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Scott Benner 0:00
Hello friends, welcome to episode 1115 of the Juicebox Podcast.

Next son was diagnosed with type one diabetes in the middle of the pandemic. found during lunchtime at school shaking uncontrollably. He was rushed to the PICU where he was later diagnosed. 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 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. If you're not already subscribed or following 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.

This episode of The Juicebox Podcast is sponsored by the Dexcom G seven made for all types of diabetes Dexcom G seven can be used to manage type one, type two, and gestational diabetes, you're going to see the speed, direction and number of your blood sugar right on your receiver or smartphone device. dexcom.com/juice box. This episode of The Juicebox Podcast is sponsored by the continuous glucose monitor that my daughter wears the Dexcom G seven dexcom.com/juice box Get started today using this link. And you'll not only be doing something great for yourself, you'll be supporting the Juicebox Podcast.

Nick 2:16
My name is Nick and I am the father of a type one diabetic son. I also have a 16 year old daughter and a wife.

Scott Benner 2:25
How old is your son?

Nick 2:27
He is 13. He'll be 14 in August. When

Scott Benner 2:31
was he diagnosed?

Nick 2:33
may have three years ago may. Okay. 2019. Right in the pandemic,

Scott Benner 2:39
any other autoimmune in your family?

Nick 2:42
No, none that we're aware of? Like nothing. It's strange. I hear you ask that question a lot. And I'm like, I don't have anything. We get a couple brain tumors and my wife's family lives had there were 100. So I

Scott Benner 2:58
know nothing. Celiac thyroid, uneasy stomach after dinner like nothing. You can think of

Nick 3:05
ah, you know, I may have a touch in the last six months, like gluten sensitivity. I don't know if it just been almost 45 Or what it is. But I've kind of watched my Gluten seems to help. But as far as any diagnosis, family members or any other type one or thyroid or anything like that, there's nothing yet. So

Scott Benner 3:25
how did you end up finding out that your son had diabetes, what clued you into it?

Nick 3:31
We came home they were in home school at that time, or online school. And my wife and I have a small business with her family here in town and came home for lunch to get their lunch going because they were you know, each on their computers and our son had been you know, shows showed all the normal signs before looking back. But my wife came home about 15 minutes for I did got his lunch ready brought it upstairs as I was coming home to you know, make a quick sandwich. We're going back to the office and I just hear a scream and my wife come downstairs like there's something wrong. There's something really wrong. That's like, okay, she's gonna call him the doctor now go up there. And he was just kind of shaking and couldn't really talk and to sit I did. Something's wrong. Ended up you know, even though it's lunchtime, our doctor answered the phone, we ran over to his office. And it was only one like only one parent could go in at a time. So my wife ran him into the office and I'm course you know, in my car, googling what the heck this could be and coming up with some pretty bad stuff. And about 10 minutes later, she calls to get the car there have a room for him at the emergency room and I was like, Okay, that's great. But what is wrong? Like, why? What's going on? I know nothing right now. She just said they said something about diabetes. And I was like, What are you talking about? Like there's no way and she's like Nick it just, we gotta go there's already a room so we run across the street to the hospital and I Uh, sure enough, he was in DKA. And in not doing real well.

Scott Benner 5:05
Wow. So he was convulsing, not quite convulsing,

Nick 5:09
but he was shaking, he gets really shaky. And he was pale white, and couldn't really communicate well, I don't remember what his blood sugar is, it was pretty high. And they got IVs. And, um, you know, started bringing them down. And then he got transferred. They told us there's another child in the ER also with the same thing going on. And whichever one is worse, is going to go to the Children's Hospital about 30 minutes south first on an ambulance. And so I'm just kind of sitting in my car and I see the ambulance leave, and I call my wife. She's like, Nope, we're still here. So about an hour later, they take him and we're not allowed to go in the ambulance with him. And follow him there, dropped my wife off again. And then my son, and he was admitted and spent about three nights in the PICU. Wow.

Scott Benner 5:59
Yeah, that's, uh, that sounds like both of those kids weren't doing well.

Nick 6:04
No kidding. You know, but we managed to get through it. My wife would spend the days there and I'd spend the nights or vice versa, whatever we needed to do and got out of there and just started this new journey.

Scott Benner 6:18
When you said that can't be the her, is it because he was 11. And they said, diabetes. I

Nick 6:24
just, it never crossed my mind. It's a possibility. My dad's best friend was a type one. So I grew up around it. I knew a little bit. And he's actually been a huge resource and help the last three years, and I just it just never crossed my mind that that's what was going on that this could cause what was happening to him. I mean, obviously, uncontrolled blood sugars have great effects in your body. I had no clue. Yeah. And I just, you know, the first thing, honestly, there's no way like, there's something else, he's got a bad infection, there's something else going on, there's no way. Again, no family history at all. So it just kind of came out of the blue. You know, obviously, he picked up some bug. We think, early December, we were on a trip to DC. So when we first started noticing some signs, looking back, my wife, remember smelling his breath, and it was sweet. And he's a really good kid. And he would have to move the outbreaks and was looking just thin, you know, wetting the bed, all the common signs looking back that we just missed, and probably would have taken him to the doctor, at some point, but doctors weren't even seeing patients unless they were super sick that time. So that, you know, it kind of makes you question. You know, could we have caught this earlier? Probably could have. But in the current climate that time, there's no way I don't think we could have,

Scott Benner 7:45
how did they manage manage the education piece when you guys couldn't be in the hospital at the same time, we

Nick 7:53
were allowed. We did have a class at that hospital before we left. In all honesty, it wasn't very good and probably set his back years of trying to get this under control. Like we left the hospital and never even I never even gave him a shot. Never practice a shot. Nothing. They just kept saying here's all the gear you need. Here's all this, you know, pins. And we walked out with two suitcases with the supplies that I didn't need. With very little knowledge. In my opinion, I was not happy. We ended up changing doctors, that the first year after about six months of putting up with it. It just we were not a good fit. Or they weren't a good fit with us. And you know, we've walked out had no idea what we were doing basically, he was starving, hadn't eaten anything really in three days. You know, grabbing the hamburger across the parking lot. And like, Thank you need 10 units of insulin. I don't know what this kind of what the math turns out. I don't know how we do this. So I stuck him. And that's how we started and then I had to figure it out from there.

Scott Benner 8:56
Well, your wife, also she didn't get direction either. It wasn't just you. Oh, we

Nick 9:01
were together the whole time. Oh, God, like we didn't have to. We didn't feel like we had good education at all. We Yes, we count carbs. And our carb ratio was like 20 to one or something crazy like that, that time just didn't know anything. Like we kind of left in a in a fog. And there we go. Here's a number to call if you have any questions. Well, you know, we're checking blood sugar on his finger and it's going crazy. And we're calling and having to wait, you know, an hour and a half for an answer. Oh, you know, for them to call back. Like, why are you even calling because we don't feel comfortable giving him his insulin. We don't know what we're doing. Yeah, we'll just give it to him. Well, I mean, that's the right thing to do. I mean, we were scared. literally scared at this point.

Scott Benner 9:45
Also, so it was all the stuff that led me to call you is 90 minutes old now. So exactly.

Nick 9:51
Yes. Totally different. Pretty, pretty hot conversation with a doctor or PA few times before we decided we gotta find looking better? This isn't gonna work for us. It

Scott Benner 10:02
was was this, I don't want you to tell me where but was it an institution that otherwise you would have been trusting of?

