about that.
• 26:36
  Speaker 2: Yeah, that's a deep one.
• 26:37
  Speaker 2: I think you can, at least for me, and I've seen it with some of the people that I've worked with, whether they have diabetes or not understanding your food and if you're shocked that some food that you eat every day has this many carbs and this much fat and that's shocking to you, you need to learn what that portion size is Then.
• 27:10
  Speaker 2: What is in your food and it's just a neutral thing, but just the knowledge of learning the carbs and fruits and the carbs and fat and protein, that can almost make it even more neutral.
• 27:32
  Speaker 2: Instead of this more negative relationship to food.
• 27:38
  Speaker 2: Get it more as data, as just science or trying to separate it.
• 27:46
  Speaker 2: Learn about it.
• 27:47
  Speaker 2: Read labels, know what the makeup of your meals are, even if it's just your typical meals.
• 27:55
  Speaker 2: That's obviously where I would suggest starting and I think that that can really start to change the tune in your head if you're struggling.
• 28:04
  Speaker 2: Knowledge is power.
• 28:08
  Speaker 2: It's a cliche, but it's true.
• 28:10
  Speaker 1: It's true, yeah, 100%, if you want to understand about your food.
• 28:14
  Speaker 2: You're going to have more control over it and be able to make more intentional decisions surrounding that meal and your insulin dose.
• 28:27
  Speaker 2: I think food needs to be a little bit more neutral than we make it, because we're supposed to enjoy it, and it also is fuel.
• 28:42
  Speaker 1: They're not just things, they're combined.
• 28:46
  Speaker 2: So, yeah, it's complicated and each person has their own experience.
• 28:50
  Speaker 2: But that's typically where I tend to start looking at all of this is data.
• 28:58
  Speaker 2: You're bombarded with numbers constantly, especially with CGMs.
• 29:02
  Speaker 2: Every five minutes you have a new number and trying to separate that from who you are and what you're doing and look at it as data.
• 29:16
  Speaker 2: Looking at it, if you're going to try pizza, it's an experiment.
• 29:19
  Speaker 2: You're gathering data for an experiment.
• 29:23
  Speaker 1: Yeah, I love that the experimentation is so powerful to understand that, because I know I get in front of a bunch of tons of people that are just like I can't figure this out.
• 29:34
  Speaker 1: I can't figure this out and like, well, what have you tried?
• 29:36
  Speaker 1: And like, well, I've only tried this.
• 29:38
  Speaker 1: I'm like, well, did that work?
• 29:39
  Speaker 1: No, then why you keep doing it?
• 29:42
  Speaker 1: Try something different, come up with a different strategy.
• 29:45
  Speaker 1: Maybe it's because you ate something two hours earlier, maybe it could be like the list goes on of how many things it could possibly be, even as someone that's not diabetic.
• 29:57
  Speaker 1: So I think that is an important piece and I love that you brought that up the experimentation, because it's all about especially with diabetes too, it's like experiment fail, figure it out Experiment fail, figure it out, and you might even figure it out, and then the next time that same thing fails.
• 30:14
  Speaker 1: That happens to me all the time.
• 30:15
  Speaker 1: With pizza, that happens to me all the time.
• 30:19
  Speaker 2: Yeah, and because of all the other things that we don't have control over, like, maybe you had a stressful afternoon and your adrenaline still pumping.
• 30:27
  Speaker 2: Maybe for women, where are you in your cycle?
• 30:33
  Speaker 2: Maybe you tried pizza in the first half of your cycle and now you're trying it, that's a good point.
• 30:38
  Speaker 2: You're insulin resistant, so there's just so many other factors that go into it that maybe next time it's not going to work.
• 30:45
  Speaker 2: But it's not always your fault.
• 30:48
  Speaker 2: There's a lot going on.
• 30:50
  Speaker 1: I love that.
• 30:51
  Speaker 1: It's not always your fault.
• 30:52
  Speaker 1: That is, that's great.
• 30:54
  Speaker 1: It is because it's not.
• 30:55
  Speaker 1: It's not always your fault.
• 30:57
  Speaker 2: Really all we can do is count carbs and do our best to give the right amount of insulin and really that's it.
• 31:05
  Speaker 2: I mean that's like the basis of it.
• 31:09
  Speaker 1: I mean there's a lot of things.
