Kerry Reller 0:28

All right. Hi, everybody. Welcome back to the Get Healthy Tampa Bay podcast. I'm your host, Dr. Kerry Reller, and today we have Robyn Kavin. We've waited way too long to have you on the podcast, but this is one of our very own, our health coach at Clearwater Family Medicine and Allergy. Welcome to the podcast, Robyn.

Robyn Kavin 0:45

Thank you. Thanks for having me

Kerry Reller 0:48

Yes, I'm excited. We've waited too long, but here you are. So you have a very unique background. If everybody can tell right away, you have a lovely accent. So tell us about that.

Meet Health Coach Robyn Kavin

Kerry Reller 0:57

Tell us about who you are and what you do

Robyn Kavin 1:00

Okay. I have a background as a registered dietitian. I was a dietitian for over 15 years in South Africa. That's the accent. I was in private practice, and I saw mainly weight loss and chronic diseases. And then I moved to sunny Florida, and I decided I wanted to get into health coaching 'cause I really realized that health is multidimensional. It's

From Registered Dietitian to Health Coach

Robyn Kavin 1:28

really more than just your physical health. And so health coaching now allows me to help patients where I'm also looking at their mental health, their emotional health, and their spiritual health amongst their physical health. And so that's... Yeah, that's kinda what I'm doing now

Kerry Reller 1:47

I love it. Yeah, health coaching is this lovely new field that I think medicine has been in need for many years. So and we are excited to have you and all the other health coaches of the world, but especially you. You do a lot for our practice, and I, I think patients truly appreciate that extra touch that they get to have with you. So tell us a little bit about how that works or, what do you see in the practice, and anything else you wanna share.

Robyn Kavin 2:14

Absolutely, yeah. Health coaching is... I learnt it- it's very different to when I was a dietitian in that I do not make meal plans for anybody anymore. I am not the authority, and I'm not there to tell people what to do. that's pretty freeing for me. There's less pressure on my shoulders

What Does a Health Coach Actually Do?

Robyn Kavin 2:36

because it's really about helping patients to tap into their resources and their knowledge base and maybe directing them in the right direction to find w- the, those resources. 'Cause, information is pretty easy to come by.

Kerry Reller 2:53

Yeah, I was gonna say, I've sent them to ChatGPT to create their own meal plan of whatever they want. So you can do those things. Information is easy, right? So directing them in the right way is important. Yeah

Robyn Kavin 3:06

knowing what to do, but doing what you need to do, there can be a gap. So

Kerry Reller 3:13

I think there's always a gap.

Robyn Kavin 3:15

and

Kerry Reller 3:15

Yeah

Robyn Kavin 3:16

doing Yeah. Exactly. If knowing all the informa- all of the information would help to fix the issue, wouldn't have any issues, right? But knowing all the information is not always the solution. Finding out how to implement that information, and finding out what's preventing you from following through, what are the barriers in between, and navigating those barriers, that can sometimes be, a person's stumbling block, those are the kind of things that we deal with in health coaching. What's holding you back?

Kerry Reller 3:50

No, I totally agree, and that's why I love to send them to you because I, while I like to do those kind of things, it's not realistic to do in a medical setting appointment, right? We need that additional time and space really even to ask those questions and find out what is inhibiting them from knowing all the information and not being able to implement it. I totally agree with that. Yeah

Robyn Kavin 4:10

And it's so exciting, to be able to work in a multidisciplinary team like this. Because if there is anything that I can even identify, I'm like, "Hey, Dr. Reller, I'm sending him back to you. This is what I found," and you can then just go and investigate. It's a really great backwards and forwards relationship. And that patients know that they're getting really a comprehensive management that way

Kerry Reller 4:36

That's certainly how I like to see it. What is something that you see like over and over again from our patients? Is there like a common theme or anything like that?

Robyn Kavin 4:46

Definitely. Majority of our patients do have chronic diseases. There is the diabetes and the high cholesterol and the high blood pressures. And many struggle with weight management.