Nick 10:08
I think so. Yeah. Yeah, I mean, they had, I've never dealt with them directly. But I can guarantee you with anybody, I've had three or four other families in our immediate area that we know that whose kids have also been diagnosed type one about the same time as my son within a year or two and all the same age, and we tell them, here's our experience there. I don't know, you know, just be careful. And here's kind of what we like now. And it's worked a whole lot better for us. So we ended up driving an hour and a half north now to see our endocrinologist and then they have a satellite office that will meet with a physician's assistant two or three times a year also. Just so we don't have to drive as far.

Scott Benner 10:51
Alright, so he's diagnosed now you guys don't have a ton of direction they give you pens. What kind of insulin

Nick 11:01
human log and whatever the longest. Lantus. Okay.

Scott Benner 11:06
Lantis de novo and Huber log novella. Yeah, one of the sorry, no, vlog, I apologize. And you don't know what you're doing? You're counting carbs. One unit covers 20 grams,

Nick 11:17
something like that? It was it was ridiculous. Yeah, it was it was on a.

Scott Benner 11:22
That doesn't sound right. For an 11 year old? Yeah, it's all?

Nick 11:27
No. So we obviously struggled for a while until we we ended up. Like I said, part of it too, was our insurance. Like I said, we have a small family company. So we didn't have the correct insurance to deal with an auto immune disease of a child at the time, we basically had catastrophic insurance and something happened to my wife or I, because you know, your kids are supposed to be healthy all the way through life. So we ended up just calling and saying, what's the cash price? We'll take it. I mean, until we get our insurance fixed, because we can't change it to the first year. Right. So we had, you know, that's the other side that we have to deal with all the time that just makes you want to pull your hair out. That's actually harder sometimes in trying to be your kids pancreas, dealing with

Scott Benner 12:10
the insurance company. Oh, absolutely. Yes. Yeah, no kidding. I, my sister all just called me this morning, that she got something from her doctor was no trouble. They gave it to her. A month later, she calls back and says, Hey, you know, I need to refill and the insurance company says now you can't have that. She gave it gave it to me 30 days ago, like Well, now, you know, yeah. Now you need this. It's like what what? Okay, she's trying to work today, you know, and instead she's on the phone with an insurance company. Like, you know, begging people, people who don't know what she's talking about, like, you know, just phone jockeys. And and it's just a, it's a never ending hellscape of and then once it's diabetes, it's insulin meters and pens, and you know, insulin pumps and CGM and you're having like a different argument over and over again. It's, it's maddening. It really is. 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 wear. Arden has been wearing a Dexcom g7 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 g7 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 Awan C's 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 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.

Nick 14:27
Yes, I mean, we had to read our one year for Omnipod. Five now. So got the new prescription. It got kicked back something along the lines of it also had the intro kit on it and then need it prior authorization. And so they wouldn't even give us the pods because that was part of it.

Scott Benner 14:44
Yeah. And that was in the very first the very beginning of Omnipod. Five there was like an insurance. I don't remember exactly how it went anymore. But yeah, they would give you the intro kit but then you could but not the pods or something like that afterwards. And

Nick 14:57
yeah, so a year later, we're still having some issues with what's getting coated and it's been a fight and my wife just, I just say, Oh, it's six o'clock, it's time to here's a glass of wine, Go, just go try to relax. You're

Scott Benner 15:11
gonna say, here's a glass of wine, drink it, then we'll call the insurance company. Well,

Nick 15:16
I don't have to bail her out of jail.

Scott Benner 15:20
Well, how long does your son use injections for? And what was his experience like being diagnosed? Was it something that he went with? Or did he kind of fight against it how to all work?

Nick 15:32
I will say this, he has been awesome. Never really any downtimes he has learned to speak up and say, Hey, I don't need any more juice, or I don't need any more insulin, like y'all are wrong. I don't care what the number says, Just trust me. We learned pretty quick to communicate with him. And then let him kind of take charge of what he thinks he needs. Because we weren't doing it right. But we're still not doing it. Right. My opinion, we're still learning to this day, we have some room for improvement. I think the initial doctors that we had, they scared the heck out of my wife and me and my wife still gun shy on insulin sometimes. And just because, you know, they're sitting there telling you, there's 100 units of insulin in this thing, and it could kill your kid if you give him too much. You know, there's still that thought in the back of our minds that I think has hampered us early on. And we're just now coming over that bridge to like, okay, we can we can do better. Okay. My son Drew is been a rockstar doesn't let them bother it. He doesn't go where on it. Like, he doesn't go to school. He goes to a small school here in town. And the administration was like, Do you want to give a presentation on your first day? And he's like, No, I just want to be a kid. Like, I don't want anything special. I don't you know, he could, you know, he gets to have this phone at school and no one else does. And his sister does. This gets she gets an alarm. Outside of that. He's like, I don't want anything else. Like, I just want to be a kid and his friends don't care. He just goes and has a good time. They were lucky. They're real lucky. But yeah, he's had, he'll let us know. Because we were holding him back in certain areas, just because we didn't know what was going on. He was like, hey, you know, it's okay. I can have a friend over like, we can, you know, we can do things. Like oh, yeah, okay, you're ready for that? We may not be but you're ready for that. That's fine. Tell

Scott Benner 17:28
me a little bit about how everything gets so confused. Like the I don't really know what I'm doing. We don't feel like we're on firm footing. You know, you're down to listening to the kid tell you I don't need more juice right now. Like, so it starts off rocky at the hospital, I get that the end up with a doctor. That's not real great for you. And but now how long have you been with a better physician?

Nick 17:50
We're coming up on I guess two years now.

Scott Benner 17:53
Okay, that's fair, a fair amount of time that so yes. What? What happens? Is it just the fear? Do you think it was just someone saying to your wife, hey, this insulin, you gotta be careful. And then so she sort of can't use it the way it needs to be used? Or is it Poor direction?

Nick 18:10
No, I think, a combination, but the fear, I think is what's limited us the most. And like I said, we're overcoming that now. We lived in fear of insulin for too long, I found your podcast started listening about a year ago, and kind of started injecting some of the information you give out throughout the year, you know, just to see if some of this will work. And you know, and of course, the one time I say let's Pre-Bolus, early, whatever we did, we screwed it up. And it was you know, he shot down like, it just hit the floor. So we're doing better now. But it you know, it was a lot of trial and error trying to get get him down. I will say the the Omnipod five has helped make things better, because when he was just on the regular one, I was up all night, his Basal rates obviously weren't right. I didn't know what I was doing. And when I say I, if I slept through the night, once during a week, for two years, it was a miracle. I mean, I was up all night with him. So I think part of it was just pure exhaustion to distress. You know, you're in a pandemic, you don't know what to believe, trying to make sure. You know, he doesn't get it because at that time, we were afraid that you know, he'd end up in the ER, and you know, or worse. So we were locked down actually took him out of school for two years, hired a teacher to homeschool and basically, you know, online, his last two years of elementary school Wow. Which worked out great for him because he's very diligent. He got his work done by noon and was playing video games after lunch the rest of the day, so he's happy that

Scott Benner 19:47
I can maximize this time. I know what to do. Like Absolutely.

Nick 19:51
Like homeworks done Dad, let's get lunch and I get some video games to play. And we always know who was sick because they're like who you're playing with. Oh, so and so. Okay, even She said, because he's done that at school right now.

Scott Benner 20:01
Isn't it fascinating that the message is insulin is dangerous, but then there's no effort from them to make sure your settings are correct. Correct.

Nick 20:10
Every setting change was very incremental. We finally get to the point, I guess, about a year ago, we started. And my wife and I manage this together, we manage everything together and slowly have been trying to get, like I said, his had the competence to change the setting away from what a doctor said. And we're doing a lot better job.

