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Podcast Episodes

The Juicebox Podcast is from the writer of the popular diabetes parenting blog Arden's Day and the award winning parenting memoir, 'Life Is Short, Laundry Is Eternal: Confessions of a Stay-At-Home Dad'. Hosted by Scott Benner, the show features intimate conversations of living and parenting with type I diabetes.

Filtering by Category: Omnipod

#1198 Hitting Cows

Scott Benner

Dakota is a young man living his life with type 1 diabetes.

You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon MusicGoogle Play/Android  -  Radio PublicAmazon Alexa or wherever they get audio.

+ Click for EPISODE TRANSCRIPT


DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.

Scott Benner 0:00
Hello friends and welcome to episode 1198 of the Juicebox Podcast.

Today I'll be speaking with 26 year old Dakota who has had type one diabetes for a little over a year, Dakota has struggled with anxiety and depression, and today we're going to be talking about his story. Please don't forget that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan or becoming bold with insulin. This episode of The Juicebox Podcast is sponsored by cozy Earth cozy earth.com use the offer code juicebox at checkout to save 40% off of the clothing, towels sheets off of everything they have at cozy earth.com If you're looking for community around type one diabetes, check out the Juicebox Podcast private Facebook group Juicebox Podcast type one diabetes, but everybody is welcome type one type two gestational loved ones. It doesn't matter to me. If you're impacted by diabetes, and you're looking for support, comfort or community check out Juicebox Podcast type one diabetes on Facebook. And please don't forget to take the survey AT T one D exchange.org/juicebox. That's US residents who have type one or are the caregivers of someone who does T one D exchange.org/juice Box. Today's episode of The Juicebox Podcast is sponsored by Omni pod and the Omni pod five. Learn more and get started today at Omni pod.com/juice box. This episode of The Juicebox Podcast is sponsored by the ever sent CGM and implantable six month sensor is what you get with ever since. But you get so much more exceptional and consistent accuracy over six months, and distinct on body vibe alerts when you're higher low on body vibe alerts. You don't even know what that means. Do you? Ever since cgm.com/juice box, go find out. Hi,

Dakota 2:13
my name is Dakota. And I've had type one diabetes for almost a year and a half now.

Unknown Speaker 2:20
How old? Are you? 26.

Scott Benner 2:23
Let's see. You're 26. Now you've had diabetes for about a year or so. Yep. And is that diagnosis your first or it's something come before that?

Dakota 2:34
That was my first diagnosis. Okay,

Scott Benner 2:38
so prior to a year ago, you were not living with any, like health issues.

Dakota 2:43
I mean, I have a history of migraines and some mental health conditions.

Scott Benner 2:47
But other than that know how far back to the migraines go. Sixth grade, sixth grade. Sixth grade, what does that make you like? 11? Ish.

Dakota 3:00
I'm not I'm not a math person either.

Scott Benner 3:02
Don't get caught on the techno in the details. Second, around 11 years old mental health issues like

Dakota 3:07
depression, anxiety. I have been in like a psychiatric unit for a couple days and

just off and on different kinds of medications since I was about 14. Okay,

Scott Benner 3:26
so around 14. How did it start? Depression, anxiety, depression, depression started with Yeah, any in your family?

Speaker 1 3:33
dad and sister. Sister,

Speaker 1 3:37
I believe has bipolar. Okay.

Scott Benner 3:44
Can you tell me how you're not sure if your sister has bipolar? It

Unknown Speaker 3:47
was a diagnosis

Dakota 3:48
when she was younger. I know she was misdiagnosed. At one point. I don't know if it was that or ADHD or what? But

Scott Benner 3:58
that seems to happen a lot, by the way. Yeah. A lot of people are told they're bipolar. And then they get to a different doctor or a better doctor or something like that. And then they hear well, no, it's not that it's more like this. And, you know, I wonder if that's just the medical community's understanding or if they're changing terms, or I guess I'm never gonna I hopefully I'll figure it out one day. But she was okay. She was like 14 You said your dad is depressed.

Dakota 4:25
Not currently, but he has gone through. gone through it addiction. I've seen him suicidal, but he's never been diagnosed with anything. He's never gone to the doctor for

Scott Benner 4:38
Dakota. You've seen your father suicidal. What does that mean? Like

Dakota 4:42
him talking to me about how he wanted to take his own life

Scott Benner 4:47
when you were how old 16 Oh, that's fun. Yeah, yeah. Geez. So at that point, you were had shown signs of depression already by 16. Yeah. Did the anxiety come when your father started talking about taking his own life or did that come? Yeah,

Dakota 5:05
I remember. Yep, definitely about around that time. That's when my parents got divorced.

Unknown Speaker 5:11
Yeah, yeah.

Scott Benner 5:14
Did you go with your mom?

Dakota 5:15
We tried to do, like 5050. Kind of I ended up just staying with my mom because of the condition that my dad was in. Sure. Yeah. How

Scott Benner 5:24
long did the 5050 trial go for? Four months? It's not bad. Yeah. And he good memories from those four months? Yeah.

Dakota 5:32
Yeah. And me and my father have a really good relationship now. Yeah,

Scott Benner 5:37
what sort of addiction? And do you think the addiction was him trying to self medicate? Or do you think the addiction came first?

Dakota 5:43
I do believe probably it was self medicating. Okay.

Unknown Speaker 5:48
But it's he's been

Dakota 5:50
sober for, like six or seven years now. I want to say good for him. Yeah, yeah. Before, like, throughout my childhood, he was,

Speaker 1 5:57
like, on and off, like harder drugs. Do you have examples? meth and cocaine.

Scott Benner 6:05
And you saw that done in the house?

Dakota 6:08
I never saw it done. I just after I heard my argument, or heard my parents arguing about it, and knew about it afterwards.

Scott Benner 6:17
Your mom pretty upset that she married guy doing meth? And, yeah, and everything that came with it. You know, how was your mom with substances that she is?

Dakota 6:26
So my mother, she was good for a long time. Now? I'm not sure.

Scott Benner 6:32
Dakota not sure. Because you don't live with it any longer? Because you don't have contact? I

Dakota 6:37
don't I don't see it happening. I don't hear about it. But my mother does live with me. Yes, she moved in with me. A year and a half ago. Oh, right. Before I got diabetes, she moved in with me. So

Scott Benner 6:49
you were off on your own and then your mom moved in with you for your needs or hers? For her needs. To code. I don't know how you're not supposed to be anxious. Right? You haven't said anything yet that I'm like, oh, that doesn't make sense at all. At all adds up. Yeah, that all adds up for certain. My gosh, okay, well, we'll likely get back to that. But let me hear about your diagnosis. What was your first sign? I see a lot of people in my private Facebook group talking about their love for Omnipod five. If you've seen those posts and thought that you wish you could have the same experience with an insulin pump? Well, you can there's no reason to experience Fuu any longer fumo you say what is that? It's the fear of missing out on Omni pod. If you have FOMO you may be experiencing symptoms like wishing you could wear outfits without pockets or dreaming about walking past that doorknob without getting your tubing caught. But don't worry, you don't have to experience foo any longer. Because you can go to Omni pod.com/juice box and get started right now with the Omni pod five on the pod.com/juicebox there is no reason for you to fear missing out on anything. How many times have you thought it's time to change my CGM. I just changed it. And then you look and realize I got it's been 14 days already a week, week and a half. Feels like I just did this. Well, you'll never feel like that with the Eversense CGM. Because ever since is the only long term CGM with six months of real time glucose readings giving you more convenience, confidence and flexibility. So if you're one of those people who has that thought that I just did this, didn't I? Why? Well I don't have to do this again right now. If you don't like that feeling, give Eversense a try. Because we've ever since you will replace the sensor just once every six months via a simple in office visit ever since cgm.com/juice box to learn more and get started today. Would you like to take a break? Take a shower you can with ever since without wasting a sensor. don't want anybody to know for your big day. Take it off. No one has to know have your sensor has been failing before 10 or 14 days. That won't happen with ever since. Have you ever had a sensor get torn off while you're pulling off your shirt? That won't happen with ever since. So no sensor to get knocked off. It's as discreet as you want it to be. It's incredibly accurate. And you only have to change it once every six months. Ever since cgm.com/juice box drinking

Dakota 9:31
a lot of water constantly. Like I felt like I could always chug a gallon of water

Speaker 1 9:38
all day. How long would that go for? Maybe a month. Okay, and then

Dakota 9:43
going to the bathroom constantly. Like every hour. Intense leg cramps was sleeping. The blurred vision. I woke up one morning and my vision was just blurrier than normal. And I remember I made an appointment at the IDI After and I told them that and they didn't think it was like out of the ordinary or anything.

Scott Benner 10:04
They didn't think blurry vision out of nowhere was out of the ordinary. Right, exactly. So I could see yesterday I can't see today and you're like, oh, maybe you need a script.

Dakota 10:14
Exactly. Got some stronger glasses. Yeah, we'll

Scott Benner 10:17
get you some reading glasses. Would you like to wear driving goggles Dakota? Oh, my God. Well, after you bought glasses, you didn't need what happened next. Funny. I'm

Dakota 10:28
still actually using those glasses because they're expensive. Right? But no, I can see through them fine. There was like an adjustment period where I didn't need glasses at all for a little bit.

Scott Benner 10:38
Interesting. Did you need them prior to the diagnosis? I

Dakota 10:40
did. Yeah. I got them. Because the migraines in middle school. Were from like eyestrain at first I say. Yeah,

Scott Benner 10:48
at first. Do you think they're they became more about mental health at some point?

Dakota 10:52
I don't know. Have you heard? TMJ temporomandibular joint disorder?

Scott Benner 10:58
Hold on. I thought you're gonna say that thing that. Actually Dakota you're too young for me to make that joke about what my wife said about TMJ. So let's just go past that. And let the older people laugh while I'm looking up. TMJ, it's not something with the jaw and your muscles. Okay, nevermind. Sorry. So

Dakota 11:16
I think after I got my wisdom teeth pulled when I was 17. No out of 16. When I got my listen to fold, I was awake for the entire thing, which was terrifying

Scott Benner 11:27
to coda, you and I have something in common? I remember hearing you talk about that. Yeah, I had them yanked out of my head. Yes. Yeah. Yeah. Tell me about your story, though.

Dakota 11:36
The put like a five inch needle into the roof of my mouth. Okay,

Scott Benner 11:40
hold on, let's slow down to go to give me the sweats. It's early. Okay. Go ahead. I'm

Dakota 11:46
like grasping onto the chair. One doctor holding my head down to the chair, and the other one pulling out my teeth. And

Scott Benner 11:54
did this happen to you for the same reason that happened to me? I couldn't afford to go to a surgeon.

Dakota 11:58
This was the nearest place that my insurance would cover? Because I was on medic, kid. Okay. state funded insurance.

Scott Benner 12:07
Are you in the middle of nowhere?

Dakota 12:08
Iowa? Midwest,

Unknown Speaker 12:10
you could have just said yes. Yeah.

Scott Benner 12:13
Sorry, no disrespect to the people in Iowa or the Midwest. I'm just saying like when you have to drive when my brother tells me that it's 45 minutes to go buy something. I'm like, Dude, where do you

Dakota 12:24
live? That's how it used to be until I moved to the city. Yeah,

Scott Benner 12:28
I would imagine. Yeah, for reasons of insurance. You got sent to what I'm gonna call a horse doctor who took out your wisdom teeth. And so, so yeah, basically, the answer is, yeah, you and I had the same thing done for the same reasons. Oh, yeah. I had a big city doctor, but I didn't. But I couldn't have I didn't have insurance. And I couldn't afford it. And you know, I'm sitting there, and he's telling me Look, these wisdom teeth, and I was like, 19 by them. He's like, they have to come out. And I said, Okay, how do I do that? He starts telling me, you go to this guy, and they're gonna put you out, blah, blah. I'm like, I don't have insurance. I'm like, What's that gonna cost? And I forget at the time, what he told me but whatever number he said, sounded like $8 billion, because I couldn't have come up with it to save my life. And so I said, Well, what do you charge to pull a tooth, and he just kind of like, he wasn't listening to me. At first, he was 50 bucks, and I can give you $200 to take them out. I can do that. And he looked at me like, What are you talking about? And I was like, I'm like, man, if they have to come out, this is the only way it's gonna happen. And so he went, got his assistant. They numbed me up. And his assistant literally stood over my head with both palms on my forehead holding my head down to the chair so they could yank out my wisdom teeth. Yep. Yeah, that happened to you.

Dakota 13:47
Yeah. And then a couple of years later, I had a cracked tooth from like clenching my teeth while I sleep. And they had to pull that one out, too. Yeah. And I was terrified. I was like having a panic attack in the dentist's chair

Scott Benner 14:00
Dakota is it possible were each other's doppelganger because I had a cracked tooth I had to have taken out and it was it came out in pieces and I sat there for like a half an hour while the guy was like mining it out of my face going what is happening but I don't have anxiety. So not the same story. I just sat there being annoyed by it you obviously a you know, or in another situation. I wish that on no one ever by the way. Yeah. Yeah, it was was not not pleasant. Anyway, Jesus, that's terrible. I don't even remember how we got to that I'm sorry. I was so like, enamored by the idea of like this happened to someone else. But I guess we have broke people's stories. Right? That's a strong like, we keep going in this direction. That's a good title for the episode I'll chop down broke people's stories isn't bad, although, part of me that thinks this is going to turn into an after dark if we keep talking. So let's wait and see what happens. Yeah,

Dakota 14:54
there's a possibility.

Scott Benner 14:57
Okay, so you're, you know, all that stuff's going on. Is your mom having now lived with you again? Does she say you gotta go the hospital? Did you figure it out? How did you make it to medical care?

Dakota 15:07
You know, it's just these little things. So maybe I'll just get better if I waited out is what I was thinking. Eventually, I made an appointment with my primary care and gotten to see her. And once I told her my symptoms, she left and she came back in with a, like a glucose meter. And they prick my finger. And my fasting was 327. Yeah, it might even see it was 11.7. I'm

Scott Benner 15:34
gonna say the vision made me think your agency would be in double digits. Yeah. She did not stick that needle in the roof of your mouth and come at you with a pair of pliers. That's good. Not that time. Thanks. Thanks for getting better already. See? You just got to put it the right perspective to go to Thanks for looking. They put you in the hospital? Did they manage it from the office?

Dakota 15:53
They managed it from the office, I left with Lantis and a meter. Okay. Pins, but they didn't give me a script for needle tips. Perfect. Right. So the first day I didn't take my injection. But when I went to the pharmacy to pick it up, they were so short staffed that it was drive thru only. So no one had, like shown me how to even do it. Oh,

Scott Benner 16:21
you couldn't even look the pharmacist the face and be like, I don't know what I'm doing. Right. Because yeah, because you're in the drive thru line. Yeah. Oh, my gosh, did they think you had type one does that? Or did they say you have diabetes? We don't know what it was. She said.

Dakota 16:34
It was most likely type one. But she was gonna run labs, like the C peptide and GA D antibodies again,

Scott Benner 16:42
look at you like, you know, yeah, I

Dakota 16:44
have a good doctor.

Scott Benner 16:45
Gonna say that's amazing. Like, all your stories happened, and now made me feel like you went into a barn to get your doctrine. And like instead, boom, person does exact right thing. All right, finally. All right, again, thanks for looking on. Except now you have diabetes. So you go home to your mom with you. It's interesting at your age, does she go with you for that? Or do you just go on your own? I think I went on my own for that. Yeah. Is your mom, not the kind of person I'd want in that situation? Or just you're an adult? You feel like I'll take care

Dakota 17:16
of it. I'm an adult, and I can take care of it. Okay,

Scott Benner 17:19
okay. Cool. Yeah. All right. So they give you some Lantis and a meter send you home, you have no idea what you're doing. You don't even know how to inject it. How do you start to get your information?

Dakota 17:28
I think I went on YouTube and like looked up, like how to inject insulin. I mean, it couldn't be that hard. Brown, but still poke, but not knowing anything about it. I have no idea where to start. And then I'm a podcast listener. I listen to a bunch of other podcasts. So I searched diabetes. In the podcasts, there was a different one I listened to first. And I had mentioned to my educator about that other one. And then she asked me, because I couldn't remember the name of it. And she was like, was it the Juicebox? Podcast?

Scott Benner 17:59
Oh, see your inability to remember the name of the podcast you tried? Got you to mind? Yes, it's excellent. Also, Dakota, we shouldn't tell the other people that there might be other podcasts about diabetes, because they could go looking for them and abandoned me, like my parents did when I was younger. No, I'm just kidding. You guys can listen to other stuff. If you want to. Listen, I'm just going to ask you, you've now listened to two different diabetes podcasts. I do not want to know what the other one was. Please don't tell me. Where does mine rank with the other one that you heard? Above it? You want to say significantly decode or anything like any use any modifying words? Go ahead, try again.

Dakota 18:34
You post five times a week, and that is a lot better than what is

Scott Benner 18:39
a Dakota? Let's take an off like a little off ramp here for a half a second. Yeah. First of all, I want to thank you, because I make a podcast that is largely heard by people who are not podcast listeners. And so they're not people who used to listen to a radio show every day, or want content given to them constantly. But you do right? Yeah, yeah. There's more of you out there than I think there are. I don't have anxiety. But the closest I come to anxiety Dakota, is trying to produce, make and keep going a podcast, it is not easy. And I know that there are podcast listeners out there. And I know that some of my new listeners who are people are just maybe looking for information. I do think that some of them will become the kind of people who get up in the morning and do what I do. In my free time. I pick my phone up and I go to the podcasts that I listen to. And I'm like, and I put them in my ears while I'm cooking my breakfast or driving the car stuff on. Yeah, yeah, I know you guys are out there. I love and appreciate all of you. I know you're not the people I hear from usually I hear mostly from management oriented people on Facebook. You know, people are really looking for like nuts and bolts answers or community type stuff. But I all the time I actually just reminded Are you in the Facebook group? Oh, yes, I actually, you know, Isabelle helps me with the Facebook group. Yep. Yeah. I just reminded her last night, I was like, I can't make decisions just based on what Facebook says that there are only a portion of the people who are listening to the podcast. She knows, but we were having one of those back and forth conversations. And I just, I ended up thinking that a lot. But so this is touching to me. I appreciate that. Do you think it's an age thing? I gotta get more young people listening?

Dakota 20:25
I'm not sure. Honestly. I don't know. Yeah, probably. I don't know, many older adults who listen to podcasts frequently. I

Scott Benner 20:36
saw my Spotify wrap up for the podcasts I listened to. And I was like, Oh my God. There's a lot of minutes. You know, the I'm not gonna say the name but the the show I listen to the most. Currently, I listened to for 13,000 minutes last year. Wow. And I was like, That's felt insane to me. But I wish I had the device with me that I did the screen capture on. But someone shared with me their Spotify wrap up if people don't know what that is, at the end of the year, your Spotify listener, they give you this little thing like this is your top podcasts, your top music and stuff. And here's how many minutes you listened to it. A person who I'm now going to call the person I love the most in the whole world sent me their Spotify wrap up. And they had listened to the show for 40,000 minutes this year. I have to tell you, like it made me feel like Oh, good. I'm not wasting my time. Like, you know what I mean? Yeah, yep. Yeah. So it's, uh, let's do it together, though. Real quick. i You said you weren't good at math. But I think we could still figure this out and earn their 60 minutes an hour, 24 hours in a day. Right? So let's do 60 times 24. And we're gonna get 14 140. So if they listened to 40,000 minutes of the show, divided by 14 140, I'm using a calculator.

Dakota 21:58
I think I can hear that. Thank

Scott Benner 21:59
you. I pray I didn't, I just didn't want people to think I was like, trying to like pass off that I was doing math in my head. That means that they listened to the podcast last year for almost 28 days. Well, I love that person. I don't know who you are. But thank you, and anybody else out there doing that you complete me. So I don't want to go into it to go to but a ton of work. And mostly you're blinded to who's listening, how much they're listening, what they enjoy, like that kind of stuff. It's all just dumb luck. You know, sometimes you just make the podcast you make and it it, it resonates or doesn't. Anyway, okay, so you found the podcast, then you start learning about taking care of yourself for me? Pretty

Dakota 22:40
much because the soonest, so I was diagnosed in July. And as soon as I could get into the endocrinologist was the end of October. So I was working with my primary care, and then one of the diabetic educators over at the endocrinologist where I started up

Scott Benner 22:57
for months to get you in to see them. Okay. And for those four months, you know, it's funny, I was gonna make fun of I was gonna make fun of doctors and you said, I had to go to YouTube to learn how to inject insulin, I was gonna be like, you're sending people out in the world to get their information from God knows where and then you're like, but I listen to the podcast. I'm like, oh, nevermind, I won't say that. God knows where maybe that's the episode title. So,

Unknown Speaker 23:22
wow. Do you

Scott Benner 23:24
start with conversations and just pick bits and pieces out of them? Or do you find the Pro Tip series or something like

Speaker 1 23:30
that? I don't remember. If I started on conversation. Eventually, I

Dakota 23:38
found the bulk beginnings. Okay. And then I found the pro tips.

Scott Benner 23:44
Do they work the way I hoped that bold beginnings feels like a light but not too light overview, and then the Pro Tip series brings it all together?

Dakota 23:53
Yes. Excellent. Good. The defining diabetes thrown it in there too.

Unknown Speaker 23:57
How helpful was that?

Dakota 23:59
It explained some of the terminology that's used in the other episodes. Yeah. Yeah.

Scott Benner 24:05
which I liked. As a podcast listener and a younger person to go to, is the format like is the way I set it up? It works or did you find it clunky? Did you think oh, I wish it was more like something or other?

Dakota 24:18
Oh, I like the way it's set up. Just like searching for episode topics can be hard, like searching through the podcast app? Because the names are not, and there's no description really.

Scott Benner 24:31
So Well, first of all to go to let's have fun.

Dakota 24:35
Games are funny. I liked the names. Okay.

Scott Benner 24:39
It's my consideration that if every episode was like, you know, in this one, we talked about diabetes, you'd be like, Yeah, that's what they're all about, but they're not and like and how would I ever do description of your episode so far? You know what I mean? It's impossible. So yeah, and let us put the blame firmly where it belongs on the podcast that They're not set up well, like, and that's none of them. They're all kind of set up with the idea of podcasts are really just radio shows, you don't have to listen to it a certain time, and that you go to the most recent one, and that nobody's going to listen back. But that's not true of my podcasts. And others. By the way, there. I'm not the only one who has a deep back catalogue of evergreen material that you would find interesting and valuable two years after it was out. But the apps are set up for the lifestyle that they think people have, which is just give me the next thing, I'm probably not going to listen to the whole thing, like and then it's disposable and it goes away. And that's the problem is the apps aren't set up for how my audience needs the information. But there's nothing I can do about that.

Dakota 25:50
Yeah. And like Spotify, can you create podcast playlists? Yes,

Scott Benner 25:55
we have them. But ironically, my show is so overwhelmingly listened to in Apple podcasts.

Unknown Speaker 26:03
That's yeah, that's

Scott Benner 26:04
what I use. Yeah, that I just don't have it. That's not ironic. A lot of people have iPhones, right, that I don't have as many listeners in Spotify as I do an apple podcast. So the so they're all there. Like, there's great actually, playlist. I think all the series have a playlist in Spotify, but I just, I don't even know I can look, but I don't know what the breakdown is between Apple and Spotify, but it's a pretty big. It's a pretty big gap. Actually, though, Dakota what you know, what's happening to me right now?

Dakota 26:38
What's up?

Scott Benner 26:39
The man is give me, I don't know if you know this phrase. But

iOS 17.