Weight Management and Chronic Disease

Robyn Kavin 4:59

And I would say, a lot of patients come to you directly because they want help with their weight because they have been struggling for a while, and they really want, to be managed by a doctor who's knowledgeable in obesity medicine. That's been a really a huge growing field. And it's much needed, especially here in the US, 'cause we are the largest population of obese patients. So there's a very great need for it, and with that comes the growing increase in chronic diseases and diabetes. Patients see that

Kerry Reller 5:35

I would add to that that I believe obesity is a chronic disease itself, right? So it has, it relapses, it comes back. You have to chronically manage it for the rest of your life, whether you're using medicine or your lifestyle habits, like you're, it's a chronic disease that you're managing, and I truly I believe that. So but yes, coming with it is other comorbidities, is what we call that fancy word, with, diabetes, pre-diabetes, cardiovascular diseases, and heart attacks and strokes, and chronic kidney disease, you name it, cancer of course. So it's important to, have those conversations about why you're there in the first place. One is, the, the main overall picture of chronic disease and health management, and then the second- secondary things may be, the superficial or, what the weight actually is, and how to manage that, and all the psychosocial things that come with that as well. Yeah.

Robyn Kavin 6:30

100%. And we know also that a lot of the underlying, cause for all of these chronic diseases is inflammation. And that if we are overweight, we are gonna have more inflammation, and then there is gonna be that increased risk for all of those comorbidities. So if we can handle, and get the weight under control, it's gonna obviously have a positive impact on all of these other comorbidities.

GLP-1s, Weight Loss, and Breaking the Stigma

Robyn Kavin 6:58

And so with that, I'm sure a lot of people have seen there's just been this emergence of use of GLP-1s, in practice. And this was something that I found really interesting a previous registered dietitian traditional medicine trained, and knowing that, people have to... they have to eat a certain way. They have to exercise. They have to have-- They need to be doing lifestyle changes to help to manage their weight. And the more that I started working with more patients in your practice, who are on the GLP-1s, the more I actually started noticing a couple of things. And

Kerry Reller 7:46

mhmm

Robyn Kavin 7:46

this was something really im- really interesting that I wanted to kinda touch on. I had a light bulb moment the other day where I was chatting to my best friend actually, whose husband is diabetic. And I remember when he was just diagnosed as pre-diabetic, and he struggled to, get his exercise in and eat properly and all of that. And it progressed, and he then got diagnosed as a diabetic. And the more his wife, my friend, really just to support him as much as possible in, his diet and his exercise and lifestyle and whatever, he just hasn't managed to-- He hasn't been at that point ready enough to take action or sufficient action to properly manage his condition, and it's just spiraled. And doctor had a conversation with him, his endocrinologist had a conversation with him and suggested GLP-1s. And she was talking to me about it and saying, there's such a stigma around GLP-1s. She's not behind it she thinks that it's really it's a fad, and if people are eating right and they're exercising, Why take a drug? And I said, "You know what? You're right. There is still a stigma attached to GLP-1s, but the research has been going on for many years." In fact, you, Dr. Reller, had said 15, 20 years they've had GLP-1s around

Kerry Reller 9:23

Liraglutide? I can't remember when liraglutide came out, but it's definitely more like 15, yeah.

Robyn Kavin 9:28

years.

Kerry Reller 9:29

Let's see. Years keep adding up, so

Robyn Kavin 9:31

it didn't come around yesterday. Okay.

Kerry Reller 9:33

Yeah

Robyn Kavin 9:34

And there I realized that now practicing as a health coach, I don't look at people as how I want them to be. I meet people where they're at. I look at the reality, and the reality is for this for this guy in particular, he's now diagnosed as diabetic. He already has high blood pressure. He has all of these other comorbidities. He's pretty much a ticking time bomb. If he does not take charge and bring down his A1C, it's just gonna get worse. So do you wanna carry on being hopeful and hoping that he is going to make those dietary changes, make those exercise changes to turn his diabetes around, which may not happen? Or if there is the option of bringing down his A1C quickly whilst at the same time dealing with those lifestyle changes, what makes more sense?