Scott Benner 20:32
I just mean, I don't know, like, I don't know what I mean. I mean, it'd be like, if you bought a car for the first time, and someone said, listen, cars are great, but gasoline is very flammable. And then they just started pouring it in the glove box for you to store it there. They're like here, just, we can get two gallons. And here, maybe we could fill the seats like, well, like this insulin, it's so scary. If it's so damn scary. Why don't you make sure that the kid's Basal rates, right so that he's not low all night long? Or that his insulin to carb ratio is somewhere near? Correct. So you're not bouncing all around during the day? It's just, I don't know, I find that fascinating that someone in a position of power could say that I know enough to say that this is dangerous. I don't know enough to tell you how to use it. Like that's like, how is that the person in charge telling you? You know what I mean?

Nick 21:22
No, I know. And then we know we're with the head guy, or whatever. And go, Sure you're just too busy. Too busy talking to my son like he was for like in cartoon voices the whole time. And we just were like, this isn't right for us like that. My son's like, really, he's a doctor. So once we changed, it kind of changed the direction but it took it took a year or more for us to start trusting the process like okay, here's what we need to do. And understanding we were set back a year, easily

Scott Benner 21:51
they of course, 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 or 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, with 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 gen blood glucose meter, do tell contour next.com/juicebox head over there now get the same accurate and reliable meter that we use.

Nick 23:01
And you know, and also, you've said this a million times you trust the doctors like doctor said, it's this many carbs. And this is supposed to work and then his blood sugar sits at 300 for the rest of the day. What the heck are we doing wrong? Like why? Why can't we get this right? You start questioning every decision you do right now, you just want what's right for your kid, especially

Scott Benner 23:21
when the variables are unknown. Or you could be could have eaten something where you counted the carbs correctly, but the impact was greater than the carb count. And so now you're like, you roll past that in your head. You go now we count the carbs, right? That's not it. And then you move on to what else could it be? You don't even know what else it could be. And you're missing you know, you end up missing the the actual problem and also men who don't have children shouldn't be allowed to talk to kids.

Nick 23:48
Or know if you have kids or not. That's a good golden rule. I can I can stand behind that one for sure.

Scott Benner 23:54
It before guys have their own kids. They're not like, they're not terrific at it. You know, I just I just love that your son's sitting there. 1112 years old. You know, somebody's talking to him like Donald Duck and he's like, Oh my god, what is happening?

Nick 24:10
He's gonna wicked little sense of humor very dry. It's like, it's real funny. He'll be like, thirsty dead. This guy, Julian kind of quiet this guy like this as best we can do like, Okay, you're right.

Scott Benner 24:20
I've walked through a number of parking lots of my life with art and goes, Why do we come here? Like, they have the they have the prescription pad. I don't know what to tell you. I don't know where to get one of those. So

Nick 24:34
we kind of need this guy for a little bit at least a little bit longer.

Scott Benner 24:37
So in your, in your note to me. You said that you you kind of found the podcast first. So how did that happen? How did you find it and what did you start taking from it?

Nick 24:46
I was probably just desperately searching online for answers. Got a couple books, kind of skim through them. Nothing jumped out at me is making sense. I don't No, I can't remember exactly how I found your podcast. But when I came across it, I started listening. I drive a lot, usually hour and a half to project. So put a podcast on. And so once I found yours, it just a lot of what you were saying was making sense. I just liked the stories that people tell, you know, everyone has very similar stories in a lot of ways, same struggles, and it just felt like, okay, I can connect with this, I can see what's going on this little nugget here may help me out down the road. And it just, you know, and then I got on the Facebook group, and my wife does not listen to the podcast, but she's on the Facebook group as well, as long as another one. And in the north Texas area, that she knows a couple moms or is referred to that got her into a little private group up there. And it's just, it's just a good community for information because he's 13 he's getting ready 14, we're dealing with growth hormones, and you know, trying to do sports and have a normal life with him and that whole Beckham or a sister or anybody else, and just having as much information, or someone at least to call and say what the heck did we do wrong? Or what do we do here? Who do you call we're not happy with this or that? And it's just it's just a nice feeling of community that gives you a little bit of confidence that you're not the only one living this life of being your kids pancreas. Yeah,

Scott Benner 26:19
no kidding. So okay, what started to make sense when you were listening? Like what was the first thing that struck you is like, oh, that's inconsistent with what I'm doing, but makes more sense than what I'm doing.

Nick 26:31
First thing I remember is that our Basal rates were not right. I was trying to Okay, he's going down at two o'clock in the morning. So at two o'clock in the morning, I was adjusting his Basal rate. All that did was when I gave him juice, or whatever he was, you know, sugar tabs, whatever we were doing at the time. You know, an hour and a half later, he was skyrocketing up and I'm sitting there up all night long, you know, popping him with insulin trying to get him to come back down. You know, I learned like, okay, insulin takes more time. Basal rates, what happened 45 minutes or an hour ago with his Basal it's affecting him now. Yeah, I mean, that's the first thing that opened my eyes like, okay, we're trying way too hard to manage this. It'd be five minutes with basil when that was the wrong technique.

Scott Benner 27:14
Yeah, I in my head pictured as two different clock faces. And there's the impact, like what your blood sugar's doing, and there's what the insulin is doing. And I always wish there was a way to say it, like without pictures, but you can just, if you just turn that clock face back, the insulin clock face back so that it shows you, Hey, I know all everything is happening at two o'clock feels like this is where you should make the adjustment. But let's just move the clock face back for the insulin, and then say, oh, okay, one o'clock, one o'clock is when I should be trying or even 1230? Who knows? Right? However long it takes that insulin to work for you. I don't know, I tried a number of different ways to say that say it. But I think what I've come up with is that, you know, what's happening now is from what you did before, you know that that kind of thing is, is so important to understand, right? Because it's a, I don't know, again, if it was a shield and somebody was shooting at you. And the shield was really heavy. It took an hour and a half to pick up. You wouldn't know that you know, the first time you somebody pointed gun at you and you go home and pick up the shield and you couldn't get it done. But if I told you at noon, hey, someone's gonna come here at 130 and shoot it you start picking up the shield now. And then you know, you'd be okay. No one like a doctor's never going to tell you that again. Like oh, insolence very dangerous, but you don't want to bother to let me know how it works. It's fascinating, right? Like it? No, it's not right.

Nick 28:40
It's frustrating that you've kind of feel like that should be insulin 101.

Scott Benner 28:43
Yeah, the first day. Hi, this is how this works.

Nick 28:47
And how this works. Not you're gonna kill your kid with this. If you give them too much.

Scott Benner 28:50
Most of them are just so busy going like, well, let's inject into a banana or an orange. You didn't even get that, by the way. But But all that does is take visually the scariest part of it and make it more scary. Because by the way, like, you know, I get wanting to practice and all that's fine. But that's not the same as doing it to somebody. I gave Arden an injection last night. She hasn't had an injection like, I don't know, a year and a half. And I'm holding that needle going. I don't know what I'm doing. I haven't done this in forever. You know? Yeah. And at the same time, it's the insulin like the actual scary part is how the insulin works and that I don't even think forget, they don't teach it to you. I don't think they know either. Especially in a hospital setting, by the way.