Yeah, it's, it's gonna kill me. So iOS 17 changed the podcast app. And instead of, I think it's defaulting to just downloading the five most previous episodes. So, you know, everyone doesn't listen, every day, they don't get up every morning and open up the app and go, I wonder what Scott made today. Like, everyone doesn't do that. If they did, I'd get all my downloads on Monday. And like, quite literally, you know, just get one download for person, Tuesday, Wednesday, Thursday. But instead, people like open up an app, they go, Oh, cool. There's, you know, I'll get these last four episodes, let me download these bang, bang, bang, and then I'll listen to them. And while they're listening to them, I put out four more episodes. And then they open up the app again. And then now they have to go in and decide, give me this one, give me this one, give me this one, which might sound to you like, Oh, that makes sense. But before it would kind of take like the last 10 and put them in your player for you. And that way they were there for you and available. And from my perspective, that means that every time somebody opened up an app, they would get like 10 episodes. And now they're opening up the app and getting five. Oh, it's like cut in half. Yeah, my downloads are cut in half. Even though my downloads for new material, first 30 days, first 45 days for 60 days, that all actually is absolutely strong. It hasn't changed at all. And it's still growing. So the people are still there. But they're not being served as many downloads. Now. You say, Well, why does that matter? They can go find them when they need them. And maybe they were downloading some that they never listened to all fair. But at the end of the year, when I go back to the advertisers, who are the complete and utter reason that Dakota knows how to take care of his blood sugar. I know that sounds disjointed, but it's 1,000,000% True. Right? They're gonna go Hey, what happened to your downloads, and then I'm gonna have to explain the new podcast app to them, they're gonna have to believe me, I'm gonna have to show them the new numbers like look, first day numbers are still good first 30 numbers. So all these numbers, everything you care about is still good. But someone's gonna get focused on the big number and say, I don't know that when dropped. And when we're out, and if that happens, then I'm screwed. And then if I'm screwed, then the next Dakota is screwed. And like so that at the moment is the thing that are keeps me up at night and makes me bang my head on this wooden desk right here. So don't worry, Dakota, I will figure it out. But I'm gonna cry while I'm doing it. I'm very, I'm very pissed about it. Like I swear to God. I don't know why Apple did that. It's it's a thing that impacts so few podcasts. Like there was no reason to do this. Like most podcasts don't put up an episode five times a week. Right? But can you imagine as a podcast like it, can you work your way through it? Why did they make the change? Because I know why. But I wonder if it's obvious to you, like a

Dakota 29:42
storage issue on people's phones.

Scott Benner 29:43
Well, that's what they're gonna say. They're gonna say it's a storage issue, but it's not a storage issue. It's between them and the advertising community, probably Madison Avenue, who is probably getting ripped off by podcasts that are putting up 30 seconds, two minute episodes with no content in them. So what kind of unscrupulous people will do? Like imagine you have 100 listeners, and you put out an episode once a week, then you get 100 downloads about if all 100 of them like download, but if I put out, you know, one episode and then on Tuesday, like a blurb that's like, Hey everybody, don't forget to check out the website, you know. And then the next day it's like, you know, some like crap that after you listen to it, you're like, This is a complete waste of my time, right? If they do that four times a week, then they get 500 downloads a week from 100 people. But that contents meaningless those those other like shorts, right? They don't actually, they don't actually provide content to the listeners and and if there's an ad on it, nobody's hearing it. And so they're ripping off the advertisers by making kind of fake content, and then saying, No, I get 500 downloads this week, not 100. So they can charge five times as much for their ads. The difference between them and me is that is my humble opinion. You could listen to just one episode this week, and throw darts at a wall and choose what day you're gonna get a quality episode of this podcast. Yeah, right. And so I'm not doing that thing that they're guarding against, but I'm getting screwed for it. So like everything else in life, somebody else went out there and, and stood on the rules and acted in bad faith, and the people who aren't are gonna get hurt by it. So anyway, I'll figure it out. But it really makes me mad.

Dakota 31:30
Maybe you need to write a strongly worded letter to Tim Cook,

Scott Benner 31:35
the or Tim Cook. To me? Is that what you're trying to do? No, I do honestly, like joking aside, like, I do wish I could explain to them that there's a method to this. Like, I don't expect everyone to listen to five episodes a week, 20 episodes a month, I genuinely do not expect that. The reason it's there is because if somebody wants to listen to all of them, it's available for them. Be because there's enough of a mixture throughout the week that you can find something that you would enjoy, right? And see it keeps you in the ecosystem. And I know that we think of that sometimes it's like a bad thing, like advertisers are trying to keep you in there in their app or something like that. Yes, but not for the reasons you think. I'm trying to keep you here so that you keep listening to episodes. So you keep learning something that you're able to see in your time and range keep getting better so that your life is better so that your health is better than that so that I can keep making the podcast for the next kid named Dakota who gets diabetes out of nowhere, when he's 25. or somebody's kid who's two or a 60 year old lady who's like I can't I got diabetes, like what the hell I've been alive all this time. Now. I haven't said it like this in a while Dakota. But if you're not involved and making content on the internet, here's what it's like. It's like taking a stone. And bringing it just setting it down in front of you. And it's freezing cold. And you hold a lighter to the stone. And you hold it and hold it and hold it and hold it and eventually very slowly the stone warms up, right. The minute you take the flame off the stone, it's ice cold again. And that's making content on the internet. It takes forever to get warm. And once you're warm. If you look away for five seconds, you're a cold stone, and it's almost impossible to heat it back up. So, you know people not my position would know this. But making a diabetes podcast that's popular for nine years is the hardest thing I've ever done in my life. It is not easy to accomplish, and it is not easy to maintain. And one of the ways I maintain it is by growing the show growing the downloads, selling those downloads, for advertising so that I can afford to come in here every day sit down, probably get coronary artery disease from not moving around so much, and making all this content to help people with diabetes. Now, you know, if somebody were to whisk in here one day and be like Scott, here's a, you know, an amount of money that would keep you going for five years, just make the podcast for people. You know, at the end of the year, I tell them my advertisers Hey, guess what? I don't do advertising anymore. And sorry, good luck. So that's the situation that arises from all this, but I'm sorry, it has nothing to do with your diabetes. Hopefully people found that interesting. But I want to I want to get kind of back into your stuff here. So picking through your mental health you you know, I've mentioned the anxiety and the depression but in your note, I have suicidal ideation but I haven't heard that from you yet.

Speaker 1 34:36
Back in 2018 December,

Dakota 34:41
I was just in a really rough place, stressed out about a lot of different things I didn't know what to do. I didn't know who I could turn to so I took myself to the emergency room one day after work and told them how I was feeling and

Speaker 1 34:59
They got a, like a telehealth, psychologist or psychiatrist on this phone to do like my emergency

Dakota 35:13
room eval for that thing.

Unknown Speaker 35:16
How was it that you were feeling?

Dakota 35:19
I didn't want to be alive anymore. I don't want to wake up.

Speaker 1 35:23
I was crying all the time. Yeah.

Scott Benner 35:26
What kind of work were you doing at that point?

Dakota 35:28
I was a cook at a nursing home. Okay.

Scott Benner 35:32
And you went to high school? Did you finish high school?

Dakota 35:35
I grew up okay. And I have a associate's degree. Graphic Design,

Scott Benner 35:40
Oh, you went off to college to try to learn a thing. And turns out they don't have computers in Iowa. So you can't do graphic design there. That's probably the that's probably the problem. And you probably have a lot of similar problems as Canadians, but I don't want to get into that right now. So you ended up with a job that I'm not very fulfilling, I guess.

Unknown Speaker 35:58
Yeah.

Dakota 36:00
Yeah. It could be more fulfilling, but, you know, making connections with the residents. There is

Scott Benner 36:07
a good part of this. Yeah, definitely. So you know, enough that you need help. But you don't feel like there's anyone in your life to ask me. So you

Speaker 1 36:18
aid. I don't want to be a burden. Oh, you think

Scott Benner 36:21
there are people in your life? You could have asked? Yes.

Dakota 36:24
Okay, there's a few people I could have turned to. But

Scott Benner 36:28
instead of feeling like you were gonna burden them you went, at least you went and like did something about it. So I mean, did you really? I mean, do you look back on it now and think if I really wanted to die, I wouldn't have gone until somebody? I'm

Unknown Speaker 36:41
not sure.

Dakota 36:43
I look back at it as a very positive experience. I was only there for three days in the psychiatric unit. But those three days I learned a lot. They got me on an anti psychotic while I was there, which actually I want to talk about a little bit. It's called olanzapine, the name brand is Zyprexa. But at the time, they told me, you know, could mess with your cholesterol a little bit. You'll have to get regular bloodwork done. It's like okay, I don't know much else about the side effects. A little, I don't know, maybe nine months ago, I was reading up about it, and it causes weight gain due to raising blood glucose. Okay, and that can accelerate the onset of type one diabetes.

Scott Benner 37:34
Do you have any other autoimmune in your family?

Dakota 37:36
My mom has thyroid? She takes a level of thyroxin

Scott Benner 37:41
Okay, she she has hypothyroidism. Do you know if it's Hashimotos? Or if they it wasn't

Dakota 37:46
Hashimotos? She tells me that they just told her that her thyroid died. Yeah,

Scott Benner 37:50
pretty much. I don't think people get very good care around their thyroid problems either. So

Speaker 1 37:54
what was the name of the meddigan? Level? Say roxham? No,

Scott Benner 37:58
no, I'm sorry for the the anti psychotic. Oh,

Dakota 38:01
olanzapine. Zyprexa,

Scott Benner 38:05
olanzapine is used to treat the symptoms of schizophrenia and mental illness it can cause disturbed or unusual thinking of loss of interest in life or strong inappropriate emotions and adults and teenagers 13 years and older. But it sounds like it was like written by a sad PR person. Imagine that your life. You gotta get up every morning and go try to make olanzapine sound fun. So let's go olanzapine and type one it's a second generation anti psychotic medication that has a relatively low risk of inducing. Wow, X trap a miracle side effects chronic treatment with those Lanza pain has been associated with weight gain hyperglycemia insulin resistance inducing or aggravating diabetes mellitus

Speaker 1 38:50
and metabolic syndrome. Well, you

Scott Benner 38:53
don't want to kill yourself anymore. But you have diabetes. Yep. Yay. Okay. So is that has a doctor ever said to you, they think that's what happened. No. Just you it's your, your your thinking and kind of Google

Dakota 39:07
is my thinking. Yeah. Okay. Because I wasn't ever, like sit around.

Unknown Speaker 39:15
Like leading up to my diagnosis.

Scott Benner 39:17
No other I mean, maybe maybe you just had the is it possible you had the markers and this move things along?

Dakota 39:24
That's what I'm thinking. Yeah. Yeah.

Scott Benner 39:26
That's what I mean, that makes the most sense to me. I always just want to make sure people don't think that like diabetes magically appears like you're you likely had, you know,

Dakota 39:36
they wave a wand and bam. Yeah, yeah. Karma,

Scott Benner 39:39
by the way comes around. By the way, if karma is in charge of giving away things, you did not need diabetes. You

Dakota 39:45
already heard anything else about that. Yeah. I

Scott Benner 39:49
also don't know like how, how a 14 year old deserves bad karma. So are 11 year old so. Okay, so Jesus, are you still on that medication?

Dakota 39:58
So I was off of it for a while. But but I'm back on it now amongst the lowest dose that you can be on

Speaker 1 40:04
what to do for you. Oh my gosh. Sorry. What happened?

Dakota 40:10
My Music app popped up, and it started playing music in the air. If

Scott Benner 40:14
something pops up, I want it to be my podcast, not the music.

Dakota 40:18
Sorry, what was your question before that? What

Scott Benner 40:20
does the medication do for you?

Dakota 40:21
I feel like

other medications like regular antidepressants weren't working. So they got me on that. levels. Now I'd say. I found this on the web. No serious talking to me. She's

Scott Benner 40:35
worried about it happens to me while I'm making the podcast sometimes. So I wonder what you said it levels me out. Yeah, that's interesting.

levels you out meaning? Like,

Dakota 40:46
I don't get as angry or I'm not as irritable. Okay.

Speaker 1 40:49
But I'm also on to antidepressants, and anti anxiety meds,

Scott Benner 40:58
Dakota, has anybody checked your thyroid? So I have had

Dakota 41:01
it checked multiple, like, every time I go to the doctor for labs, they run it just because of my mom. And now my diabetes. My last value, it was under two, but in the past, it has been like between three and four before

Scott Benner 41:14
it's popped up. jumped around a little bit. Yeah. You know, I mean, listen, I'm not trying to say that thyroid condition gives you like some of the things that you're dealing with, but it is attached to anxiety, depression, like that kind of stuff. Like if your thyroids bouncing around. It would make sense that it's impacting you, at least I'm not saying it's the cause the root cause, but it would make things worse at times. Yeah. You know, so keep on top of that, please. Yeah, definitely. Good. When's the last time you thought I don't want to be here anymore.

Dakota 41:49
Shortly after I got diagnosed probably. Okay.

Scott Benner 41:53
Were you on the med at that point? I was yes. Yeah. And it didn't get rid of that thought?

Dakota 41:58
No. Okay. But I started going back to therapy more regularly. Good. And

Scott Benner 42:03
that helped a lot. Yeah. It's just talk therapy, right? You're not seeing a psychiatrist.

Dakota 42:08
Just talk therapy and EMDR. How do you find that? I like that, actually. And we've done it through telehealth before. Okay,

Speaker 1 42:19
I didn't think it would work. Because,

Dakota 42:23
you know, before they were either having their fingers up in front of your face, moving on side to side, or holding on to these like buzzers that vibrate in your hands. Okay. And then when you're over the phone, you're tapping your knees, or your shoulders. And it works. It worked. Yeah, I really made me realize some things.

Scott Benner 42:42
Wow, what can you share with me something that made you realize

Dakota 42:46
some of the like, it brought up a lot of memories from my childhood. Okay. And a lot of those memories kind of explained why I feel the way I do. Like nowadays. I remember, when I was in middle school, I couldn't get a hold of my mom when, like, I was texting her. So my mind instantly went to Oh, no, the house is on fire. And she's

Speaker 1 43:09
trapped inside. That's a leap. Yeah, yeah.

Dakota 43:13
Yeah. Like, I didn't realize I had anxiety as a child. But looking back at it after doing the EMDR.

Unknown Speaker 43:20
Yeah.

Scott Benner 43:22
No kidding. Yeah. Yeah. Well, obviously, because that's such a, you know, it's such an odd leap to make the most people wouldn't think like, oh, it's probably because my house is on fire that my mom's not me. You might think like, oh, maybe she doesn't have her phone with her. Right. Yeah, right. Oh, that's interesting. Now, when you have that realization, to the process, does it help you? Or is it just a question answered?

Dakota 43:46
It's a question answered, it kind of takes a little bit of weight off of my

Speaker 1 43:53
shoulders from time to date to go to No, I'm not currently dating.

Scott Benner 43:59
Is that lack of interest or lack of opportunity? Lack of interest. Okay. So there's people out there, but you're not up for it right now. Right? Do you not want to be a burden to them?

Dakota 44:11
I don't like people, I'd say. You like, yeah, you're fun to listen to. I like you. You're a good guy.

Scott Benner 44:19
But if we hung out, you'd get sick of me pretty quick. You thank my wife says that's what what happens by the way.

Dakota 44:26
I'm not sure other

Scott Benner 44:28
people seem to like me just fine. I actually have a text here from one of my daughter's friends. It says you're the best person I know. I'm gonna have a friend. Put it on the fridge. You put it on the fridge. You're hanging around my wife. Sure, she'll be able to take it off if she wants to. But okay. You don't like people? What does I hear people say that sometimes. What does that mean? Large

Dakota 44:47
crowds, social anxiety to large crowds, strangers, small talk, those kinds of things I don't like so that makes me not want to interact with people. So much.

Scott Benner 45:00
Are you having trouble doing this with me right now? No,

Unknown Speaker 45:03
no. So

Dakota 45:05
it's hard to tell the difference between too much caffeine anxiety and a low blood sugar for me.

Scott Benner 45:11
Too much caffeine anxiety and a low blood sugar. Because they all kind of make me shaky. They make you shaky. Yeah. Anxiety, like physically moves you. Yes. So when when the shake comes? How do you discern, discern what to do first. First, I check my blood sugar.

Dakota 45:31
If it's like, not low, I'll check my graph and see if I dropped fast. Because I'll happen like after I wake up and get in the shower. Sometimes I'll drop fast after my shower.

Scott Benner 45:42
Right? You think that's because you relax in the shower? Honestly, I

Dakota 45:46
thought it was because of the hot water. You know, exercise can increase insulin sensitivity. But originally it was because when I was I was taking my Atlantis before I'd get in the shower. And I think it would peak too quick. Now I'm on Omnipod five, index kanji six. Nice. So that doesn't happen as often good. But so after I checked my blood sugar, then I'm like, Did I have caffeine on an empty stomach? Which that's my issue. Right now. I'm drinking a cup of coffee for breakfast.

Scott Benner 46:15
You're a little shaky right now? Yeah. Okay. Well, the first thing I would say is try to wrap your head around the idea that maybe you're just relaxing in the shower. And that if your anxiety goes away, maybe you're using a lot of insulin to combat the anxiety. Right? And so if you're, you see, you've got this act of insulin going because you're always anxious. And that plus you have diabetes. So you have diabetes, you're anxious, whatever. And that's all happening. And then you get in that shower and just chill out a little bit. And then maybe that anxiety lifts a little and you drop. It's a possibility that that's what happens. I never considered that. Yeah, no, you have to listen to more of the podcast that would have come up. By the way, I I wanted to very beautiful. I'm not trying to give you things to do like, the last thing I need is for me to be part of your anxiety. And I don't want to be that's not what I want to be for you. But yeah, I mean, it's a consideration. Like, honestly, like maybe you just have hot water hits you and the world goes away a little bit. Maybe you like the sound of the waterfall. Like who knows. You know what I mean? Yeah. So, okay, well, that's interesting. And how long you got to Omnipod five and G six pretty quickly. How long until you get to CGM I imagined that came first.

Dakota 47:26
Yeah, so first, I got the libre to, like trial through my educator. Got one and worked good. I didn't like scanning it with my phone. Yeah, as a bummer. And then they gave me another one. And it failed. Like right after I put it on. So then we tried Dexcom. And I knew I wanted to be on a pump eventually. So I just went with Dexcom from that point, okay. Because the integration, right? Yeah. And then I got on Omnipod, five in about six months after I was diagnosed. Is

Scott Benner 47:56
that suggested to you? Or was that a thing you you sought after?

Dakota 48:00
That was the thing I sought after? Because of the podcast? Oh,

Scott Benner 48:03
cool. Great. Omni pod.com/juicebox? There you go. Dakota keep going. You should have just slipped, you should have slipped right into that. Well, they

Dakota 48:12
you don't get credit when you order through the doctor like that.

Scott Benner 48:15
I know it. Yeah. Trust me. Advertisers, they know the situation. They understand that I'm Yeah, yeah, we're pushing links. But that mostly, whatever the podcast, my guess is that a significant part of what the podcast drives through advertising is not directly attributed to me. So you count on having partners who understand the umbrella effect of the podcast and, and give you credit for it, which everyone I work with is, is very, I think they all understand the impact of the podcast. So, you know, I don't have a lot of trouble with that. But it does suck because, you know, when it comes down to like, you know, brass tacks, everybody points the numbers and goes on Oh, no, no, right. I'm not complaining. They advertise. I'm being genuine. The advertisers are terrific. The the reason that the podcast exists, I said it earlier. Absolutely mean, it's the reason why when you looked for it, it was there. It's why your diabetes educator knew about it. This is not a thing. I don't know what people expect, even at five episodes a week. And I don't want to act like I'm complaining because I'm certainly not. This is not just my job. It's like a large portion of my life. Like last night I stopped working at like 930 And that was because Arden's like, Hey, do you want to watch all the murders in the building with me? And I was like, Yeah, cool. Let's do that. I recorded twice yesterday. I did editing I banged my head right here on the desk for an hour thinking about my apple podcast problem. I made content. I had two different conversations with two different advertisers about things that they want to do with their messaging. I backed up a computer I learned how to use that NAS drive better, which is boring as hell but as to do with backups. I spoke with my editor. We made this Decisions about stuff. I'm trying to decide about new content for 2024. I just I compiled a list yesterday, Dakota, because the world wants shorter content. I'm going to make some shorter content next year. And I compiled a document. Hold on a second. By the way, I'm being texted right now about something going wrong on the website that somebody needs help with. So you're

Dakota 50:24
very busy adult energies is appreciated. No sugar. Oh, no, dude,

Scott Benner 50:29
I talked to enough people who listen, I know people appreciate it. I'm saying that. It's why there's ads. It's why like, you gotta click on the damn link. Like it just if that I hate

Unknown Speaker 50:40
hates a strong word Dakota.

Scott Benner 50:43
I wish there was another way to go about it. Not because I have problems with the advertisers, I don't. But because I have two jobs, basically, that and I don't know if that makes sense. Or not like I make a diabetes podcast for people, I would like that to be my only job. But I have another full time job, which is keeping the diabetes podcast going. And that's a ton of like, not fun stuff. But anyway, I've got this great document here that I spent yesterday putting together like most of the afternoon, and I've basically taken like key takeaway points from each of the Pro Tip series. And I'm going to do short content, probably two to five minutes for each takeaway.

Unknown Speaker 51:30
Okay, like a like a summary.

Scott Benner 51:32
Yeah, almost like almost like, summaries tough. Like, I'll just like pick one here. You're off scroll, randomly scroll. Here's the bump and nudge episode, it's episode 1007. One of the one of the things is your timing and amount are key factors in managing blood sugar levels. It's a takeaway from that episode. So my thought is, is that, you know, one of these takeaways, or maybe a combination of a couple of them are thought, and that if you ever stopped and heard me like, speak, live somewhere, or when I do like an online thing, or something like that, I'm basically just regurgitating all this information, you know, on over an hour and a half or two hours while you're speaking. But what if you said, Hey, here's a rock solid takeaway about diabetes that will help you with something. Here's the thought, let me talk about it for two minutes. You understand it in context? And if you want to learn more, go back to Episode 1007. And then bang, you're in and out? And what if that went up every day, and acted as a reminder for people about a little thing they could do that would help themselves? You know what I mean? Like, wouldn't it be easy to hear a three minute episode every day? And then go? Oh, that's right. I need to do this. Or Oh, for sure. Yeah, like, so. I don't want to call them affirmations. Because that sounds

Dakota 52:47
very, that was what was popping? Yeah, it

Scott Benner 52:52
sounds crunchy. So um, I won't say that, when I when I find a way to name it. But I do think there's a ton of value for people there. And so what I did was I looked for ways to find what people want with content. Some people want short, fast, but not just a throwaway thing that makes a download, but actually gives you like, actual like, like usable information and value. So now, after I put in, however, many dozens of hours into making the first 20 of these or so I'll be able to put them out and see if there's something that people like there. And if it catches on, then I'll just keep making them. That would be a job in and

Unknown Speaker 53:32
of itself. Oh, for sure. Yeah,

Dakota 53:35
no, um, but I liked that idea.

Scott Benner 53:36
Thank you. I'm glad that's why random past you because I'm like, You're like an actual podcast person, you might like, have some, like, if you went, that's a bad idea. It's gotta be like that was my best idea. Also, by the way, this coming up this year, in 2024, which by the time people hear yours could have been months ago, a whistleblower series. So that's going to be doctors, pharmacists, nurses, other professionals around health, who speak anonymously and get their voice change so they can tell you like the real stuff that's going on. In their professions. I've recorded six of them so far, they are shocking. And a grand rounds series which is Jenny and I basically talking directly to doctors about what people need. Okay, so that's other stuff is coming next year anyway, that the thing that happens is you guys like open up your podcast app, and you go, Oh, whistleblower, that's nice. And then you make this blind decision to listen or not listen, but I've been working on that for 18 months. Wow. Yeah, by the time you get it, so anyway, not a lot of fun. I need three producers and five more hands. I think. What else do we need to talk about here to cut or what have we not hit? I see marijuana use? Are you self medicating? Alright,

Speaker 1 54:57
yeah, self medicate. How How does it help you? calms me down shows me a little bit. How often? daily, hourly? No, not

Dakota 55:09
hourly,

Scott Benner 55:10
you're not hitting a pan and walking away. No, I don't have

Speaker 1 55:13
a pen. You smoke. You don't smoke at work.

Scott Benner 55:17
You roll like weed though, like you're not doing like a vaporizer, or one of those things.

Dakota 55:22
No, I use a, what's called a water pipe. That's that's the technical term, a bomb.

Scott Benner 55:29
The technical term.

Dakota 55:32
That's what they make you say in the shop when you go buy one.

Scott Benner 55:34
I need a water pipe plays. Okay, so you Okay, so you're only smoking at home. This is not something you can take with you. That's correct. Right. Have you ever considered one of those dry vapes?

Unknown Speaker 55:45
I have used one before.

Scott Benner 55:47
What do you think of those?

Dakota 55:48
I don't like the ones where you put the dry herb in it. I like via oil. Okay. That one is that one will be vaporizer,

Scott Benner 55:58
tell me the difference between the oil and the dry. The oil

Dakota 56:02
is more concentrated.

Speaker 1 56:03
So you need less of it. Get hit? Does it hit you harder? Yeah. Yeah.

Scott Benner 56:09
So you're looking to get knocked off your ass a little bit?

Speaker 1 56:13
Every once in a while? Yeah. Okay. For how long? A couple hours. So,

Scott Benner 56:20
how do you manage being out of it and your diabetes? I

Speaker 1 56:25
haven't really had an issue with weed

Dakota 56:29
and diabetes. Besides getting the munchies and not

Speaker 1 56:33
dosing correctly, and then go into go into bed.

Dakota 56:36
That is an issue sometimes.

