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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 1119 of the Juicebox Podcast.

Well, the new cold wind series is four weeks old now and I thought it would be interesting for those of you who are enjoying it, to know where I got the idea. The goldwind series came from my experience recording the episode you're about to hear. This episode features an anonymous female. She's a nurse practitioner who works in an endocrinologist office, and she has type one diabetes. I think this episode may be two years old. While the recording is you've never heard it before. At the end of the episode, you'll hear me say, I don't think we should put this out. I'm afraid you would lose your job. And it was in that moment that I thought I wish I had a way to mask her voice. But back then I didn't. I held on to the recording because I really did wish I could put it out and I thought maybe one day we'll be able to change people's voices. And of course now we can. And we're using that technology in the cold wind series. So you want to hear this anonymous guest talk about where she works, and tell her story buckle in, because we're gonna get going in just a moment. Please don't forget that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan or becoming bold with insulin. This episode of The Juicebox Podcast is sponsored by 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/juicebox This episode of The Juicebox Podcast is sponsored by touched by type one touched by type one.org. And find them on Facebook and Instagram touched by type one is an organization dedicated to helping people living with type one diabetes. And they have so many different programs that are doing just that check them out at touched by type one.org. Hello, and welcome to the cold wind series from the Juicebox Podcast. These episodes will feature physicians, nurses and other professionals who agreed to come on the show anonymously to share what they see in the healthcare profession. I've altered the voices of each guest so that they can remain anonymous, and feel comfortable telling us what really goes on at their job. Just listen to how well the voice altering works.

Speaker 1 2:48
My name is Beth and my oldest child has type one diabetes diagnosed in October 2020. My name is Beth and my oldest child has type one diabetes diagnosed in October 2020.

Scott Benner 3:01
If you work in health care and have a chilling story to tell about your experiences in the healthcare field, contact me today. I'll get you right on the show. Your story does not need to be specific to diabetes. I'm going to find out a little bit about you. How old were you when you were diagnosed?

Anonymous Female Speaker 3:20
I was 17.

Scott Benner 3:22
That's only four short years ago. Yeah,

Anonymous Female Speaker 3:25
no, it feels like an eternity. But it's really been like nothing.

Scott Benner 3:29
So really, it does feel like a long time.

Anonymous Female Speaker 3:32
It kind of does is the past few years is like when you're like actually becoming a human like the rest of it is like growing up. And I mean, that's obviously part of your life. But like the part where you're like you're autonomous and like making decisions like my adult formative years, I've had type one so it kind of just feels like it's what I do.

Scott Benner 3:48
Yeah. So you kind of don't think of yourself prior to that. adulty starting makes sense. You were you graduated from high school when you got it or not quite.

Anonymous Female Speaker 3:59
Um, so that's a whole weird story in itself. I graduated from high school in a different country when I was 15.

Scott Benner 4:05
Okay, slow down. Hold on. She's Jesus. Okay, hold on. How why were

Anonymous Female Speaker 4:12
so I, I got a scholarship to study abroad. And it was my mom was like, you can never study about it. I was like, What if I get a scholarship and she's like, that'll never happen. It ended up happening. I went abroad and the school systems kind of different. So I was able to like use the credits I had and I graduated high school there. And then I after that year, I came back to the US re enrolled in American High School and kind of did like my last two years again, so it was like weird, but it worked out

Scott Benner 4:42
what made you want to study abroad like when you're 14 or 15 years old. What makes you think I want to go to another country to finish high school.

Anonymous Female Speaker 4:49
I kind of just wanted to see something else because like, things get like monotonous. It feels like the same thing every day. Like I love it. But it's very much the same all the time. And I was like I kind of want to see what's out. They're so seriously. No, it wasn't. It was a really neat opportunity.

Scott Benner 5:03
How long did it take you to get acclimated?

Anonymous Female Speaker 5:06
I kind of felt okay, after about three, four months. Wow.

Scott Benner 5:10
And how long were you there in total? I was there a year. Wow. And the credits piled up differently. So. So you were graduated. When you were 16,

Anonymous Female Speaker 5:20
though? Yeah. So I graduated. And then I moved back to the US.

Scott Benner 5:24
Were you planning on going to college early, or were you going to like mess around, so I

Anonymous Female Speaker 5:30
didn't want to go to college, really. So I went to EMT school. And then I finished the NP school. And I was like, this is cool. But I want to do more. So I went to paramedic school. And then once I finished that, I went to college. Wow.