Nick 29:32
Yeah. And you're already stressed out and you're just trying to, you know, learn as much as you can, and you have no idea what's going on and what what the future is going to look like. Right? Yeah. And then you throw in other factors. I mean, his first week back at real school, you know, it's hot. It's in Texas, it's August. And you know, first week went fine. I think it was like the Monday after that. They're school they can they the kids eat altogether. Like from seventh grade all the way to 12th grade. And I'm in about an hour and a half away, and I'm checking his Dexcom. And everything's looking good. And my wife said, Okay, we gave him five units for lunch. And I'm checking out at lunch. And between getting my check and getting to my car, his blood sugar was just falling off a cliff like double arrows straight down. My wife calls that I'm running a preschool now, because they don't have a nurse at our school or too small. And just like just call him so he's walking to the office. So I call them to Hey, buddy, what do you do? And he's like, Oh, I was playing football with all the juniors. Like, it's 104 degrees outside and it's I just ate real quick took all my insulin and now I'm playing. I was playing football. I was like, okay, that's why your blood sugar is dropping like a rock acid. Alright, drink some Gatorade, you know, stay on the phone with me to get their moms in the way. Yeah, and you know, they have a whole refrigerator, just a shell for him. He gets it. It's like, Alright, I need to check your finger. And you know, the administration's their wife's there, there's a lady to help to take care of them whose husband is type one as well. And because at this point, I think it's like 55 double arrows down. He's already had two or three Gatorades and juices just trying to stop this drop. And, you know, I'm in the car by myself. Just listening cannot be there to help. And, you know, he checks his finger and the five seconds go by and I hear like this. gasp I said, What number is it? He said it. But I'm like, There's no way he'd be you know, there's no way he's thick. So they get to glucagon. He goes, Oh, wait, I'm holding upside down, isn't it? Oh, good child. Now the room when he said six, like I was like, he shouldn't be standing. How's he at six?

Scott Benner 31:42
That's the story of how I had a small seizure and stroke of my own sitting in my car. Wow. Like

Nick 31:49
your number for sports from now on is now six. You realize that don't you?

Scott Benner 31:53
Wait, it goes six? Oh my God, that's six. No, and that helpless feeling? Nobody can? No one can describe it. Probably. I know it. You know it. A lot of people listening know that feeling. And it's in your wife's, you know, mad dashing across town. Try not to, you know, take out somebody's dog in a crosswalk. And. And that kid's just sitting there. You know, doesn't know what he's he just tried to play football. That's it? Yeah. He's trying

Nick 32:24
to hang out and be cool with the older kids. Yeah. So we're like, hey, well, then then that started that downward spiral of how you I want to play? Are you gonna play with your friends after? You know, during lunch? Yes. Okay, so we're gonna try to dose after lunch. We spent a year trying to figure out how to, we never got that right, we still still haven't got that right. Trying to dose him right, depending on his activity, then try to catch it up when he's in study hall afterwards. That if you have any tips on that, because it's eat, play hard for 30 minutes, and then go sit in or, you know, sit in a room for the rest of the day. We never got that right. Very rarely get that one. Right, what's happening

Scott Benner 33:04
is he's falling during the activity or after it, usually

Nick 33:07
pretty quickly, during he fall pretty fast. I mean, there were times when he has 90 carbs. And he's like, Hey, I'm gonna go play football or soccer. And we're like, just don't even dose we'll figure it out afterwards. Like I don't, it's 100 degrees, you don't need to go have a bunch of insulin ahead of time, at least in our opinion. And then you know, he'll go play and then text my wife for me afterwards, I got done playing like, All right, well, let's start guessing how much you need now, because you stayed kind of level for 1520 minutes, but you're getting ready to shoot back up? Yeah. That's that's been the one thing that we have not figured out the math yet

Scott Benner 33:44
on how to put just a small amount on for the activity and then get the rest going before the spike.

Nick 33:50
Yeah, absolutely. We get hit with the spike almost every day. So, you know, two hours later, we finally get them back down. And then it's time for basketball practice or golf or something else. Is

Scott Benner 34:03
it not? Is it not just as I mean, I guess, as I'm getting ready to say that, I guess it's not but I was gonna say is it not just as easy as bolusing during the, you know, towards the end of the activity, but he's doing something so you're he's not going to stop to remember to do that. I guess. No,

Nick 34:19
he's not going to stop honestly. Yeah. No, he's just not. Yeah. I mean, I guess if we point blank asked him to Yes, he would. But let him play this is that's 15 or 20 minutes of freedom throughout the day. Yeah, yeah. No, I

Scott Benner 34:34
hear what you're saying. And that's a 90 carbs for a lunch. Is it if that's a fair amount of insulin for him to I would imagine. Yes,

Nick 34:42
it is. I mean, he'll go anywhere from 60 to 9090. is probably pretty high that one day, you know he wanted we do not limit him on what he wants to eat and let him he needs to put on weight he needs to grow. honestly think that first year that we really didn't have control. All His blood sugars are way too high all the time. I don't think he got as much nutrition. That's what we've been told as he needed to, just because his blood sugars are too high, and he's a little bit behind in height. He's gonna be he's a late bloomer. Anyways, I was a late bloomer, my wife was my daughter, you know, very late. So, and he should be going into his freshman year. And because of his late birthday, he's just going into eighth grade. Now, we held him back a year. He's still one of the shorter kids, even though I'm fairly tall, both his grandfather's are very tall. But I was 99 pounds. five foot one my freshman year in high school, my junior year, I was six foot one, so I ended up growing late.

Scott Benner 35:44
Do they check his thyroid for you during the bloodwork?

Nick 35:48
Oh, yeah. Thyroid, they actually started scanning his hands to see his growth plates, I think, growth factor. They're a little worried about that. But I think he's slowly catching back up. But now his downloads have been fine. Okay. And then any issues everything in the correct range. We like his new doctor. He's very analytical look me. He spends a lot of time with you going over all the test results explaining everything where he is. He's he's kind of the mad scientist type. And we just kind of like, the way he addresses everything very point blank and goes throughout the entire chart. So we kind of know, why is this number this and this number is this. And then his PA is really good here in town. It really helps more with the car ratios. Okay, I think you can kick this up a bit more, try working on this.

Scott Benner 36:41
Do me one favor, go check the last lab work when you get a chance. And just make sure that it's T sh isn't just in range? Make sure it's below two below two right now? No, because if it's like three or four, they'll say it's in range. But that's very indicative of him needing a thyroid replacement. And that could be a reason for like slow growth. Meanwhile, this could all be wrong, but it's just worth looking at. Because they'll call like a three TSH in range. And optimal and range are two different things.

Nick 37:20
Absolutely, we'll do it. Yeah. Cool. So I appreciate it. Yeah, of course.

Scott Benner 37:25
I mean, the other thing about the activities, it's just sucks, like you could you know, you're using a pod FiVER, I would say you could use a, you know, maybe an extended Bolus, where it didn't, he didn't get anything upfront, but it started to go in, I don't know, over an hour. And that way as he's eating you, like, you know, thinking about an old extended Bolus, like you so many algorithms now. But, you know, if you ate at noon, and you said, Oh, this is 60 carbs, I'm going to extend the Bolus, give it to me over an hour. And I want 0% upfront. So basically, it would like you know, whatever that say you were one for 10. So you're gonna get six units, it would slowly give you six units over the hour. And that might get him past the, the activity. And that has already you know what I mean? Then have enough going so that it's it's active and starting to work as the spike comes around. That's just one of the ways I would think about it.