Scott Benner 56:39
Oh, it's just falling asleep. Yeah. So the the algorithms looking out for you while you're high? Yeah, it's trying to it's doing its best to pick on the bottle. work that into their PR. Have a button on there for it. Actually, listen, obviously, they're not going to but a lot of the world's smoking weed at this point. Yeah, I might. I might find a way to say it. Like, you know, should you disappear for a little bit. The Omnipod five will be on your side. By the way, we're only three years away from like marketing people being like, Yeah, let's do it. Like oh my gosh. So when does the weed smoking start? At what age?

Dakota 57:20
I dabbled in it when I was starting. Teen maybe 15. And then it became a regular thing.

Speaker 1 57:27
Probably when I was 18.

Dakota 57:31
Because that's when my migraines were getting real bad. That's what I was trying to use to help that

Scott Benner 57:37
is weed legal legal in Iowa. So

Dakota 57:40
they just passed it for medicinal use only. Do you have a card? No.

Scott Benner 57:45
What are you doing? Dakota Come on. From what I understand here in New Jersey. The medical weed is stronger than the

Dakota 57:53
not here in Iowa. They limit the strength in the amount of stuff that you can get

Scott Benner 57:59
how much THC what percentage are you looking for?

Dakota 58:01
I'm not sure like I've been to Colorado and been to dispensary before, and it'll be like 60% 80% Okay. And then this stuff, like through the medical shops here in Iowa. It's like, less than 5% 5%

Speaker 2 58:18
That doesn't sound okay. Yeah, I think from what

Scott Benner 58:22
I understand, like weaker weed in Jersey is more like 18 to 21% thc right now, but 60

Speaker 1 58:31
Jesus Dakota. Yeah, that's strong stuff. No kidding. I mean,

Scott Benner 58:36
what is it like? Wow, that would

Dakota 58:38
be Yeah, that's for like, like wax. Oh, okay.

Scott Benner 58:42
Like for them. The flower though. Is

Dakota 58:45
the flowers. Probably not that strong.

Scott Benner 58:48
I was gonna say I don't think you can get it. It's probably like 30 at the

Unknown Speaker 58:50
most.

Scott Benner 58:51
Do you smoke with people? Is that a social thing for you are now

Dakota 58:55
there's a few people as smokeless? Yeah.

Scott Benner 58:57
Are you like people then?

Unknown Speaker 58:58
Yep.

Dakota 59:00
They're my I have a few good friends that stuck next to me since high school.

Unknown Speaker 59:04
Okay. As to how valuable

Scott Benner 59:05
is that been for you?

Unknown Speaker 59:07
Very. I'm glad I have them. Yeah.

Scott Benner 59:10
They know everything you're going through.

Unknown Speaker 59:13
And they're supportive. Yes.

Scott Benner 59:15
Do they have problems issues? worries too, or are they doing are they like you're

Dakota 59:21
your own set of problems?

Speaker 1 59:23
I'd say. Yeah. We're like a big support team for each other. How much you This is where you live? Do you think? How much of what is where you live? The math

Scott Benner 59:33
with your dad?

Dakota 59:34
Oh, okay. I feel like it's very prominent in my hometown where I grew up where I grew up for sure. And where I live now?

Speaker 1 59:42
Yeah, it's still pretty prominent.

Dakota 59:46
So I work overnight at a gas station and I get kind of all the crazy people.

Speaker 1 59:52
I've seen it. Yeah. Yeah, it triggers me sometimes. Tell me what do you mean when you see I like the way they're acting. Just carrying themselves or talking to people who are altered or, or mentally unstable. That's triggering to you. When I can tell that they've been using our drugs, yeah. Makes think your dad

Scott Benner 1:00:19
or just brings you back to a bad time.

Dakota 1:00:21
Just brings me back to a bedtime. Yeah, I

Scott Benner 1:00:23
would, I would imagine. Okay.

Unknown Speaker 1:00:25
Yeah, that's sad.

Scott Benner 1:00:28
But you see your dad's doing better now, right? Oh, yeah. Have you shared all this with him? Hey, doing meth in front of me wasn't a good idea. I'm kind of stopped. Now. What do you know?

Dakota 1:00:37
We don't Yeah, we don't really talk about her feelings much.

Scott Benner 1:00:42
He's saving that for when you're dead? Probably yeah. Do you want to tell him or do you think it would hurt him? Or? Or maybe knock him off his path?

Speaker 1 1:00:53
It might like, take him by shock. Okay, I would bring it up. Are you protecting him? Or? No, it's just kind of like a thing of the past.

Scott Benner 1:01:05
You don't think it would be valuable for you to share with him? What happened to you? I don't think so. Okay, you handle that in therapy? Yeah, yep.

Unknown Speaker 1:01:15
I got it. Okay. Yeah, I don't

Scott Benner 1:01:18
know. Trust me. I don't know what I'm talking about. I don't know if it helps or doesn't help. I'm just asking questions. So yeah, you get that from listening to the podcast, right? Like, I'm just inquisitive. I don't actually actually know what I'm talking about.

Dakota 1:01:33
You got to learn somehow.

Scott Benner 1:01:34
Well, look at all I learned about weed. I know about dry vapes. And I know about like THC levels. And like, I've learned a lot make up this podcast. For sure. I would like to see you use the dry. Vape just said, I don't want to see you smoking. I don't like the idea of smoke in your lungs. You're not gonna listen to me. It's okay to go. I'll give it a thought. You're like what happens when it's not charged? And I want to smoke? What do I do then? Scott.

Dakota 1:02:00
That's the power goes out.

Scott Benner 1:02:03
I gotta be able to get high if there's an electrical problem. Now you got me buying battery packs in case something happens. I need a solar panel is too much of a financial outlay. Do you do beings being serious? I don't know if we've been serious or not, or maybe have been the whole time. But you don't worry about fentanyl, things like that shown up in drugs. You're buying off the streets? No,

Dakota 1:02:29
I've never even considered that.

Scott Benner 1:02:31
I think I would like you to consider that.

Dakota 1:02:35
I have heard about people putting it in. Like at raves. I've never been to one like

Unknown Speaker 1:02:40
LSD. I think

Dakota 1:02:42
we're Molly. I don't know much about that stuff.

Scott Benner 1:02:45
Yeah. Well, you don't want to find out about it by mistake.

Unknown Speaker 1:02:48
Right? Exactly. Okay.

Scott Benner 1:02:51
I don't know. Like there's something about being able to buy illegally that makes you feel like it won't be tainted. And then I think if you were my kid, I'd be like, please buy it legally. So that you don't have to, like I don't if I could, oh, I would offend. Like you get in a car and I don't see how you look like a walking talking medical marijuana card to me. Just walk in there and be like, hey, when I was 11 and before you get off,

Dakota 1:03:16
you're you're done. Yeah, you're

Scott Benner 1:03:17
good man here. It's all good. Dude, you said you were diagnosed at like an 11? A once a year. So where are you now?

Dakota 1:03:26
My last one was 6.8 I believe my first agency after I got on Omnipod was down to 6.3. And that would have been

Scott Benner 1:03:38
only five five 6.3. Yep. And then why do you think it went up recently? Before

Unknown Speaker 1:03:43
I because I was like,

Dakota 1:03:47
kind of learning. You know? So I was eating lower carb.

Unknown Speaker 1:03:50
Oh, okay. Yeah. You're

Scott Benner 1:03:53
asking more of that insulin now? Yep. Right. What's your what's your favorite snacks?

Unknown Speaker 1:03:57
Like ice cream?

Dakota 1:04:00
Peach rings. Oh, peach. gummy candies?

Scott Benner 1:04:03
Dakota you and I do have a lot in common. Like you put your gun to my head. I want simple sugar if I'm gonna snack. All right. Yeah, yeah, about that. Look at you. You and I can get together. Yeah, did the

Dakota 1:04:17
dark chocolate chip thing I heard you talking about for a while. Did that help? It did but then I ran out of chocolate

Scott Benner 1:04:23
chips. Yeah, they're expensive too. Yeah, I know. That's the other problem. Is that like the bad stuff is cheap?

Dakota 1:04:30
Yeah, yeah. It's yeah, it's definitely more expensive to eat healthy. I tried to buy like fresh foods, meal prep and then freeze it. Good for you. Rather than buy in like stuff. I can stick in the microwave and warm up.

Scott Benner 1:04:44
My son went off to be honest zone this year. One of the like, most proud things, like moments I had was when he said, like really early on. He goes everybody's spending so much money on food. And I'm like, great. He goes I'm not going to do that. I want to save money while I'm here. And I was like Okay, so he's stedfastly goes out goes grocery shopping buys his food preps it packages it up and eats it all week long. Yep. Yeah, it saves him. He was actually with a job that wasn't paying, you know, a ton of money. He was able to save a significant amount of it because of that. Yeah, I was really proud of them. And if you if you do that, that's that's excellent. All right. Let's test how like we are. Dakota, then I'll let you get out of here. Ready? Okay. Swedish Fish better.

Unknown Speaker 1:05:27
Fresh.

Scott Benner 1:05:28
We're a little stale.

Speaker 1 1:05:29
I think I'm a little still because they're a little harder. Yeah, you're right. Okay. The

Scott Benner 1:05:33
peach rings. You bite them or you stuck on them? To go to where the same person this is fastening? Yeah. Cuz you like the texture better. Right? Yeah. You like where the sugar crunches through the soft stuff? Yep. Dakota, you might be my son. But yeah, it's very possible that I have ever met your mother. You know, I'm saying?

Speaker 1 1:05:56
I don't think so. No, okay. You ever been to Iowa?

Scott Benner 1:06:00
Not so far. Although I did find myself saying the word Iowa out loud recently, when I was talking to an organization that has chapters on college campuses. And I said, I hear there's a really big chapter in Iowa. I'd love to go talk there. So I don't know if that'll ever happen or not. But I did say the word Iowa in the last 24 hours before I talk to you. So you guys got airport, right? I'm not gonna walk there. I think yeah, I'm not writing a cow to Iowa or whatever the hell has to happen. You know what I mean? Seriously,

Dakota 1:06:31
speaking of cows, just random fact. My cousin has hit a cow three times. Like, you know, people hit near

Scott Benner 1:06:36
the same cow. No. Okay. Three different cows. How does it car? Well, I have a lot of questions. Now. I'm gonna let you go. How does a car hold up striking a cow? How does the cow hold up?

Dakota 1:06:49
Neither hold up very well.

Scott Benner 1:06:51
You kill a cow if you hit it with your car. So did they cook it after that? What do they do?

Dakota 1:06:57
I don't know what they did. I mean, maybe the farmer. You know, it'd be property.

Speaker 1 1:07:05
Your owns the cow you'd butchered right. Thanks. So

Scott Benner 1:07:10
she is I don't want to go down this rabbit hole. But I do want to Google that. But I'm not going to. Is he Hi, the friend. How do you hit a cow three times a night at night? It feels like it's on purpose. After the second time.

Dakota 1:07:24
I think someone wants their gate open.

Scott Benner 1:07:26
So if you leave the barn door open a cow will escape. Yes. And then your buddy will find it with a card god damn for sure and hit it.

Unknown Speaker 1:07:32
Yep.

Dakota 1:07:34
Why is he? Six? It's a sixth sense.

Scott Benner 1:07:36
What I like him home. Why is he out after dark? What do you think he's out there doing?

Dakota 1:07:40
Oh, hidden cows.

Scott Benner 1:07:45
All right. Well, I'm not gonna lie to you Dakota. This episode is called Hidden cows. And, and we're done. I like it. I don't know why you waited till the very end. But God bless you because anybody doesn't work. Dakota when I pick the title from later in the episode. Do you hang in to wait?

Dakota 1:08:01
I do. Yep. And I'm like paying attention the entire time waiting for

Scott Benner 1:08:06
it is my marketing genius of all marketing genius. Thanks. So I came up with that on my own by the way, nobody steal it. By the way, do you think anybody else would steal it? Like my podcast episodes are ridiculous. Even I when I'm typing them in, I'm like, What the hell am I doing? Did you enjoy the frozen urine of diabetes? I don't think I heard that. Well, it's the title. Go find it.

Dakota 1:08:33
I heard like butthole adjacent butthole

Scott Benner 1:08:35
Jason is the guy to be it's got I toyed with the idea Dakota of starting another podcast and calling it butthole. Jason. Oh, God. Well, I would talk about my the guy that does the editing for me who will hear this has to be talked into. He's talked me into me believing that I'm I'm a good podcast or not just a good diabetes. podcaster. And he's like, I would listen to other stuff if you did it. And I started thinking I was like, I started the podcast. I will call it but Hola, Jason. I've listened to it. Because are we talking about generals? Are we talking about me basically being in DC? I'm saying like, see how it works? Yeah. Like, are you being a J? Are you adjacent to the butthole? And am I the butthole? Or you get it its own way? Yeah. See? Yeah, it's not bad. Did you check out Bork Bork Bork from last week.

Dakota 1:09:23
I have listened. Yes. I liked that one. Let's

Scott Benner 1:09:26
roll through for a second. Let me just click a couple here. We'll come up with the stiff person is like

Dakota 1:09:32
oh, I liked that one too stiff person. wasn't that interesting? Yeah. I've never heard of stiff person syndrome.

Scott Benner 1:09:39
I hadn't either. Until I talked to her time is a construct, which is fantastic. Because it has nothing to do with the episode. Exactly.

Dakota 1:09:46
Yeah.

Scott Benner 1:09:49
It's a thing I said the Arden ones that I bring up like 45 minutes into the podcast. Kick. The goat will probably end up on a list somewhere with hitting cows. Whack a Mole.

Dakota 1:09:58
Yeah, there you go. Here's another one that is on the same line. Some

Scott Benner 1:10:01
people call me, Maurice.

Dakota 1:10:04
These are just recently I did hear the mortgage one.

Scott Benner 1:10:07
Yep. Fancy tractor. That one was his. I don't think she said I have a fancy tractor. I'm just like, What the hell does that mean? Then some of them like see like comparison and blame diabetes pro tip like my brains like boring. But I like the other ones. Do you like Arden on the podcast?

Dakota 1:10:26
I do. I like hearing her. She's fine. Okay.

Scott Benner 1:10:29
All right. Truthful. Yeah, yeah, she doesn't seem to have a filter.

Dakota 1:10:33
You guys are a lot of light. So it's fun listening to you bicker back and forth. Yeah,

Scott Benner 1:10:38
I appreciate that. Okay, by the way, nice day from for a mo is a line from a Steve Martin movie from the 80s. And I don't know, though. Yeah, of course you don't 25 You might not even know Steve Martin is I do know

Dakota 1:10:51
the Pink Panther. That's how you know Steve Martin. Yep. Oh, and Cheaper by the Dozen. And you mentioned the murders in the building earlier. I've never I've never seen that show.

Scott Benner 1:11:02
There are 100 years old that but it is funny. Okay, so I'll keep making silly names for the podcast. And you'll keep listening. And I appreciate you very much. Thank you for coming on and doing this.

Dakota 1:11:12
Thank you, of course.

Scott Benner 1:11:20
A huge thanks to Omni pod. Not just my longest sponsor, but my first one Omni pod.com/juicebox. If you love the podcast, and you love to Bolus insulin pumps, this link is for you omnipod.com/juice bar. I want to thank the ever since CGM for sponsoring this episode of Juicebox Podcast and invite you to go to ever since cgm.com/juice box to learn more about this terrific device. You can head over now and just absorb everything that the website has to offer. And that way you'll know if ever sense feels right for you. Ever since cgm.com/juice box Diaby diabetes diagnosis comes with a lot of new terms, and you're not going to understand most of them. That's why we made defining diabetes. Go to juicebox podcast.com up into the menu and click on defining diabetes to find the series that will tell you what all of those words mean. Short, fun and informative. That's the finding diabetes. Thank you so much for listening. I'll be back soon with another episode of The Juicebox Podcast. The episode you just heard was professionally edited by wrong way recording. Wrong way recording.com


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#1197 Cold Wind: Pediatric E.R. Nurse

Scott Benner

"Dani" is a Pediatric E.R. Nurse and the mother of a child with type 1 diabetes. 

You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon MusicGoogle Play/Android  -  Radio PublicAmazon Alexa or wherever they get audio.

+ Click for EPISODE TRANSCRIPT


DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.

Scott Benner 0:00
Hello friends and welcome to episode 1197 of the Juicebox Podcast.

Today we'll be calling my anonymous guests Danny, this is a cold wind episode of course. Danny is an army forces reservist, a pediatric ER nurse, the mother of two children, and one of them has type one diabetes. Today we're going to hear about what she sees at her job. Nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan. Don't forget to save 40% off of your entire order at cozy earth.com. All you have to do is use the offer code juice box at checkout. That's juice box at checkout to save 40% at cozy earth.com. Do you have type one diabetes? Or are you the caregiver of someone with type one? Are you also a US resident? If you are? I need your help. And so does everyone else. Go to T one d exchange.org/juicebox and complete the survey. That's all I need you to do. Your answers to simple questions that you will know the answer to are going to help to push type one diabetes research forward it takes about 10 minutes T one D exchange.org/juicebox. Support yourself. Support the podcast support other people with type one. Today's episode of The Juicebox Podcast is sponsored by the contour next gen blood glucose meter. This is the meter that my daughter has on her person right now. It is incredibly accurate and waiting for you at contour next one.com/juice box. This episode of The Juicebox Podcast is sponsored by the ever sent CGM and implantable six month sensor is what you get with ever since. But you get so much more exceptional and consistent accuracy over six months, and distinct on body vibe alerts when you're higher low on body vibe alerts. You don't even know what that means. Do you ever since cgm.com/juicebox Go find out this show is sponsored today by the glucagon that my daughter carries. G voc hypo Penn. Find out more at G voc glucagon.com. Forward slash juicebox. All right, Danny, let's get some background from you. Let's start personal first, What's your connection to diabetes?

"Dani" 2:33
My daughter who is four is a type one. Okay has two children, but

Scott Benner 2:38
she's the type one and how old was she? When she was diagnosed? She was to two and a half year and a half ago ish.

"Dani" 2:45
Yeah, a little over a year and a half ago. So

Scott Benner 2:48
it's your oldest, youngest.

"Dani" 2:50
She's my oldest. I was pregnant with my other child when she was diagnosed perfect.

Scott Benner 2:57
I mean, honestly, right. You're trying to make a baby.

"Dani" 3:01
I had definitely some moments where I was like, I definitely asked my OB, I was like, what kind of testing can we do on this fetus? Because like, I'm really stressed out, it was, you know, you just go in that spiral mode at the very beginning when you're like, just overwhelmed with all of the information. So it feels

Scott Benner 3:17
like it's a joke a little bit to you're like, I'm, I have this little baby, and I'm making another baby. And this is what's gonna happen right now. Yeah, anyway. Yeah. How about professionally? What do you do professionally?

"Dani" 3:28
I'm a pediatric emergency room nurse.

Scott Benner 3:31
How long have you been doing that for

"Dani" 3:32
this role? In particular, I've been doing for five years, I've been a nurse for about 12 years.

Scott Benner 3:38
Okay. That's a long time.

"Dani" 3:40
It's a minute, it's

Scott Benner 3:43
how do you get that education like the undergrad? I hear people talking about it all the time that some nurses go to like private schools and cost a lot of money. And they feel like the education is not much different than if they had gone to community college. Is that about? Yeah,

"Dani" 3:57
I think that it, like, there's definitely different ways that you can do it. Like there's a lot of different routes and a lot of different ways to skin a cat. And you know, at the end of the day, an RN degree is an RN degree. It does affect like your ability to sometimes get hired at like magnet facilities, if you don't have a bachelor's degree. I graduated during the recession. So it was really hard to get a job at a baseline. So it was like a bachelor's degree was a must have. Yeah, you can get an associate's degree and still take the NCLEX, which is the same test that you're going to take if you have a bachelor's degree, okay, and take doing a bridge program to get your associates to your bachelor's. It's really not that complicated. I have my master's degree as well. But

Scott Benner 4:35
okay, let me take you back for a second to you finished your NCLEX. Right. You took them they went well, you passed. What was your feeling about your readiness at that point? Like if I could go back and talk to that naive person? Was she like, I am Danny with an eye and I can probably do anything, or where were you then?

"Dani" 4:57
I think that's an excellent question. I was thinking about this yesterday. Today, when I was walking into work just like Who was I, as a nurse, when I was a new grad and walking into work, so naive to just like people and how human beings are and like how that has changed, like my perspective, so much like, you know, over time as I've become a parent, as I've had a child with a chronic illness, how that perspective has changed. But I think like when I was a new grad nurse, I went to a really great school I had, I mean, nurses listening to this will think this is strange. I took seven semesters of clinical normally, it's only four semesters of clinical. So I was adequately prepared for my, like college that I attended. But I think you're naive, you don't know what you don't know. And it is on the job training. And there is so much that you learn like when you are taking care of real human beings. And you're not just like having these hypothetical situations where you're like, This is what's going to happen when you have this patient scenario present. So yeah, I think just like the night naivety, I was 22 years old. Also, I was mature. So like, let's be honest, about how much that changes things, too. So

Scott Benner 6:10
what do you think you learned about people? Like, what were your first, like, oh, my gosh, I didn't realize this about the world stuff.

"Dani" 6:17
Yeah, I actually live with my best friend, the first year. And I remember we had our hallway full of sticky notes of like, one positive of the day, because I honestly wanted to quit nursing after the first year, I worked on a cardiac step down floor. So as taking care of adults, you know, I think you come out of our I came out of nursing school with the perspective of like, I'm going to make people better and I'm going to help people in be a really great person to people. And like, people don't care about themselves sometimes, like, I'm taking care of these adults that like, don't take their medications. They're there for a congestive heart failure, like episode where they're swollen all over because they haven't taken their medicine or, you know, they didn't go to dialysis. And so now they're in an arrhythmia that we need to resolve or, you know, they like you'll get a patient that just had open heart surgery and then their families bring them Burger King and you're like, Well, you didn't get this way from

Scott Benner 7:13
in the hospital. Yes, have it your way. Absolutely.

"Dani" 7:17
You know, so you're just like, I think that the humaneness part of it is like something that I just was unaware of and it would just be really frustrating like I'm trying to help you and you don't care like the patient doesn't care.

Scott Benner 7:29
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"Dani" 9:01
I think it's probably all of the above, I worked in a very urban area when I was a new grad like I worked in the same city that I mean, I can like say like a general area of that, but I don't work in that area and more a very, very large city in the United States. And like you have a conglomerate of people. So there is going to be an educational discrepancy between different people have like what they know, resources available to them. Like level of care, sure, but like definitely level of understanding of the impact of what they're doing, how that's gonna affect their health in long term. Like do

Scott Benner 9:34
you think taking the Burger King example? Do you think they don't know that's not good for them? Do you think they don't know? That's what got them into that position? Or do you think they know and they just, they don't care? It's all they can afford? Like,

"Dani" 9:48
I mean, like if you look at it from like a general demographic standpoint, like I think that there's absolutely all of those variables in play like some people do, like want to do better for themselves, but they can't afford it like fast food is cheap. And so like, you're still gonna get really good, like, not overly cautious about you know, like of value

Scott Benner 10:05
for your dollar as far as like quantity and not buying

"Dani" 10:09
organic lettuce is more expensive like buying a salad is more expensive than buying a Burger King hamburger. Yeah,

Scott Benner 10:16
I gotcha. Okay, so like but to you the person who's got to get up drag their ass there do this thing. Poop pee pee pee, a lot of unpleasant things happen in their death, people are generally at their worst, you know, for not their even their fault. Like when you get thrown into that over and over again. You said you felt like you wanted to quit early on? Do you think that it's easy to blame them? When it's the situation? Where do you think it's them?

"Dani" 10:44
I think that there's definitely both but like having worked with adults and children. I think that in large part, like, I think that at some point in your life, you have a choice to make, and you're an adult, and you can make your own adult choices. I think my perspective changed a lot when I worked with children, you know, like, parents want the best for their children. And so they want them to be well, and they will do without at whatever cost in general. Not always. But in general, they will do it at whatever cost and I think adults like sometimes they know and they're just like, this makes me feel good right now. And so I'm going to do that because that's what's best for me right now. Like whether that's like, a financial issue, an emotional issue, a literacy level, like problem, like a resource level problem. It's hard to say exactly what the specific issue is. But I think like it is variable depending on the patient, but I think people in general, like have a choice to make. And at some point, you're an adult, and you get to make choices. And there are consequences to your choices.

