#998 Diabetes Myths: The Doctor Knows Best

September 14, 2023Scott Benner

A brand new series examining the myths surrounding diabetes.

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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 998 of the Juicebox Podcast.

Today on the Juicebox Podcast Jenny Smith returns for another myth episode today's is like super sized compared to some of the other myth episodes. Maybe that's because we're tackling the myth that your doctor knows best. If after this is over, you'd like to hire Jenny Smith. She works at integrated diabetes.com. Please remember 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. We're becoming bold with insulin. If you're looking for an omni pod, check out Omni pod.com forward slash juice box. If you'd like to start drinking ag one you can get five free travel packs in the year supply of vitamin D with your first order at AG one.com forward slash juice box. And you can wear the same joggers I do sleep on the same sheets Well, not exactly the same. They all come from cozy earth.com is what I mean I guess. Anyway, you can get those sheets and joggers and bath towels and everything else for 40% off when you use the offer code juicebox at checkout at cozy earth.com.

Today's episode of The Juicebox Podcast is sponsored by touched by type one, they'd like you to check them out on Facebook and Instagram and it touched by type one.org. The podcast is also sponsored by Dexcom, makers of the Dexcom G seven ng six continuous glucose monitoring system. My daughter is currently wearing the G seven and it's terrific small, easy to wear. You almost don't notice it's there. That's a rhyme dexcom.com forward slash Juicebox Podcast is also sponsored today by us med. That's the place where Arden gets her G sevens from and her on the pods and a lot of other stuff. U S med.com forward slash juicebox head over there now. Get your free benefits check and get started today. If you don't like you don't like using the internet. You can always use the phone 888-721-1514 Get started with us med tech. Yay. All right, I hit record. Hey, Jenny, welcome back to the diabetes myth series. Yay. Are you

Jennifer Smith, CDE 2:39
I'm fine. How are you?

Scott Benner 2:40
Good. Oh, I'm good. It's Friday. So it is a good day. Yeah, yes. Yes. Friday is a good day. So we're gonna tackle this one today. Your healthcare professional knows best.

Jennifer Smith, CDE 2:52
That's Oh, that's a fun one. Yeah.

Scott Benner 2:55
And it is supported here by so much feedback from people. And now didn't come the way I expected. So you're basically in this episode going to hear a lot of people's stories about interactions they've had with medical professionals. And then you and I will banter about voila. While we move from story to story. That makes sense. Fabulous. Yes. All right.

Jennifer Smith, CDE 3:19
This should be fun. Well, yeah. Okay. Coffee today.

Scott Benner 3:24
I'm drinking water with what did you tell me to put my water? Oh, the electrolyte? I did that.

Jennifer Smith, CDE 3:30
Oh, good job. Do you like them?

Scott Benner 3:32
Yeah, they're terrific. Actually can put a little flavor in the water makes everything better? It does with the new which one? Did you go

Jennifer Smith, CDE 3:39
in there? And you you and yes, I did.

Scott Benner 3:41
Yeah. So put the water and I drop in a tablet? Fizzy and go. Fabulous. Okay, so I'm going to point out some obvious ones here based on the feedback. Apparently, a lot of our dentists and I doctors fancy themselves diabetes professionals. So the endless things here. My eye doctor asked my daughter has she checked her blood sugar today. Because Jenny's laughing already. I was like wait, well, first of all, we have a CGM. And she checks her blood sugar all the time. She has type one diabetes. And that that was it. He didn't know what they were talking about. Just write her diabetes and said Did you check your blood sugar today? Yes, that's

Jennifer Smith, CDE 4:36
I, I feel like where it kind of stems from is the fact that they know they they have questions that they have to ask. Right. And they're on a typical intake form. This being one of them that coincides with a diagnosis that is on their medical history right And so they have to ask a question about which they really don't have good education at all. Because they are in a dentist or an eye doctor, or even potentially like a podiatrist, they're in a field that is very narrow. And so they know a lot, thankfully about what you're there for. Right? But on a baseline, they know that with diabetes, you should check your blood sugar. They may not even know very much about the medication that you take. I mean, I've had doctors, which I've only gone to once and I've been like, you're fired? Did you take your insulin today? We're really did I take my insulin today? That's

Scott Benner 5:47
the one Yeah, like so that's just so I think that's the obvious. Tell, I'm talking to a person who doesn't know what they're talking about. But another person makes the point that while I'm at a an appointment, and the doctor, the nurse, the somebody has no clear idea what they're talking about. My kid keeps looking at me like, you like, why are we here? Like, yeah, like, you know, why are we listening to this person who doesn't understand all of this stuff that I know, a lady said that, um, they were in the ER, and people started flooding in and treating the kid like a sideshow to look at his decks calm and look at his pump. And they're like, Oh, look at this. Like they had never seen it before. It was magical to them. And then the kids response was, he shouldn't these be the people who know what this stuff is. But no, and it's not like one story, Jenny, it like goes on and on and on. I can't tell you how many comments sound like this. My dentist, firmly lectured my three year old and told her to never drink juice because it's bad for her teeth. And he knew she was diabetic. Well, first of all, you can't really lecture a three year old.

Jennifer Smith, CDE 7:08
No weird decision.

Scott Benner 7:11
But But then, like, clearly the

Jennifer Smith, CDE 7:13
dentist also does not know Child Development very well, either. Yes.

Scott Benner 7:17
So then they describe look, the kids got diabetes, sometimes her blood sugar gets low. And we have to drink juice because they get in a dangerous situation. But then blank stares, because then there's no next thing to say like they're programmed. Don't drink juice. Don't use gummy bears, like like, these are the things my dentist will tell you the same thing over and over again, don't don't chew like potato chips, because they're dry and they get stuck in your teeth. Like bright gummy bears. sugar all over your teeth, it gets stuck, blah, blah. Yep. But then once you say, well, I need that stuff, then they don't know what to say. After that.