Nick 38:21
Yeah, not found going to manual during the day. If he's got a sticky Hi, and bumping up as basil pretty good. Gets him down better than just keep hitting him with boluses it just for whatever reason. Maybe I'm not hitting him hard enough. But without crashing him. I can usually get him down better. If we don't give him his insulin fast enough, or he just has a sticky high, which still happens too frequently. But that's on the five it seems to work best for us to get him down without just you know, the crash and catch situation all the time. Yeah,

Scott Benner 38:55
yeah. You don't want to be doing that if you don't have to for sure. No,

Nick 38:58
absolutely not.

Scott Benner 39:01
So but um, we've had five overnight. It's been great for you. You're sleeping again. Yes,

Nick 39:05
I'm sleeping again. Absolutely. I don't think we would not be sleeping without it. I mean, from almost the first week. It has been great. As far as the nighttimes go. And it took you know, a month or two for things to kind of settle out but we weren't that great before. So my expectation you didn't take much to impress me like I said, we were coming out of you know,

Scott Benner 39:33
shooting pretty low. Like my bar is not Hi, Scott. I would like to just sleep a couple of times a week. Oh my gosh. Oh, yeah.

Nick 39:43
Now we joke. If if I'm up all night is because I screwed something up with his meal for dinner or we just we screwed it up. It wasn't anything else. It wasn't a pot. It was something we did messed it up.

Scott Benner 39:56
Arden had Chinese food last night and for Get the first hour or so I was like, wow, her, her Bolus was really great. And then I kind of started working in the evening. And I just like, silence my phone, I was making the podcast. And when I when I was done, I looked up like what the hell happened to your blood sugar and she was downstairs like cooking, she was baking. And she's like, I don't know, I've been baking and like, it's not going well. And I'm like, Well, I'm like, you're way off here on your blood sugar, like your blood sugar is like almost 300 like 280 or something like that. I was like you did not. Then I looked, I'm like, this is the amount of carbs you did for that food? Because yeah, I'm like, that's not enough. So she's like, Well, I've been trying to push it back down. I'm like, I'm like, screw that. And we just injected a bunch like of insulin. So like, I did a quick calculation in my head. And I was like, Look, you're gonna have to inject some, like, let's get ahead of this. You know, and so she did. And she came back down really nicely. But I think she missed. She missed those carbs by my gosh, a lot, maybe 20. And that was enough to really cause a problem. And that funny, like just just missing it by 20 carbs. And it feels like you didn't even give yourself insulin. So it

Nick 41:10
looks sure it's like looks like it. Yeah. On the graph, right. Yeah. And then, you know, the other thing is, don't look at the arrows. Look at the graph. We've learned that from your podcasts as well. The arrows will scare you. But if you look at the graph and see the numbers, you can you can kind of tell he's leveling out. We don't need to panic right now. Yeah. Because I mean, we'd be panicking. It'd be you know, whatever. 122 straight down and giving him juice and then literally the next reading the minute laters, like 121, straight down like the arrows dead straight down, but he only went down to one and we just, you know, now we're giving corrections. So we've learned to look at the graph, trust our son, he says he needs it or he doesn't need it. Right now. He's just struggling with a very active 13 year old boy, right? Even last last night, just you know, he was invited by a friend of mine to go play in a golf tournament. So his son and I drew this son, and him and Drew and I went and played golf and got back afterwards and a meal that we've nailed. When the few that we hit every time. He was tanking afterwards, I'd be just four units. Like what is going on? Yeah, the walking and I, yeah, we're in a cart now. I don't walk into it was 101 at seven o'clock last night.

Scott Benner 42:31
Scott, why am I working so hard if I have to walk during golf?

Nick 42:36
Absolutely. You know, and we took the best golfer in town with those invited us and so, you know, us sounds like we got second place. It's like, you realize we use like we have to use one of each of our shots and we only use one of each of our shots and he he shot the other ones. And that's what we got second place. If there was any other person on this team, he would have got first place but he had to use our three shots. That's why we lost. Do

Scott Benner 43:00
you do you notice like there's your son drop with golf usually

Nick 43:05
drop out when he played for school. He did great in they have to walk actually, they can use a push cart. So he has to walk nine holes that was easy to manage like it he was freed as an arrow. He'd start dropping a little bit, drink a little Gatorade or some goldfish and he'd come right back level. Never had any issues. Basketball was a whole nother story. Luckily, I was able to coach him and we'll be able to coach him next year. practices you know, it'd be five or six minutes I'm cheering him up some more. It's funny the first game and every game honestly. His adrenaline's just spikes him like to the through the roof. Yeah. Like the head coach would be like, hey, you know, how's your doing in the game? Don't you take them out? Like this blood sugar's 350? Leave a man like he's just he's so amped up. We can't I'm giving him insulin during games.

Scott Benner 43:58
Yeah, now it's interesting. How you that does the adrenaline hit him every time.

Nick 44:04
Every game? Yeah, I mean, second he goes in. He's going straight up.

Scott Benner 44:08
Have you tried to give him a little bit for the adrenaline before before he plays?

Nick 44:13
Ah, no. Because second is done. It comes straight back down.

Scott Benner 44:18
Yeah, you gotta eat you gotta eat at the end. But you can mitigate the adrenaline a little bit if you if you Bolus for it. We actually learned that during basketball. So yeah, we figured it out. When Arden was little she played in like a little rec league. And and we were very early on with diabetes still, like, by the way, in my mind early on meant like five or six years into it. I still didn't really know what I was doing completely. And one day, my wife and I were like sitting in the stands and I'm like, Man, some days we come to this game and our blood sugar is super stable. And other games we, you know, come to shoots way up and it took us a while to figure out that Arden was pretty competitive. But then, but that she didn't see all the other girls as a threat, just some of them. So when she got to a game where she thought, like, wow, we're really gonna have to play if we want to win, she'd get the adrenaline bump. And if she saw like a bunch of cream puffs when she got there, she was like all she coasted through it. It's very interesting to figure out. So we started. It's actually kind of one of the tenants of the podcast came from this, which is people always ask, well, you know how to like when I'm first trying to learn about how much insulin I can use, and I'm trying to use extra, I don't, I never know how much extra I can safely use. And I used to say, well Bolus for a juice box. And if you need it, then great. And if you don't, then the juice boxes, basically just Pre-Bolus. And so we started doing that with the with the basketball. If we thought this was a game where she might jump up, we gave her an insulin and amount of insulin that a juice box could cover. And then if the adrenaline came, then great, then the adrenaline and the insulin fought with each other. And if the adrenaline didn't come, then she would drink the juice. And we basically just Pre-Bolus for a juice. And then we learned that after basketball that was bolused for you did have to get the food pretty quickly afterwards. You didn't have you didn't have a long time before the adrenaline went away. And a little too much of that insulin was still leftover, if that all makes sense.

Nick 46:20
That makes total sense. Yeah. Your daughter sounds like my daughter when it comes to sports. She hates the practice, only stepped up for the big games or when it matters, and then just kind of lollygag around the other times, like maddening sometimes.

Scott Benner 46:37
Yeah, yeah, Arden played pretty competitively. For softball she was when she was 12. They were two wins away from going literally to the Little League World Series. And they were in they were in Connecticut playing in like a regional championship and, and you could tell it like, it hit her heart and you had to hit back. And there was no, there's no perfect answer for some of these things. Adrenaline is one of them. Like if you're going to fight it off so that you don't have a high blood sugar. So you can perform. You just have to be ready on the backside to catch it. Like that's yeah, that's what we found. I wish there was a better answer than that. But there just isn't

Nick 47:15
really. Yeah, that's just part of you having to manage it day by day. Yeah. 100%. Yeah. But I think he he's had a good attitude. I'm praying that it stays. I know you asked it earlier, but he's had a really good attitude throughout this whole thing. And I think that's important. He's probably had a better attitude. My wife and I had, you know, you want him to have a good attitude. I'm glad he does. So he just wants to be a normal kid. He does what he has to do. We're thankful that my daughter was not the one type one because we'd be you know, she'd forget or not care or not want to do it. And he's a great kid, but she just a free spirit and a lot of ways, right? He's our diligent when like, Hey, Dad, it's school nights. 1030 I'm gonna go to bed now. You've got to tell me. She'd stay up to one the morning.