Scott Benner 11:43
Yeah, no, I want to tell you, I agree with you. Like Like, and I've also, I've also been in the middle of a situation where I'm watching myself make the wrong choice. Right. And while I'm doing it, I think this is not the right thing to do. Right, and you just don't stop that part is difficult to understand, I guess, for me personally, but you said parents want the best for their kids. What about parents who clearly don't want the best for themselves? Do they still want the best for their kids? I

"Dani" 12:14
would say on a whole Yes. Even the really, really, really terrible things that I see. There is some level, you know, like, unfortunately, I see really sad things like I see people abusing their children. And there is some level of remorse even if they're the abuser like you can see it like,

Scott Benner 12:32
are you there? Yeah, I'm here. I'm sorry. You paused, it was such a pause. And I thought, Oh, my God, so quiet. I think she's gone. I actually I was in the middle of a thought and you pause which screwed us up. I was in a I was in a home store recently. And this guy was being really pity to his, like, 11 year old daughter. And I was in an aisle looking at something and I was trying to concentrate on something. I didn't know exactly what I was doing. So I was learning while I was standing there. They were 40 feet away. And just over and over again. He was just like, reductive to her and kind of treated her like she was stupid. Like you don't I mean, like the end. And then it stopped and you thought okay, maybe there's a bad moment. And then they open their mouth again. And it's happening again. And there's this feeling inside of you like I can't do anything about this, right? Like what am I good to good? Like,

"Dani" 13:27
there are definitely parents that come in and I see the way that they interact with their children. And it's unfortunate that they are inadequately prepared to be a parent Parenting is hard. Don't get me wrong, I yell at my children sometimes. I don't want to do that either. But like

Scott Benner 13:41
you have to their little mother.

"Dani" 13:46
Just sometimes last night, get in bed. It's time now. I've been awake all day.

Scott Benner 13:51
But so I had that moment where I thought like, is this like, is this a great guy? These two have a fantastic relationship. And there's just something happening right now. And I thought in the end, I thought maybe, you know, but there are also people who that's their. That's how they are to each other constantly.

"Dani" 14:07
Totally. I don't. I don't think it sets kids up for success in some ways. But like, I hear what you're saying like Absolutely. But at the end of the day, you brought your child to get care in some capacity. Whether you are present in this care, because I've had a kid dropped off literally yesterday, a young teenager like early teenager dropped off by her parent and her mom said, let me know when you're done. I'll see if I can leave work to pick her up. type of a problem.

Scott Benner 14:33
Can you tell me vaguely what was wrong with the kid?

"Dani" 14:36
I don't remember what she came in for. I feel like it was like abdominal pain or something. But like, that's really sad. Like we did lab work and you're just gonna let her do this by herself.

Scott Benner 14:47
Yeah. Interesting. Like a taint like 13 like that kind of a Yeah,

"Dani" 14:52
I think she was like 1314 Yeah, just sit in the ER

Scott Benner 14:55
and give me a call when you're done. And if I can get out of work, I'll come get you.

"Dani" 14:59
I'll see I'll see if I can get out. Interesting, isn't it? Yeah.

Scott Benner 15:03
I don't know how to ask this question. Oh, boy, I don't know how to ask this question. Was the mom a big mess? Like, what was the problem?

"Dani" 15:11
No, I think like, you know, from a resource standpoint, and I don't understand everything, I got social work involved. And it's probably like, I need to work because I need to make sure that I can pay for my child right on, I'm trying to, like, look at it like, from a different perspective to like, yeah, yeah, I think it's really crummy. I would never do that to my child. However, I don't know what your financial work situation is. Maybe you just started a new job, and you're on your like, 90 day trial, and you need to show up, because you need to make money to pay your mortgage. Maybe you're a single mom, like, I don't know, all these other variables that are going into it. So I try to be like gracious in that piece. But I'm also like, though, I wouldn't do that to my kids. But this is what we're dealing with. So Right. Well, yeah, I

Scott Benner 15:53
mean, I guess that's really the issue is that you're, you know, first of all, you're experiencing it over and over again. I'll talk to that piece. first talk about what happens when you're surrounded by repetition all the time. Do you start believing the worlds that way? Or do you just believe that works that way? This episode of The Juicebox Podcast is sponsored by the ever since CGM. Ever since cgm.com/juicebox. The ever since CGM is the only long term CGM with six months of real time glucose readings giving you more convenience, confidence and flexibility. And you didn't hear me wrong. I didn't say 14 days. I said six months. So if you're tired of changing your CGM sensor every week, you're tired of it falling off or the adhesive not lasting as long as it showed or the sensor failing before the time is up. If you're tired of all that, you really owe it to yourself to try the ever sent CGM. Ever since cgm.com/juicebox, I'm here to tell you that if the hassle of changing your sensors multiple times a month is just more than you want to deal with. If you're tired of things falling off and not sticking or sticking too much, or having to carry around a whole bunch of extra supplies in case something does fall off, then taking a few minutes to check out ever since cgm.com/juice box might be the right thing for you. When you use my link, you're supporting the production of the podcast and helping to keep it free and plentiful. Ever since cgm.com/juice. Box contour next one.com/juice box that's the link you'll use. To find out more about the contour next gen blood glucose meter, when you get there, there's a little bit at the top, you can click right on blood glucose monitoring, I'll do it with you go to meters, click on any of the meters, I'll click on the Next Gen and you're gonna get more information. It's easy to use and highly accurate. smartlight provides a simple understanding of your blood glucose levels. And of course, was second chance sampling technology, you can save money with fewer wasted test strips. As if all that wasn't enough, the contour next gen also has a compatible app for an easy way to share and see your blood glucose results. Contour next one.com/juicebox. And if you scroll down at that link, you're gonna see things like a Buy Now button, you could register your meter after you purchase it or what is this download a coupon? Oh, receive a free Contour. Next One blood glucose meter, do tell contour next one.com/juicebox head over there now get the same accurate and reliable meter that we use. I

"Dani" 18:39
actually think like the last year has really changed and shifted my perspective, like from people. I don't know the whole story. I don't know the full picture. I try to see like the other side and like, view it from a different lens, like take a step back. What are the resources available to this person or this nurse or this family that maybe are lacking or are abundant and maybe affect the way that they perceive this situation? So

Scott Benner 19:07
this last year has changed your perspective a little bit are you talking about since your daughter has type one?

"Dani" 19:14
Absolutely like so I just had a really crummy year right around the same time that my daughter got diagnosed like my dad was in ICU for two weeks with a subdural bleed and had brain surgery. This was like two weeks after my daughter was diagnosed and I had my child that my my younger child that was not a planned pregnancy. Like I just thought I had gotten back from a deployment. That's the short version of the story. I just got back from a deployment. And so it was just an unplanned pregnancy and not not not unwanted. But it sounds really terrible. If you got the whole story, it would be even better. Then you can really go with the stripper name. You can

Scott Benner 19:52
just roll in the door. You're like me so yeah, yeah. Okay. All right. All right. Well,

"Dani" 19:57
it's even better than that. So yeah, my I'll just tell you, the whole bit. I went on a deployment, my father in law ended up getting really very ill. So I went on emergency leave for my deployment came home, because my husband was trying to take care of his father, and of life choices, things like that. Yeah. And just was overwhelmed with taking care of our child. She was not diagnosed at this point in time. This is like right before she got diagnosed, but, you know, it's overwhelming. Like, he doesn't have the extra resources and help. So came home. I was home for literally a week because

Scott Benner 20:29
his cover like citement sex, what were you doing? Were you trying to make him feel better? Yeah, it's

"Dani" 20:33
great. It's grief. You know, it's a real thing. Yeah, I think we all understand. Yeah. To my deployed location. In the Middle East, buying a pregnancy test is really fun and pleasant. So it was a really great lifetime.

Scott Benner 20:48
Oh, my God, I want to remind you to stay close to that microphone. I like you so much better when you're close to it like that. Okay. Wow, I didn't realize you were in the military. Are you in the reserves? Yes. I'm

"Dani" 20:57
a reservist. Okay.

Scott Benner 20:58
So you got back and you say to somebody, Hey, I can't stay long.

"Dani" 21:03
Yeah, it was definitely one of those moments. I mean, I like was knew that there was going to be consequences to my choices. I had sex with my husband, which is not allowed. But those are things that, that there is consequences to my actions. So I dealt with those. And it was just like, you know, hard on that piece of my career time for the military. You know, this is not, it's not unwanted. But it was unplanned pregnancy. So I'm, like, overwhelmed, like with hormones. And then my child has this chronic illness diagnosed, my dad's in the ICU, like, it was just overwhelming.

Scott Benner 21:33
His father's passing. Yeah. Are you? Is it a great, I don't know what the word is, I'm looking for like, are you not allowed to get pregnant? Like cuz you're in the reserves? Like, what? What is that?

"Dani" 21:46
You are allowed to do those things, you would think based on some of the ways that people respond to those things that you are not allowed to do those things.

Scott Benner 21:53
And that you maybe did it on purpose to get out of your deployment?

"Dani" 21:56
Right. And I definitely did not. Like he was crying. What

Scott Benner 22:00
did you want me to do? Yeah,

"Dani" 22:03
I hear you. Yeah. Yeah, the way that that is handled in the military is just really sad. And I get it. Like, I'm not saying that people don't do that on purpose. But I didn't. And like, you know, I was disappointed in myself, like, from a career perspective. And it was frustrating. And it was embarrassing in a certain way. And did it hurt you?

Scott Benner 22:21
Like, career wise? Did it hurt you? Oh, absolutely. Absolutely. Just get put, like on a mental like, Oh, she's one of them lists? Yes,

"Dani" 22:30
some of the things that were said, like, behind my back that came to me at some point were entirely inappropriate. And there is, you know, I was eligible for upgraded my role responsibilities, and someone was giving me feedback. And basically, I repeated to them, and I'm like, so basically, what I'm hearing you say is that I'm being punished once again, for having children. This was pretty recently interesting. In the last six months. Yeah. So I was like, okay, like, that's fine. I will pick my children every time now. So yeah, interesting. It was experiences definitely just, you know, made me feel like, you don't always know the whole picture of what's going on with someone. So

Scott Benner 23:07
right. So that's the idea is that now people come into that er, and it's easy just to think like, Oh, you shouldn't just drop your kid here. So I do this thing, Danny. It's this idea that I took out a commencement speech. So this is convoluted. But this, this writer gave a commencement speech, it's gotta be 20 years old. At this point, it's called This is water, you can actually buy it as, like a little book now. Or you could you could listen to it on YouTube or whatever. One of the things I took from the man's speech was that I don't know why people are doing what they're doing. And there are reasonably speaking, speaking, people doing those things for poor reasons that they could have avoided. And there are people doing those things for reasons that were unavoidable. And so the example I normally use is if somebody's driving horribly and cuts you off in traffic, and it's all very dangerous. I can choose to believe that that person's an asshole. Or I can choose to believe they're about themselves. They're trying to get to a bathroom. Right? Yeah, absolutely. And I don't know, which is which. But it only hurts me to choose that they're an asshole. Like that. Absolutely. That's what it taught me is that that if I if I decide everybody's a dick, then that's an anger that lives in me. They don't know. I feel that way. And, and it's of no value for me to walk through the world believing that everybody's terrible. Because the truth is, is that some people are terrible, and some people aren't. And some people just need to get to the bathroom. And so like when I don't know the truth, why would I choose to believe everybody's terrible?

"Dani" 24:52
Anyway, I agree. You said it's called This is water. Yes. I'm gonna have to check that out. You can listen

Scott Benner 24:59
to it on So I mean, somehow back then there was a video camera there, you can actually listen to him give the speech, the little book when people graduate, I give them a copy of the book. It's not really a book, it's the, you know, it's the speech press down. Just because it's just such a clarifying thought for me that I don't know, your situation. And you might be an asshole like, I might be 1,000,000%. Right, right. You might just be driving badly. But

"Dani" 25:28
you might have Crohn's disease and be needing to go to the bathroom.

Scott Benner 25:32
All I'm getting that like somebody's just trying to get to the Starbucks and get through the lobby without looking too conspicuous. You don't I mean? Yeah. And what is it helped me? It only helps me to believe that they're just the person in a bad situation.

"Dani" 25:47
Absolutely. I think that like, that peace of clarity and like level of compassion, and empathy is something that takes time to learn. And I don't think that when you're, you know, a new grad nurse when you're 22, that you have the life experiences to like back that. Yeah, no, some people do, but I didn't.

Scott Benner 26:04
So let me say this, this all makes me sound very, ultra liberal and soft. I want to be completely clear, I do think some people are just getting horrible.

"Dani" 26:13
Oh, I don't disagree with that. There are some people that I'm like, Yeah, okay, well, you're kind of a piece of, again,

Scott Benner 26:20
it's, how is it for me to decide who's who. So instead, I just keep a balance in my head that I know that, you know, there's a spectrum of the way people act. And there are a spectrum of different implications that are happening in their lives that are changing their, you know, their behavior. I know, I'm a decent person. And I also know that you could easily find me and isolate two minutes of me and think back is terrible. And as a matter of fact, it happens to me sometimes. So like, because of what I do, if somebody is just to pick up the wrong episode of this podcast as the first one, I'll might come off very poorly to them. Well, I

"Dani" 27:02
mean, like, I still have this, you know, deep feeling of deep seated empathy and like wanting to grow and be a better human being at this point, but like, there are days that I have no real bitch. No, I'm not always the kindest human being in the world, either. Like as an I realized, like that I have flaws. And I'm not perfect either. So yeah, like,

Scott Benner 27:20
let me give you a great example from from right kind of around. Now. It's been a few weeks, but someone tried the podcast, and started off on an after dark episode about sex workers. And that episode, it's called after dark sex worker, and it's called sex worker, because that's what the person called themselves. Colloquially, she's a stripper. And if I was going to name the episode, I actually would have called it after dark, like stripper, but she called herself a sex worker. So I did her the respect of being in that in the title right. Now, I had this long conversation with her. I mean, I don't I can't remember if I'm being 100% honest with you. I couldn't like if you took me to court right now, what I could remember about it was she was a newer diagnosed type one. She was stripping her she said that her diet consisted of Jack Daniels and cocaine. Like when I tried to ask her about her like, she was talking about our blood sugar. At one point, I tried to ask her about her diet. And she's like, it's mostly Jack and Coke. And I realized what she was saying she told me a story in there about her father dying of an opioid overdose,

"Dani" 28:29
like recently, and

Scott Benner 28:33
I remember her making a joke about how great are puppets were? These are the things that stuck out in my head. I asked her Do you feel bad? Do you feel bad getting those guys in the back room, getting them worked up and taking their money off of them? And she said, No, because I've got great tits. And I was like, Oh, fair enough. And like, so good. We moved on. This is literally my remembrance of this conversation. And it went on for an hour. And I don't remember the rest of it. Yeah. A week or so ago, someone left a review to let everybody know how icky I am and how terribly I treated her and all that other stuff. Now, you know what that person doesn't know. That six months ago, that girl sent me an email, said she's clean now. And is giving me the credit for it. Bravo to her write fantastic for her. And she listened back to that episode and hurt herself for the first time and made some changes to her life. Now, the person who heard the review, read the review. What does she really know? I assume it was a woman. And so, I mean, I don't know. All right, that was sexist, but I assume there's the reviews from a woman. Now, here's the funny thing. Danny, someone's going to hear me say that and leave a review six months from now that says I'm a misogynist. That's what I mean about not being done. Not possibly, Danny, I've been doing this for a long time. I know exactly how this is gonna go. Yeah. But like that's what I mean about not knowing other people because do you know me as a misogynist? No, I

"Dani" 30:00
don't see you as that. But I yeah, I don't know you on a day to day basis ether. So

Scott Benner 30:05
Well, all I do is I kick dogs and punch women. What does that make? Yeah,

"Dani" 30:09
100% I definitely wouldn't have imagined that. But you know, if that's what you do in your spare time, that's your choice if you do differently, but see, obviously,

Scott Benner 30:19
you can you can tell a joke and be funny and sarcastic, and someone will come along and miss that they won't know that you were being sarcastic, the review will say he said he kicks women and dogs. And that woman laughed, right? Like my point is, is that we can't know each other, right? Like, like really know each other and what's in our hearts and what's happening. Now having said all that, let's talk about what it's like to work in an ER, and especially a pediatric er. And I want to know, all the things that have struck you that you've reevaluated since your daughters had type one diabetes.

"Dani" 30:56
That's a that's a lot of things to think about and say, but I think, you know, there are times in your life like becoming a parent, I started there. Right around the same time I got pregnant with her, I had worked at the same facility in like, several years prior for like, nine months or so. So I'd worked for that company before. But being a parent changes the way that you treat other children, because you have a level of empathy and compassion that you didn't have when you weren't a parent. And not to say that I wasn't a good nurse and wasn't compassionate and empathetic before that. But I think it gives you a perspective that you truly can't understand until you become a parent. And then more. So like, when you become a parent with a child with a chronic illness, you become empathetic in a way that only people with a child with a chronic illness can understand. I mean,

Scott Benner 31:53
you have something that you look back on and think, oh, I shouldn't have done that that way. Or we shouldn't be doing this like this. Because nursing is a younger person's game,

"Dani" 32:03
right? I mean, bedside nursing tends to be a younger person's game. Absolutely. Okay.

Scott Benner 32:07
So go ahead, please. Yeah,

"Dani" 32:10
there's absolutely been moments, I'm trying to think of something more specific. But there have been moments where I'm like, Man, I didn't say that the right way. Or I could have handled that situation differently. Or I should have said something else to the patient, because maybe they perceived what I said wrong. And I am the first to go in and say, Hey, I'm really sorry. I think maybe we misunderstood each other. It is hard. Like I don't I don't do it right every day either. Yeah.

Scott Benner 32:34
And that's not for lack of trying or concern or desire. Right? Right.

"Dani" 32:40
But there are people that I work with that maybe don't have the same tact or compassion or empathy, to be, like, just aware of those little isms that people are giving off and vibes that people are giving off. So,

Scott Benner 32:55
yeah. So you see it now, like another nurse will do something, and you'll think, Oh, I would have done that five years ago. And Oh, absolutely. Right. Now, do you say something like, is there a mentoring situation? Or is that not the vibe? Oh,

"Dani" 33:11
100%. I am like real big. Like, that is one of my great passions. And like feedback, it's hard to give feedback, it's hard to receive. But like, that's the only way that anyone is going to be better like, and there's a time and a place to do it. So I'm not going to do it in front of a family member, if you're making unless it's a glaring safety mistake, I'm not going to like, correct it in front of a family member, because I don't want them to lose trust in the person that's taking care of them, if I'm just in there helping you hold for a procedure or whatever. But I will pull you aside afterwards and say, hey, my feedback for you next time. Like would be to do it this way. Yesterday, I had a new grad, I was in charge yesterday. She had, she kept sending me messages. And there was one message that she sent me that was kind of urgent. And so I didn't see it right away because I was doing something else. And I was like, if you ever have something urgent, just give me a call next time. Like, I want to help you and I want to help you do it. Right. Just give me a call like, because I don't always see the messages in the chat

Scott Benner 34:13
that helped is that received? Well, normally, the

"Dani" 34:17
constructive criticism I have learned but it's it's not always it's not always received well, but I think that it's the presentation and like, you know, feedback is hard. Again, it's hard to receive at any point in time, but like recognizing like, Oh, you're really busy right now. This is definitely not the time to give it to you or hey, I have something that I want to talk to you about. Let me know good time for you. So that they're in the right headspace so that they receive it better.

Scott Benner 34:40
Have you seen nurses in a position of power? give good feedback the wrong way? Oh, absolutely. And then is that just a stone wall then like it's not received? Well at all. It's just for nothing. Absolutely, yeah. And why do you think that happens? Why do you think that people are like pity in that situation?

"Dani" 34:58
Some people have an ego that is larger than it should be an inflated ego like, we have, you know, like, there are some people that are really great nurses, or they're really, really intelligent and maybe they're not as socially aware, is that the right way to say that, like, you know, they can be incredibly book smart, but maybe they're not as good at communicating things with like family members. And then there's some people that are vice versa, that they're really, really good at having rapport with the families and communicating with patients. But maybe you're like, wow, like, you got to think through this, like prioritization right now, like socializing with the family and developing a rapport is not as important as getting this antibiotic to accept a kid right, Bob. So that

Scott Benner 35:38
seemed like a very specific example. But okay, just sitting around chatting while the kids just drifted off into hell. And they were like, holding the hold Mr. Engineer hand, like that kind of thing. Yeah, yeah.

"Dani" 35:48
There are definitely some times where I'm like, I love that you are so good at communicating with people in developing a report. Right now. That's not the time.

Scott Benner 35:58
It's not the thing. Yeah. How well, I mean, it's a pediatric, er, how prepared is that er, or others that you've worked in? For a DKA? A child in the UK, for example.

"Dani" 36:14
I think it depends on the nurse that you're going to get for the day, which is really sad. I think that there are people that are more well equipped to handle that type of patient. And there are people that are not as equipped to handle that type of patient, I think on a whole, my colleagues are going to provide care that is reasonable, but like, the detail oriented and like attention to detail, and the things that are required in the why they're required, is lacking in some of them. I definitely think that there are many people like I think on a whole, my colleagues aren't adequately equipped to do it. But maybe the details are a little muddy.

Scott Benner 36:54
I'd have to be honest with you, the use of the word adequately is not is not filling me with hope. Okay, great, as long as everyone's adequately prepared.

"Dani" 37:06
Yeah, I think I think people forget to look at the resources and like, they realize there are some people that I have seen, like, rely on their memory of what the, you know, policy or says, and it's like, I look it up every time. I'm like, I feel like I'm pretty good at this, like now, but like, I'm going to look it up every time because number one, it changes. Number two, I don't know everything. Like I don't want to miss something. Because this can be a really critical patient. Tell us why

Scott Benner 37:34
the why is important. Like how come not just following the rules is important. Or it's step by step, like, why is the why am I doing this? Why is that so important? I

"Dani" 37:46
think the why in what you are doing helps you understand the details. So you know, the way that our policy is written, like you're supposed to do a full neuro exam every hour on a patient, that is in DKA. And I think that I just know, like that. Some people don't do that every hour. And I think if you don't understand why you need to do that, like that this patient is at high risk for cerebral edema, then maybe, if you knew why, then you would do it. Because you're like, Oh, that makes sense as to why I'm need to do and

Scott Benner 38:18
we're looking at brain swelling, because if it tips the wrong way, it could go quickly. Right?

"Dani" 38:23
If you are dropping their blood sugar way too fast, or they're so acidotic, like they have a high risk for those changes, like osmotic pressure changes to occur. That would be bad for your patient and could potentially be fatal. I mean, feels strong, but like, you know, can cause them brain damage. So how

Scott Benner 38:45
many kids that go into DKA

"Dani" 38:49
end up with brain damage? I feel like I looked this up very recently. I don't think it's a really very high number. Like it's probably less than 5%. But there are certain, like populations that are at a higher risk for cerebral edema, you know, like if they're under a certain age if their blood gas so something that you check to see if they're in DKA if their blood gases more severe than that can really increase their risk for cerebral edema. Yeah, okay. But

Scott Benner 39:21
if it's 5% Then you're saying five out of every 100 kids could end up with like irreversible damage.

"Dani" 39:29
brain cells don't go back. So the degree to which your brain cells like also you're going to have you know, potential damage if you're like, hypoxic or something. But yeah, brain cells don't go back but like irreversible damage. Like To what degree like I don't think I think 5% is like probably generous, but don't quote me on that. Because I don't know. Yeah, I don't know off the top of my head. I

Scott Benner 39:53
think that's what I read. Have you seen it happen in your 12 years? Oh, yeah.

"Dani" 39:58
I had a kid probably like Six months ago that I was taking care of who was definitely altered and needed mannitol. So, and 3% because they were having cerebral edema, so Wow. Because they were so I mean, they already came to us in a really bad place. Sure. So it wasn't us. Like it was the situation. And we just, yeah,

Scott Benner 40:19
gotcha. No, I understand. I just Yeah, trying to give some context for people. So

"Dani" 40:24
Right. I don't I would say the majority like that. I think that that is the only one like, there's another one that I think I took care of a long time ago that needed that in the PICU. But I would say the majority are well, and I would, I don't have the statistics or data to support that. But like, we send a lot of patients home from the ER, that are new onset, and we don't even admit them to the floor. They go and they follow up outpatient, that are new, that new diagnosis, why

Scott Benner 40:50
would they not be admitted? Depending

"Dani" 40:52
on your level of like, if you're not truly in DKA, like if you come in, my child was not admitted, we went home and we followed up with our patient the next day, even though she was two years old, which that was more because I asked them to do that. And I was

Scott Benner 41:05
looking back, should you have done that? No, I

"Dani" 41:09
actually think it was fine. It really early. And so she wasn't truly a DKA. I mean, her blood sugar was 701. Like the blood sugar is going to you can be a DKA as you know, like and your blood sugar can be 120. Yeah. So yeah, I think we do send people home that are new diagnosis. I would say the large majority don't even go to pick up on a lot of kids just to med surg. So

Scott Benner 41:31
is there any other autoimmune in your family or any other type one?