Jennifer Smith, CDE 7:51
They're more comments. And I think that's that's the frustration really is that they have a comment to share. Because they know from again, they're very narrow, narrow field of focus, that extra food or excess food, especially sugary types of foods or carbohydrate rich types of foods that gets stuck and may not get brushed off. Sure. Yeah. Can that create dental problems? Absolutely, it can. But to go the distance that dentists then should be able to say, Okay, if you need to treat this way, I recommend doing this. If at night, you have to treat with sugar. Try to treat with juice and have your child take a drink of water and swish it around in their mouth if possible at night, right? That's

Scott Benner 8:40
what there should be steps you don't think they should say, Oh, you have to give sugar to stop low blood sugars. Isn't his diabetes under control? Oh, you don't think that's what they should have said? Because that's the next one. Right? This dentist told the person stop using Skittles. Give your daughter something healthy. And she's like, so what am I supposed to do at three o'clock in the morning? Exactly. Yeah, what am I what am I what am I supposed to do?

Jennifer Smith, CDE 9:12
I think what it honestly boils down to is again, the general public including people who we think of as being well educated right have advanced degrees have advanced medical type of degree is it boils down to the even them not having a basic idea whether it's type one or type two, from a dental perspective. At some point someone may need to use sugar. Right? So they should have an understanding that if they know the impact of sugar on the teeth for this population of people, why do you should have an extra explanation to what to do?

Scott Benner 9:53
Well, this person was told the dentist told me my old dentist told me you're an adult And you should know better than to have a snack or drink juice at night. And then went on to say that diabetics don't actually have to monitor their glucose at night. Because, because and this is a quote, that's not a thing. Well,

Jennifer Smith, CDE 10:17
clearly that was their old dentist. Now, I don't know if they mean old as an age. We got rid of this.

Scott Benner 10:25
Yeah, after we stopped going to that dentist, but the being serious. The responses here about dentists and eye doctors go on and on and on. And I do listen, my expectation is this eye doctors especially. They're thinking type two, they've been trained to look for problems in your eyes, right? Yes. And their expectation a lot like when I talked to emergency room workers, is that a lot of the people that they see, don't have great agencies and stability. And so it, it's always the, the example I always use is that my friend is a police officer. And through the course of his day, most of the people he meets are trying to get over on him one way or the other. And that he noticed that was slipping into the way he was thinking in his private life and had to like stop himself, because he just expected everyone was lying to him. And I think that's what happens. I think they expect that. Instead of saying, Well, I work in a hospital. So I'm going to see sick people. You know, they say, well, these people are here because they have diabetes, not because their diabetes isn't managed, well managed. Yeah. But because they have it in general. So let me jump to the to this one. Hold on a second. Where is it? Sorry, there's so much here.

Jennifer Smith, CDE 11:45
But this was this one must have like yellow highlighting around? Well, I'm

Scott Benner 11:49
jumping over hang out for you. I'm literally jumping over all the repetitions, my seven year old was yelled at by her dentist. And then I was told that you need to call her doctor and regulate her numbers.

Jennifer Smith, CDE 12:03
And that's a way to get you to come back to the dentist.

Scott Benner 12:06
Well, that's where that leads into all of these comments from people that the amount of people who have been asked, Are you stable? Are you regulated? Are you that that language right there in all different kinds of settings?

Jennifer Smith, CDE 12:21
And we can even go back to some of the other myths where that was also stated, whether it's how do you deal with comments coming from people that are just outright they're stupid? I'm sorry, I hate that word. But they are stupid comments, right? So it kind of goes back to the idea that at some point, you should know enough to be able to have this quote unquote, regulated or stabilized. And I don't know how to break that. I don't know how to break that idea that at some point, it'll all just work itself out. And you won't have to deal with lows or high blood sugars, or, you know, any of the stuff that clearly these medical professionals think is possible. Yeah.

Scott Benner 13:08
No, it's tough. I mean, this is going to lead really well. People don't know who are listening. But when you and I are done recording the myth series, we're going to move on to some stuff for for doctors. And so I think this is I might hold on to something he's actually so we can go back around that would be fabulous. Yeah, it just, it really is interesting to see this feedback from people. And the older, what I'm seeing here is the older people are, the longer they've lived with diabetes, the more of these experiences they've had. And the it just doesn't stop. Like you're too old to have type one. You're too thin to have type one. Like all of that stuff just keeps happening. You don't have type one diabetes, you were diagnosed in your 50s.

Jennifer Smith, CDE 13:53
Or it's been a dentist told somebody Oh,

Scott Benner 13:55
no, this is now we're getting into doctors. Oh, yeah. This woman was told that the worst thing that she said ever happened to her was the doctor told her that she has a progressive disease and it will get worse. Like she's going to deteriorate is what she was told. And that's not that long ago, by the way. This was told to her. Yeah.

Jennifer Smith, CDE 14:19
And this is where I feel like as an educator, I truly feel so sad. That that I wish that I could just announce like a big announcement that every single person could hear. Let's take Can you please keep your comments and really do your learning before you make a comment about something right. It's where I wish that I could go to conferences and speak to you know, medical groups or dental boards or these these groups of medical professionals who clearly are not getting it right and then are coming with comments to those who are actually living the day to day grind of life with diabetes again, regardless of what type it is, I'd like to be able to just stand up and be like, Look, can you please get your information, right? Don't use, don't flap your lips, unless you actually know what you're gonna say.