Scott Benner 48:04
How come no one's mentioned sleep. It's too. I'm getting tired.

Nick 48:08
Well, you still have to wake up and go to school, honey. I'm fine.

Scott Benner 48:12
Tell Tell me this. You find the podcast, you find it valuable. You said but your wife doesn't listen to it. Does she? Like what's that? Like? Because you use the phrase in your intake letter that is a it's something that goes through my head constantly. Like what did you say? You said? I'm finding it here. Oh, hold on a second. am I struggling found the podcast. It made sense to me. However, it took me time to convince my wife Oh, to trust that I learned something from some guy on the internet. Yeah, like that's exactly. By the way. That's my level of common sense, too. I wouldn't listen to me if I was in a reverse situation. I'd be like, I am not making a decision about this. Based on some story a guy told on a podcast. How do you get that to her? How do you say look, I heard this thing I did it. It worked. Like how do you make her kind of believe it? Especially if she doesn't listen to it?

Nick 49:03
Slowly over time, okay. And then something I'll say and then maybe one of the doctors or somebody else we know will mention the same thing. I think it just has to be reinforced by another source. Other than other than media or you know, or voting you. Please don't take it personal. Please. I just she wants everything verified and doesn't want to make a mistake. And it just that's why it's gonna go a little slower. I think in the last three or four months, it's we just realized okay, it's time we really got to get on top of this. You know, he's at school now. No more excuses. We really got to make sure he has the best care we can give them and what we were doing is not working. You know? He still has a once he's under seven and sometimes I don't know how. I just don't he sits right about 697 all the time. Our goal is to get him down closer to the lower sixes by the end of this year,

Scott Benner 50:04
did you find that you were just hoping, like, maybe this will just get better?

Nick 50:09
Did you ever have no, I knew it wouldn't get better, okay? My only thinking along those lines is that I keep hearing once he gets in this early 20s, it'll be easier to I keep getting told that, you know, his body's not changing all the times, hormones aren't quite as crazy. So that's the only knowledge I've heard. Other than that, I just hear, hey, the next three to six years are going to be hell, like, you know, once you get something going for a week or two, it's going to change. So just hang on.

Scott Benner 50:35
I don't know, it's, it's a, I get the sentiment, I understand the messaging, I wonder if people can take it a little farther and realize that if you wait seven years for something to regulate, which is a word that is meaningless, but what you're gonna do is you're gonna build bad habits in the seven years, it's not going to matter once you get there anyway, because you're going to start accepting it, like just oh, this is what it does. And, you know, you just keep accepting failure and accepting things you don't want to go it, but it'll be better in the future in the future. And I think he gets to the future, and you don't even know how to manage it anymore. I it just sucks. But it's a, it's a thing you have to dive into, you have to understand it. And once you get the basics down, like the real understanding of how insulin works, and what the different variables are, with the situations are, I think it translates to everything age, you know, hormones, weight, the whole thing, it just takes time. And it's hard to, it's hard to, to give that much time and attention to something that it doesn't feel like you're really understanding or getting any better at and it's so hard to explain to people but really like, time and effort is that's all it is. You just keep putting in the effort and the time and eventually it starts to make sense to you. And before you know it, you don't really remember that part anymore. It's just, you know, hard to hard to believe that in the in the moment, I think.

Nick 52:03
Yeah, definitely. When you're living in the moment, it's hard to see the big picture sometimes. Yeah, you got to step back and just okay, hey, we need to reevaluate. Let's just kind of put it on the table and pick one or two things that we can try and see if we can do better and get better results. I think we got his Basal rates a lot better now. Definitely use like his weight as a factors and how we calculated it. I know it's not supposed to change what's going on with the Omnipod five, but when he goes to manual mode, you know, it's definitely way higher than it was before. And he's at point seven, five an hour now. And he weighs about 80 pounds. I think it was at point five before for the last year. So

Scott Benner 52:43
yeah, that seems that seems like it might have been too low. Yeah,

Nick 52:46
I think it was definitely low. So we've adjusted that it's made an improvement. And just I'm not waiting as long to give corrections. We used to wait to the alarm went off the alarm was way too high. And so now I look down like hey, you're 180 Now let's do a correction. And it's not wait to 250 or whenever the alarm is supposed to go off. Yeah. And that's helped me too. So I think it's just going to be incremental. Okay, let's see what we can get away with. Alright, 180 was fine. Let's try out 160. Let's see then. Yeah, and use the rest of the summer to really kind of get it nailed down. That's where he gets back to school.

Scott Benner 53:19
That's the key. If you move that low alarm to 140 his day once, he'll be more like six. Now

Nick 53:24
I think the problem is right now. If he's eating he's over 140 all the time. Like he's never not over 140

Scott Benner 53:33
Is that are you Pre-Bolus eating the meals?

Nick 53:36
doing a better job now than it was even two months ago? Okay, yes. So we're still probably not quite enough. I've heard on the pod five, you don't Pre-Bolus quite as much before this, but a lot of people I think I've heard that once or twice before? I'm not sure.

Scott Benner 53:51
You know, I've heard people say that too. And I have to be honest with you. I don't understand why that would matter. I'm not I'm not I'm not I'm not sure about the I honestly, that I'm out of my depth on that right there. But it doesn't make a lot of sense to me. We're getting

Nick 54:06
a slightly more aggressive on Pre-Bolus thing. We're now probably about 10 minutes before, sometimes a little bit more than that. I've noticed sometimes that when we Pre-Bolus that we don't have to give them quite as much insulin either. Yeah.

Scott Benner 54:21
Because well, when you're when you don't allow the blood sugar to jump up, then you don't need extra insulin to fight the high. So yeah, I mean, listen, rule of thumb, I don't know, but 10 minutes seems short to me. So you're looking for a Pre-Bolus that, that if it's some sort of a regular food, meaning you're not like I don't know, having like a giant glass of like a Slurpee or something like that, like something reasonable, you know? Yep. I would say that your Pre-Bolus should hold you wherever you are. For at least the first 45 minutes. I you know, a good a good Pre-Bolus You're not going to see us bike in the first 45 minutes or an hour, and and then if you see one after that, and it goes up and never comes back, then I think you didn't have enough insulin. If, you know, if you Pre-Bolus 10 minutes you go up and crash back down, then that sounds more like the Pre-Bolus wasn't long enough. Like there's actually there's a person, some person on line who made a list of things I've said about Pre-Bolus. And I should find it because I read it. I was like, This is great. What is this? And and I asked, I said, Where'd you get this from? She goes, it's all things you've said, I just put it like, in this little like, you know, graphic and I was like, oh, I should quote myself more often. I'm like, I think this is right. But it's, there's, there's a place, right? I mean, I don't think I talked about this nearly enough in the podcast anymore. But, uh, Pre-Bolus is, if you've heard me say this, I guess you could stop me. But it's like a tug of war. And so like, if you think of a classic, like schoolyard tug of war, there's a rope. And there's a team on the left and him on the right. And we all go and both teams pull the you know, the goal is for one of the teams to yank the rope to the other side. But a Pre-Bolus is very similar. You have insulin on one side, you have the food on the other side of the rope. And, but the goal is different, we don't want one side to win, we want the flag in the middle of the rope to stay in the center. So if you think about that flag in the middle of that rope as a steady line, and then instead of thinking of them pulling left and right, kind of turn it in your head so that you know, in the insolence pulling down and the foods pulling up. Like when you see a stable line that has active food and insulin in it, that's what you're seeing, you're seeing the insulin is pulling, you're seeing that the food is pulling, but that neither can overpower one another. So as you move forward in that timeline, that middle, that rope just stays on the same plane as it began on. And then eventually, the insulin wears off as the food impact is wearing off, and everybody drops the rope and we just keep going into the future. So no one can win. Like, that's what you're trying to do with a Pre-Bolus you're trying to set up a fight that no one can win. And that kind of ends at the same time, meaning the insulin surge starts to, you know, go away, as the impact of the carbs goes away. That's a stable line during food. That's all that is. If you don't have that, then you're gonna get all the things that you've described.