Kerry Reller 10:44

Honestly, it's a, it's a little bit of an unfortunate case because it sounds like he was diagnosed with pre-diabetes, so whoever was managing him was actually doing pretty good drawing those labs early enough to know that he's been insulin resistant for some time, and that he could have intervened more then, right? And that's something that I obviously try to intervene with more. And even I know we're talking about pharmaceutical companies here, but they also are getting lower indications to, con- I guess, combat these conditions and diseases earlier on, right? So not just waiting till your BMI is high, not waiting till your A1C is high, but realizing that if you keep on the same path and don't change anything, you're going to lead to that, right? And as you said you're gonna get sicker and sicker as you, are not as more, as controlled. So unfortunately, you mentioned something about... I guess I would've said that person didn't have the readiness to change. That's kind of the words that we use, you know, with like cognitive behavioral therapy and then I would think in health coaching too, and he wasn't ready, right? So you have to meet him where he is, but I don't know what in could have happened before when he had pre-diabetes, but that would've been, a little bit better time. But, he might not ready, so what are you gonna do, right? And I have plenty of patients who just say, "Give me a medicine" or whatever. But, and they don't want to do all of the other things with it too, and I... It depends on, I think, on the patient, the motivation, the generation a little bit, I think. I think that's a kind of an unfortunate case, but obviously what w- I don't know if you finished the Is there more to the story?

Robyn Kavin 12:19

I think I haven't seen what's happened lately, but it really just... it got me thinking about how I used to have my biases around what I thought it was. Oh, it's a quick fix. It's just, it's a silver bullet. And working with it now, I see that it isn't. Because

Why GLP-1s Aren’t a “Quick Fix”

Robyn Kavin 12:39

there are people who can be on a GLP-1, and if they don't make any changes to their diet, and they're not doing any exercise, specifically the resistance exercise, they're not really gonna see the great results that they could. So it's not necessarily a quick fix and, some people do get those side effects that go along with it. So these are things obviously that that I try to help some of our patients with if they do run into any of those side effects, that we see.

Kerry Reller 13:09

I see. Because most of the time, honestly, I think we do a pretty good job managing those and I don't hear too many side effects. It does depend which medicine they're on and what they're doing, but most of the time I don't hear I haven't been hearing as much lately. There are some mild this or that or the other, but nobody's saying I need to stop or anything. That's not everybody, but yeah. Yeah

Robyn Kavin 13:30

I'm not talking about severe side effects like that. I'm saying "Oh, okay, they don't have any appetite. Their appetite's been

Kerry Reller 13:37

Oh, that's

Robyn Kavin 13:37

Yeah.

Kerry Reller 13:37

definitely a side effect. Yeah

Robyn Kavin 13:39

y- you can look at that as a benefit and it can be a side effect as well because

Protein, Nutrition, and Protecting Muscle

Robyn Kavin 13:44

somebody has lost their appetite, number one, they may not be getting in all the nutrients that their body need. Part of those nutrients can be protein, and we've also got micronutrients as well, your vitamins and minerals. You may become deficient in certain vitamins and minerals 'cause you're not eating enough or you're not eating enough of a varied diet as well. So you've got to then look at seeing, how can you get that nutrition in that you have a smaller appetite? And how can you time things? And how can you make things more appropriate for you? So though that's kind of one of the things that we tend to look at. We also do regular body composition checks. So we wanna see what of your total weight is muscle what of it is fat. And then we can see okay, you're maintaining your muscle or it's going up, and your body fat is going down. That's a great direction. But if it isn't, if your muscle's going down, then we can say, "Okay could you be getting in enough protein? Could you be doing enough resistance exercise?" And these are things that we can tweak, and then we Can look at it again. you know, muscle loss is a big thing when you're on GLP-1s. So we want to really maintain that muscle, and we wanna try and build it as well 'cause you're gonna have a faster metabolism if you've got more muscle. your insulin is gonna work a lot more effectively if you've got more muscle. So that's definitely a plus.