Scott Benner 15:23
Listen, I was invited to talk at one of those things. And when I told them, what I wanted to talk about was how I've been able to communicate with people about diabetes, and help them they told me that I wasn't a doctor, and I couldn't talk about that. So if you didn't have the credentials, I could come in and be like a, like a famous person and just say, blah, blah, blah, blah, and fill a room for them. But they didn't want me to say anything real. So I didn't go. So great. Yeah, I so I don't know how you get there, the gatekeepers? They are Yeah, so they're absolutely even if you could get in there and he started talking, you might get a tomato in the face, and you'd be out of there in five seconds. Anyway, get down, I

Jennifer Smith, CDE 16:00
wouldn't take honestly, I would be happy to take tomatoes as long as I could stay on the stage and just talk and be real. And say, you need to learn, you need to learn from real examples of what the people coming to you for help are talking to you about. And again, especially for the practitioners who are more the very centered type of, you know, practice, like, again, a dentist or an eye doctor where you may know enough that diabetes can have impact on this part of your body. But before you ask questions that are just coming from a form that you have to read off and checkboxes on Ask them in a way that actually makes

Scott Benner 16:51
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here's a very specific answer. This woman is a 35 year plus type one. She said she goes to a regular doctor or to a dentist. She has gingivitis the doctor with no access to her medical records, no knowledge of her time and range or agency or anything else says, Well, you know take control of your diabetes can prevent this. It just that's the only thing they said to him. So she went to another physician kind of figured out once the doctor said that didn't have access. Like they just kind of talking about this. So she went to a woman's health provider and it turns out she gets something called menstrual gingivitis. Oh, and okay, who would even know, right? You know what I mean? But but the first guy told her do better. And this won't happen. And if she would have left with that in her head, then she would have spent the rest of her life torturing yourself all by the way, already with a great agency and time and rich everything would have tortured herself, not gotten this issue, figured out and spent her whole life like flailing with this I I very much like take that too. When my wife went to endocrinologist for years with what was clearly hypothyroid, seven months and they would look at her tests and go you don't have that because your TSH isn't high enough. It's in range, they would say. And then seven years she struggles until finally we learned enough to push a doctor to do something. Right.

Jennifer Smith, CDE 23:12
Right. And if this was a I mean, just obviously singling out this one particular example, this dentist then clearly didn't know enough even in his own practice setting to be able to say, Well, sure you have diabetes. But again, another question. How are you managing and then this person could have come back and said, I manage really well. My agency is here. I mean, my dentist actually asked me what my ear one a one C is which is great, right? But she could have come back and said it's here. I do really well. I manage my diabetes really well and then the dentist could have said his knowledge base should have been to understand that menstrual gingivitis could have been an issue.

Scott Benner 23:59
Well, maybe it's you will so we do the same thing like I lead with Arden's a one says this she is it's been like this for years she's incredibly well managed, like get past that because a lot of these things are like every doctor I go to blames my diabetes for no matter what it is the you know, and this here's an interesting one friend of mine has type one for years. She moves needs new Endo, gets the new Endo. The endo insists that she has type two and not type one diabetes and tries to like manhandle her into getting off of insulin. I don't even know how not to laugh, like so she's the type one for years. And someone you've just met goes looks at a piece of paper No, you don't have type one diabetes and didn't want to give her scripts I don't know what this is

Jennifer Smith, CDE 24:56
it the ones that you like run out of the room like oh my Gotta like I gotta go, almost announcing to the waiting room full of people do not see this person, right. That's how you honestly feel I had one example of that when we first moved to the DC area, I went to see a primary care just to get new prescriptions before I could get into my Endo. Like two months later or something, right? This primary care doctor had to look in, like a pharmacy manual to figure out how to write the script for my insulin. And then was still confused. And I ended up telling them how to write my prescription. This is, I mean, in general, even primary care. should know the basics of insulin prescribing.

Scott Benner 25:48
Yeah, I Arden's first. Oh, God, she really is gonna listen back to this one day and be like, What the hell, but her first ever OB appointment I was at. And like the intake nurse. We couldn't. We couldn't find a way to describe to her that insulin wasn't a thing she took, like once a day. Like I just I'm like, listen, there's Basal insulin. And there's no it just was a she. I just I stopped. I was like, write down whatever you want. I don't even care. Because we're not

Jennifer Smith, CDE 26:20
here for this. We're only here for hormonal menstruation needs gynecology. That's what we're here.

Scott Benner 26:27
And then you know, what ends up happening later is that a person who actually understands looks at it, if you get lucky, and they go, why is it like this? And I just said it lady, the lady that was talking to me earlier, she just wasn't getting it. So I let it go. You know, what am I supposed to do? A lot of the you need to regulate her numbers has has he leveled out yet. That's a big one. My daughter was in the emergency room waiting to be discharged. So they're in there for a non diabetes thing. And I asked the nurse, can I get a juice because my daughter's getting low. The nurse laughed, laughed, and then said quote, no juice for you. You're diabetic. So the lady has to then explain to an ER nurse. Yes, she's diabetic, she has insulin, she's had too much of it, her blood sugar is getting low, I need the juice to save her. And that that had to be explained before it can be brought in. Again, a lot of this also

Jennifer Smith, CDE 27:23
is it makes me think of the reason that a lot of people with diabetes and or a medic, another medical condition that isn't necessarily well understood. In general. It sometimes feels like you have to put on a coat of armor, to like stand up and be able to stand up for yourself. Right? And to address these comments that are so hurtful isn't the right word, but they are it's like you have to defend yourself against stupidity.