"Dani" 41:34
There's no type one that we know of autoimmune. I think that that is like, I've never been formed. Personally, I've never been formally diagnosed celiac that I've been gluten free for like 15 years, my dad has been told that he's probably shouldn't have it. Like more formally, he does take like a liver enzyme called Kreon. It's like a pancreatic enzyme that helps him digest food a lot better. Now, she's, she just drew the short straw. Gotcha. Okay,

Scott Benner 42:04
what made you want to come on the podcast? Like, what what did you hear that you thought, like I can add to this?

"Dani" 42:10
I think like, the big thing that I'm like super passionate about is like, we can do better. Like there's always room for medical professionals to do better and be better. And, like, it is the small things that matter. And it's also the big things that matter. Like there are small ways that you can interact with people. And there are big ways that have bigger impact, just knowing that, like if you're a healthcare provider listening, like you can do something small, like for example, my facility, or whatever reason, I don't know why they have this. But before my child was diagnosed, like we were using adult lancets to do fingerprints, and like those turret like. And so like, and they don't use those in outpatient facility, like, literally, not very far from the building. And so like we advocated to get those parts numbers and stuff close in our floor. And so that's what we use now. Because you can get an adequate sample of blood test glucose with a smaller Lancet. So why would we not do that? And like cause less harm to the patient? It's a small thing.

Scott Benner 43:09
But it's easily I

"Dani" 43:11
think it has a big impact. Yeah,

Scott Benner 43:13
let's easily adjusted and it does have a big impact. Because if, I mean, if you're being tested that first time, you know, and it hurts that badly, it will flavor what your expectations are moving forward, probably your anxiety level and a number of other things. Yeah. Have you made other adjustments at work based on your new knowledge?

"Dani" 43:33
Oh, absolutely. And I will be the first person to say, before I had a child that was diagnosed with type one, I was scared to take a patient with DKA, I was probably adequately prepared to do a standard, I could follow what the policy said in black and white, but I didn't really understand the why behind everything in the level of capacity that I should, because like, you need to know enough about a lot of things. You can't know everything about everything. Like you can't, you just can't you don't have the bandwidth for that. And so it's not something that I was like, deeply passionate about. But I think that's because like I remember in nursing school, that diabetes was something that I had a hard time understanding. And I just did it, like, totally grasp it. And so it was something I avoided because it wasn't easy for me.

Scott Benner 44:15
Do you recall how so? Like, why? What about it was difficult to understand.

"Dani" 44:20
You know, when I was in nursing school, like you'd have to like know, the peaks and the troughs of like all of the different kinds of insulins. And like, I think it was just overwhelming to me. And I don't know why but for whatever reason, it was just not a type of pathophysiology that clicked well for me and my brain. And I tend to be a learner that if I don't get something right away, like I am a relatively intelligent human being, but if I don't get something right away, I get frustrated. And so I avoid it, which is not the best way to handle things. But like, I knew enough to get by and pass my test and do things in an adequate way. I wasn't good at it. And so I just avoided it because there was things that I was more passionate about, like But I was good at

Scott Benner 45:00
what do you think the difference between what the average person believes a nurse and understands and knows? And the reality of what they understand? And like, what do you think that gap looks like?

"Dani" 45:13
Hmm. I think that that's a hard question to answer because I think that there are varying degrees of prepared versus like, there are people that can skate by nursing school and not actually know the information. And there are people that like, really spend a lot of time and really study and maybe can't articulate it very well. But you know, that they know the information deeply. So I think that that's a hard question to answer entirely, because I think that it is varying on the level of what people know, and what their experience has taught them.

Scott Benner 45:38
Maybe the question should be, how should we be defining what a nurse is? And what they and what they know? Like? Do you really mean like, because I'm trying to put myself in the, in the perspective of an outsider looking in? And, you know, to me, I mean, I used to say this a lot on the podcast, but I think there are some things we don't question. You know, doctors, you just you go with what a doctor says, anybody connected to the medical field, you go with what they say, I know, people who are receptionists in doctors offices, and act like they're smarter than they are. Because I work in a doctor's office and people go away, do well, a doctor's office, you know, that kind of thing. We do that for teachers, a lot of times, sometimes we do that for police officers, we do it for people in positions of authority normally, right? You know, so like, I'm sick. First of all, I'm sick. I'm not coming to the hospital for fun. So I'm rundown, I'm not thinking straight. I'm scared, I'm worried about money, worried about my job, all the things, I'm worried about my kid, I got all those things going on. I get there, I get to the magic place where the wizards live and the people who helped the wizards. And then I get there to learn that you're not a wizard. You're 22 You just wanted a job? And you don't you avoided diabetes at school? Because it was confusing. Now? Yeah.

"Dani" 46:56
I mean, like, I'm the first person to save that. And now I live and breathe it every single day. So I couldn't avoid it anymore.

Scott Benner 47:03
Yeah. So like, what would it help? What would people need to know do you think would help them balance their expectations and get them a better outcome in a hospital setting? That's the question. Well, what what should my approach be?

"Dani" 47:17
I think just knowing like, you know, there is like standards of a curriculum that are required from an educational board review to like, allow you to take the NCLEX, the NCLEX is going to have like, there's a new NCLEX now. So I don't know exactly how many questions it might be the same sort of go me because I didn't have to take this one. But it used to be anywhere from 75 to like, 200 questions about a wide variety of things, it's going to be covering, like babies all the way to, like geriatric patients. And it's gonna cover everything from the brain to musculoskeletal situations, like it's, and pregnant people, like, you're gonna have so many random things on there. And if you're only gonna have 75 questions that you're tested on particular license, like I took my mind was, I do remember my passing 75 questions, but like, people can know, just like, you need to know just enough about a wide variety of things. And then it's up to the nurse like to understand like, later on, like, as you grow, and in your profession, like you are able to get certifications, but like that is self accountability of like, wanting to grow professionally, and like, be a certified nurse in whatever area that you're in and continue your education and development so that you can be the best that you can, but like, really, people have this general knowledge. And like people, even if you're in a specific area, you're gonna have passions that you're and things that you're good at, and things that you're bad at. And so maybe this is not their strong thing. And especially in the ER, people know, like, a lot of things have, like a lot of things, but they don't know, like, not everyone, but most of them know a general amount about a lot of

Scott Benner 48:58
different things, just not a lot of specificity. Right. But

"Dani" 49:01
if you go to the endocrinologist, like if I go to the clinic, they're going to know a lot about diabetes, where I would hope they do.

Scott Benner 49:07
Okay, so I was gonna say, Does this extend to the doctors in the ER, like, Are there are there doctors in that er that you look at and think if I fall over, please don't take me over there.

"Dani" 49:17
Yes. Yeah. Like, I know that they're like, my pediatricians that I work with even the like ones that are fellowship trained in emergency pediatric emergency medicine. I swear when we if there is someone that comes in that is pregnant because they just see the sign that, you know, says that there are children that come here, they lose their minds, like they don't like OB patients like that is not for them, but they're really good. A lot of them are really good at taking care of kids like but they're going to console like a cardiologist. If a kid comes in with a heart issue. They're going to console endocrinology when we have a dk a kid every time because they want the expert in that specific area to make sure that they're giving them the resources so that they can give this patient the best care that they can receive.

Scott Benner 50:06
Okay, but there are doctors you wouldn't want your kid to go to.

"Dani" 50:11
Yeah, there's ones that I would rather see. And not like I happy with who took care of my child when we were there. DKA. So does the doctor know that about themselves? I don't know, like, and I will say like one of the I had, I ended up with two providers taking care of my child like, one of them. I'm really glad that that was the provider that took care of my child. He is incredible and so thorough and so compassionate, but he is slow. And so like, when we are really busy, it's really frustrating. Like to be a nursing staff. He's going to take really great care of his patients into a really, really good job. But we are not going to be there's going to be a waiting room and it's going to keep growing, which, which decreases patient satisfaction. So then you're maybe not going to listen, like there's the flip coin of that.

Scott Benner 50:54
Yeah. How about just knowledge like, are they're, like, not just slow or fast?

"Dani" 51:00
Yeah.

Scott Benner 51:00
Do they know they're not good at it? Yeah, I don't know how I can force you to assess that. But do you think they know? Or do you think they're like they're pretending? And they're like, I don't know what I'm doing. But I gotta look like I know what I'm doing? Or do you think that they are just they think they're out there slaying it, and everyone else is looking and going, Oh, my God, like, we gotta like, don't send this one over there. Oh, killer. I'm trying to understand if people understand who they are or not.

"Dani" 51:27
Yeah, I think that it is varied. And I think that some people are introspective enough to say, this is not something that I love. And it's not something I'm passionate about. And so like, because I just know that I'm not as equipped to care for this patient as maybe. Dr. Smith next to me, who really loves this type of patient. Like I have a colleague who's like one of our providers whose child was diagnosed shortly after, and like, she loves taking those kids now because it means something to her like, she feels like she's making an impact. I think it's because of her child's like that. She feels more passionate about it now than she did before that happens. So

Scott Benner 52:11
you're very nice person you won't like put yourself in other people's like, minds and tell me what they think. Which is, which they call generalizing in case you want. Yeah,

"Dani" 52:21
yeah, I know, I'm really good at generalizing. I have opinions. But

Scott Benner 52:25
but you're being fair. You're younger than me, too, right? Like by a lot. But I also

"Dani" 52:31
like can be introspective enough to know that I, again, don't know everything about everyone. And like, my opinions are my own. And they may or may not be right. But they're the ones that I view the situation. And

Scott Benner 52:42
yeah, absolutely. But I was saying about the age thing, because like, I just didn't come from a gym, I don't really care. What could be nice to people if I don't want it. So yeah, when I'm being nice. I'm doing it on purpose. And when we're having conversations like this, I don't see the value in being nice. Like we're trying to get to the bottom of something. Do you know what I mean? Like so

"Dani" 53:06
I mean, yeah, I see what you're saying, for sure.

Scott Benner 53:09
But a couple generations behind me, you guys are just nicer.

"Dani" 53:13
Yeah, I, I will say like, there is a level of holding back. Because it's professionalism. And like, I know how to, like I tried to present myself well, but like, I will tell you like when I say that there, my co workers are adequately prepared. I know that they can step up and do the job if we really need them to. But I have a lot of co workers that are incredibly lazy. And I might not tell them to their face that they're incredibly lazy, like, out of being nice, but they're just lazy. And so they'll just delay things, which affects patient outcomes, because they're being lazy.

Scott Benner 53:44
So sometimes when I'm in that, in that ER room, and and things are taken too long on two hours, and I'm like, there's no reason for this to take that long. I'm right there just out there sitting there staring what looking at their email, is that right?

"Dani" 53:58
Sometimes, I will say that that's not always true. Because like you have to wait for the data provider to put the orders in. And if the provider then gets like sidetracked and does something else like, like I literally cannot like the way that things generate, like I can't pull medication out of the Pyxis if it's not available because you didn't put the order in ultrasound, maybe they have two other patients that need to be seen. So like it's not, not always but like there are definitely some times where I'm like, there are some of my colleagues. So I'm not speaking about myself, but there are some of my colleagues from like, What the hell are you doing? Like this patient, like, yesterday, I grabbed somebody else, like I had a colleague that was encumbered with something far more critical and there was a DKA patient there, but we had a patient that was trying to die like this patient was the other patient was not actually in DKA but it was like soft and slipping. Yeah, like me needs insulin but like, you know, it can wait but like let's get it going because like there's two other people that are available. To get this signed off and get it started while there, the nurse that was assigned to that patient was legitimately encumbered. So there was a delay in care, because they were, you know, saving someone's that was dying. So yeah,

Scott Benner 55:13
but but do some people just slip through the cracks? Like are there like, are their doctors and nurses that are just like, you know, crackheads, and you just like, do you look at them and think like, I How did you even like pass the test? How did you get here?

"Dani" 55:25
100%? Like, are there lights in your head? Like, wake up? Okay.

Scott Benner 55:34
Yeah, absolutely. All right, and do and we have some people who are very knowledgeable, who are have bad bedside, but you're gonna get good care. There's people vice versa. There's like, there's all different kinds of people. Does it balance itself out? Or does it lean to the wrong side?

"Dani" 55:50
I hope that it balances itself out. I hope that it does. I generally genuinely think people that work in pediatrics have like a different perspective than people that work with adults. And maybe that's like a little bit harsh. But I think you have to have some level of patients that you don't have to have with adults. And like, I think your level of patients with adults is like my level of expectations when I'm taking care of adults is that you're going to curse me out and you're going to like, be mean and rude and disrespectful. Even though I'm literally here trying to help you. And like, kids are just better, like kids are so much easier, even if they have parents in there like kids, if they're upset and crying like they have a legitimate reason to be doing. So the majority of the time. I think that that lends itself to like being able to be a little bit more empathetic and compassionate as a provider like and someone caring for that kind of patient. I see. I see. I have been cursed out one time since I've in the five years that I've worked there and I got cursed out almost every single time that I worked before with adults so with adults every day somebody let you have it in one way or another and yeah, absolutely mean or just Kersey both like sometimes mean sometimes shore sometimes, like legitimately wanting to get something like that I just don't have the resources or bandwidth to support

Scott Benner 57:06
right can they get personal? They like like your looks or something like that come into play or anything that ever Oh, totally okay. Oh my god. So sorry. So basically can go got you imagine you're working as hard as you can. And on top of somebody all that somebody's like talking about your thighs or something at the same time. And you're

"Dani" 57:34
like, Yeah, I like we'll never forget this one patient whose name I cannot use quite like when I was a new grad like working on this cardiac step down for her. She was just mean to everyone like so mean. Like, I was definitely the youngest person on my floor. And she would just like let me have it for being so young. Like you snarky little brat like you think that you know everything at 20 years old, like get out here. I like she would come out with her walker and just like, oh, he ended up yelling at me. Oh.

Scott Benner 58:05
And that's part of the job, right? Yeah. Okay,

"Dani" 58:08
got it. I understand. I mean, she was mad because you're not pushing her morphine fast. So that, you know, no, okay, you mad at me? That that's just it is what it is right now. Ma'am.

Scott Benner 58:18
I had somebody else. Tell me something recently from a pediatric er perspective that threw me off so much. I'm going to ask you the same question. You see kids come in OD on things that their families leave around the house. That every day, that's a thing that happens constantly, right?

"Dani" 58:35
Every day, every single day. You know, I guess there's, I don't have to talk so I can't speak to this, but there's a tick tock challenge. Don't take too much Benadryl that can kill you. Also, it makes you hallucinate and be crazy. Like I feel like Benadryl right now is like the thing. Thailand, like I'm not exaggerating yesterday, like we had three overdoses yesterday. Intentional, and like abusing drugs like you know, we'll get kids that come in that smokes or do marijuana within whatever way that they do it. Usually smoking but I know people take edibles and whatever.

Scott Benner 59:10
I'm just thrilled that you said do marijuana. Go ahead to

"Dani" 59:13
marijuana however, whatever way you do it, I don't know. I'm not. I'm gonna guess I learned a lot from these teenage kids like things that they told me I'm like, I am learning a lot about drugs right now. No,

Scott Benner 59:25
I'm gonna guess you don't do marijuana by the way. You said that. I like being reservist. I have never done it in my life. Yes, No, I've never done it so so it's a funny way of saying it.

"Dani" 59:35
Yeah. Like

Scott Benner 59:36
so edibles late like little kids get a hold of edibles laying around the house. Yeah, we'll get like two or three year olds in there that like you know, have some brownies and their highs. They're just little kids are high as a kite. Right?

"Dani" 59:47
Well, they're just like, pass out like for hours like Yeah, yeah.

Scott Benner 59:53
What happens there? Do you report the family there to social services or how do you handle that? Yeah, it

"Dani" 59:58
actually depends on like, Yes you do make a report Social Work handles that but like what degree DHS follows up is really variable. You know, if somebody is positive for marijuana and they're breastfeeding their child there's actually like higher levels. THC in breast milk because it binds to the fat like that is how Oh, THC is like done so like the there are higher levels in breast milk. A better

Scott Benner 1:00:21
way to do edibles. Yeah, in breast milk.

"Dani" 1:00:25
There you go how some smokes marijuana still. Eats edibles.

Scott Benner 1:00:31
You're fantastic. Okay, so, you know, I mean, listen, when Cole was like, a year and a half, two years old, it was Halloween. And we were carving pumpkins, and I left that knife on the floor, and he kicked it. So we got to cut in between this the webbing of his toes. We take him to the ER, it's terrible. Yeah, social services was called on us for that. Yeah. And I was like, Oh, okay. Like, it was a scary moment. I remember, like, wait a minute, like, you're gonna take my kid because I was carving a pumpkin with him. Like, that's weird, huh, I think it's a great thing.

"Dani" 1:01:02
I mean, we screen every child that is under the or two and under for child abuse. So there's like a 14 spaces is what it's called. And it, you know, helps us identify potentially kids that are slipping through the cracks. And, you know, that's a really good advocacy piece of things.

Scott Benner 1:01:17
But do you pick kids up weekly, daily?

"Dani" 1:01:20
I don't know what the data is supporting from that. So I couldn't speak to that, like on a

Scott Benner 1:01:24
but you've had it happen to me you've screened so I thought this kid's being abused. Actually, my child, this is really embarrassing, like,

"Dani" 1:01:31
right when we rolled this out, one of my co workers, the short version of the story is my child had a bruise on her face. She was just starting to like walk at that point in time. And so like, you know, like when they're just walking and getting bruises on their face, but it flagged as positive for that particular screening because she had gone in for croup. Yeah. And I screened positive for my own child,

Scott Benner 1:01:51
right when we went live with that. So and even though you work there, they report it.

"Dani" 1:01:55
It's literally on her chart. I can see it on there still, to bear. We have kids that come in there. And like if it's explained, and like I'm not hiding it, like this is what happened and right. You know, she's just walking and starting to like, she hit her head on a table like, yeah, like, I was supervising her. But she is a klutz right now because she's

Scott Benner 1:02:14
just paddling. That's where the word comes from. But yeah. And

"Dani" 1:02:18
so like, it's an explainable like situation. That just happened to like, she hit her face just on the wrong spot that just kind of flag that screening. Yeah.

Scott Benner 1:02:26
And so now the good thing is, it's written down in case it happens again and again and again, then we can correct Yeah, see, see the pattern? I got patterns? Yeah. Okay. All right. Oh, God, do you wish you weren't a nurse? To wish you would have picked something else? No, I

"Dani" 1:02:40
think that I like what I do. Now, I've gotten to do a lot of different kinds of nursing. And I've done some other nursing that I've really enjoyed. And I really can't imagine doing anything else. And I am really, really grateful for the opportunities that it's afforded me and people that I've met and things I know, like, it makes me a better human, to have to learn how to communicate more effectively. Like, I don't think I would be good at business because I think it's taught me how to be empathetic in a way that you can't be empathetic otherwise, yeah, I'm glad I'm a nurse,

Scott Benner 1:03:14
I'll tell you a secret. It's not really a secret. I'm telling you. My wife just started a new job, okay. And for her entire career, my wife's an old person, she's 50. And so for her entire, she's not that old. Oh, my God, I don't know, she looks don't tell her that. She's actually younger than I am starting a new job. And for her entire career, she's put a premium on being kind to the people that work for her. And to help them progress and to learn and to grow and to move up. And over and over and over again. Throughout her career. It has been held against her. And and, you know, by people above her when they're looking at my wife for her advancement, it will be listed as a detriment not a positive that Kelly cares about the people who work for. Like, I've seen it numbers of times. Right? Right. But she just started a new job yesterday. And it's a great position. It's one of those like, career cumulative things like this is exactly what she wanted to be doing. On her first day, the person that hired her said, we knew immediately you were the right person for the job. And keeping in mind 75 people

"Dani" 1:04:30
applied for this job. Wow. Bravo, Kelly. Oh,

Scott Benner 1:04:33
very cool. I'm super excited for but one of the things the women's The woman said was, we're very focused on our employees being treated well. And it was clear that you knew the technical aspect of this job and had that lifelong experience. And on top of that, were willing to put in the extra effort to be a good people manager. And so my wife finally got paid back for what she's been doing for, like three decades now as a professional person, but for the first three decades, it it hurt her pretty consistently. Yeah,

"Dani" 1:05:09
I think I can relate to that, like in the military, I'm, I've always been kind of a sensitive soul and has not always served me well in the military because I have moments where I cry more than most. And like, as an ER nurse, that's not something those people tend to be a little bit more harsh, I guess is the right word, like just direct maybe is a better way to describe it. And so, I mean, it's, it's, those two things have really encouraged me to be more direct, but I don't think that I still lacked the empathy, which is valuable. And I think like you again, you have good managers and bad managers. And I think the way that you say things matters to people, it does impact them. So

Scott Benner 1:05:49
I'm gonna finish with this. First of all, ask you, is there anything we didn't talk about that you wanted to? And then I'm gonna ask you one last question.

"Dani" 1:05:55
I don't think so. I mean, I'm sorry, we didn't talk a ton about diabetes. And it was more about

Scott Benner 1:05:59
No, you're misunderstanding this is all. If this goes the Well, the way I expect, people are learning how to navigate the medical system by listening to this conversation, which will help them immensely with their diabetes, like, listen, like just because today, we talked about Danny and her working in the ER, this is no different whether you're in an ER going in a doctor's office, or you know, in an urgent care or anything like that, to remember that you're just dealing with people, right? That's it. They're not magic people. They're not wizards. They're just people were like, you know, I think I'm gonna be a nurse, or I'm gonna try to be a doctor, just the same way. You said, like, I think I want to be an actuary. Yeah. You're not perfect. You're not a perfect act. Although actuaries are a bad example. Those people might be perfect. That's a mental illness in and of itself, but good for them. But very, very, very specific. But you know what I mean, like most of us go into things because like, yeah, this seems interesting. But 15 years later, you might be like, I don't even like this, or I'm not very good at this. But I'm stuck, I got a mortgage. So I go in every day, it's not to say that people are bad at their job, or that you're going to get bad health care, because you're going to get plenty of great health care. But you don't know who's who. So you can't just absolutely, you can't just run in and go, I'm here to take care of me. And if it's all going backwards, go well, I must be dying, because everyone here is on the exact same level and has the exact same amount of enthusiasm for this because that's not the case. And I just think people need to be reminded that sometimes it's nothing. Like, if I could say one thing to people like as patients coming in, like, you know, an advocate cating for your child, like Sorry, I'm not gonna speak to the adults, because I have worked with kids right now advocating for your child like, one, you don't see the whole big picture of what's going on in the emergency room. And like, yes, that can be incredibly frustrating. And maybe you do have a lazy nurse. And for you, I'm

"Dani" 1:07:57
very sorry that you got stuck with that assignment, like you got stuck with baby nurse. But I think taking a deep breath and saying, even if you say it to the nurse, like I don't care when people say this to me anymore, I think I probably cared when I was 22. Hey, I know that you're here and you're taking care of my kid. I just want that what's best for them. And I'm not trying to be like, giving you a hard time. But like, how can I make this better? Or what can I do to like contribute to this situation? Or like, How can I help us bridge the gap of like what I need. So like, I really want this to happen right now. And like, if you just I think sometimes people get rightfully so deeply concerned about their child, and I want them to be deeply concerned about their child, because that's who they're therefore, right. And I have other patients I'm managing, but like your child is the most important. Just remind me of that. And it helps me take his time out to be like, oh, yeah, like, absolutely matters right now. I think it helps people slow down to like, Yeah, I'm here and I care about my child, and I just want what's best for them. I'm not trying to take it out on you like, sorry, if I'm getting a little snarky, or snippy, but I want what's best for my child,

Scott Benner 1:09:06
remind the doctor or the nurse of the humanity, the whole thing? Yeah,

"Dani" 1:09:09
like you're doing the best that you can. I don't know the whole picture. But I care about my child the most right now. And you should know. That's great.