• 31:10
  Speaker 1: You guys heard it here first.
• 31:11
  Speaker 1: That's all it takes.
• 31:14
  Speaker 2: Perfect blood sugars.
• 31:15
  Speaker 2: But like we don't, we can't control what happened earlier in the day that made it, you know, made us feel stressed for the rest of the day, or something that we're worried about that's going to happen tomorrow, or if we're coming down with a cold, or we don't have control over those things.
• 31:33
  Speaker 2: So you have to do your best with what you know and what you can control and experiment.
• 31:42
  Speaker 1: Yeah, I love that Awesome.
• 31:45
  Speaker 1: So okay, let's, let's shift back, because I want to go into this next part.
• 31:51
  Speaker 1: You know you have four little ones or four kids.
• 31:55
  Speaker 1: How old are your kids?
• 31:57
  Speaker 2: I have four boys.
• 31:58
  Speaker 2: They are nine.
• 32:00
  Speaker 1: Good for you.
• 32:03
  Speaker 2: Nine, seven, four and almost three.
• 32:05
  Speaker 2: He turns three in a couple of weeks Nice.
• 32:09
  Speaker 1: Four boys, good for you, good for you.
• 32:11
  Speaker 2: It's wild and Whatever you're picturing in your head.
• 32:14
  Speaker 1: That's probably what's happening.
• 32:16
  Speaker 2: I love it.
• 32:18
  Speaker 1: So, yeah, talk me through these pregnancies, because a lot of people, a lot of women, I feel it's like all over the spectrum of the of how they get through these pregnancies in terms of bad to good, good, bad experience to good experience.
• 32:41
  Speaker 1: And I would, I would love to hear your thought processes, maybe even from the first one to even the last one, different things that you learned, different things that you did differently, that type of stuff.
• 32:55
  Speaker 2: Okay, yeah.
• 32:55
  Speaker 2: So when I was first diagnosed and even I still feel like some of that fear is still there but that was like post steel magnolias Julia Roberts, you know dying from her pregnancy with type one diabetes era, and I feel like a lot of that fear is still still there.
• 33:18
  Speaker 2: When you talk about pregnancy with diabetes, um, it's gotten tons better.
• 33:23
  Speaker 2: Um, yeah, I don't get as many comments like, oh, aren't you scared?
• 33:28
  Speaker 2: Or you know whatever?
• 33:30
  Speaker 2: Um, so that's definitely gotten better.
• 33:33
  Speaker 2: I'm very glad because a lot of that has to do with technology and everything improving with our care.
• 33:41
  Speaker 2: Um, so by the time my husband and I got married and we were, um talking about starting a family, I first met with a maternal fetal medicine doctor and met with him just to go over expectations.
• 34:03
  Speaker 2: What was my care going to be like and that made me feel really good.
• 34:10
  Speaker 2: He was really happy with where my A1C was already.
• 34:13
  Speaker 2: My endocrinologists were happy with my pre-pregnancy blood sugars and A1C and everything.
• 34:22
  Speaker 2: That really gave me a good amount of confidence.
• 34:25
  Speaker 2: Going into that first pregnancy was just kind of going over the basics of what was going to be expected.
• 34:32
  Speaker 2: I did have to tell them no, I'm not going to fill out a meal and blood sugar log because I have my DEXCOM and my endocrinologist looks over it.
• 34:44
  Speaker 2: So I'm sorry I'm not going to do that.
• 34:47
  Speaker 2: I think, as women going into pregnancy and all the decisions we have to make, you do have to know yourself and be able to advocate for yourself and say no, this is going to be taken care of this way.
• 35:00
  Speaker 2: Sometimes you don't have a choice, but most of the times you do.
• 35:03
  Speaker 2: My first pregnancy was pretty standard.
• 35:12
  Speaker 2: All of them really were just kind of your usual feeling gross at the beginning and all of that.
• 35:21
  Speaker 2: You just kind of double down on counting carbs and pre-policing.
• 35:30
  Speaker 2: I really don't change too much about my diet when I'm pregnant for all four of them.
• 35:39
  Speaker 2: Some people are really surprised by that.
• 35:41
  Speaker 2: They'll say, oh, you're not following a diabetic pregnancy diet.
• 35:47
  Speaker 2: I'm like well no, no, why.