Kerry Reller 15:28

Yeah, that's obviously something that I look at very closely especially when we're thinking of adjusting the dose, right? So they may wanna go up in the dose, and I'll be like no." Be like your muscle is not there," or, "I'm worried about that," or, "You're barely eating to maintain this muscle." So that's where I really, they may wanna go up, but I might say, "Let's hold off." Or, "Oh, I only lost three pounds this month." I'm like, "What are you talking about? That's fantastic." If as long as it's, not muscle mass. But they- it's unnecessary to go up 'cause you don't want to lose that quickly in the first place, right? It's unlikely to keep it off as much. So yes we love our body compositions. And to speak with what you brought up earlier was, like, inflammation and everything like that. On the body comp... Now, I know it's just a calculation, but with the device that we use, we have the visceral fat calculation, right? And looking at that, we know that's the more of the inflammatory fat and the fat that causes more chronic disease. So w- watching that number. Now, that number goes down a lot slower than everything else. So when that moves, and usually I'm looking at that over months or a year even we'd usually hear that the, the patient is feeling better and, just overall feeling better. It's interesting. And some of them will even say less inflammation. But I don't know where they get the exact feeling of that. But that's definitely one of the markers we also look at on the body comp as well. Yeah.

Robyn Kavin 16:53

absolutely. That,

Visceral Fat, Inflammation, and Body Composition

Robyn Kavin 16:54

that visceral fat, that's that really deep fat that sits on your organs. You'll find that around your abdomen, around the middle. And if you find that your inches are coming down and your waist measurement's coming down, it usually indicates that your visceral fat's coming down. And that's where all the in- a lot of the inflammatory chemicals are being produced in that visceral fat. So it's a really important key indicator for reduced inflammation

Kerry Reller 17:19

Yeah, honestly, I wish we did more of the measuring of inches and stuff like that. I feel like it's awkward in the office. I'm always like, "Oh, please measure your, your waist, your chest, your calves, your thighs," all that stuff at home. But it's hard to... I'm not gonna do it in the office. I don't know. But we, 'cause we have the body comp, but

Robyn Kavin 17:35

I do that actually

Kerry Reller 17:36

Yeah.

Robyn Kavin 17:37

with some of the patients

Kerry Reller 17:37

Yeah. You still... that's great. I definitely like them to put the trends in, which is why in our app it has it there, but I know they don't exactly use that, but it's a good marker also of, improved body composition overall.

Robyn Kavin 17:50

Yeah.

Kerry Reller 17:51

What do you... oh, go ahead.

Robyn Kavin 17:52

why it's so important, that, we are, we're tailor-making our approaches to different patients. 'Cause some

Kerry Reller 17:59

mmmm.

Robyn Kavin 18:02

It's triggering for them, and others are really interested in that. So I like to try and keep it as simple as possible. And sometimes just a tape measurement in the office around their waist and and their belly, can be sufficient. Yeah

Kerry Reller 18:18

Now, while you're on here, you brought up the triggering thing. So I do know that in some of our programs as we move toward this Medicare bridge, we're having more patients do what we call remote patient monitoring since we're an insurance-based practice, and part of that is weighing in. And I do understand that can be very triggering for patients. I've had plenty that don't wanna weigh in. That's totally fine. They need to tell us that. As far as that monitoring thing if they just get on it and don't even look that's fine by me. Or, maybe they're not doing it every day. I will allow them to do it once a week, which is helpful, enough for, the data and everything that we wanna see. But, I do realize that you can have a free pass. You don't have to weigh in or do the body comp. It's okay, but I like to see the difference. What did you do differently this month? Maybe instead of skipping the body comp, let's just see what it's like so you know what habits that you're doing that are actually working, right? So I do realize that we gotta keep that in mind 'cause you don't want it to go in the wrong direction for someone, like in an obsessive pattern or anything like that as well. Yeah.

Robyn Kavin 19:20

absolutely. Absolutely. So what also, what I like to do is, approach people from a, a whole person perspective. Yes, of course, the data is important and it's important for us to make sure we're on the right track and if medication needs to be adjusted or anything else needs to be adjusted, 100%. but also bearing in mind that we are, we're making lifestyle changes and those don't necessarily happen overnight. It's about changing habits. And those are things that are important to, to work on because hopefully, this patient's not gonna be on a GLP-1 forever. And we wanna make sure that they're being supported so that they can make those good healthy changes so that by the time they do go off the GLP-1, they can continue on that trajectory

Do You Have to Stay on a GLP-1 Forever?