Scott Benner 28:03
I think it's exhausting. I think it's hurtful. It's hurtful in that it's exhausting. Like you're just like, oh again, is this gonna happen again? Like okay, and then you gotta rally and you be like, okay, so juice and you know, but the whole time you have to be thinking you are a nurse in an EMR. Like, you can't possibly not understand what I'm saying, like I get when my mother in law brings the wrong thing. When I say Arden is low, I don't understand what a nurse says you can't have juice because you have diabetes. All right here, this one is from a doctor. They kept telling this person it's okay. If your son's blood sugar spikes to 400 as long as it comes back down.

Unknown Speaker 28:46
I've heard this many times. Yeah.

Scott Benner 28:50
Now she's having a remembrance of this time the kids blood sugar goes to 432. And because they gave him like pizza and stuff that they didn't even understand how to manage yet. The kid flies up over 400 She's upset. So she's calling the nurse. And the nurse is you know, at the the the Windows Office is telling her like you don't do anything. Just wait. And hours and hours and hours go by and they're waiting and waiting. And she's no she's doing the wrong thing. And it's making her upset. And the doctor's office is telling them no. Like, yeah, just No, you don't don't Bolus again, you have to wait. You put the insulin and it's going to work, right? I mean, some of the bread and butter this podcast is talking about bolusing for fat and protein. Like people love those episodes, because it is obviously a thing that nobody tells you about work. I mean, in this example, they just don't even understand. A school nurse told this woman her child did not need to Pre-Bolus because another child in the school has diabetes, and they don't Pre-Bolus

Jennifer Smith, CDE 29:54
Because and that's the only example that this person that this nurse in the school has and says, Well, it works for this person, this must be the standard of care. So this is what we're going to use.

Scott Benner 30:06
More importantly, had she met the Pre-Bolus ng family first, then when the non Pre-Bolus ng family would have said we don't Pre-Bolus She would have been Oh, no, you have to? Because the other person I know already does it. Like that's literally, that's just stupidity, that's not being able to work. Well, that's also

Jennifer Smith, CDE 30:23
like saying, Well, you have this condition, you should be using this medication. Right? It's not a person to person, we very much obviously know that it's very different. So person to person, even with type one diabetes in a school child, this child might be using this type of a system in which this type of strategy is necessary. This child might be completely different. So strategies need to be very individualized.

Scott Benner 30:56
Well, I went through this with Arden in school. When I I called the nurse's office one day and I said, Hey, art, and she was she was still really young. And I was like, Arden needs to come down and get insulin. You know, I texted her, and she told me what her blood sugar was. It's too high. It's like 200. And I needed you to push it down. And she goes, We're not going to do that. And I said, why not? She goes, there's like four or five kids in the school. We don't do that for any of them. And I so where I am, I don't know what's wrong with me why I'm wired the way I am. But I was like, Listen, I don't give a crap what those other families are okay, with. It's meaningless to me if they want their kids to walk around with high blood sugars, that God bless, like, that's fine. My daughter does this not doing a thing? Because other people are doing it? Are you out of your mind? Like what kind of like, there's no common sense, whatsoever. But But even after, but to their credit, after I explained it, she's like, okay, but like, why was that the first thing she said? Like, why can't people think is is my problem? Like? Like, I already heard this from somewhere else. So that's the rule, because you heard it first. Like, I don't I don't get that. I really don't. There's a comment here that's not attached to a story that I just want to read. I wonder if the people who tell us these lies, would follow those rules if they had type one diabetes themselves?

Jennifer Smith, CDE 32:20
Well, and that's a it's a great because quite honestly, even if they learned a little bit about type one diabetes, they would change their tune very, very quickly. I think it also makes people I know myself, as I think about it, in going into any new health care provider, someone I've not seen before, as I said before, I sort of on a subconscious level, I know that there's going to be explanation that I have to bring in that I feel really frustrated about that I have to provide this almost this education session in just like a two minute conversation, to get them to understand that. Please, please don't offer me information. I don't need your information, like I'm here for this. Please give me this. I will tell you this about myself, I will answer it for you. And we will go on our merry way as

Scott Benner 33:21
well. And look how sad that is. So you know how to take care of your diabetes, so you don't need them. But other people need them. And what they're getting from them is not just wrong, sometimes. But awesome. Opposite here. Here's an opposite. I was having a hospital stay. The resident told me, I will need less insulin because I'm bedridden. So less activity. Not that's opposite. They're likely going to need more insulin for being. Right. I mean, maybe not exactly. But the idea that it's definitely going to be less because you're not moving around is countered.

Jennifer Smith, CDE 33:57
And the fact that they're there for a hospital stay is probably a stressor, right? It's not like you're bedridden at Disneyworld, and like enjoying Mickey Mouse breakfast, right?

Scott Benner 34:09
Also, by the way, there could be there's always variables, here's one that jumps in my head. If you're a person who's not well hydrated, and you use a lot more insulin cuz you're not well hydrated, then I sit you in a bed and I put an IV in your arm and hydrate the hell out of you. Your insulin might work better. And you might have a different so maybe that's what there's who knows, but it's just that person knew that's not right.

Jennifer Smith, CDE 34:29
But there, I think there was no explanation. And so I think that's another piece behind all of this is that there's no explanation for some of the silly comments that end up coming out. And you are the person with diabetes or the caregiver, you know, a child or somebody you're left thinking, how could they think this like what am I supposed to do with this nonsense information that you're talking about?