Nick 57:35
Does that make sense? Absolutely. 100% Yeah,

Scott Benner 57:38
that's it. It's it's a, it's a tug of war that you don't want anybody to win. But you still have to fight it, you still have to play it out. So instead of yelling, Go, and everyone starts pulling, you tell the insulin, it's allowed to pull first, because it doesn't pull it full power. As soon as you yell go. So you say insulin start pulling, and it pulls the little bit on the rope and doesn't really move it, then the rope starts to move a little bit, a little more. And then just as it starts to get its power up, and it's really starting to yank that rope and you think, Oh, if they're gonna win, they're gonna yank it over to the side. That's when the food comes in and starts pulling back again, the food doesn't usually need some foods don't need as much time to start pulling. So you let the insulin start pulling first. And then you say, okay, carbs. It's about to get, you know, off balance here, you start pulling now. And that's sort of it. I mean, to me, that's what a good Pre-Bolus is. No,

Nick 58:34
it makes 100%. And I appreciate you saying again, I've heard you say that before, but I think especially the way our talk is going today, it's been more technical and less storytelling. And I think that's important, too. I think it just a good reminder. Here's what we need to do.

Scott Benner 58:50
Yeah, well, for me, for me that good. It's funny, I've heard you say things throughout the episode. And I can have like, if I'm not paying attention, my tendency will be well, that's there already. I did an episode about the math of your Basal insulin. Except everyone doesn't hear that. You don't I mean, so like as as you kind of keep the podcast alive. If the thirst stuff back in once in a while, remind people like go check, like, in the end, like, you know, if I kept saying the same thing over and over again every day, nobody would listen. Oddly, but if I forget to say it every once in a while, then it doesn't help anybody. So, like a weird balance. No,

Nick 59:27
no, I appreciate both sides, your podcast. I mean, especially when you try to make someone's mom blush with some crude joke. I laugh every time it's not gonna work that into my conversation.

Scott Benner 59:41
Yeah, you can't do that at your job. But I'm allowed to know.

Nick 59:46
I can't my wife was slapped me upside the head.

Scott Benner 59:51
Things need to stay light. Nikkor I don't I don't understand how you keep listening. Like, seriously, like,

Nick 59:57
I know you're 100% Correct. It needs to Have? Yes, it can't just be technical all the time, like no one would listen, you need to have some some humanity behind it.

Scott Benner 1:00:06
There's a massive diabetes organization who has had a podcast for ever before they knew they were called podcasts. Do you know what I mean? Like they were putting audio on the internet, right? Yeah. And it took them. I think my, I think what I heard recently, if I'm right, it took them like 12 or 15 years to reach a million downloads. I don't I've never listened to it. But I'm gonna guess they know what they're talking about. Right? They must send on doctors and all that stuff. 12 or 15 years to get to a million downloads. And at the moment, I'm doing a million downloads every 60 days. That's incredible. Right? And so what's the difference? I don't know. Because I haven't heard their content. But what I'm gonna guess is they're things not fun to listen to. No, it's boring. Yeah, I'm gonna guess. And so again, you could have the secret to life, but nobody listens to it on is it? If a tree falls in the woods, and nobody hears it? Did you know Did it make a sound? You know, so that's the thing, like, and that's what, that's what happens a lot in this space. To people's like, well, this is good information, like great, I put it down somewhere Great. Nobody heard it. Nobody's drawn to it, the person that somebody did hear it, they weren't, they didn't think to tell somebody else about it. You might as well not have done it. And I mean, I'm happy for anybody that's trying to help anybody. But if you make something for 15 years, and it takes, it takes that long to get a million extensively, no one's listening to it. Like you should be able to reach that number much more quickly. And

Nick 1:01:51
and I think that they're probably spending 1000s 10s of $1,000 a month on marketing or more than a dime. Yeah, I'm,

Scott Benner 1:01:58
you know, quite certain that that's a thing like that. There may be getting, if I use 12 years, they're getting at three, they're getting at 3000 a month, if I use 15 years, because I can't remember what the number is, I heard they're getting 66,000 a month. So now you're talking about a month to reach what this show does in a day. And it's just you're not going to anyway, I bring that up. Because if you gotta say stupid shit, and be funny and have fun, or no one's gonna listen. And then nobody gets helped. And then a bunch of academics just sit around and go, I don't know what's wrong with these people. We told them, You told them nobody listened. You're in a doctor's office saying something in a way that is completely impossible for people to pick up or put into practice. Like, just because you said it out loud doesn't mean you help them. Like that's not. You don't I mean? Like, because that's the case, Nick, you're a parent, it would just, uh, why don't you just carve out six hours today? Sit down, tell your kids all the rules of life and then give up because that thing you told them? They got it now? Anyway, I don't know why I get upset about that. I think it's because of the beginning of your conversation and how poorly you were. Were led in the beginning made me upset for you. Well,

Nick 1:03:16
in the funny thing is they have a million downloads, and probably most people turned it off after five minutes.

Scott Benner 1:03:22
Very possibly. It mean, yeah, that counts.

Nick 1:03:26
I don't know how y'all industry count downloads. But if you just click on it, listen to it for five minutes. Does that count? I mean, I can't tell you how many I clicked on. And like not as this guy is not for me, or this girl is not gonna work, or just this isn't the right message I'm looking for and never went back. I'm

Scott Benner 1:03:41
saying downloads, they're not that you're 100%. Right. They're not the full measure. The full measure is, is engagement. You know, the full the full measure is that your wife doesn't want to listen to the podcast, but she's still in the Facebook group. That

Nick 1:03:56
Oh, yes. You're telling me stories in the Facebook. Hey, you know, you know, whatever story is that catches her eye. And, you know, we'll have a conversation about that, that helps in our management of our son. It just she doesn't like to sit down and listen to podcast when she ever has her free time. It's not her thing. Yeah, totally fine. But I think this has helped get us on the right track. Without it. We'd still be stuck. You know, same thing we were doing two or three years ago even with a good doctor. Yeah, because we were scared like I didn't you know, I had no idea. And there was no no one explained it and I think getting past that barrier was the first step or realizing there was a barrier there and then going okay, we got to get past this barrier. This isn't gonna work. I you know, I kind of get tongue tied on it, but it's just you look back and you just can't even why did I do that? Right I could have done so much better. Yeah, yeah, second guess a bunch.