Kerry Reller 20:13

And I would argue it's okay if they have to be on a GLP-1 forever, too. I think we have varied cases in our office, which is why I really believe, like you said, it's whole person care, personalized approach because n- not everybody might have the same goal, and it may not be realistic for everybody. But I do think, we just have to see how they do. I can't really predict it, but I cer- I certainly think it is feasible to go off, and I certainly think that there are patients who much prefer to do it long term, as the studies show. If you were to come off of it, you could have the regained weight. So either direction really, but it is patient-dependent completely

Robyn Kavin 20:48

Yeah. And that's a common conversation that comes up as well. They're anxious to start it because what if they have to stay on it, forever, and how long are they gonna stay on it? And if they're gonna be coming off, how's that gonna work? Are they gonna put the weight back on?

Kerry Reller 21:04

mhmm

Robyn Kavin 21:04

are

Kerry Reller 21:05

mhmm

Robyn Kavin 21:07

real discussions that do tend to come up. And, there, there are other sort of factors that come into play with that whole discussion. What support system do they have? What are they currently doing? And how are they gonna continue to make those healthy changes? So again, it comes down to lifestyle medicine and that's what we're here to do, is to support them with that. And if they need the ongoing, doses of their GLP-1, then so be it. If it's gonna help to keep keep that inflammation at bay or, keep a little bit of the lid on their appetite, so be it

Kerry Reller 21:48

Yeah, NP Sarah and I even had a podcast about, more the anti- anti-inflammatory effects and things like that. And, it is a different perspective and a different patient population, but they're doing very low dose, right? So I do think that there's a role to use it maybe as needed or, spread it out if it's low dose or, everyb- every, like I said, everybody can be very different.

Robyn Kavin 22:09

Everybody is different,

Kerry Reller 22:11

I know they have certain labels right now because of, the FDA approvals and the studies, but I think in reality there are so many ways to be thinking outside the box on what is the label, so like the microdosing and things like that.

Robyn Kavin 22:24

point. That's, that is a really good point 'cause it's, it's not about oh, pushing a medication, and I'm not there to push a medication. I'm, I am there to support patients however it is that they need that support. And if that includes a GLP-1, then that's what I'm there to do

Kerry Reller 22:44

We have some patients still, on traditional phentermine, and I've had patients do nothing, so it, whatever wants them to do. Is there anything that has surprised you on maybe positive things that patients have said while using a medicine and coaching with you?

Robyn Kavin 22:59

Absolutely. Less pain. Less pain. How their kind of arthritic sort of pain is lessened. Less water retention. And it comes back down to that anti-inflammatory ability. And I even had one patient say, "You know what? The weight loss benefit aside," she loves it purely because of the anti-inflammatory benefit that it provides her. She's pain-free. She's able to move easier. And if that's increased her quality of life, that's a win in my books

Kerry Reller 23:38

Yeah, mobility is very big and important because maybe they aren't able to exercise in the beginning. And that's a little bit difficult because they could have a big decrease in muscle mass. But once maybe a little bit of a good weight loss, maybe 5, 10%, and they feel good enough to exercise, it might be okay to, manage it in that way too, right? So the muscle might go down, but then, it can be recovered once they feel good enough to move more. So you gotta be watching that kind of person closely I think, but I do think that is a way that we have to approach it sometimes. Usually I'm always like, exercise is at the same time because I think it also just helps people feel better usually. But sometimes if they're having so much pain, that might not be right for them right yet.

Robyn Kavin 24:24

Exactly. And that's a really, that's a really good point actually that you bring up is that, even if they start losing a little bit of weight in the beginning, in itself can be a great motivator for them to then say oh, wow I've dropped some weight. I actually feel ready mentally to actually now start doing some walking or doing a few weights," or whatever it is that feels good to their bodies. so just that bit of a drop in weight could

Kerry Reller 24:53

I think that's a big comment too because I will say that patients are more likely to be motivated to do something if they're having some success, and I do think that's some of the reason behind me sampling it, right? You don't know you wanna get into this. Why don't you just try it, see what it feels like, For a week. See if it's making your pain go away or feel better. Seeing if you do lose some weight and what happens. Seeing if it quiets that food noise that you've been obsessing over your entire life, right? So just experiencing that and maybe some people even use the word like feeling normal, like they're not having all that food noise, that it's a very different feeling that they want to keep, going with, so I think that's one reason behind sampling them when we have that opportunity. Luckily, we are having that opportunity, thank you to the pharmaceutical companies. But I think it's nice for them to try it on,