Scott Benner 34:56
Or isn't it even more shocking to hear than a person Somebody's told you have to have type two diabetes, because you're older, but that person who told him that is a neurologist, like, isn't there? I mean, am I? Am I the only one who hears neurologists and thinks you must be a pretty bright person? You don't I mean, would like the capacity to remember a lot of things and correct? Yes. This person says, I hate having a lazy Doctor Who decides that anything else wrong with me, has to be my diabetes. And then the response is, if you lower your agency, this is This one's interesting. If you lower your agency, your osteo, arthritis in your hand will go away. You had a abscess in your tooth, because your diabetes is uncontrolled. That's why you need a root canal and antibiotics because your diabetes is not managed well. Then this one is fascinating. And by the way, the amount of people who then said this happened to them was mind numbing. They had rotator cuff problem, okay. But because they had diabetes, they told them, they had frozen shoulder, okay. And then they put them through vigorous exercise, frozen shoulder exercises, on their chewed up rotator cuff that had nothing to do with frozen shoulder. The amount of people in one sub thread that talked about this happening to them is mine.

Jennifer Smith, CDE 36:25
So literally, they didn't have frozen shoulder, which is no potential complication of that it is yes. But they actually didn't have frozen shoulder. They were told that they did. When it was really more of another issue.

Scott Benner 36:38
They all had rotator cuff tears, and it was nothing. But there's four people here saying that they all had rotator cuff tears. Their doctor said, Oh, you have diabetes, this is frozen shoulder. And then they get I don't know how people know, like they they want to break up the chair that the What am I thinking? Right? Yeah. And so they they're they do these, like, if you've ever had a torn rotator cough, which I have had. So I have thankfully, I have a good feeling about this. It's incredibly painful. And moving your arm makes it a lot worse. So this one lady did it for a year. A year. And then finally the doctor was like, oh, let's take an image. Oh, you're

Jennifer Smith, CDE 37:24
doing image to be good, like fright? I don't know. Yes. Yeah, I would think so. Like if you're gonna die or anything. I mean, you don't write

Scott Benner 37:34
I guess you. But that's this is what people talk about over and over again. And they see the diabetes first. And then they have mind runs to that those ideas that I always like, you know, you see people online talk all the time. The phrase, are you like real person sick? Like, like, I don't feel well? Are you real person sick? Do you have a cold? Or is this your diabetes? Like, like, you know, like, that's the thing people say. And I think that's an example of the doctor just skipping over a real person's stick and going right to Will you have diabetes, so this must be that. That's it. My this, this conversation about the shoulder thing goes on forever. Oh, here, here, in the same vein, I went to the ER with sepsis. This is a serious thing. But they told me to go away control my glucose levels, and I'll be better. So they, so they didn't, she had sepsis. They didn't take time to realize she was septic. They just tested her blood sugar and told her that was the problem. And it was probably high because she had sepsis. Well, she said, I do believe that it's because I had sepsis that my blood sugar was high. And then she ran into a woman in the waiting room. And that person said, I just saw someone die of this last year on

Jennifer Smith, CDE 38:57
something you put one that's

Scott Benner 39:00
yeah. I'm not laughing at this absence. Everyone knows.

Jennifer Smith, CDE 39:05
I wish what I honestly wish I could honestly which clearly it would be so illegal to do. All these people are like, don't go to this establishment. This doctor did this. Clearly we can't do that. But I mean, really, wouldn't you want a list of all the all the people that clearly are not good to go?

Scott Benner 39:25
You're saying like the way you can google sex offenders. They come up on a Mac? Yeah, yeah, I get what you're saying. Oh, sorry. No, no, no, I did. Yeah. Okay. Please don't post your dash. Yeah, I don't think we're supposed to do that. Like I'm not calling. A nurse in a hospital said would you like some honey in your tea? I know you have diabetes, so you can't have sugar. But since honey is natural, it won't affect your blood sugar.

Jennifer Smith, CDE 39:54
That's another good one. What kind of actually makes me think of the Skittles comment that you said earlier like Can't you find something healthier than Skittles? Okay, sure. How about I try raisins. They're just as sticky and gluey as a Skittle is right. sugar is sugar on the teeth. So whether it's a healthier option, or a completely like, created product in some food lab, some place, sugar that's gonna stick to your teeth that you're not going to brush away is still sugars Good.

Scott Benner 40:27
Well, this, this is another one that got a lot of responses, the honey thing happens to people a lot. Like, oh, just use honey, it's natural. That thing. This person said, I was going through the grocery store line. And my bagger kept complimenting me on my health, healthy food choices, but then got to my Truvia and told me I have to put this back and get honey. Because that would be better for me. And she's like, well, I have diabetes, so I'm right. Not and they're like, give it this is a chemical. And yeah, no, I don't is

Jennifer Smith, CDE 41:05
the amount of people I think that again, want to give what they think is going to be helpful information. Because out of the goodness of their heart. They just Oh, I know, I know this thing. I totally want to share this thing with you with no knowledge of what you or somebody else is living with or dealing with. They just, they just want to spew there.

Scott Benner 41:34
Yeah, yeah. All right. I already I already told you this one. Here's one. This is this is more generalized. How many people are told that, quote unquote, tight management is not possible without it being a huge mental load? I think that's, yeah, that happens a lot. Right? Like so. So people are told, don't take that good care of yourself. Because it must be upsetting to you to have to focus on it like that. So is that? Are they trying to say? Trade, mental health, for

Jennifer Smith, CDE 42:08
physical health? What it sounds like, overall,

Scott Benner 42:12
so I'll be happier as I'm dying. It No, that won't happen. When you're dying, you definitely won't be happy. So. So hold on. So I get the ISO, I guess I get the high level idea. Yes. Like don't tax yourself too much. But if, but when I see this, sent to me, it's very frequently by people who will later tell you I'm not taxed by it. Like I figured it out. I'm doing well. Maybe once these the five, and then they go to a doctor's office. And they're told, stop. Like, I want your agency higher. Those words come out of people's mouths a lot. Yes.