• 35:51
  Speaker 2: I'm just going to eat what I feel like eating and be careful about my insulin doses.
• 35:57
  Speaker 2: And as soon as I see you just keep cranking up the insulin as the trimesters go by, it really is incredible to see.
• 36:06
  Speaker 2: Usually my insulin will triple by the end of pregnancy.
• 36:12
  Speaker 2: Which is just wild.
• 36:13
  Speaker 2: I think people also forget that that happens.
• 36:19
  Speaker 2: Whether you have diabetes or not, your body is making.
• 36:22
  Speaker 2: Every pregnant woman's pancreas is making more insulin.
• 36:30
  Speaker 2: The entire pregnancy it goes up because the baby and the placenta are using all that up too.
• 36:38
  Speaker 2: You're growing a human.
• 36:40
  Speaker 2: I think it's annoying sometimes, but it is just crazy to see what our bodies are doing and to see that insulin usage is just wild.
• 36:56
  Speaker 2: I did go into labor with him before they would have gone for an induction.
• 37:02
  Speaker 2: I avoided an induction with him, which is what I was trying for.
• 37:06
  Speaker 2: I didn't like the idea of going in and being induced.
• 37:10
  Speaker 2: Thankfully, for the next three, I went in to labor before they would have wanted to induce me, which I'm very thankful for.
• 37:20
  Speaker 2: I know that's not always the case.
• 37:21
  Speaker 2: I know my pregnancies are not.
• 37:24
  Speaker 2: It's not what everyone is going to have, but I want women to know that it is possible.
• 37:31
  Speaker 2: It's not something to be scared of.
• 37:34
  Speaker 2: Again, we can do everything.
• 37:38
  Speaker 2: It just takes a little bit more planning.
• 37:41
  Speaker 2: My second was pretty similar Just watching the insulin go up and staying on top of my carbohydrates and insulin doses and didn't have any big issues with him.
• 37:55
  Speaker 2: My third, kind of a similar story.
• 38:01
  Speaker 2: He was the only one who had a low blood sugar after he was born.
• 38:07
  Speaker 2: It was pretty uneventful labor, but his blood sugar was, I believe, 16 when he was born.
• 38:16
  Speaker 2: Breastfeeding didn't bring it up, the glucose gel didn't bring it up.
• 38:21
  Speaker 2: He was in the NICU for a couple of days on a glucose drip Then did fine.
• 38:28
  Speaker 2: His blood sugars came up and held themselves steady.
• 38:30
  Speaker 2: That was definitely a different from the first two having to do the trips to the NICU back and forth.
• 38:39
  Speaker 2: He was great.
• 38:41
  Speaker 2: He responded great to that.
• 38:43
  Speaker 2: My fourth, I did have to be induced.
• 38:48
  Speaker 2: I think this one is more of an interesting story diabetes-wise.
• 38:54
  Speaker 2: I knew that if anything weird happens, especially at the end of pregnancy, with your blood sugars or with your insulin needs, you got to talk to your doctor.
• 39:06
  Speaker 2: It was over Martin Luther King Day weekend and my, so almost the three years ago, because he's almost three, so he, my blood sugars were.
• 39:23
  Speaker 2: I could not keep them up.
• 39:23
  Speaker 2: I kept going low and over about a period of a week my insulin needs dropped pretty dramatically, almost maybe like six To like 60% of what it was.
• 39:36
  Speaker 1: I was like I don't remember this happening before and then one.
• 39:40
  Speaker 2: So it was.
• 39:41
  Speaker 2: So Martin Luther King Day, the doctor's office was closed and I was like this is still happening, like I just can't keep my blood sugar up.
• 39:49
  Speaker 2: I keep having to treat these lows and decrease my insulin.
• 39:52
  Speaker 2: Something is off.
• 39:53
  Speaker 2: So that Tuesday morning I had about a.
• 39:58
  Speaker 2: In the about a four-hour period I had about a at least a hundred grams of carbs and Maybe like five units of insulin, which, wow, when you're which I mean even if you aren't pregnant that's crazy.
• 40:15
  Speaker 1: Yeah.
• 40:16
  Speaker 2: And it just kept like I would.
• 40:18
  Speaker 2: My blood sugar would go up a little bit and then it would just start to come down.
• 40:21
  Speaker 2: Yeah, and I'm like this is not ever happened before.