Robyn Kavin 25:47

yeah. And that

Food Noise, Hunger, and Your Relationship With Food

Robyn Kavin 25:48

food noise that you brought up is something also that we tend to focus on with some of my patients. Because I think it's really important that we are able to regulate our appetites through our diet and lifestyle as well. And so those are things that we talk through. How do we eat regular meals? How do we balance out our blood glucose levels? Because if those are... if our blood glucose is balanced, our appetite is better regulated. If we're eating sufficient protein throughout the day, our blood glucose is better regulated, and our appetite is as well. So yeah. So like the GLP-1 is it's not the only way to quieten that food noise, although it's, it is a definite, there is a definite effect. But opening up the idea that you can still do that through diet and lifestyle

Kerry Reller 26:40

Sometimes it's like a discussion with the patient when they're having a lot of more food noise and they've been on it. Do I-- I've raised the med dose because they have so much food noise even though they're, maybe the weight is fine, but because it's so uncomfortable and difficult for them to maintain or whatever it is. So I've raised it, but I've also taken the other approach where work on, okay let's manage that, right? You're gonna be hungry. That's part of life, and if-- are you truly hungry? Are just thirsty? Are you bored? Which is 90% of the problem. Or are just out of habit eating, right? So really focusing on the emotional side of eating and trying to still manage that just with a little bit of the medicine helping you, rather than increasing it. So it really is dependent on the situation and the person, whether we would go up in it or if we would try to manage it in different ways. So I think that was a really good thing to talk about with the food noise and the, I think that, that whole concept is really amazing that it's helping patients really, right? 'Cause it's cl- crossing the blood-brain barrier, and that's how it's working on our brain. Yeah.

Robyn Kavin 27:42

Amazing. And that is actually a good point that you say there. It is something that often comes up, between is it physiological that you're hungry or is it psychological that you're hungry, And figuring out the difference between the two, that's also really important

Kerry Reller 28:02

Would you say anybody says that they have a healthier relationship with food or the opposite when taking the medicine?

Robyn Kavin 28:10

Some of them will say they're very neutral around food now. They just they'll eat it because they know they need to eat it. They often will forget to eat, so they've got to, they've gotta remind themselves, that they need to eat. but yeah, some of them really do feel that they have a better relationship because they're able to control themselves better. They can go and have dessert once in a while, and one or two s- one or two spoonfuls feels sufficient to them. They've had the taste, they've enjoyed it, and that's been enough for them, and they've felt happy doing that. So

Kerry Reller 28:54

That would be a great feeling. I can jot down one of those.

Robyn Kavin 28:58

Yeah. One of my patients specifically, who really was well over 300 pounds, Experienced that, and she's struggled with, with weight her entire life, and she's now at such a great point where, knows that a month or whatever she can go and have a little bit of dessert, and she has one or two spoonfuls and she doesn't feel deprived, but she knows that she's enjoyed it and that it's been okay

Kerry Reller 29:27

That's, that's, so that's where I'm like, okay, so you ha- you mentioned the patient who said it was neutral, food is neutral. So that is very dependent on the person too, right? What if this person was a foodie? They got all their pleasure from food, and now they have nowhere else to get pleasure. That's sad. Is that what they want? Or, maybe they do want that. So I don't know. So it's very patient dependent on whether they wanna be so neutral to food, or if maybe they don't like that feeling at all, and it may not be the same foodie person, that they want to experience more pleasure with food and therefore they wanna be on a less dose or, maybe not on the medicine. So it's, you got one person that may be, "Oh, thank God I'm not obsessing about it," or, maybe I'm like, "I kinda miss actually enjoying what I'm eating." 'Cause some people think that their taste buds change, and then like you said, they're just kinda, "Eh, whatever." Yeah

Robyn Kavin 30:18

of them do. Like some of them their tastes have changed, and that can be pretty normal for them. But I also to look at where else in your life are you getting joy? else are you finding joy? Are you... Is food your reward when something joyful happens? if it is, does it make sense to maybe look and see what else could you use as a reward?