Scott Benner 5:41
So all those different experiences led you to believe you wanted to go to college? Or were you just finally willing to separate?

Anonymous Female Speaker 5:47
Yeah, so I got back. And it was like, it was being away was like that, like exhilarating thrill of like, this is something It's all new. And then I knew that college was going to be like, more mundane than that, per se. Which sounds bad.

Scott Benner 6:00
I don't know that. When you're away by yourself. Do you end up having more adult experiences than you would have at that age? Or is it not like that? Completely?

Anonymous Female Speaker 6:09
Like, I never imagined that as a 15 year old, I'd be like, lost in a train station in the middle of nowhere and like, have to find my way back. Like, absolutely horrifying in the moment, but it kind of gives you that like, feeling like I can do this. I'm

Scott Benner 6:23
okay. You feel like that because nobody jumped you. Exactly.

Anonymous Female Speaker 6:26
Probably like I would have been accosted from behind that would be

Scott Benner 6:30
great. If you're like No, somebody beat me senseless and took my wallet from me, then you'd be like, you know, I've learned I really don't want to be by myself at the train station. It's interesting how your experience shapes the rest of it. 100% All right, cool. So you went you got your high school diploma, you came home. You're like, Hey, this is great. And then you got diabetes? Yeah. Yeah.

Anonymous Female Speaker 6:52
100% Total

Scott Benner 6:53
party. Anybody else in the family have type one or other autoimmune issues?

Anonymous Female Speaker 6:59
No, but no type one, but autoimmune. Like my mom has a host of autoimmune things. My grandma, my great grandma. My dad like it's there, for sure.

Scott Benner 7:08
Really? Can you give me a quick fire cell list? Yeah,

Anonymous Female Speaker 7:11
so my mom has hypothyroid she's rheumatoid arthritis, and she has lupus. Wow. And then my dad has rheumatoid arthritis

Scott Benner 7:18
is a trifecta for your mom. So yeah. Yep. Do you have any of those?

Anonymous Female Speaker 7:23
I do not knock on wood. Let's keep it that way.

Scott Benner 7:27
I can we can beat on someone actually, if i i might hit my desk. My desk is what I gotcha. Do you feel worried that there might be coming?

Anonymous Female Speaker 7:35
I mean, I've never really kind of like, put it in the forefront of my brain. So I hope it doesn't happen. But I don't like sit and like, sit in my bedroom at night and like lose sleep over it.

Scott Benner 7:46
Yeah. Okay, so tell me a little bit about the experience of I mean, were you like a paramedic and EMT while you had type one. So

Anonymous Female Speaker 7:54
it's actually kind of funny, because you just put out an episode with I believe her name was Sarah. And she was talking about how she was like diagnosed in EMT school. Yeah. So in the paramedic program I was in it was like an expectation that the paramedic students would help teach the EMT class. And EMTs couldn't check what glucose values until like 2017, which is wild to think that like, you think someone's showing up to your house to save you and they can't even check your blood sugar. Well, so we were teaching the EMT students how to check blood sugars. And we were using like the paramedic students like dummies, and I was like, Oh, you guys can check my blood sugar and the meter just read Hi. And I was like, Haha, that's funny. It's broken.

Scott Benner 8:34
Dexcom G seven offers an easier way to manage diabetes without finger sticks. It is a simple CGM system that delivers real time glucose numbers to your smartphone, your smartwatch. And it effortlessly allows you to see your glucose levels and where they're headed. My daughter is wearing a Dexcom g7 Right now, and I can't recommend it enough. Whether you have commercial insurance, Medicare coverage, or no CGM coverage at all Dexcom can help you go to my link dexcom.com/juice box and look for that button that says Get a free benefits check. That'll get you going with Dexcom. When you're there, check out the Dexcom clarity app where the follow Did you know that people can follow your Dexcom up to 10 people can follow you. Right now I'm following my daughter but my wife is also following her. Her roommates at school are following her. So I guess Arden is being followed right now by five people who are concerned for her health and welfare. And you can do the same thing. School Nurses, your neighbor, people in your family. Everyone can have access to that information if you want them to have it. Or if you're an adult and you don't want anyone to know, you don't have to share with anybody. It's completely up to you. dexcom.com/use box links in the show notes links at juicebox podcast.com. And when you use my link to learn about Dexcom you're supporting the podcast The podcast is sponsored today by touched by type one, head now to touched by type one.org. Click on that Programs tab at the top to learn all about what touched by type one is doing for people living with diabetes, the annual conference awareness campaign bowl for a cause their dance program dancing for diabetes, their D box, the golf outing, and so much more touched by type one.org.