Jennifer Smith, CDE 42:47
Yeah. And I think there is, I mean, the mental component of managing? Absolutely. Could it become overwhelming if you really are over the top in, like, consistently, like, click, click, click, click, click, I gotta see, I have to see I have to look, I have to do this, I have to adjust this, I have to do this, blah, blah, blah. And you never really do learn how to get to that. I don't want to use the word stable. But that place of just knowing for the most part where

Scott Benner 43:16
your decisions, your decisions lead to stuff that doesn't read, constantly bumped around.

Jennifer Smith, CDE 43:21
Yeah, so the mental load can definitely be considerable. But for somebody to say trade, the mental part of it for happiness with less management, by no means is going to make you happier.

Scott Benner 43:37
Also, wouldn't you start off by asking, do you find this too taxing Right? Right. Yeah. Because maybe the person will go yes, actually, it is. But but for the people go, No, I'm good. Like, thanks. Like, you just are assuming that because my numbers are lower than other people's, that I must be putting a ton of effort into it. Oh, that is what it is. Okay. Yeah. Let's see how it was that one. And that, that leads into my my spouse also thinks that I'm micromanaging things. And then they call me a control freak. And but the person says, But I'm less stressed now than I was before. Right? Because I'm seeing blood sugar's mainly between 80 and 130. My mom told me that I was being too hyper about this. My son's endo is good because he has type one himself, but still, the nurses are not helpful. Isn't isn't that interesting? Right, like you, the doctor knows. And somehow the staff doesn't know.

Jennifer Smith, CDE 44:41
And I think there's a different level of understanding there. To a degree. I've also always thought that nurses or the other support clinical staff within an endocrinology practice, they really should be well schooled. In that particular medical condition, right. And so I think that's where a little bit of that lack might come in. Maybe you do have a really awesome Endo, or nurse practitioner or PA who does get the diabetes part of it the way that they should. But the support staff may not. And it's frustrating. I know.

Scott Benner 45:27
My neighbor is a nurse and told me quote, at least you'll never be fat. Oh. Is that? I don't know. Is it easy to be a nurse? What is happening? i It seems like something that would be difficult to accomplish.

Jennifer Smith, CDE 45:43
And easy. I mean, no, there's a lot of schooling that goes into being a nurse. I,

Scott Benner 45:49
yes. I don't even want to dig into that. Because I don't even understand what that means, like type ones. Oh, she just means type twos.

Jennifer Smith, CDE 45:58
I don't know even what that means. Oh, God,

Scott Benner 46:00
I don't even know how to pick that one apart. I went to pick up my prescription and the pharmacist told me, No one needs to check their blood sugar eight to 10 times a day for test strips, and then went on to say I doubt your insurance companies even going to approve such a crazy amount of test strips. Crazy amount. You're crazy.

Jennifer Smith, CDE 46:20
I had, I actually had this as a personal experience at my pharmacy. I did. And I really did. I wrote a letter to that I wrote a letter to the company. I was so angry. I was I had gotten to pick up my test strips. And my order is for a good number of test strips, right? Even though I have a CGM, right, who knows about the zombie apocalypse? Right? Standing kind of outside of the area where they're filling, and there's an open window and like the pharmacy techs and the pharmacist can have discussion. And this pharmacy tech was looking at my order. I know it was my order, because I was the only one there. And the specifics of the order for the number of tests a day. She actually said something to the degree of what this comment is that knowing that I was there and that I could hear she was like, what kind of person why would you even need to check your blood sugar this many times a day. That just seems outrageous. And I was to Yuming I was so angry and I was like, keep it together Jenny. I was like this is going to their corporate office. I was so so angry about just the comment. And so I wrote a letter and I got a really good I got a really nice letter back. And whether it's that this person doesn't work the same shifts or whatever, I've never seen this person there again. Whether it's got let go or had significant discussion or whatever it was, but I was I was fuming mad.

Scott Benner 48:06
Do you think the nurse was let go Who told someone their three year old didn't need a snack because the pump was going to stop the load from happening. The adults said there was a lot of insulin on board left. They told me that I was over managing him didn't know what I was talking about and the pump take care that pump takes care of everything. So

Jennifer Smith, CDE 48:27
literally this person was refusing to provide a treatment to hell.

Scott Benner 48:32
Yeah, we're, we're gonna end up here with some after this one, we're gonna end up with some school nurse stuff. So but you have to hear this one. My son had his first seizure from diabetes from a low when he was nine years old. To complicate things we had been doing karate the night before. And I was afraid that maybe he had his head too hard being thrown. They live in a rural area, and they went to the emergency room after giving him glucagon during the seizure. The ER doc had already been eyeing me because I'm a large bodied person, and I was getting judgmental looks. Then the CT scans came back. And I guess they were clear that they were they were clear. And the doctor said the CT scans are clear. And then quote if you guys just stay clear of the MooMoo burgers this won't happen again. Oh. And then while he was saying that, he was tracing Oh my god. I don't usually get thrown off by

Speaker 2 49:30
oh my gosh, I just thrown off Uber

Scott Benner 49:33
well while the ER doctor said if you guys just stay clear of the moo moo burgers this won't happen again. He was using his finger to trace her form in front of her oh wow, that threw me off. He walked out before I could muster up how to explain to him that one obesity doesn't cause type one diabetes and children. That to my child is actually adopted. And that fast food doesn't cause seizures. Oh, yeah, he still works at the hospital. She said she had to go back and wood and refuse to Sam. Oh my god. And she did she did write a letter to. Anyway, I actually made me upset

Jennifer Smith, CDE 50:18
makes I'm so sorry to that person. If I know I always tell people like when I'm working with, you know, people on Zoom, obviously. And sometimes there's a very, like emotional conversation. Sometimes people just get teary eyed and like, I wish I could give you a hug.