Kerry Reller 30:45

Uhum. Uhum

Robyn Kavin 30:46

Again, looking at their life and looking at other aspects that impact their health and that it's not all about the food

Kerry Reller 30:55

Such a hard discussion, 'cause you don't want them obsessing over something else if they were obsessing over food. We very well know that patients who have bariatric surgery often have alcohol problems later. You don't wanna substitute one thing with another. But I think it's important to find joy, and celebrate your wins as well for little things like that, and not with food. I usually say let's not celebrate with food. Let's do something else," we don't wanna have our associations of weight loss or whatever your goal was with celebrating with food. That's kind of the opposite. I guess you could celebrate with exercise. I don't know if that is a, I don't know what the word is, but not fair or something if you...

Robyn Kavin 31:37

Listen, for some people that sounds totally normal,

Kerry Reller 31:39

yeah. I think that sounds fun. Let's go kayaking or something, yeah.

Robyn Kavin 31:43

lo- I think you love running, right?

Kerry Reller 31:46

Eh.

Robyn Kavin 31:46

Okay.

Kerry Reller 31:47

I do. I do, but it's been painful during the run, honestly, since perimenopause. I don't know. I used to be a lot faster. Anyway, I do running, but if I was celebrating, I might say, "Hey, let's go kayaking," or paddleboarding. So to me that if I were making a goal, it might be something like that, like a hike or something. I don't know. But other people have different goals.

Robyn Kavin 32:10

And for some people... Exactly. Exactly. So finding out what are their goals and what is their background, how, what was their upbringing like? Did they grow up with, "Oh, you've been such a good kid. Here's a sweet." Here's some

Kerry Reller 32:20

Yeah

Robyn Kavin 32:20

for you 'cause you've been well-behaved." And recognizing those, those things and seeing okay, how can we find that find that trigger, find the reason for the behavior, and switch it with something that is healthy and that'll still give you that sense of satisfaction

Kerry Reller 32:41

And just break that relationship with the, the trigger. I- that's always a, I'm not gonna bring up this subject, but you know how kids... we were all pretty much raised like that, I think, and that's a, it's not good, and I'm trying my best not to do that. But it is very difficult in this society. Anyway, that's a whole nother story when we're bringing in kids into the situation, which we, we don't see too many pediatric. I had a few, but I'm not opposed to doing that. But it's it's a different ballgame really.

Robyn Kavin 33:09

Oh, yeah, but

Kerry Reller 33:09

but,

Robyn Kavin 33:09

we still do it.

Kerry Reller 33:12

What,

Robyn Kavin 33:13

do

Kerry Reller 33:13

Oh, absolutely. What else would you like to share today? You can always come back another day, but what else would you like to share today on the podcast?

Robyn Kavin 33:21

I think the idea that health coaching is, it's really broad, and it is whatever you want it to be because we are there as professionals to help to support patients in what their goals are. It's not our agenda. And really, everybody is an individual. And we want, we wanna help you to be the healthiest version that you can be

Kerry Reller 33:52

Mhm

Robyn Kavin 33:53

whatever modality you are open to

Kerry Reller 33:57

That's beautiful. That is exactly what, the goal should be, is trying to make everybody as healthy as they want to be and can be and striving to be better. 'Cause we all are needing to be better, I'm sure. So that's good. Great. Normally I ask, where can people find you, but you work at Clearwater Family Medicine and Allergy, so they can find you there. We are accepting new patients, and if you wanna work with Robin, you obviously let us know. We do... are mostly insurance, but we do cash pay health coaching too, so that's an option if we don't take your insurance or we're n- you're not a patient. So if you are looking to...

Robyn Kavin 34:32

At both locations

Kerry Reller 34:33

Huh?

Robyn Kavin 34:34

Both locations

Kerry Reller 34:36

Oh, yep, two locations, Clearwater, Palm Harbor. Our phone number is 727-446-1097. You can find us at cfma.health, and there's, information there. And everybody please stay tuned next week for next week's episode. Thank you so much, Robyn, for coming on the podcast, and we'll obviously have you again.

Robyn Kavin 34:52

Thank you.

Kerry Reller 34:53

All right. Bye everybody.

Robyn Kavin 34:56

Bye