• 40:26
  Speaker 2: So I, you know, called my OB, called my endocrinologist, and so what, most what?
• 40:34
  Speaker 2: What they think was happening was my placenta was not working well and the baby wasn't getting what he, what he needed.
• 40:41
  Speaker 2: So it didn't, it wasn't using the insulin like it was before and my blood sugar just kept crashing.
• 40:49
  Speaker 2: So it was actually the first day of the semester and I was in the middle of a zoom like going over the class schedule and everything, and I had to exit out and you mail my professor and tell her that I was going to the hospital to be induced, so that that was my first experience with an induction and it went.
• 41:12
  Speaker 2: It went smoothly, it went well and, yeah, now he's gonna be three and so, yeah, that was definitely the most unique diabetes related pregnant in late.
• 41:29
  Speaker 2: You know.
• 41:32
  Speaker 2: But again, everything you know if you're, if you're paying attention and you know your body and you know what's expected With your blood sugars through each trimester.
• 41:42
  Speaker 2: You know, in the first trimester, a lot of times insulin needs go down, which is kind you wouldn't expect in the first trimester.
• 41:50
  Speaker 2: A lot of times you'll have more lows and then your insulin needs start to go up, up, up, and Towards the very end of pregnancy your insulin needs kind of it stops going up, it kind of just tapers a little bit and I knew that it wasn't normal to have a drop in my total daily insulin.
• 42:12
  Speaker 2: So if you know what to expect and you know your, how you, how your body responds to things, you can catch those things.
• 42:21
  Speaker 2: And I caught it, you know.
• 42:23
  Speaker 2: I mean, yeah, I caught it and talked to my doctors right away and we did what we had to do.
• 42:32
  Speaker 2: So, being prepared, going into pregnancy, probably, especially with your first, and I really feel for women who are Scared to get pregnant, you know, when you look at the, the goals of Pregnancy blood sugars, it can feel completely undoable.
• 42:52
  Speaker 2: They're very that you're the goal ranges for pregnancy.
• 42:57
  Speaker 2: Fasting and after meals is much lower than Then when you're not pregnant, and it can feel very Just that, well, that's gonna be impossible.
• 43:09
  Speaker 2: How will I ever be able to have blood sugars like that and a lot of mine weren't, you know it, especially with type 1 diabetes it's you really have to look at.
• 43:21
  Speaker 2: You know more than just each individual number and you have to look.
• 43:27
  Speaker 2: I think it's really important to look at that time in range during these times, to and just stay in touch with your doctor and They'll tell you if something looks a little off.
• 43:41
  Speaker 2: Yeah, you really have to have that trust there and If you don't trust, even if you're OB, if you don't trust your OB, find another OB.
• 43:52
  Speaker 2: That that relationship is so crucial.
• 43:55
  Speaker 2: Yeah during this time to get through all of pregnancy and the birth.
• 44:03
  Speaker 1: Yeah, it's, yeah, that that's.
• 44:05
  Speaker 1: That's crazy about your, your your fourth, yeah, and the insulin needs and like that, like how it all turned out, and yeah, and I think it is.
• 44:16
  Speaker 1: I think is a really another really cool thing, because I think I think pregnancy and women's hormones and in Diabetes and women is just so fascinating because it's it's hands down different than the males.
• 44:30
  Speaker 1: It's just hands down way different.
• 44:32
  Speaker 1: And I remember like the, the crazy mood swings, the craziness of my wife going through our art with our two girls and Then having really good conversations with women that are type one and.
• 44:50
  Speaker 1: Everything that they have to go through and just like, oh my gosh, you guys are freaking troopers.
• 44:54
  Speaker 1: Freaking troopers for what?
• 44:57
  Speaker 1: What?
• 44:58
  Speaker 1: Not just having to think about, okay, I'm doing this for myself, I Am managing my diabetes on a very high level for myself, so I can be healthy, but now you have this other person, that every single decision affects them as well.
• 45:15
  Speaker 2: Yeah, it's like it's no, that it's very.
• 45:18
  Speaker 2: It could be very overwhelming.
• 45:19
  Speaker 2: I think you get an ultrasound typically every four weeks and they're really looking at the, the size of the baby, the size of the baby, the size of the baby, and I can't tell you how guilty I felt sometimes seeing that percentage Jump up a little bit and it's like I could have just been a little if my a1c was just lower or if I didn't have that one meal or whatever it was.