Scott Benner 50:34
I'm so sorry. That one threw me off except that like, I get that pins in my chest. I think I got I think I was mad. That was really something. Okay, so the school nurse, either get a good one or you don't? I don't know another way to say really are some really great ones. And oh, my god, there are Yeah, no, no, there, there absolutely are we and we ended up having good ones. I've heard of school nurses who have bought iPads with their own money to follow tax comps, things like that. But this person points out, you're going to get told by the school that the school nurse is trained to handle the problem. And that really might not be the case. So advocate, I don't

Jennifer Smith, CDE 51:17
think might is that marry, it may very well not be the case, you will very likely have to go in and educate in your individual nature of need. Because even if the school nurse has had experience with a type one, like you said before, in that example, which astounds me, no one will need the same management.

Scott Benner 51:44
And you might get this one who called the mom to say her sixth grader was on a trip with a school and they had a low blood sugar. But don't worry, they made sure he did not have any candy because they know diabetics cannot have sugar.

Jennifer Smith, CDE 51:58
Oh, I'd be in the car. Drive to wherever my child, my child. Oh, wait, hold by gets scarier especially like a child who really is old enough and knows better. would likely have something on their person and would likely know well enough to be like, Look, I'm going to treat this, I don't care what you're saying, I'm going to do what I need to do. But for a very small child, or one that doesn't really know quite yet what to do on their own. You are leaving it to the power of this nurse to help.

Scott Benner 52:34
Yeah, no, I mean, listen, there's a bigger conversation here, you have to educate them, you have to go to a meeting before school starts, you really have to lay the whole thing out, you know, put your intentions upfront how you want to manage it, what your expectations are of them. It's a it's a very delicate,

Jennifer Smith, CDE 52:51
I think I've seen often too, especially since school is really coming up for a lot of people, I see the discussion about five oh fours and all of the different plans and, and everything in what I've seen work the best, quite honestly, is a what I call a decision matrix. It's like an if this then this type of scenario. Very well bulleted, very easy to read in the moment in the need. So that you really can drive those points forward in an easy way. And then they

Scott Benner 53:23
will learn well, it won't take long to learn it after that. This one's a random one. I was diagnosed with type one and couldn't see an endo for the first year. But the doctor I was seeing kept giving me advice about how I could eat so that I could get off of insulin.

Jennifer Smith, CDE 53:37
Oh, thank goodness for that doctor. Yes, I'd like to talk to that doctor. Maybe he can teach me how to eat so I can

Scott Benner 53:45
Yeah, maybe you could get rid of why? Why is she bogarting this doctor who has all the great information. This is a long one I'm going to kind of synopsize a little bit because I think it makes a point. This person said that they were diagnosed for less than 90 days. And they got no note nothing like no information because happens to adults all the time. I know people like to say all the time, it's so hard for a kid to be diagnosed, it's hard for an adult to be diagnosed because they're like, here's insulin, good luck. And you know that that's it, this person found the podcast and this is not me just like trying to say something nice about possible but taught themselves what to do. And then use that information moving forward to shape how they were being managed by the doctor. Like by having like, information and knowing what you want. She was able to say look what I've accomplished. This is how I accomplished it. I'd like to keep doing it like this. And then what you don't know will happen but I trust me I know what's going to happen is the doctor is going to be relieved that they don't because I mean you've just heard these stories forever. They're gonna be like finally one of them I'm not going to mess up and like and then they can they're going to be thrilled to help correct

Jennifer Smith, CDE 54:57
so and help and me Maybe if you really get to have a good doctor there, maybe there will be very willing to ask you questions so that they can also learn more and help someone else who doesn't have the knowledge that you brought in, right? Maybe if they're really good doctor, you know, I also think that the doctors are like, thank goodness, this one's gonna help my ratings go up.

Scott Benner 55:24
Somebody's gonna look like me. They're gonna

Jennifer Smith, CDE 55:26
show that I actually know what I'm talking.

Scott Benner 55:30
So do you have a couple of minutes to just rapid fire through some miscellaneous ones at the end? Yeah, I've got about five minutes. I don't know what this one means. My 10 year old was getting her annual labs for celiac and thyroid, the phlebotomist said, at least you know, she won't grow up to be a junkie. Don't know what that means. Listen, I don't know. I was told by my doctor not to feed my son too much rice, because that will make him get diabetes.

Jennifer Smith, CDE 55:57
And this person already had diabetes.

Scott Benner 56:02
I don't know. I. So this is the stuff that people said that they hear. It's just diabetes. It happens because of diabetes. You need to get off of that stuff. Referring to insulin, insulin. All of my health thought problems are blamed on being diabetic. At one point, this person had a brain bleed. And they were telling them that this their blood sugar is why they have a headache. That on this made me curse. I am sorry, that was I know that they have to label me as uncontrolled for insurance reasons. But I worked so hard. And it really feels like a slap in the face. Yeah. So this person sees their chart and they say uncontrol Also, we didn't get into this. But I think a lot of this maybe we should find a place to get into this in the podcast, but the ADA still say and seven right for an agency. I think that's part of the problem, too. Let's see. I've been told that I can't do things because I have diabetes. Oh, you're a one C so good. Are you sure you even have diabetes? Oh, no, not

Jennifer Smith, CDE 57:15
it's all gone. Now that I got my a one C at this 5.2 level? Clearly I no longer have to do anything. Any. Hallelujah. I fixed it. Yeah.