Anonymous Female Speaker 10:27
And then another group did on a different meter. And I was like, oh, all these meters, let's just be broken. But in my brain, I was like, This is not good.

Scott Benner 10:34
I have to ask the question. It's nothing to do with us. Yeah, go ahead. When you heard Sarah, tell that story. Were you like son of a? That's my story.

Anonymous Female Speaker 10:42
I'm not lying. I was on the highway. And I pulled over. I was like, I'm not hearing this right now. I was like, This is insane. Like, I didn't think that this could ever happen to anybody.

Scott Benner 10:52
And not only that, but she stole it from you telling it on the podcast, too. Yeah,

Anonymous Female Speaker 10:56
I know. I was like, I think I have this like Sorry. It's kind of wild. And then it was like, actually not that wild happened to

Scott Benner 11:03
a girl named Sarah as well. That's amazing. I have to tell you, I I had to google Arden's name today. And because we were talking about, I just recorded with her and I was talking with her. And we were talking about how, at one point, I was aware of another person with her first and last name, who also had type one diabetes. That's why and that just seems crazy, because I don't have a completely common last name. And Arden's first name is, is fairly uncommon.

Anonymous Female Speaker 11:31
And I know it's not like a Joe Schmo like John Smith or something like that. It's pretty unique. Yeah.

Scott Benner 11:36
So I googled it. And then I found there are two other people with that name living within like, like one of them's in Harrisburg, and one of them with the school in Philadelphia. And I was like, but we're not related. A while. Yeah, I thought that's odd. Anyway, um, I'm thinking the same thing about your story, but it is interesting. Like you were like, I have an incredibly unique diagnosis story. And then it's just not. And then a podcast, you're listening to some girl comes on and tells your diagnosis.

Anonymous Female Speaker 12:04
Yeah, I was like, Am I hearing this or not? Is like, is this real? Yeah, it's really, that's,

Scott Benner 12:09
that's really amazing. Okay, so you find out and do you get a free ride an ambulance when that happens, or what do you do?

Anonymous Female Speaker 12:17
No. So I went to my pediatrician. And the whole thing kind of manifested weirdly. My, like my blood sugars. It was just strange. It wasn't like a classic diagnosis situation, because I had like, really wild pies, where I'd be like five hundreds, and then I'd have days where it was like, okay, so it was actually started on like Metformin, which is strange, because I'm a very small person, then on Metformin, then on the nuvia. That didn't really work. And then we kind of just and then it was like, Okay, this is type one. And I started on insulin.

Scott Benner 12:51
So how long was that process of going through the medication?

Anonymous Female Speaker 12:54
Aisle? Like a long while? Yeah, a year? It was probably, yeah, it was actually honestly, like a year. Oh, okay.

Scott Benner 13:02
Yeah. So now you're 18 You've done everything, right. You've lived away you have your diploma, you've decided no college, but at some point, when does the experience of being a paramedic and EMT and make you feel like I'm gonna do something else?

Anonymous Female Speaker 13:19
So that summer, I did end up going to college, and I like worked as a paramedic through college, which was, I didn't love school. I mean, for me, it was just weird. Like, I my interest. I'm like, the world's most boring person. I don't drink I don't go out. I'm just like, boring. I know that sounds bad. But like, I don't really do anything. So for that, he's I didn't love college. But I loved like working as a paramedic through college and like, showing sounds sounds so bad, like showing up for the drunk people. I'm so bad, but I don't know. It was just weird.

Scott Benner 13:53
Wait a minute. First of all, I don't think it's boring. If you don't like doing stuff like that. I think that's fine.

Anonymous Female Speaker 14:00
Yeah, it was it was an interesting experience. Yeah. Also

Scott Benner 14:03
the school you went to and not drinking. That's fairly uncommon. Oh,

Anonymous Female Speaker 14:08
trust me. I know. I know. I don't think there's anything wrong with drinking. I just think like smells really bad. So I sound like an idiot saying this. I

Scott Benner 14:17
don't mind how you feel about it. I'm just saying that to get through that particular college without drinking is a bit of its own accomplishment. Honestly,

Anonymous Female Speaker 14:26
I like I didn't live on campus. I lived in the firehouse so I was like slightly removed from it all but wait,

Scott Benner 14:32
yeah. Wait, you live. Were you a paid a paid person? So

Anonymous Female Speaker 14:36
I was paid for a local hospital. I was a paid medic for our local hospital and then I was a volunteer in the firehouse and

Scott Benner 14:43
you got to live there.