• 45:50
  Speaker 2: That to me was was probably the hardest part was Trying to let go of that Guilt that oh type of like diabetics just have bigger babies because they have high blood sugars.
• 46:08
  Speaker 2: It's like I work so hard to have not high blood sugar yeah it's still happening and we forget that people who don't, women who don't have diabetes, they have big babies too.
• 46:19
  Speaker 2: It happens to.
• 46:22
  Speaker 2: We have babies of all different sizes.
• 46:24
  Speaker 2: Um, so yeah, that was really hard Trying to let go of that guilt.
• 46:32
  Speaker 2: I don't know if I, if I do have another one I don't I probably will feel the same.
• 46:36
  Speaker 2: It's really hard to let go of that and not have that be like a personal attack on yourself, seeing that Measurement of the baby, which probably is not it, might not be accurate either.
• 46:48
  Speaker 1: Yeah, that it's.
• 46:50
  Speaker 1: It's also interesting.
• 46:52
  Speaker 1: I Want to ask you what this follow-up question, because we're talking a lot about fears and you brought up fear quite, quite a lot in that, in that span of talking about pregnancy and like Think emotions that you're going through, do you, do you have emotions towards your kids possibly becoming being diagnosed with type one?
• 47:20
  Speaker 2: Mostly no, some I do if they're, if they're just off and Sick or they have a fever, but it's, you know, like if something's weird it's not like a normal sickness, or if one of them goes to the bathroom a couple more times, then Then normal, it does cross my mind like, oh, like, if this keeps going I'm going to check their blood sugar, or you know.
• 47:49
  Speaker 2: But overall I don't worry about it too much.
• 47:53
  Speaker 2: The, the percentage, the percent chance of your, the child, of someone, with diabetes Getting diagnosed themselves is, I believe, only like a half percent higher than the normal population.
• 48:09
  Speaker 2: So I Just keep that in mind.
• 48:11
  Speaker 2: It's really not that much higher of a chance.
• 48:15
  Speaker 2: So I I try not to worry about it and mostly I don't.
• 48:21
  Speaker 2: My four-year-old was I don't know if you just drank a little bit more than usual last week and he like ran to the bathroom like three times in like an hour and a half and I was like, okay, if he does this again, I'm gonna check his blood sugar.
• 48:36
  Speaker 1: Have you checked their blood sugar before?
• 48:37
  Speaker 2: I have, yeah, yeah, just some weird illness, things that didn't make sense.
• 48:42
  Speaker 2: I have yeah and I, I just tell myself, you know what?
• 48:45
  Speaker 2: Who like I can know, like right now, yeah, like I could just poke their finger and know right now whether or not I don't have to, I don't have to wait to know.
• 48:56
  Speaker 2: Yeah usually it's like 80, you know no, yeah.
• 49:01
  Speaker 1: I have done it.
• 49:06
  Speaker 2: And you know.
• 49:07
  Speaker 2: I mean, I know what to do If it did happen, I know what to do.
• 49:12
  Speaker 2: I mean it's really stink, it'll be awful, and awful horrible but we know what to do and I could know right now.
• 49:20
  Speaker 2: I could check all my kids' blood sugars right now and catch it before any symptoms.
• 49:26
  Speaker 1: Yeah, I love that because it's, I know, for me.
• 49:30
  Speaker 1: I've struggled with those emotions.
• 49:32
  Speaker 2: Yeah.
• 49:33
  Speaker 1: And like it used to when my first was born.
• 49:37
  Speaker 1: It used to keep me up of like thinking about it and every time she would have a cough, every time she would have to go to the.
• 49:45
  Speaker 1: You know just, it would keep me up.
• 49:47
  Speaker 1: And it took my wife to say saying to me that you know it's not gonna happen, but here's the bright side.
• 49:57
  Speaker 1: If it does, who better to be in a position to support them than someone that lives with it themselves?
• 50:04
  Speaker 2: Yeah.
• 50:05
  Speaker 1: And that, just that really aligned and stuck with me and it's, and even just that one phrase has allowed me to take a step back and like, totally right, if it happens, it happens.