Scott Benner 1:09:18
That's great advice. In your note to me, you said that the lessons you've learned from the podcast, not from your 10 years of nursing have been valuable helping your daughter. Yeah. And so this is question asked partly. So that, you know, you can say something nice about me. But also because I want to understand what it is that a 10 plus year nurse didn't know about type one diabetes. I

"Dani" 1:09:48
mean, I said it previously I was scared. And it was just because of a lack of knowledge and lack of desire to learn from a personal standpoint, because it was something that I didn't understand. And so It has not only helped me like with the tools have like, the things they don't teach you necessarily right off the bat of like Pre-Bolus thing and thinking about fat and protein. And, you know, like, your range doesn't play like they were telling me to treat a low at 90 at the beginning, I'm like, treating low at 90, you are insane. Just got an IV. Like, you know, knowing that I can change my target range, and it doesn't have to be the same and like that my child, like I cared the most about my child when I go to endocrinology appointment, and they're doing what's best for the masses. And not everyone has the same knowledge and literacy and medical understanding and background that I do and like knows how to advocate and do those things in the same capacity. So like they are teaching at a level that is generalized because they have to because that is the way that they can reach the majority of people. When

Scott Benner 1:10:52
I say that on the podcast, I wonder, I hope it comes across the way I mean it like it's not an indictment. Like it's just it's, it's what it is, you're gonna get,

"Dani" 1:11:02
I don't think they're doing it in a malicious way either like they're doing it because I mean, I see people on a day in and day out basis, like the people that listen to this podcast, like, good on you for wanting what is best for your child. But I'm going to tell you, like some people just don't have like the bandwidth space knowledge bank, like resource level, like the gear to know that there are that there's more out there to get better.

Scott Benner 1:11:28
Yet to even imagine that there's more than what's being said. Yeah, yeah. And I take that for granted. Because that's a that's a basic personality trait of mine.

"Dani" 1:11:37
I'm with you. I want to be better, I want to do the best that I can. I assume

Scott Benner 1:11:41
that I am always doing something wrong. Right. And I don't mean that in a way of like judging myself. I mean, that I assume that there's more information that I don't have. And I mean about everything. When I'm buying something, when I'm taking care of a pet when I'm you know, trying to consider my children's health when I'm trying to consider my own health. Like I never think oh, we got it. I always think Alright, well, there's more. But there's, I bet you there's more past that. And what is that? And how do I find out what that is? Yeah, that's a like a mainstay of how my brain works. Yeah. Can I ask a disconnected question to see? Yeah, absolutely. earlier in the episode, you said the company I work for. And I think people would don't think of hospitals as companies. But very much so right. I'm

"Dani" 1:12:34
not going to speak to like my specific role. But at the end of the day, a hospital is a business, and they are there to make money. And there are bottom lines, I know that I still have a lot to learn about that piece of it. Because it's not something that I like, I've been a bedside nurse for the majority of my time. But it's a business at the end of the day, and they're there to make money. And there's a bottom line. So yeah, it's a company in an organization. And they might be not for profit. They're there for a profit, they have to pay people and they have to pay an overhead fee, and they have to keep the lights on.

Scott Benner 1:13:06
So they also want to be careful moving forward about some of these organizations that have so much capital that they're they're basically a hedge fund operating as a something else. Don't I mean, I see colleges like that now, where their goal seems to be more about investing the money that they have, then teaching kids. And that can happen in any industry, once capital gets so big, they can start seeing themselves literally as an investment firm that happens to also own hospitals. Right? Anyway, so the reason I be wrong,

"Dani" 1:13:41
I think my organization really does care about children and wants what's best for them and the outcomes that are best from them. But at the end of the day, there's a bottom line. Also,

Scott Benner 1:13:48
also, yeah, I'm not flattening out the organization talking about it. Like it's a general, the people on the ground are normally always very, I think about that even like when people complain about like pharma companies and stuff like that. They're like them them, like, you know, most of the people that work there are people and they're trying really hard to do a good job, you know,

"Dani" 1:14:06
right. Majority of the employees there are that

Scott Benner 1:14:09
right, and there's somebody at the top is counting the beans and being like, yeah, would that make the toilet paper thinner? Like, you know, like that that kind of thing is happening? Right. But do you think like, based on that idea that they are money making ventures? Have you seen enough of AI based stuff to think that it's going to make its way into hospitals because right now, I'm involved with a company called Vision AI, it's a startup, but I'm seeing what they're putting together. And it's almost cursed for no reason. But it's being fascinating, like mine, a person I know, was having a problem the other day, right? And this problem, would they call me they described it to me. And I said, I think you need to go to the ER, but first and I opened up this vision AI poor All that I have, because I'm able to be using it now before it's widespread with everybody. And I put in not even like a coherent sentence, I said to the person, send me all your symptoms. And she sent them to me not like not even coherently like there weren't even like periods or commas. And I copied it, pasted it in the the AI, the AI came back with five possibilities of what could be going on. They were all rock solid. And the top three guesses. I was like, it's going to be one of these things, it's either going to be a drug interaction, or it's going to be a mass. And like seriously like that, clearly. And I said, Go head off to the hospital off the hospital did a brain scan came back it a little more testing said, Hey, you're having a drug interaction? And that was it. I was like, Oh, my God, the machine knew. Like, like, at what point? Do we stop worrying about how long the doctor takes to get back with its orders? like at what point are we going to start asking machines and then having doctors be overseers of the information that comes back?

"Dani" 1:16:05
I think that you're spot on. I think that technology is always advancing, and we would be amiss not to use that type of technology, and integrate it and it's only going to propel things forward. And I'm really, like, hopefully positive, like you got to have guardrails on it to make it safe. Of course, yeah, we would be remiss not to like I know that efficiency has increased as a result of technology. But even in the diabetes realm, I was talking to one of my other providers the other day, like, the way that ai ai has extracted information, and helped us create data from that that's meaningful is only going to allow us to like not have to spend the time as human beings doing that. And now it's generated. And so then that will propel us forward to the next step of whatever AI can contribute. So yeah, I

Scott Benner 1:16:52
have this idea of theory that people are going to become technicians in healthcare, and no longer the repository of information because that's really a doctor as a person who's taken years and years and years to learn a lot of things and interactions. And this plus this plus this could mean this, this and this. And here's how we'll figure out if it which one of those it is right. That's all it is. It's it's a process of elimination. Yeah, I'm pretty right about that. Right?

"Dani" 1:17:21
I will tell you that I see my providers, even the ones that I think are brilliant minds, looking things up on up to date.

Scott Benner 1:17:30
Right, it's Yeah, being a doctor is process of elimination. It's it's starting off with some knowledge honing in and then eliminating till you get the answer differential diagnosis till you get the answer. And so we're counting on reasonably intelligent people. Which by the way, I've seen a study recently, it says that the most intelligent people are not the people who become doctors. They're still very intelligent, but they're not at the top of the anyway, that's not important thing. Yeah. So. So we're asking, intelligent, well educated people to make these decisions and whittle us down. And you can see that it works great. In some situations, you break your arm you go in. Now, there's a flowchart where, yes, the arms broken, this is the kind of break here's how we're going to fix it, boom, six months later, your arm feels better. Hey, tada, that works great, right? We're really good at stuff like that, hey, my hands are always cold. My hair's falling out. We're not as good at stuff like that. Like, you know, and, and you might have to go to a doctor for years and years and years. 15 minutes here, 20 minutes there before suddenly, there's this epiphany between you and the doctor and the notes and everything where somebody goes, Oh, my God, you've got whatever. Right, right. And now I think it's going to be possible for your literally like a portal, a web portal, you're going to be able to go to the hospital and say, hey, my AI doc says, This is what's wrong with me. And then go through that process and their AI Doc's gonna look at it and go, yeah, it agrees, then you're gonna have a technician who we used to call a doctor, go over it and go, I concur and move forward, and you're gonna get through that process. So much more quickly. Interesting to an answer. That's how I feel like it's gonna go. Interesting.

"Dani" 1:19:11
I think that you still have to have the human aspects because you still sometimes need, you know, like, you talk about like thyroid or like, you know, a glucose level, like, you're still going to need the human being to say, it could be that we need to do XYZ to figure out that you have diabetes or your arm is broken,

Scott Benner 1:19:29
or Yeah, no, I agree. I mean, I think I genuinely believe that. Obviously, a person is going to be necessary. I mean, for the foreseeable future that I can understand. Right? But absolutely, but I know generation two, I don't think I'll be alive to see it without it. Right. Right. But I I don't know that. We're going to need them to do all the work.

"Dani" 1:19:48
I agree. And I think we would be a mess. I mean, you think about it from like a telehealth perspective to like people can call a doctor on the phone. Yeah. Like, you know, videotaping. I will also say I've done In telephone triage at one point in my career, it's really hard to do some of that stuff. But there are a lot of things that you can rule out very easy over the phone.

Scott Benner 1:20:06
Oh, my God. Yeah, I mean, telehealth taught us a lot telehealth. Oh, we don't really need to see you that much. I guess. I'm trying something right now to show you. And if it works out, I'll read it to you. And if not, I'm going to call this the end. But I just typed something into this vision AI portal that I have. That's actually connected to Ardens, glucose information, her lost her live glucose information. So you can ask this thing. Anything from what's my blood sugar to, you know, I'm about to eat, like, bah bah, but I just asked it a pretty obtuse question. And it's thinking, and I'm wondering what's going to happen. So hold on a second, let's figure out here. But I've already asked it things like, you know, I'm going to eat 15 grams of carbs. Or I'm gonna eat 30 grams of carbs. I think 15 of them are going to be pretty fatty. How would you proceed? And it gives, like, pretty rock solid advice. Interesting. Yeah. And at the moment, the company is I probably shouldn't say this out loud. But I've entered into an agreement with them and they're, they're taking the information from the podcast and adding it to the what the algorithm what the AI understands. It's pretty cool. Okay, so hold on. Thank you for adding valuable information. Oh, yeah. What do you say? Okay, so I haven't pre read this art and just had a spike. Now. She clearly didn't Pre-Bolus Emile, but she didn't miss by much because it shot up and came right back down again. Okay, how could I have avoided the most recent glucose spike to address most recent glucose spikes you experienced which peaked at 252 at 11:49am. Today, we can analyze the surrounding circumstances and data to provide some actionable steps. Analysis of the glucose spike one timing and previous meals the spike occurred late in the morning which might suggest it was related to your breakfast or late morning snack. reviewing what and when you ate during this time could provide insights high carbohydrate meals or snacks without adequate Pre-Bolus and can lead to spikes to insulin Bolus and timing at 11:44am and 11:40am. You administered point nine units of insulin each time that's the algorithm by the way her algorithm was Bolus. It knows all this because it has access to her Nightscout. Before that, at 11:30am, there was another point nine units that were given considering the timing of these boluses in relation to when you ate can be crucial. If the Bolus was given too late relative to when you started eating, the insulin action might have been delayed relative to the peak glucose rise from your meal, carbohydrate counting and insulin to carb ratio ensuring that the carb content of your meals is accurately counted, and that your insulin to carb ratio is accurately adjusted or correctly adjusted for the time of day will help in ministry the right amount and in some observations. The Bolus has given were relatively close in time, which might indicate either a response to food intake or an attempt to correct an already rising glucose level the amount of insulin administered suggests either a smaller meal or a corrective dose. If it was meant to cover a meal it might have been underestimated. Then it gives actionable steps talks about Pre-Bolus thing you could aim to administer insulin 15 to 20 minutes before eating bla bla bla, review your heartbreak count, continuous glucose monitoring adjustments, use your CGM trends to make real time decisions, dietary adjustments, consult a diabetes care specialist by and it gives by the way, every bullet point I just went gives a description about that underneath.

"Dani" 1:23:23
Interesting. Yeah, I will say like one thing I've noticed about AI, is I feel like it's wordy. And I know you can change like the grade level. But I've noticed I've noticed that it's relatively wordy. And I think for a vast majority of people, they kind of need more of like a one liner, two liner gut punch of like, Yep, I think that much information can sometimes be hard to consume and digest for the majority of people. Yeah, that's my only comment on AI in its ability

Scott Benner 1:23:59
to No, no, no, no, I agree with you. Like it's going to have to get more and more colloquial and, and concise. Yeah. Right. And be

"Dani" 1:24:08
like with our generation of like that. And I'm saying my generation, like I'm 34 like, I'm not, like really old or anything. But I know people want it fast and want it now. So they want to have it their way.

Scott Benner 1:24:21
I think it's coming because I mean, this is trained the way this company, you know, decided to and by the way, this isn't just for diabetes, this is for everything. Like I said I might, a person I knew was having a cognitive issue. And it boom, it was like it's either this or it's this and it was just it was just right. It was it was really incredible. It's fascinating, and these things didn't say anything. I wouldn't have said if you didn't if you would have asked me this question personally. Yeah, yeah. So and then on top of that, it's going to be trained on all of the management episodes of the podcast.

"Dani" 1:24:56
Yeah, yeah. So I'm really excited to see how technology Can you leveraged to make things better in the future? So

Scott Benner 1:25:04
I'm telling you, I'm super excited by the whole thing, so, okay, I'm gonna let you go. I've had you longer than I said I would. Danny, thank you so much for doing this with me.

"Dani" 1:25:12
Thanks so much, Scott. Yep.

Scott Benner 1:25:17
A huge thank you to one of the sponsors. G vote glucagon. Find out more about Chivo Capo pen at G Vogue glucagon.com forward slash juicebox. you spell that GVOKEGLUC AG o n.com. Ford slash juicebox. Arden started using a contour meter because of its accuracy, but she continues to use it because it's adorable and trustworthy. If you have diabetes, you want the contour next gen blood glucose meter. There's already so many decisions. Let me take this one off your plate. Contour next one.com/juicebox. A huge thank you to ever since CGM for sponsoring this episode of the podcast. Are you tired of having to change your sensor every seven to 14 days. With the ever since CGM you just replace it once every six months via a simple in office visit. Learn more and get started today at ever since cgm.com/juice box. If you're looking for community around type one diabetes, check out the Juicebox Podcast private Facebook group Juicebox Podcast type one diabetes, but everybody is welcome type one type two gestational loved ones. It doesn't matter to me. If you're impacted by diabetes, and you're looking for support, comfort or community check out Juicebox Podcast type one diabetes on Facebook. If you're not already subscribed or following in your favorite audio app, please take the time now to do that. It really helps the show and get those automatic downloads set up so you never miss an episode. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast. The episode you just heard was professionally edited by wrong way recording. Wrong way recording.com


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#1196 Ambivalence and Motivation

Scott Benner

Erika and Scott talk about Ambivalence and Motivation.

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DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.

Scott Benner 0:00
Hello friends and welcome to episode 1196 of the Juicebox Podcast.

Helped me welcome back Erica Forsythe today Erica and I are going to discuss ambivalence and motivation. If you're interested in learning more about Erica you can find her at Erica forsythe.com. US residents who are type ones themselves or the caregivers of type ones have an unique opportunity to help move type one diabetes research forward without leaving their home. Take the survey and completed AT T one D exchange.org/juicebox. This 10 minute survey will do just that it will help move type one diabetes research forward. All you have to do is answer simple questions you will know the answers to these questions. And just like that you've helped T one D exchange.org/juice box. Don't forget to save 40% off of your entire order at cozy earth.com. All you have to do is use the offer code juice box at checkout that's juice box at checkout to save 40% at cosy earth.com When you place your first order for ag one with my link, you'll get five free travel packs and a free year supply of vitamin D. Drink ag one.com/juice box

registration is now open for the big live in person touch by type one event I will be speaking there in Orlando touched by type one.org. Go to the Programs tab and get your free tickets right now touched by type one.org. I'll see you in Orlando. This episode of The Juicebox Podcast is sponsored by Dexcom dexcom.com/juice box get the brand new Dexcom G seven with my link and get started today. Today's episode is sponsored by Medtronic diabetes, a company that's bringing people together to redefine what it means to live with diabetes. Later in this episode, I'll be speaking with Jalen, he was diagnosed with type one diabetes at 14. He's 29. Now he's going to tell you a little bit about his story. And then later at the end of this episode, you can hear my entire conversation with Jalen to hear more stories with Medtronic champions. Go to Medtronic diabetes.com/juice box or search the hashtag Medtronic champion on your favorite social media platform. Eric, Hey, welcome back.

Erika Forsyth, MFT, LMFT 2:35
Thank you, it's good to be back.

Scott Benner 2:38
We're gonna do something that we kind of talked about in your last episode towards the end. Today we're going to talk about ambivalence. Yes. And you have some like clear thoughts about how to walk through it, I'm going to let you take the lead on this.

Erika Forsyth, MFT, LMFT 2:51
Okay, sounds good. So I was thinking it would be helpful for us just to spend a minute or two in the beginning to define what is ambivalence? Because we might hear the word we might know the word and have some basic understanding. And sometimes I know even I will think ambivalence means that you just don't care. Or you don't know how, but it really means that you have contradictory or mixed feelings about it. I even looked at Webster definition. It's simultaneous and contradictory attitudes or feelings, such as attraction and repulsion toward an object person or action. And the second definition, uncertainty as to which approach to follow. So you might have ambivalence about goals. You might have ambivalence towards a person towards marriage or in through our lens today, you know, ambivalence towards your your diabetes management. But certainly we can apply some of these themes and tools towards anything you might feel ambivalent towards. Well, it's

Scott Benner 3:55
interesting, because I actually think I think of the word as meaning I don't care one way or the other. Yes. Which, yeah, which is not really what you're what I'm saying here at all. Oh, that's interesting. The boards get co opted sometimes. You know, that's interesting. So simultaneously, and contradictory attitudes or feelings, simultaneous and contradictory attitudes are feeling so I feel one way and another way about the same thing. I'm ambivalent. Oh, wow. Yeah, I do misunderstand that word. Did you think that week did you like, like, I know, you understood what ambivalent meant. But do you think other people might be confused as well? Well, I

Erika Forsyth, MFT, LMFT 4:34
even as I was thinking and preparing for our this episode today, I didn't add in the definition until about 10 minutes before we started talking because I thought, You know what, I really want to understand the exact definition because I often think about like you're torn, which leads to either you're stagnant or you're blocked, and you don't really care enough to make a move, but it really is. because of these two contradictory feelings or thoughts that are happening exactly at the same time, so you're feeling torn, and

Scott Benner 5:09
then stock sort of sticks you in the middle, and you don't move one way or the other. Okay? All right, diabetes management ambivalence. What is this here that you're, that

Erika Forsyth, MFT, LMFT 5:17
you're so I hear this, I have certainly felt this way in my diabetes life time, and I hear it frequently. I know, I should fill in the blank Pre-Bolus, inject, take my blood sugar, watch my data, look at my data more frequently. But I just can't or I don't want to and I don't know why often is the kind of that the end piece. So there, people might present with this. Exactly, simultaneous and contradictory attitudes or feelings of like, I know, I should. And I know all the reasons why I should, but I just can't or I don't want to, or it's hard to meet for me to remember and I don't really understand why this

Scott Benner 6:00
is happening. I know from the outside people can take that as they don't care. Do you think that that feeling can confuse you into believing you don't care when you do? Yes.

Erika Forsyth, MFT, LMFT 6:11
Okay. Yes. Because you often you're so confused in these these, you know, contradictory feelings. You're like, well, maybe maybe I guess I just I don't care enough. Or I don't know how enough or I don't feel like it's important enough. So I guess I'm just going to stay here in this place. And this happens a lot when people are trying to think about job changes. I know what I know, I this is good enough. But I know I could do more. Like, gosh, that feels scary. And then you might feel stuck in that ambivalence spot where you're feeling content where you are, but also have that like hunger to for more, or you want to do something different.

Scott Benner 6:49
This is boiled down to simplicity to like, picking up my clothes or folding my laundry or like that, like, I know I should I want to in my heart. I know that. It's something I should not just I should be doing. But it's a thing. I don't know how to explain this. It's a thing that I know I am, right. I'm a person whose clothing is put away, but I'm not going to do it. And it's not because I have more pressing matters. I'm just going to ignore it. So can that go all the way down to something small like that? This episode is sponsored by Medtronic. diabetes, Medtronic diabetes.com/juice box. And now we're going to hear from Medtronic champion. Jalen. I

Speaker 1 7:32
was going straight into high school. So it was a summer heading into high school was that particularly difficult, unimaginable, you know, I missed my entire summer. So I went to I was going to a brand new school, I was around a bunch of new people that I had not been going to school with. So it was hard trying to balance that while also explaining to people what type one diabetes was. My hometown did not have an endocrinologist. So I was traveling over an hour to the nearest endocrinologist for children. So you know, I outside of that I didn't have any type of support in my hometown.

Scott Benner 8:05
Did you try to explain to people or did you find it easier just to stay private?

Speaker 1 8:10
I honestly I just held back I didn't really like talking about it. It was just it felt like it was just an repeating record where I was saying things and people weren't understanding it. And I also was still in the process of learning it. So I just kept it to myself didn't really talk about it. Did

Scott Benner 8:25
you eventually find people in real life that you could confide in. I

Speaker 1 8:29
never really got the experience until after getting to college. And then once I graduated college, it's all I see. You know, you can easily search Medtronic champions. You see people that pop up and you're like, wow, look at all this content. And I think that's something that motivates me started embracing more. You know how I live with type one diabetes. To

Scott Benner 8:50
hear Jay Allen's entire conversation stay till the very end. Medtronic diabetes.com/juice box to hear more stories from the Medtronic champion community. Today's episode of the podcast is sponsored by Dexcom. And I'd like to take this opportunity to tell you a little bit about the continuous glucose monitor that my daughter wears the Dexcom G seven, the Dexcom G seven is small. It is accurate and it is easy to use. And where Arden has been wearing a Dexcom G seven since almost day one of when they came out and she's having a fantastic experience with it. We love the G six but man is the G seven small the profile so much closer to your body, the weight, you can't really feel it and that's coming from me. And I've worn one. I've worn a G six. I've worn a g7 I found both of the experiences to be lovely. But my gosh is that g7 Tiny and the accuracy has been fantastic. Arden's a onesies are right where we expect them to be. And we actually use the Dexcom clarity app to keep track of those things. That app is built right in to Arden's Dexcom G seven app on her phone iPhone? Oh, did you not know about that? You can use an iPhone or an Android device to see your Dexcom data. If you have a compatible phone, your Dexcom goes right to the Dexcom. app. You don't have to carry the receiver. But if you don't want to use the phone, that's fine. Use the Dexcom. receiver, it's up to you. Choice is yours with Dexcom dexcom.com/juicebox.

Erika Forsyth, MFT, LMFT 10:25
Yes, you got me with the laundry, I know I should do fold the laundry. It would look better. And I would feel better about this space. But I just don't feel like it. Or I just am too tired. Or I'd rather do X, Y or Z. Yes.

Scott Benner 10:41
So you just let it go. But it doesn't, but you don't really let it go. You don't let it go to the point where it doesn't bother you anymore. You just don't do it. Or ask or think it or say it or whatever it is you have to accomplish. But it's still gnaws at you. Yeah, yes, yes. Oh, that's just it's very interesting, like, so go through your list here about how a person becomes ambivalent.

Erika Forsyth, MFT, LMFT 11:04
Okay. Right. So I think that's when you arrive, you're you might not even know that you're in an ambivalent plays if it's if it's a larger life choice or with diabetes. But even you know, with our like, you know, house work skills, you might know that you're feeling ambivalent, because you're like, Yeah, I should, but I don't want to. And so we want, I think it's important as like, how do you get there? And can you start out feeling ambivalent from the get go? And I was thinking about that through the lens of your diabetes? And I think it really depends on the age at which you're diagnosed. A stage of life. Are you the caregiver and what's going on in your life? Are you the person living with it? And then can you be go through seasons of ambivalence? Which I have seen all of those things, but so I think it's really important to understand that like, maybe your your five year old, is diagnosed, and is doing just fine. And managing well. And then oftentimes, I know we've talked about this a lot. In their teenage years, they might come across, probably most likely ambivalent, but you as the caregiver, or the onlooker might say, I just don't care enough. Yeah, or they're

Scott Benner 12:21
not trying. Mm hmm. That's the other thing I hear people say, my kid doesn't try. I'm like, Oh, that's a weird way to think about it. You know what I mean? I just talked to somebody today, who's got a five year old, you said five year old have made it jumping in my head. And she said that, you know, if my five year old is with a cousin, and that cousin hands him a cookie, he is putting that cookie in his mouth and eating it. And he is not going to come to me and say, Hey, I just need a cookie. I need insulin, like he's not going to happen. And I feel like she said, I don't know how to make him care about that. But I don't know, I don't think it's care or not care. I definitely after talking to so many people, I definitely don't think it's because they don't care. I think everybody cares about their own health. They just find different levels of ability to follow through, or I guess different levels of less ambivalence, enough to hold them back or not. Because I've been ambivalent about things that I've done. Like, right, like, I'm like, I wish I should do this, or I should do that. I'm just I don't know what to do. I'm just gonna do it. You just kind of press through it, right? You just go do the thing. But and I've also had a situation where I've, it's frozen me, and I've done nothing, right. But why? Why does it feel like they don't care? Because I clearly cared. I had that at the dentist. Right? The dentist gave me these little trays and said, Put this glue in the tray and put the put them on and wear them once a day for 10 minutes. I mean, it just it probably couldn't be any simpler. I just don't do it. And then I'll go back to him. And I'll go, are you using the trays and I go? No. And I'm not a liar. Like we're I think a lot of you all listen, you're lying to your dentist, for example. But like not me, I just go nope, don't know why I can't bring myself to do it. And then there's poor outcomes because of it. Like I have to have other cleanings done because of it. And Ha, all right. And I'm plenty mode. I'm an active person. I'm up early, I'm awake 18 hours a day, I am accomplishing things constantly. I have some downtime. I could easily do those things. And I just won't. I know I'm not going to by the way. Why have I resolved myself to the fact that I'm not going to.