Scott Benner 57:27
This person said they had a video of their kid online and they had on a pump. And a conspiracy theorist told them that they were turning the child into an antenna. That was interesting. I don't like hearing the word diabeetus. Cuz I don't think it's funny. I was once told I had asked if I had cancer because I saw my pod. That's actually I guess people would know that I know this because of my mom. There's a chemo drug Yes. That you're supposed to get for like 24 hours after. And they put it in and on the pod. It's not. I mean, on the pod insolate makes them you know,

Jennifer Smith, CDE 58:04
I've seen the commercials. With the rare amount of television. I see. Okay, once I saw, I was like, really? They're using the pods for something else. That's amazing. Yeah.

Scott Benner 58:16
I was called a drain on the healthcare system by a doctor. Yeah, wow. I don't know. I can't do much more of this. This is like this goes on and on and on forever. Like this. This is pages and pages of responses from people. This is just

Jennifer Smith, CDE 58:34
I mean, it goes back. I think it was probably within the first one or two of the myths that we did something about comments. You know what not and I said, you even my kindergartener has learned the whole Zipit locket put it in your stomach. Come on, just don't speak. If you're going to come out with something that's absurd. Just leave think first.

Scott Benner 59:02
Yeah, being I've been told I'm a helicopter mom for taking good care of my child's health. Okay, and I'm going to end on this one. Because this

Unknown Speaker 59:09
one, this is the end all of them.

Scott Benner 59:12
I mean, in my mind, it kinda is. And honestly, I can't keep scrolling like it goes on for freaking ever. Although Hold on. When you're nine years old, and you have a low blood sugar and your Dad Hey into a course to fix it. Oh, hold on. Here's what I'm ending on. A nurse told me a nurse who has diabetes. Type one told me another diabetes person. I run better on high octane. I leave my blood sugar high. Okay, there you go. Good luck, everybody.

Jennifer Smith, CDE 59:56
Oh, I don't even I don't know a comment for that. Other than that. I clearly should not be hopefully a diabetes nurse specialist because that's,

Scott Benner 1:00:07
yeah, this one wasn't a doctor, but I once told a friend I was pregnant and they said, I didn't think diabetics were allowed to get pregnant.

Jennifer Smith, CDE 1:00:14
Yeah, I've heard that more often than I need to, especially with the year that we are in currently and all the technology we have and what we know about that.

Scott Benner 1:00:24
Yep. Okay, Jenny, we've done it.

Jennifer Smith, CDE 1:00:28
I wish you know, I was like, smiling and happy and beginning.

Scott Benner 1:00:33
I know, we were all like, it's Friday. All right, I think it's obligatory to say, not every doctor doesn't know what they're talking about.

Jennifer Smith, CDE 1:00:42
100% There are really good physicians are really good nurses. They're really good health practitioners out there that really do what they are aiming to do for the benefit of the people that they're working with. Absolutely. But this clearly demonstrates

Scott Benner 1:01:00
that it exists in and there's more than a little bit of it and it's my intention to present it to you to say that if this any of this stuff or something like this has happened to you, you have to go get a better doctor. Yeah, absolutely. That's really why I'm putting this here. So I hope everybody enjoyed people's stories of ridiculousness, but thank you have a good

Jennifer Smith, CDE 1:01:21
weekend. You too.

Scott Benner 1:01:30
Always happy to have Jenny here. Don't forget she said integrated diabetes.com Speaking of being happy dexcom.com forward slash juice box, check out your blood sugar's in real time on your iPhone or Android. We're gonna thank us Med and remind you that at us med.com forward slash juice box, you can get your free benefits check and get going right away with us med or you can call them at 888-721-1514 Well, this was episode 998. Tomorrow is 999. With Arden it's her third appearance on the show. And then at episode 1000. The diabetes Pro Tip series is back and it's remastered sounds better than ever. Download them all and have them in your player for when you need them. If you are a loved one has been diagnosed with type one diabetes. The bold beginnings series from the Juicebox Podcast is a terrific place to begin listening. In this series, Jenny Smith and I will go over the questions most often asked at the beginning of type one. Jenny is a certified diabetes care and education specialist who is also a registered and licensed dietitian and Jenny has had type one diabetes for 35 years. My name is Scott Benner and I am the father of a child who has type one diabetes. Our daughter Arden was diagnosed in 2006 at the age of two. I believe that at the core of diabetes management, understanding how insulin works, and how food and other variables impact your system is of the utmost importance. The bold beginning series will lead you down the path of understanding. This series is made up of 24 episodes. And it begins that episode 698 In your podcast, or audio player. I'll list those episodes at the end of this to listen, you can go to juicebox podcast.com. Go up to the menu at the top and choose bold beginnings. Or go into any audio app like Apple podcasts, or Spotify. And then find the episodes that correspond with the series. Those lists again are at Juicebox Podcast up in the menu or if you're in the private Facebook group. In the featured tab. The private Facebook group has over 40,000 members. There are conversations happening right now and 24 hours a day that you'd be incredibly interested in. So don't wait. So don't wait. Check out the bold beginning series today and get started on your journey. Episode 698 defines the bull beginning series 702, honeymooning 706 adult diagnosis 711 and 712 go over diabetes terminologies in Episode 715 We talked about fear of insulin in 719 the 1515 rule episode 723 long acting insulin 727 target range 731 food choices 735 Pre-Bolus 739 carbs 743 stacking 747 flexibility in Episode 751 We discussed school in Episode 755 Exercise 759 guilt, fears hope and expectations. In episode 763 of the bowl beginning series. We talk about community 772 journaling so Ben 76 technology and medical supplies Episode Seven at treating low blood glucose episode 784 dealing with insurance 788 talking to your family and episode 805 illness and ketone management check it out it will change your life