• 50:17
  Speaker 2: It's not gonna happen and they won't be put on and they won't be just slept on 70, 30 and sent on their way.
• 50:22
  Speaker 1: There you go.
• 50:23
  Speaker 2: But all what we have now to.
• 50:25
  Speaker 1: Yeah.
• 50:25
  Speaker 1: To immediately just get kids rockin' and rollin' and Yep, and then I even think about the testing now too.
• 50:33
  Speaker 1: So it's you know cause?
• 50:34
  Speaker 1: I always get those questions too when I tell people that story of the fear that I've had and they won't just get tested.
• 50:40
  Speaker 1: I'm like because, regardless, if that test says is positive or not, it doesn't mean they're gonna get it, and this doesn't mean they're not gonna get it, right?
• 50:48
  Speaker 1: I?
• 50:48
  Speaker 2: personally do not at all want to know or know that there's a chance, because why?
• 50:54
  Speaker 2: What would that change other than me just waiting?
• 50:58
  Speaker 2: I would just spend a state of like, anxious, waiting for that somebody and maybe it won't even come, and if I can catch it right away, which we can, so I know some people are really excited about that being able to know and get their kids tested.
• 51:16
  Speaker 2: You know it's a personal.
• 51:18
  Speaker 1: Absolutely.
• 51:19
  Speaker 2: What we can each handle, and I know that I couldn't handle, so I'm good with if they're sick or something weird's going on, I'll poke their finger and know.
• 51:27
  Speaker 1: Yeah, what position in life are you in and what do you ultimately want?
• 51:32
  Speaker 1: If you want to, you know, test your kids and take them for the treatment to you know, not allow them to have it for three, four years.
• 51:42
  Speaker 1: Okay, cool, that's, you know.
• 51:45
  Speaker 1: All power to that individual, yeah.
• 51:48
  Speaker 1: But yeah, I'm more on the side of like I know myself and I know, like I know these symptoms.
• 51:57
  Speaker 1: I know how to treat them.
• 51:58
  Speaker 1: I know how to coach someone through them, so I'm not going to make myself go crazy by a yes or no or maybe and maybe not, and just go with life.
• 52:11
  Speaker 1: Roll with life.
• 52:12
  Speaker 2: Yeah, no, we need to.
• 52:13
  Speaker 2: I struggle enough with being present and I don't need anything else to distract me from living right now with my kids.
• 52:22
  Speaker 2: So yeah, 100% 100%.
• 52:27
  Speaker 1: Well, this was just a fabulous conversation.
• 52:29
  Speaker 1: Thank you so much for jumping on here talking and you know, giving us your expertise and nutrition, giving us your expertise, and you know, being a mother with type one, going through that process I know this episode is really going to touch a lot of people, so I really appreciate that.
• 52:50
  Speaker 2: Yeah, this has been great.
• 52:51
  Speaker 2: It was a fun first podcast to do.
• 52:54
  Speaker 1: I'm really excited, so thank, you Many more to come, many more to come.
• 52:58
  Speaker 2: Yeah, for sure.
• 53:00
  Speaker 1: So yeah, for everyone that's listening, if you want to get in touch with Elizabeth, please reach out to her.
• 53:10
  Speaker 1: Elizabeth, people want to connect with you, work with you.
• 53:14
  Speaker 1: How do they get in contact with you?
• 53:17
  Speaker 2: The best way is right now is following me on Instagram.
• 53:20
  Speaker 2: My handle is Elizabeth underscore dietitian and it has links to all the ways to contact me and I'm working on getting more active on there, but I'm there, so please reach out if you want to say hi or have any questions and yeah, all the links are there to get in touch with me.
• 53:44
  Speaker 1: Awesome, awesome.
• 53:46
  Speaker 1: Yeah, please reach out to Elizabeth, follow her page.
• 53:49
  Speaker 1: I've you know.
• 53:50
  Speaker 1: Since we connected, I've been following what she's doing and what she's putting out.
• 53:55
  Speaker 1: She's putting out some really cool content, really good information that is very impactful and valuable.
• 54:02
  Speaker 1: So please make sure you guys go on to her page, follow her, send her a message and connect with her.
• 54:07
  Speaker 1: Elizabeth, thank you so much for jumping on, thank you everyone for listening and I will see you guys next time.
• 54:15
  Speaker 1: As always, thanks for taking your time.