Erika Forsyth, MFT, LMFT 14:48
That's interesting. So then I would wonder, Is that ambivalence because you don't have you're not thinking through like it's it's important enough to you do you have the desire to do it. It's our competence. How to do it. Is it denial? You know, like, Ah, I don't really cuz sometimes we get that confused as we were talking about already, like is denial ambivalence? Like it's not really an issue. But I would say denial maybe comes before ambivalence. I'm thinking about that. Yeah,

Scott Benner 15:18
I'm consciously yes to all those questions. So I don't I can't explain it to you. Because I know it's important. I know there. There are reasons why I have to do it. I know there's a, you know, something bad that happens to me if I don't do it. I'm not denying business. I just don't do it. I don't know. Is it possible I forget every day? Because I look at it. And I always think, Oh, I'll do that later. And I just never do. Never. I am before you and I started talking my definition of ambivalence about this. Yeah.

Erika Forsyth, MFT, LMFT 15:58
I wrote, well, maybe we can come back to this. Yeah. Okay.

Scott Benner 16:01
I really don't care one way or the other. So okay. Yeah, I do. But I don't not enough to. Ah, that's interesting. Okay, keep going. I'm

Erika Forsyth, MFT, LMFT 16:10
sorry. I'm gonna I'm gonna hold that hold the hold that thought held that? Yeah. So I think it's important to note, as we are talking about ambivalence, and if you are listening, and you are feeling ambivalent about your management, or you're worried about your child's, I think we really want to acknowledge this is part of a process and someone's relationship with diabetes with themselves, to acknowledge it without judgment to acknowledge that obviously, if you're acting ambivalently, towards your management for your lifetime, there will be you know, complications, consequences, but if it in a season, temporarily, I don't even want to give a time frame to that. But whatever it is to say, Okay, this is happening. And this is part of the process. And now we know, and then identifying that you're ambivalent is part of that process. And then working through and we'll we'll share some some tools and how to work through the ambivalence, but to not judge it and criticize it, but to say, Okay, I'm here, just like we just did with the, the tooth tray, okay. You're acknowledging it? Oh, I'm

Scott Benner 17:13
fully aware. And I'm, I'm happy to acknowledge it. I just, I have no answer for it whatsoever, you're gonna help me find an answer. Is that what you're saying? Well,

Erika Forsyth, MFT, LMFT 17:21
but we'll see. Well, hopefully, all right,

Scott Benner 17:23
well, let me sit back and I'm sitting back. I feel like I'm on your sofa. Now. You're gonna you're gonna help me get through this. All right. So, okay, do you want to like talk about it in, in like, more specific terms like Pre-Bolus Singh as an example, do you want to stick to like that idea as you go through this? Or do you don't think it's necessary?

Erika Forsyth, MFT, LMFT 17:43
Yeah, we can do that. But yes. So sorry, were you gonna say something or you're really sitting back?

Scott Benner 17:49
Okay, literally sitting back, I'm letting you do this. I want to say, Okay.

Erika Forsyth, MFT, LMFT 17:53
Okay. So if we're thinking about Pre-Bolus thing, and you're ambivalent, or even just doing the very basics of, of management of actually bolusing. or injecting when you're eating something, or correcting after hours of high or ignoring it. So if you're feeling ambivalent or your your child is in Veblen, in that stage, I think it's really important to also consider what else is going on in your life, maybe you already have some pre existing generalized anxiety, maybe there's also depression, maybe there's unresolved grief towards the diabetes, right? Maybe you're, you're so angry, and sad and disappointed and scared that it feels easier to ignore it. But I think deep down as we were talking about, even if you're refusing to believe you have diabetes, or and saying I don't really care, it's not going to complications aren't going to happen to me. I really do believe that deep down, there are some fears or convictions that things you know, it's it's reality. There are complications are reality. And so when you're in that ambivalent stage, like I know, I should inject or correct, but I'm feeling all of these other things. And I'm really scared about what might happen. But I just can't do it. Like that. Right in that moment, and you're might not even be aware of it or your child might not be aware of it or teen, right. Where you're feeling those two things. Okay. So you're ambivalent, you say you don't care, but you know that they're there. And none of that wants to drive and I'm not saying that's the only the only driving force to Pre-Bolus or inject but I'm talking about like these two extreme thoughts or feelings or attitudes. Okay. Other I think it's really important to also consider you might be trying really hard to get your diabetes supplies or get good insurance for your, for the supplies. So maybe you have Have I really well, I want to take care of my diabetes. But gosh, it's really hard to get my insulin right now or Gosh, it's really hard to, to get my insurance to cover my CGM or my, my pump. And all of and then the other, I think the other really important factor to consider. You might say, Gosh, I really I know I should take care of it. But I feel so alone in this. So these are all these kind of conflicting, simultaneous, but contradictory feelings like I know I should, but this is really hard, or I feel so alone. You might feel totally out of control in your life, not only with diabetes, but all other areas. These are all factors that could play into which mate might look like on the outside to people as denial, refusal, just resisting resistant to treatment, is

Scott Benner 20:48
that the what is the ambivalence doing to me? That makes that turns into inaction.

Erika Forsyth, MFT, LMFT 20:55
So what is ambivalence doing so you then? And that's getting that? Yep, yeah.

Scott Benner 21:02
Or is that a thing you're gonna get to? Should

Erika Forsyth, MFT, LMFT 21:03
I ask that again? Is that again, that's good.

Scott Benner 21:05
I mean, the idea here is, is that I have I have contradictory thoughts, right? I know, I should do this thing, but I'm not going to do it. But I really can't tell you why I'm not going to do it. But I didn't I don't do anything. Like I just sit there, right. And it's not even that I don't let it go. I hear people all the time, say, Oh, I'm a bit what do people have to say I'm a bad diabetic, I don't do this. I don't do that. Like, bah, bah, bah, like, do something or just commit to being bad at it just be like, hey, you know what, on the show, and like, just but no, we always sit in that space going, I know what I should be doing. I do want to do it. But there's never a more, there's never a like, I'll do it after I clean my room. I'll do it after I get a new job. It's just we just don't do anything. It's the inaction that it feels like it's the it feels like it's the the disease of of ambivalence to me. Does that make sense? Yes. Okay. So.

Erika Forsyth, MFT, LMFT 22:01
So we kind of understand what ambivalence is we understand what it looks like. And oftentimes, people describe it as their if they feel under constant pressure. And so you might present in all different ways, sad, irritable, kind of neutral, like, whatever, it's fine, you're exhausted. But until you might have these internal pressures of like, oh, my gosh, I know, I need to do this. And then you might also experience the external pressures. But what, what we kind of the the crux of it is, what is preventing you from making change? And that's where we look at okay, is do you have? Are you stuck in the mixed feelings about the change for various reasons, including confidence? Do you have confidence in your ability to make the change? And is that what does that look like? Does that mean that you have the support system? Does it mean you know how to do it? Like, maybe it's like, I know, I should do X, Y, or Z with my diabetes, but I really don't know how. And this was, I was told by this by my doctor, but now it's not working. And that's something that you always talk about is like, is it?

Scott Benner 23:16
Yeah, so I'll just sit here and wait till the answer comes, and then I'll do it. But then the answer never comes. Because you're not out there consciously looking for the answer. You just think I don't have the confidence, which means tools or know how, yes to do something. I'll wait until that comes to me. But it doesn't some people go look for it. But they're not it but then the ambivalence isn't holding them back. Then they have those people don't have the confidence and say, Okay, I'm gonna go find the confidence somewhere. When it gets you, you really do just sit there. You sit there, like in the middle of the desert, waiting for someone to bring you a glass of water, really like you're like, oh, it's all either die here, or someone will come along and help me, but I'm not going to get up and keep walking. That's interesting. Yes. Okay.

Erika Forsyth, MFT, LMFT 24:05
Yes. So then the confidence piece, it's then we ask, okay, if your confidence is is low in yourself, to either find or learn the ability to change, then I would encourage you to look at okay, are you stuck because of depression? Are you stuck because of the unresolved grief? Are you stuck because of fear and anxiety around? What if you make a mistake? What is your self talk like? What is your sense of security and belief in yourself? The basic is Do you have confidence in yourself? Or do you doubt your ability to change and that and then that goes back to the education tools? reaching out for help but

Scott Benner 24:49
is it definitely one of those things? Is it not possible I'm just lazy, or there is a psychological function that's holding me in that spot right? In

Erika Forsyth, MFT, LMFT 25:00
this enigma diabetes example, I would say yes, okay, yes. Because every human I think, for the most part wants to be to live and interact in life. Yeah.

Scott Benner 25:11
Okay.

Erika Forsyth, MFT, LMFT 25:12
Yes.

Scott Benner 25:13
Is there a clinical explanation for I just don't care, but I'm not depressed. I'm not this. I'm not I'm not. I'm none of those things you just listed. I just am not going to do this. But there's not there's a reason why you're having that reaction.

Erika Forsyth, MFT, LMFT 25:26
I would argue that, because if you're saying you just don't care, and you know, you've been educated about, okay, you need to take insulin, or else X, Y, or Z is going to happen, then I would argue, yes, there's some there's something underlying there that needs to be addressed. Processed. Okay. Yes.

Scott Benner 25:47
I mean, I believe that too, by the way, like, yeah, just I mean, with looking at other people in my life, myself, and other times that I've seen somebody say, I just don't care. As they're saying it, you go, Oh, you totally care. And this is why you care. And you're saying, I don't care. I see. You see it all the time. I don't care what people think about me. Ever see, people say that, like I say what I want, I don't care what people think about me? Yes, you do. Stop it. Like Like, right? Like, of course you care what people think of you. And if you don't care what they think of you specifically, you still care about who you are. So like, don't act like you don't care, you care. You just can't you're not willing to stop doing the thing you're doing. Because that's Oh, because that thing is somehow masking something else for you. Right? Like if I take it out of diabetes for a second when somebody acts all like bombastic maybe I'm gonna sit back up when somebody acts all bombastic, maybe, and I don't care what people think of me, you're protecting something, you're putting a shield up about something. Right? So if I don't want to Pre-Bolus It's because I don't feel like I have the mental space. I don't feel like I have the knowledge, the energy, I don't want to screw it up. I don't want to take responsibility for this. Because if this goes wrong, it's my fault. And if I just sit here and act like diabetes is just happening to me, and there's nothing I can do about it, then if I get sicker, or if something happens to me, I don't have to shoulder the blame for this. You think that might be it? That

Erika Forsyth, MFT, LMFT 27:24
can be definitely I wouldn't say that's always the case. Right? That path, but that makes certainly, yes. Okay.

Scott Benner 27:31
For whatever your thing is, when you're listening, because you certainly grew up one way or another and have a thing to whoever's listening, right? Yes,

Erika Forsyth, MFT, LMFT 27:37
absolutely. And, and so I think if it's, the ambivalence is high, you're stuck in between these, these mixed feelings about the change, your confidence is low. And you kind of doubt your ability to implement the change. The other two factors that we would look at, to understand why why are you having challenges making changes is the desire if your desire is low, and you're uncertain about whether you even want to make the change, right like that, you have to have that desire to make the change. So there's, yeah, go ahead.

Scott Benner 28:16
I was just thinking about how often I hear people say, my a one C, seven and a half, it's good. And they'll say, I know it can be lower, but I'm okay with it like this. I always think that's strange. But maybe this makes it feel less strange to me. I always think it's strange. Because if your heart was supposed to beat a certain amount of times per minute, but it be I don't know, it'd be 10 fewer times are 10 more times, I'm okay with it. I don't know what that means. That might be why you hear so many people try to get the answer to what's the real benefit of anyone seeing the success? Because if there's no benefit for it, then I don't have to, oh, then I don't have to worry about the fact that I'm not working towards it. If sevens fine, and six is no different than seven. That's why they're always asking for studies show me a study that says that six is better than seven. And my answer is always look, I don't know, if you don't have diabetes, you're able to season the high fours. So like, I mean, that's more more sounds like more sugar in your blood. That all sounds less advantageous to me. But they want to be told it's okay. And if it's not okay, then I'll work towards it. So that's the desire part. Like I almost feel like the ADA is in charge of the desire. Does that make sense?

Erika Forsyth, MFT, LMFT 29:29
Well, yes. And I also want to just put the caveat out, though, that if you're in the sevens, and I know you're not

Scott Benner 29:36
putting this out there, but no, I'm not denigrating a seven it's Yeah. Well, for

Erika Forsyth, MFT, LMFT 29:40
people who are like newly diagnosed at whatever stage, I just want to give a shout out. You're doing a great job. Yeah. No, 100 But I hear I hear like your question, right.

Scott Benner 29:50
Yeah. My question is, like, I'm not saying but he's doing a bad job, but they're doing a seven and a half. I'm talking about a person that has diabetes forever. could do a six if they wanted to, and they're like Yeah, I mean, because I've talked to those people, like, I'm good where I'm at. I'm like, okay, but you mean, you know, you could Pre-Bolus or, you know, stay on top of your basil a little bit or something like that. And duel. Another point last, and they're like, Yeah, I don't want to put the effort into it. I don't know, it's, it's odd to me. But I understand that a lot of people feel that way. And I wouldn't come down on it for it. It just strikes me as strange when it happens. Okay,

Erika Forsyth, MFT, LMFT 30:26
and if they're, if they're healthy and doing fine, probably have all the like, you know, no complications, all those things. But then maybe if there are these other factors that you could ask, if they wanted to change, then what? What's the is it important to them as the last piece? Yeah,

Scott Benner 30:40
it feels to me like saying I only smoked two cigarettes a day. That's what it feels like to me. Like, I'm like, Yeah, I only smoked two a day, that's not gonna give me lung cancer, probably, like, so I'll be alright. And if I die in my mid 70s, that's where I was supposed to die anyway, so it's good. And if I said, Hey, don't don't smoke the two cigarettes live to your ad. They go up there. And I'm like, okay, like, I don't I don't disagree, if help with how people feel ever. It's just that to me, is the conversation that's not happening and happening at the same time. But I'm trying to figure out like, is my desire low or high? Is that personality driven? Is it a thought someone put into your head one day? Is it just how you're wired? Do you know what I mean? Like I don't like because the desire is lower and stable, is better? I don't know what more desire you need than that. Unless you don't? I don't know unless you don't prioritize it. I don't want to say care, but don't prioritize it over other things. Is it just bandwidth? Maybe

Erika Forsyth, MFT, LMFT 31:47
I was Yeah, I was trying to think of an example of you know, you have a desire to have stable and low blood sugars, as as I do, but are in as I'm thinking of any client or human with type one, they also have maybe desires to do well at their job, or be solid parents, or interact with the community or serve in this way. And so perhaps the desire is to do the best you can and if that's and maybe yet maybe it's I think, like, is it a bandwidth question? Like the desires do the best you can and it's, you're having stable enough blood sugar's and your agency is in the range of ADA. And you're also excelling and all these other things. Maybe that's enough. That's part of it. Yeah.

Scott Benner 32:41
I mean, I desire to have a six pack, but not enough to do a setup. So like, right, like, is that kind of the same thing? Really? Right. Like, I know, that would be better for me. I know, I would like that more. I know, it'd be healthier. But I don't have the time to do something like that, or the desire. It's interesting. It just doesn't mean enough to me, for whatever reason, or use, is there a way to make me exercise more? Like to change my desire?

Erika Forsyth, MFT, LMFT 33:13
Well through I mean, yes, I want I want to get to me, you know, working, practicing the motivational interviewing, which is a tactic that therapists can use to help a client understand what you're looking for is their change, talk, what was interrupting or preventing change. And so we can do that in a minute. I just wanted to emphasize like, the fourth thing to think about is the importance of the change, okay, is is the importance if the importance is low, and the benefits of change, and the disadvantages of the current situation are unclear. Right? So you have this. I know there are these benefits if I change if I make these changes, but currently, the disadvantages of my current situation like there's not real clarity in those two things. So why would that be important to you to make a change?

Scott Benner 34:07
So this is real world, what happens when women with type one, for example, decide they want to have a baby? And then suddenly, the importance ramps up and so now they can keep the right one seeing the fives. Yes, yeah.

Erika Forsyth, MFT, LMFT 34:22
I am a testimony to that for sure. Okay. hercus, like, yeah,

Scott Benner 34:27
I was writing I was writing to seven Well, I thought I was gonna have a kid. And so but yeah, so that's see I'm trying to I mean, I know you know this but I'm trying to piece together the conversations I've had into this conversation like because I think there's a lot of value in remembering what all these people have said on the podcast over and over again. It's not my I want to be clear to people. This isn't me just like reaching out like s and being like, oh, maybe it means this. Like I mean, I've heard a lot of people say these things. So the importance and then For men, a lot of times you see that it's after the baby comes. And they have that. They have that feeling of like, it's my job to make sure we all stay alive. I can't do that if I'm not alive. And that happens outside of diabetes, right? You see a lot of people like kick recreational drugs or drinking or like, childish, like endeavors in general. I sold my motorcycle because I have a kid now like that kind of stuff. Oh, too. This is all the same thing. Just we have we see it more because diabetes presents us with these problems more frequently than other people.

Erika Forsyth, MFT, LMFT 35:33
Yes, yeah, you're forced to be making these decisions right all the time.

Scott Benner 35:39
So these are just human problems. These are things that happen to everybody all day long. This could be cleaning up your dishes, this could be doing your job Pre-Bolus thing taking care of yourself, making sure you're not going to get hurt. Like all it's all just the same thing. We're just Oh, that's a really interesting. Okay, I'm sorry. Let's move on.

Erika Forsyth, MFT, LMFT 36:01
Yes, no, it's good. Yeah. So how so we kind of understand, we're just kind of talking about what is ambivalence look like? Why does it happen? Why sometimes does it happen? And what now? What can we do about it? And so how does one become motivated to make change? And that is certainly just like, ambivalence is a process. Becoming motivated is a process. And as I mentioned, and I'm sure some of you have heard about motivational interviewing, which is a an orientation that therapists can use in therapy. And one of the tools that is really commonly used are called Scaling questions. And most, you might think of scaling as like, when you go to the doctor, what's your pain level, you know, zero to 10. Sometimes therapists might ask, like, what's your anxiety level, or level of depression? Mi uses it in a really interesting way to pull out the change talk. And so I thought, if we wanted to do you could make up an example, you could use one thing you've already mentioned, or make up something random, about something that you have felt ambivalent about, that you're wanting to change, but you've been feeling ambivalent about. Okay.

Scott Benner 37:13
Well, I think I would, I guess, endeavor to like, actually help myself with this. Let's go with exercise. Like, movement. So

Erika Forsyth, MFT, LMFT 37:26
movement, okay.

Scott Benner 37:26
I'll go with that. Okay,

Erika Forsyth, MFT, LMFT 37:28
exercise slash movement. Okay, I'll just say instead of saying slash, you want me to use movement or exercise? Yeah,

Scott Benner 37:34
same movement, movement. Okay. It makes me so a giggle because I think.

Erika Forsyth, MFT, LMFT 37:42
Okay, so how important is movement for you, on a scale of zero to 10, with zero being not important at all, and 10 being the most important, important,

Scott Benner 37:56
I'm gonna be a walking, contradiction. It's already in this, I could tell this already. I think it's a 10. I think it's incredibly important. Because I'm 52. And I have not been an incredibly like athletic person throughout my adult life. And I'd like to be able to keep moving through my older years, I'm watching a neighbor right now in his mid to late 60s already cutting back on his retirement plans, because he can't move as well as he should. So I think it's the most important, I think it's a 10.

Erika Forsyth, MFT, LMFT 38:27
Okay, so that So my next question would be and you already kind of answered it is, why are you a 10 and not a lower number, like a five, but you already just kind of answered

Scott Benner 38:37
those questions, I think I'm going to be 65 and not be able to get up and then I'm going to spend the rest of my life pissed at myself for wasting, because I'm a person who works very hard with the idea that there's a payoff at the end. And after I raise these kids, and help all you people with your diabetes, and pay my bills, and all that other stuff, I'd like a little bit of time before I kick. And if I can't move around during that time, I am going to be mad at myself. That's why

Erika Forsyth, MFT, LMFT 39:07
Okay, okay, so kind of fear of yet not being able to live fully. Once you're able to you're once you're kind of transitioning to like kind of retirement season, and being able to live actively, and also kind of fear of you don't want to be mad at yourself.

Scott Benner 39:22
Theoretically. I don't want to miss out on the things that I've worked towards. But consciously right now, I don't want to sit there and be disappointed in myself.

Erika Forsyth, MFT, LMFT 39:34
Does that make sense? Yes. Okay. Yes. Okay. So if you are the point of the exercise, if you had given me a lower number, I would then ask you like, what might bump that number up? Okay, but you're you're already at 10. Like we you would this is really, really important to you,

Scott Benner 39:52
but I couldn't I couldn't think through that. If I gave you a five but then gave you those answers. And you said well, your numbers should probably be higher. But I

Erika Forsyth, MFT, LMFT 40:01
wouldn't say that that's not MI, I would say. So the difference is, if you gave me a five, and then I would say, Well, why isn't it a lower number? And then you gave me all those reasons. Because you don't want to, you know, be mad at yourself. You want to be active, participate in life, right? And then I would ask you, well, what would bump that number up a couple of notches?

Scott Benner 40:21
It would be if somebody came in and educated me about why it was important. I think, yeah, I would need more education about you'd have to educate me about why I would need to care more about it. And then if, as if, that if, if a doctor or even an older person could say to me, Oh, I wish I would have done this too. Because, you know, anyway, and I have that example already with my neighbor. So, okay, okay. I understand. It's

Erika Forsyth, MFT, LMFT 40:46
good. Okay. So what and what were, the key is, you know, I'm looking for, you're arguing with yourself in a positive way. Like, if I were if you gave me a five and I said, Well, why isn't the number higher? You're arguing against the change, right? But when I'm, you gave me a number, and I asked, why isn't it lower? You're arguing for the change. And so it's so important to hear yourself. And for me, then to reflect back? The change that you why it's important for you.

Scott Benner 41:17
I find it frustrating, though, just so you know, but keep Uh, huh. Got that? Yeah.

Erika Forsyth, MFT, LMFT 41:21
Okay. Okay, so now, the next then the next kind of question scaling question would be, how confident are you in your ability to make this change on a scale of zero to 10? With zero being not confident at all? And 10? Being the most confident? Of so how confident are you in the ability to make this change? Number five, your five? Yeah. Okay. Why are you a five and not a lower number?

Scott Benner 41:47
Not a lower number? Because I know I could do this. Not a higher number? Because I want

Erika Forsyth, MFT, LMFT 41:54
to I don't want to hear that. Anyone here? Well, you're not a high number. You know? So you're, you're five and not a lower number? Because you know, you could do it. There's some competence in there. And but what might help you bump up a couple of points to give you more confidence.

Scott Benner 42:17
Let's abstract though my answer was going to be had I done something like this in the past to draw from but I've not done anything like this in the past. I've I've been stuck in this space for 30 years on this topic. So I would feel more confident if I had something to draw from I guess I'd have to for confidence, look towards other people my age who have gone from not exercising to exercising, I'd have to find motivation externally, I

Erika Forsyth, MFT, LMFT 42:46
would think that would help me to find other people who are like minded. Find the external motivation. Somebody

Scott Benner 42:55
who reminded me of me that was doing it would help me. That makes sense. I don't know why. Honestly, I don't think I want to dig into why but yeah,

Erika Forsyth, MFT, LMFT 43:05
yeah. A little bit. And this is this is just pretend. Okay. Dr. Phil therapy. Yeah. Okay, so we'll, that's what I think we'll Yeah, we'll pause there. So those are like, these are the two bigs scaling tools that Mia is using, and really what motivational interviewing, when, what we're kind of look what I would be looking for, as your pretend therapist is, that's, that's really fascinating. It's important to you. It's a 10. And the confidence was the five. So then we would look at, we'd go through a series of questions and rapport building and trust, and then going back and then make making plans around like, Okay, how could we implement building your confidence, right, because I imagine your desire is probably pretty high. I

Scott Benner 43:59
can tell you what I did, I brought dumbbells into my office. So when I in between doing stuff, I, I do work with dumbbells thinking that if I could see some change in my upper body, that I would, that that would motivate me to do it the rest of the way. And it seemed doable for me, and it fit into my lifestyle. So that's what I ended up doing. And as you can see, I'm jacked now.