Scott Benner 1:04:54
100% I'm gonna finish up what you said here because i Something popped into my head but I Um, as far as reaching people with your ability to help them, whether it's you know, a person making a podcast or a doctor or something like that, it's engagement. Like if you want to really measure if you're helping people see how engaged they are, right, so I put a post up yesterday, I have an idea for a new series, Jenny and I are going to do it together. And you know, Jenny and I are going to kind of build a syllabus on one side. And then we wanted to have listeners input on the other side, and we were going to use those things to feed each other while we're recording. It's all kind of boring right now, don't worry about it. But I put a post up online. And I asked a simple question, with three examples of my question. And today, it is not quite 24 hours later, and that post has 189 responses. And they're not just one word, they're well thought out. paragraphs from people like Like, like, really, like well thought out responses. And if you can't, if you can't elicit that kind of response, no one's really listening. Like, that's just how that works. Like you can get, like you said, you can count your download. But if that person isn't willing to speak up and help, or if I mean, even advertising, if you put up an ad and nobody clicks on it, no, then I don't care how many downloads you have, what you don't have is engagement, you haven't really, I don't want to say the same word again. But you have not found a way to engage those listeners in a way that makes this meaning for the for them. And to translate that to doctors, it's the same thing, you ask a question, and you don't get a response. If you're not having a real dialogue during the the, you know, the meeting that you're having with your patient, you're not really connecting with them. And therefore I don't care if you have a download, which is a doctor's visit, you know, in this case, you're not really going to make a dent in their life, like, and that's just the truth, like, the problem is communication, whether it's at your doctor's office, or somebody trying to make a thing online, if you're not a good communicator, you don't know how to keep people's attention, you don't know how to give them value for their time, you're not really helping them. And then those numbers are meaningless here. It's just wasted time, in my opinion. Well,

Nick 1:07:15
I think what helps you out too, is you come across as having good energy, even though it's on a audio platform, you can just feel it when you listen to you. When you talk to somebody, you're engaged you, you're listening to what we're saying, you have good energy, I don't know how to describe it. That's nice. I'm interested in people and people feed off of energy. I mean, you'll watch one news cast over another because that newscaster has gotten better energy, they you just oh, that's got personality. They're not just sitting there reading from a script that oh, you know, got Marcus down today, and there's a fire on Elm Street. It's, they have a personality, there's some energy there.

Scott Benner 1:07:50
I really love listening to people, I like hear what they have to say, I have a very big interest in this space moving in the right direction, because there's going to be a day I can't help my daughter. And I know for sure she's going to like at the moment, she's going to end up with a doctor who if she's lucky, has a you know, a 10 Gentle understanding of diabetes. And so I'm trying to build a world where that's not true anymore. And you know, it's, and it's my job on top of that, like I'm a I'm a I grew up a blue collar person, like, this is my job, I do my job. You know, like, I happen to like it and actually be interested in it. But even on the days when I like, sit here and like I just edited myself the other day when I was sick, like when I had COVID and I was listening to an episode where I had COVID. And you can't tell like, I still love my job. And I still wanted to have that conversation with that person that day. I don't know. That's the kind of energy we need from doctors, not them doing Donald Duck voices for your kid, for Christ's sake. shake my head every time. Like I gotta tell you, it makes me want to curse. It's infuriating.

Nick 1:08:58
It's insulting to some extent. I mean, it just really is like, yeah, I just don't know. Don't do that. I mean, he was old enough. I know it was a children's hospital. But yeah, I just said we we were done. We should have been done on day one with with that group actually ran into a guy now who's on the board of that hospital and he's okay. How's your experience? Go? You got 10 minutes. And he's just staring at me. I was like, his eyes got real big. I said, Let me tell you about my experience. That's I don't I don't know if it went anywhere. Not but I said, here's here's our experience and why we're not at your hospital anymore. Not even doing won't come back. Oh, that's interesting.

Scott Benner 1:09:35
I mean, good. Good for you. Good for you, by the way for telling them. It

Nick 1:09:40
can't get any better if you don't know. I mean, it's one of my employees. You know, hey, we can do this better. If I had no clue. Yeah, I can't make it better.

Scott Benner 1:09:49
million percent. Good for you, man. That's excellent. All right. Is there anything we haven't talked about that we should have?

Nick 1:09:53
I think we're doing good. I just said I know I'm not the most interesting stories, but I really think you helped me out thinking through some of the issues we were having with Drew, and his blood sugar, and I really appreciate your time. I really do. I know you got a lot going on.

Scott Benner 1:10:09
I gotta make this podcast man. I don't have a lot going on until trust me recording a podcast every day is one of the most important things I do. The whole thing falls apart. So don't thank me for Don't thank me for doing it. I appreciate it. And don't knock yourself like you. You were very engaging did a great job telling your story like it's Yeah, I know. You're but you're thinking like I didn't tell a story of like doing heroin and being like,

Nick 1:10:32
Man, I'm sorry. I'm pretty, pretty lame when it comes to that.

Scott Benner 1:10:36
story. Yeah, his DKA didn't happen on a speedboat. Is that what you're worried about? Don't worry. They all good

Nick 1:10:42
one. No, no, it didn't. The only thing that he was eating a hot dog when this happened, and he will never eat a hot dog again, as far as he concerned like he would I don't want a hot dog. It just makes me think that day. And I

Scott Benner 1:10:55
had KFC, like a chicken tender the day my appendix burst. And I for years if I smelled it, like I was scared. Like, I believe it was weird. The way my brain put that together was like, I think the chicken tender tried to kill us, which is obviously not what happened. But it scares the hell out of me. I was just I was out one day doing a bunch of stuff. You know, I was a young, my heavyset young father. I wasn't that young. But my kid was young. And we were out running around trying to get ready to go on this trip. And he's like, I'm hungry. And I'm like, Oh, we pulled into a drive thru. And I got him like these little chicken tenders. I gave them to him. And I had one. And like, six hours later, I'm in a hospital. And I don't know, man, that that smell of that chicken scares the crap out of me for years after that. So I understand your kid doesn't want a hot dog? That's for sure. No, it

Nick 1:11:46
does not at all. Yeah,

Scott Benner 1:11:48
the only thing I'm upset with you about is you did not say anything that it's going to make it easy for me to find a title. That's, that's on you. I

Nick 1:11:56
know, I thought about that. And I'm sorry. I'm just you know, I'm trying to stick up for a couple of the debt. You know, you have like, 90% Mom's on here. And every once awhile, we'll get a dad on here. So

Scott Benner 1:12:08
I appreciate that very much. I wish more men would come on to be perfectly honest with you. They're all in they always seem to lean more emotionally available, I think as probably like a polite way of saying it. But, but um, every once in a while, like you get a guy on. He's like a real like, man's man. I'm like, This is excellent. They just like, they're not worried about what people think. And you know, they're just like saying, what they what they're getting at, I love that I can't think of the guy's name. Did out glass replacement on vehicles. I know he's gonna you'll be upset if he hears this. And I can't remember his name. But I love that episode, like so. You know, that's the kind of stuff um, I hope I hope more guys like you reach out. So I appreciate it very much.

Nick 1:12:48
No, and I know they listen. And I encourage them to reach out and it's for the betterment their own kids for themselves. And without listening to you. I don't know where we'd be right now. I really appreciate it.

Scott Benner 1:13:01
I hear what you're saying, Nick. I'm terrific. Well, we'll leave it at that. Yeah, absolutely,

Nick 1:13:05
my friend. All right, hold

Scott Benner 1:13:06
on one second for me. Sure, thanks.

A huge thanks to Dexcom for being longtime sponsors of the Juicebox Podcast. dexcom.com/juice box head over there now get started today. 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 If you're looking for community around type one diabetes, check out the Juicebox Podcast private Facebook group Juicebox Podcast type one diabetes

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