Erika Forsyth, MFT, LMFT 44:29
Okay, that's, that's great.

Scott Benner 44:30
Yeah, it did work, by the way, because I brought in dumbbells that were too heavy, not by much, and they're not too heavy now. And so I do have that confidence that I could do it more. So what's holding me back is the idea that I don't know if I will. And I don't know how to like, again, that's you're not my therapist, but that's that's my spot right there.

Erika Forsyth, MFT, LMFT 44:53
So I would take I would take that one to your therapist, because then if we kind of came off this topic then I would look at, you know, to find motivation, if it's the confidence is low. And if we're going back to the diabetes management piece, you know, then there's obviously so many tools out there like this podcast, support systems. I feel like oftentimes, when you're lacking that motivation to make change, and you identified kind of the barriers, when you're feeling isolated, it's really easy to stay there. Yeah. And so what does it look like for you to reach out to and I think it's interesting that you made that point, if you saw somebody, sorry, I know, I'm going back to your example. But if you saw someone like you doing that, I think it's really significant when people in the diabetes community find somebody not only just living with type one or a caregiver, but very similar in age and stage. Like when I when I meet with somebody who has been living with type one for 30 plus years, I feel really connected with them. I feel connected with someone living with type one, but we've lived a different life with it. And just like for you, if you're a caregiver to someone who's been living with it for 1820 years, is different than the the newly diagnosed caregiver.

Scott Benner 46:09
I see that too. I watch people connect with certain people. And they don't even seem to know why they've made the connection that they have. But some things click for them. And sometimes it doesn't. Also. Yeah, I mean, I think that's also why you hear me talk about things in the podcast about diabetes like that, like, I don't think a seven and a half a one sees a bad a one C. But I want you to believe that a five is doable, right? Like I think aspirational is a really big part of this, like a huge part of it, actually. But I can see you make good points about where things get in the way even like, Why did I start with my arms and not my legs because my knees hurt. And I was worried that I the last time I tried to do something with my legs, I got hurt. And I think that probably stopped me from trying it again. So I went to a different part where I was like, Oh, this won't hurt as bad. Or I won't maybe I'm not running the same risk. But relating that back to diabetes. I tried to Pre-Bolus but I got low, you know what I mean? And then it happened a couple of times, and I'm like, I'm not gonna do that anymore. That's sort of I think the, the apples to apples comparison there. Yeah, it's really interesting.

Erika Forsyth, MFT, LMFT 47:17
And in the importance piece, you know, when you when we, when you're asking yourself, I know I coulda shoulda woulda do all these things. But it's, it doesn't feel important to me now. It is so hard as we know what type when because or diabetes in general, we don't see the consequences immediately. And we see the mean, you see the lows, but the when you ask yourself, you know, the immediate situation that you're experiencing, if it's not uncomfortable, and you know that, like the disadvantages, the benefits of changed are not outweighing the disadvantages of the current situation. Right. So you don't want to wait till you have complications in the future tip start making those changes. But it is hard when you're in you're in that ambivalent stage to say, Well, I'm doing okay, I have all my Yeah, I know my functionality.

Scott Benner 48:10
So if I don't have the confidence, the desire is tied to the importance to some degree, then I don't move my a one C and tell him to get pregnant. But if for another person, you don't want them to get to complications, because now we can't go backwards anymore. Very likely to now you'll know the importance and you'll probably have the desire. But you might not even put it into effect because you'll think about what's the difference. I'm here now. Although I've talked to plenty of people who have reversed a number of their complications by bringing their blood sugar's back again. So you should definitely feel motivated for that. Oh, yeah. And hope and hopeful. I see the thought line, basically, you have to manufacture the desire and or the importance before it comes in a tangible form that you can't get away from? Is it fake it till you make it?

Erika Forsyth, MFT, LMFT 49:06
Sometimes, you know, I was even just listening to something earlier about, you know, the imposter syndrome. And I don't know if that fully applies here. But it just popped into my mind around like, are you particularly newly diagnosed families where you have, you're feeling like, oh my gosh, what, what are we doing? When are we bolusing? How much all of that trying to figure out these or hates you or kind of actively in that sort of, quote, imposter syndrome. And having that perseverance, the motivation, the drive, the resilience to keep going is is exhausting and challenging. And

Scott Benner 49:46
because you have to manage EDF to manufacture that, like, Let's go I've got this feeling when you don't really have it, you don't feel like you've got it, or you need to believe like I tell people all the time because you're asking the questions indicates to me that it's going to work out for you. And so you seem interested in healthier, I think if you continue to be interested and continue to look for answers, that one day you'll wake up and diabetes won't be easy, but it'll be you'll be better at it. And that'll make it feel easier. And then you can progress in that direction. I say that to them, because I genuinely believe it. And I think it's the only thing tangible you can say to somebody when you really don't have anything tangible to say to them. You know what I mean? Like, because at the moment, you don't know how to Bolus and you don't have an experience of of time. And so you have no way to believe that even know what you're doing. You have to believe in something. So you have to have somebody who says, Hey, listen, I've been down here before, and I know the way out. There really is it right. So you know that story? guy walks by friends at a hole. Ever heard that one? Yeah. He says help me. He says to the priest helped me the priest says a prayer, you know, and other people come down and he sees his friend, his friend jumps down the hole with him. He goes, What are you doing my we're both stuck down here. And he goes, Yeah, but I've been down here before. And I know the way out. That's what you need, you need somebody to like to be like, I usually describe it as I'm on a path. I'm on the same path. As those of you who are listening, I'm just ahead of you. And I know where all the potholes are. So I turn around, I shine a light on them. So you can make it up to where I'm at. That's how it feels to me.

Erika Forsyth, MFT, LMFT 51:21
So that's good. I've never heard you say it like that. Oh, it's good.

Scott Benner 51:25
I say a lot of Erica, it's hard to keep track of all of it.

Erika Forsyth, MFT, LMFT 51:32
And I think most importantly, as I know, I always talk about to it's like in that particularly the initial stage or the 20 year stage or, you know, whatever you find yourself ambivalent, or overwhelmed you to, you know, offer that self compassion. And that it's okay to be to be ambivalent or to be stuck. And to be vulnerable in that space to is, I know, it can be hard. And speaking that out to people and not feeling alone in it. Because they know there are a lot of people out there in this stage. Yeah, but it's beginning, middle, or, you know, living with it for 50 years, to not feel ashamed in that space, to be vulnerable and offer compassion to each other and to yourself is really important part of that process.

Scott Benner 52:21
Isn't it interesting that some people get thrown into this problem, this diabetes thing, and they have all the concerns and problems that we've outlined here today. And somebody else who seemingly is the same kind of person gets thrown into it. And they just, they don't run into any of these problems. They just, they don't get stuck there. They don't become ambivalent, they're not unsure. They don't need to find desire or importance. And it's so easy to look at those two different people and make a judgement. That one's not trying. And that one is, but I genuinely don't believe that's true. I really think it's a lot about like your past experiences, all of them as an amalgam really. And that's it. Like I think you react to things based on the experiences you've had in the past. And some people turtle up and some people run forward. And then there's all kinds of, you know, in between those two ideas. I don't think that a person who's excelling, can take credit any more than a person who's faltering can take blame, if that makes sense. I think it's just the luck of the draw. Sometimes, you know, who you are and how you grew up, and the people who impacted you growing up the experiences that you couldn't have avoided that shape you one way or the other. It's very, very random. And anyway, I don't I don't like it when people take credit for their success. Because I think you're lucky to be in the position you're in, you know, to collect that success sometimes.

Erika Forsyth, MFT, LMFT 53:57
Yes. Anyway,

Scott Benner 53:58
not that everybody can't get there. But some people have more speed bumps along the way than others.

Erika Forsyth, MFT, LMFT 54:03
Yes, yeah. History, and access and all of those things. And, and I love that you just ended on and there's hope there's hope for or change, or otherwise, we wouldn't be here. There

Scott Benner 54:15
absolutely is there's always hope. I mean, you just have to find, you just have to find the right outside influences to elevate. It's not the maybe Elevate is the right word to bring you up to the place where you are the people who are succeeding are like, what did they know or feel? Or how do they respond? Like, how can I do those things to, you know, give me the outcomes that they have? That's kind of what how I think about it. I mean, I mean, I grew up really broke, I'm not broke anymore. And I didn't grow up with a lot of like, understanding around me, I have that now. You know, I grew up with people who would have just hit me. If like, I couldn't do one of these things. Then if I would have reacted, they would have thought like hitting me worked. And if I didn't react then they would go like he he doesn't care that that would have been that simple, right? I don't live around that anymore. So I've elevated a lot of my life. I think a lot of people could really. I wish everybody luck. It ain't easy, but don't give up. Yeah. So, Erica, thank

Erika Forsyth, MFT, LMFT 55:18
you so much. You're welcome. Thank you.

Scott Benner 55:26
A huge thanks to Dexcom for being longtime sponsors of the Juicebox Podcast. dexcom.com/juice box head over there now, get started today. Jalen is an incredible example of what so many experienced living with diabetes, you show up for yourself and others every day, never letting diabetes define you. And that is what the Medtronic champion community is all about. Each of us is strong, and together, we're even stronger. To hear more stories from the Medtronic champion community or to share your own story visit Medtronic diabetes.com/juicebox And look out online for the hashtag Medtronic champion. Thank you so much for listening. I hope you enjoy my full conversation with Jalen coming up in just a moment. I want to take another moment to thank touched by type one for being such a terrific and longtime sponsor of the Juicebox Podcast. I will of course be speaking again this year at their live event in Orlando, Florida. I hope to see you there. The event is absolutely free for you to attend. Touched by type one.org. Go to the Programs tab and find out more. I'll see you there. If you or a loved one was just diagnosed with type one diabetes, and you're looking for some fresh perspective. The bold beginning series from the Juicebox Podcast is a terrific place to start. That series is with myself and Jenny Smith. Jenny is a CDC es a registered dietitian and a type one for over 35 years. And in the bowl beginning series Jenny and I are going to answer the questions that most people have after a type one diabetes diagnosis. The series begins at episode 698. In your podcast player where you can go to juicebox podcast.com and click on bold beginnings in the menu. If you're looking for community around type one diabetes, check out the Juicebox Podcast private Facebook group Juicebox Podcast type one diabetes, but everybody is welcome type one type two gestational loved ones. It doesn't matter to me. If you're impacted by diabetes, and you're looking for support, comfort or community check out Juicebox Podcast type one diabetes on Facebook. Thanks for hanging out until the end. Now you're going to hear my entire conversation with Jalen don't forget Medtronic diabetes.com/juice box or the hashtag Medtronic champion on your favorite social media platform. My

Speaker 1 57:51
name is Jalen Mayfield. I am 29 years old. I live in Milwaukee, Wisconsin, where I am originally from Waynesboro, Mississippi. So I've kind of traveled all over. I've just landed here in the Midwest and haven't left since

Scott Benner 58:06
ice. How old were you when you were diagnosed with type one diabetes?

Speaker 1 58:09
I was 14 years old when I was diagnosed with type one diabetes

Scott Benner 58:13
15 years ago. Wow. Yes. Okay. 14 years old. What are you like? Do you remember what grade you were in?

Speaker 1 58:18
I actually do because we we have like an eighth grade promotion. So I had just had a great promotion. So I was going straight into high school. So it was a summer, heading into high school

Scott Benner 58:27
was that particularly difficult going into high school with this new thing? I

Speaker 1 58:31
was unimaginable. You know, I missed my entire summer. So I went, I was going to a brand new school with, you know, our community, we brought three different schools together. So I was around a bunch of new people that I had not been going to school with. So it was hard trying to balance that while also explaining to people what type one diabetes was,

Scott Benner 58:51
did you even know? Or were you just learning at the same time?

Speaker 1 58:55
I honestly was learning at the same time, my hometown did not have an endocrinologist. So I was traveling almost over an hour to the nearest you know, pediatrician, like endocrinologist for children. So you know, I outside of that I didn't have any type of support in my hometown.

Scott Benner 59:12
Was there any expectation of diabetes that somebody else in your family have type one? No,

Speaker 1 59:17
I was the first one to have type one of my family. And do you have children now?

Scott Benner 59:21
I do not know. Do you think you will one day,

Speaker 1 59:23
still thinking about it? But right now, I've just been traveling books at all my career myself.

Scott Benner 59:29
So what do you do? What's your career? Yeah,

Speaker 1 59:31
so I am a marketing leasing specialist for a student housing company. So we oversee about 90 properties throughout the US so I've been working for them for about

Scott Benner 59:40
eight years now. And you get to travel a lot in that job.

Speaker 1 59:43
Yes, I experienced a lot of travel it's fun but also difficult especially with all your your type one diabetes supplies, and all your electronics so it's a bit of a hassle sometimes.

Scott Benner 59:53
What do you find that you absolutely need with you while you're traveling? diabetes wise,

Speaker 1 59:58
I have learned My biggest thing I need is some type of glucose. I have experienced lows, whether that's on a flight traveling, walking through the airport. And I used to always experience just being nervous to ask for some type of snack or anything. So I just felt, I felt like I needed to always have something on me. And that has made it might travel a lot easier.

Scott Benner 1:00:20
So growing up in the small town, what was your initial challenge during diagnosis? And what other challenges did you find along the way?

Speaker 1 1:00:30
Yeah, I think the initial one, I felt isolated, I had no one to talk to that it was experiencing what I was going through, you know, they were people would say, Oh, I know, this is like hard for you. But I was like, you really don't like I, I just felt lonely. I didn't know. You know, people were watching everything I did. He was like, You can't eat this, you can't eat that. I felt like all of my childhood had been, you know, I don't even remember what it was like, for life before diabetes at this point, because I felt like that's the only thing I could focus on was trying to do a life with type one diabetes,

Scott Benner 1:01:04
when you found yourself misunderstood? Did you try to explain to people or did you find it easier just to stay private?

Speaker 1 1:01:12
I honestly I just held back I didn't really like talking about it. It was just, it felt like it was just an repeating record where I was saying things and people weren't understanding it. And I also was still in the process of learning it. So I just, you know, kept it to myself didn't really talk about it was I absolutely had to,

Scott Benner 1:01:29
did you eventually find people in real life that you could confide in.

Speaker 1 1:01:33
I think I never really got the experience until after getting to college. And then once I graduated college, and moving to an even bigger town, that's where I finally found those people where I was like, Okay, there's a lot of other people that have type one diabetes. And you know, there's a community out there, which I had never experienced before, is college

Scott Benner 1:01:55
where you met somebody with diabetes for the first time, or just where you met more people with different ways of thinking. So

Speaker 1 1:02:01
I met my first person with diabetes, actually, my freshman year of high school, there was only one other person. And he had had it since he was a kid like young once this was like, maybe born, or like, right after that timeframe. So that was the only other person I knew until I got to college. And I started meeting other people, I was a member of the band, and I was an RA. So I was like, Okay, there's, you know, there's a small handful of people also at my university. But then, once I moved to, I moved to St. Louis. And a lot of my friends I met were like med students, and they were young professionals. And that's where I started really getting involved with one of my really close friends to this day. He was also type one diabetic. And I was like, that's who introduced me to all these different types of communities and technologies, and which is really what helped jumpstart my learning more in depth with type one diabetes.

Scott Benner 1:02:52
Do you think I mean, there was that one person in high school, but you were young? Do you really think you were ready to build a relationship and around diabetes? Or did you even know the reason why that would be important at the time?

Speaker 1 1:03:03
I didn't, uh, you know, I honestly didn't think about it, I just was i Oh, there's another person in my class that's kind of going through the same thing as I am. But they've also had it a lot longer than I have. So they kind of got it down. They don't really talk about it. And I was like, Well, I don't really have much to, like, connect with him. So sorry, connect with him. Oh, yeah,

Scott Benner 1:03:23
no. So now once your world expands as far as different people, different backgrounds, different places in college, you see the need to connect in real life, but there's still only a few people, but there's still value in that. Right? Correct. What do you think that value was at the time?

Speaker 1 1:03:39
I think it was just what making me feel like I was just a normal person. I just wanted that. And I just, I needed to know that. Like, you know, there was other people out there with type one diabetes experiencing the same type of, you know, thoughts that I

Scott Benner 1:03:54
was habit. When were you first introduced to the Medtronic champions community? Yeah.

Speaker 1 1:03:59
So about two years ago, I was, you know, becoming more I was looking around, and I noticed it upon the Medtronic community. And I was like, this is something I really, really, I kind of need, you know, I said I, all throughout these years, I was, you know, afraid to show my pump. You couldn't, I would wear long sleeves, like, didn't want people to see my CGM because I didn't want people to ask me questions. And you know, I just felt so uncomfortable. And then I noticed seeing these people really, in the Medtronic community just they embraced it, you could see and they weren't afraid to show it. And that was something I was really looking forward to.

Scott Benner 1:04:34
How is it knowing that your diabetes technology is such an important part of your health and your care, and having to hide it? What did it feel like to have to hide that diabetes technology and how did it feel to be able to kind of let it go,

Speaker 1 1:04:47
I will refuse to go anywhere. I like to I would run to the bathroom. I just didn't want to do it in public because I felt like people were watching me and that was just one of the hardest things I was trying to overcome. You know, I was fresh out of college, going into young professional world. So you know, going out on work events and things like that I just, I just didn't think I just didn't think to have it out because I was so afraid. But then, once I did start, you know, embracing it and showing it, that's when the curiosity came. And it was actually genuine questions and people wanting to know more about the equipment that I'm on, and how does this work? And what does this mean? And things like that, which made it kind of inspired me? Because I was like, Okay, people actually do want to understand what I'm experiencing with type one diabetes.

Scott Benner 1:05:32
What did you experience when, when the internet came into play? And now suddenly as easy as a hashtag? And you can meet all these other people who are living with diabetes as well? Can you tell me how that is? Either different or valuable? I guess, compared to meeting a few people in real life?

Speaker 1 1:05:49
Absolutely. I think if you look back from when I was first diagnosed to now, you, I would have never thought of like, you know, searching anything for someone with, you know, type one diabetes. And now it's like, it's all I see, you know, you can easily search Medtronic champions, and you see people that pop up, and you're like, wow, look at all this content. And I think that's something that, that kind of just motivates me, and which is how I've kind of came out of my shell and started embracing more and posting more on my social media with about, you know, how I'm there with type one diabetes. And I think that's something that I hope can inspire everyone else. What

Scott Benner 1:06:24
was it like having more personal intimate relationships in college with type one?

Speaker 1 1:06:28
I think it was kind of hard to explain, you know, just, for example, like, no one really knows, it understands, like what alo is. And I think that was a very hard thing for me to explain, like I, you know, it can happen in any moment. And I'm sweating. I'm just really like, not all there. And I'm trying to explain, like, Hey, this is what's going on, I need your help. And I think that was something that was hard for me to, you know, I did talk to people about it. So when this happened, they were like, oh, you know, what's going on with your mate? I'm actually a type one diabetic. This is what's going on? I need your help. What about?

Scott Benner 1:07:06
Once you've had an experience like that in front of someone? Was it always bonding? Or did it ever have people kind of step back and be maybe more leery of your relationship?

Speaker 1 1:07:18
After I would tell someone I had type one diabetes after some type of Evander ad, and they were academ more upset with me that I didn't tell them up front. Because they were like, you know, I care about you, as a person I would have loved to knowing this about you. It's not anything you should have to hide from me. And that was a lot of the realization that I was going through with a lot of people. Okay,

Scott Benner 1:07:37
let me ask you this. So now we talked about what it was like to be low, and to have that more kind of emergent situation. But what about when your blood sugar has been high or stubborn? And you're not thinking correctly, but it's not as obvious maybe to you or to them? Yeah.

Speaker 1 1:07:51
So I also I go through my same experiences when I have high blood sugars, you know, I can tell like, from my co workers, for example, I didn't really talk to you know, when I go out backtrack, when I visit multiple sites for work, I usually don't announce it. And so sometimes, I'm working throughout the day, I might have smacked forgot to take some insulin, and my blood sugar is running high, and I'm a little bit more irritable, I'm all over the place. And I'm Mike, let me stop. Hey, guys, I need to like take some insulin, and I'm sorry, I'm not I didn't tell you guys. I'm a diabetic. So you may be wondering why I'm kind of just a little bit snippy, you know, so I like to make sure I do that now going forward, because that's something I noticed. And it was kind of hindering me with my career because I was, you know, getting irritable, because I'm working nonstop. And I'm forgetting to take a step back and focus on my diabetes, right?

Scott Benner 1:08:42
Hey, with the advent of new technologies, like Medtronic, CGM, and other diabetes technology, can you tell me how that's improved your life and those interactions with people?

Speaker 1 1:08:52
Yeah, I can. I feel confident knowing that it's working in the background, as someone and I've always at least said it, I have been someone that's really bad with counting my carbs. So sometimes I kind of undershoot it because I'm scared. But it allows me to just know that, hey, it's gonna it's got my back if I forget something, and I think that allows me to have a quick, have a quick lunch. And then I'm able to get back into the work day because it's such a fast paced industry that I work in. So sometimes it is easy to forget. And so I love that I have that system that's keeping track of everything for me.

Scott Benner 1:09:26
Let me ask you one last question. When you have interactions online with other people who have type one diabetes, what social media do you find the most valuable for you personally? Like what platforms do you see the most people and have the most good interactions on?

Speaker 1 1:09:42
Yeah, I've honestly I've had tremendous interactions on Instagram. That's where I've kind of seen a lot of other diabetics reach out to me and ask me questions or comment and be like, Hey, you're experiencing this too, but I've recently also been seeing tic TOCs and you know, finding on that side of it I didn't, you know, see the videos in different videos. And I'm like, I would love to do stuff like that, but I just never had the courage. So I'm seeing people make like just the fun engagement videos now, which I love, you know, really bringing that awareness to diabetes.

Scott Benner 1:10:12
Isn't it interesting? Maybe you don't know this, but there's some sort of an age cut off somewhere where there is an entire world of people with type one diabetes existing on Facebook, that don't go into Tik Tok or Instagram and vice versa. Yeah. And I do think it's pretty broken down by, you know, when that platform was most popular for those people by age, but your younger people, I'm acting like, I'm 100 years old, but younger people seem to enjoy video more.

Speaker 1 1:10:38
Yes, I think it's just because it's something you see. And so he's like, and I think that one thing, and obviously, it's a big stereotype of our diabetes is you don't like you have diabetes. And that's something I always face. And so when I see other people that are just, you know, normal, everyday people, and I'm like, they have type one diabetes, just like me, they're literally living their life having fun. That's just something you want to see it because you don't get to see people living their everyday lives with diabetes. I think that's something I've really enjoyed.

Scott Benner 1:11:08
What are your health goals? When you go to the endocrinologist, and you make a plan for the next few months? What are you hoping to achieve? And where do you struggle? And where do you see your successes, I'll

Speaker 1 1:11:19
be honest, I was not someone who was, you know, involved with my diabetes, I wasn't really focused on my health. And that was something that, you know, you go into an endocrinologist and you get these results back. And it's not what you want to hear. It gets, it makes you nervous, it makes you scared. And so I have personally for myself, you know, I was like, This is my chance, this is my chance to change. I know, there's people that are living just like me, everyday lives, and they can keep their agencies and their blood sugar's under control. How can I do this? So I go in with it, you know, I would like to see it down a certain number of points each time I would love for my doctor to be like, Hey, I see you're entering your carbs, I see your, you know, you're not having lows. You're not running high, too often. That's my goal. And I've been seeing that. And that's what motivates me, every time I go to the endocrinologist where I don't dread going. It's like a an exciting visit for me. So you'd like

Scott Benner 1:12:07
to set a goal for yourself. And then for someone to acknowledge it to give you kind of that energy to keep going for the next goal. Yeah, I

Speaker 1 1:12:15
feel as a type one diabetic for me, and it's just so hard to balance. It's a hard, hard journey. And so I want someone when I go in, I want to be able to know like, Hey, I see what you're doing. Let's work together to do this. Let's you don't want to be put down like you know, you're doing horrible you're doing it's just, it's not going to motivate you because it's you're you're already fighting a tough battle. So just having that motivation and acknowledging the good and also how we can improve. That's what really has been the game changer for me in the past two years.

Scott Benner 1:12:51
Jalen, I appreciate you spending this time with me. This was terrific. Thank you very much.

Unknown Speaker 1:12:55
Absolutely. Thank you.

Scott Benner 1:12:57
If you enjoy Jalen story, check out Medtronic diabetes.com/juice box. If you're not already subscribed or following in your favorite audio app, please take the time now to do that. It really helps the show and get those automatic downloads set up so you never miss an episode. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast. The episode you just heard was professionally edited by wrong way recording. Wrong way recording.com


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