Anonymous Female Speaker 14:44
Yeah, for for the deal. Really? Yeah, I did college in three years. So I mean, I didn't like freeload from them for four but still so

Scott Benner 14:54
that's pretty cool. And you also got, you got to save on your on your Room and Board to

Anonymous Female Speaker 15:01
Yeah, 100%, which I mean, and it was a great group of people, they were hilarious. So I enjoy that.

Scott Benner 15:07
That's really excellent for you. That is that's interesting and different stories. See, finally see, Sarah, you didn't do that, did you? Hi.

Anonymous Female Speaker 15:13
There'll be someone after me who will have the same thing.

Scott Benner 15:15
I'm now thinking Sarah is gonna write me an email. I mean, like, I live in a firehouse and college.

Anonymous Female Speaker 15:21
We should just share stories. If

Scott Benner 15:23
that happens, you guys should totally meet each other. Okay, so All right, very cool. I want to understand now. So you have type one. So why did you reach out to me originally? Were you having trouble?

Anonymous Female Speaker 15:37
No. So I honestly just reached out completely in gratitude, because I don't know how I would have been able to do like, working as a paramedic, running. Because I mean, I run distance. So I was like, running long distances, like, just kind of like, because of the things I learned on the podcast. I didn't have to lose who I was, if that makes sense. Like, I feel like, if I didn't have what I learned on the podcast, I wouldn't have gotten to be myself. And that meant a lot to me.

Scott Benner 16:06
I'm glad. That's really that's lovely to hear. Are you still in college?

Anonymous Female Speaker 16:10
No, I graduated three years. She

Scott Benner 16:13
said, Yeah, I just wanted to make sure it wasn't okay. But you would be if you didn't graduate in three years. All right. Yeah, I would. What, what was your major? And

Anonymous Female Speaker 16:23
so I majored in biology. I thought I wanted to go to med school. And then I decided, I mean, I did the whole the whole stupid nine yards, I took the MCAT I did all that jazz. I got into med school. And then I was like, You know what, I want to be a nurse practitioner instead. So I'm in school for that. Now. You

Scott Benner 16:42
got in you got accepted to a school? Yeah, we say which one? I mean, could you tell me and I'll bleep it out if you don't want it in here. Sure. Okay, good.

Anonymous Female Speaker 16:55
So I got accepted into

Scott Benner 16:57
he got accepted into four different medical schools.

Anonymous Female Speaker 17:01
Yeah, please leave that out. I don't want people to know why.

Scott Benner 17:05
Cuz you're calling your your sister a badass. And you're one is that why?

Anonymous Female Speaker 17:09
I don't know. I just I don't know.

Scott Benner 17:13
I don't know. You feel like you're bragging? Kind of how many did you apply to?

Anonymous Female Speaker 17:18
I applied to 10. That's

Scott Benner 17:21
an astonishing ratio. Thank you, for you super smart.

Anonymous Female Speaker 17:27
I like school. But at the end of the day, like, I don't know, it makes I just want to be a good person. That's my only objective. And I just feel like, silly. I don't know.

Scott Benner 17:34
I listen, my wife got out of college and wanted to go to medical school, but we couldn't even afford the applications. It's wicked expensive. Yeah. And so we were on our own and really young. And so we just picked one and set one off. It was a complete, like, there was no way it was gonna happen like that. But her M cats were good. Her grades were good. She went to a university that's respected for its sciences. And she's Kelly's super, like smart and studious. She loves to go to school and learn everything. And it was it was, you know, we never got back to it. Because we just, we have a process.

Anonymous Female Speaker 18:10
It's just ridiculous isn't the word and I don't mean to sound like condescending but it's just like, it just feels so. So like, inhuman? I don't know,

Scott Benner 18:21
if they are definitely making it as difficult as humanly possible. Like they're trying to weed people out. And even maybe I understand that a little bit. But back then, like Kelly, could I use the little grace like she was in a in a bad spot and would have been nice. If we could have applied to a couple of places. I always wonder how she would have made out I think, Well, I actually think Kelly would be a good doctor. But, you know, you make babies and start making money and you're

Anonymous Female Speaker 18:43
like, Well, life happens. And then it's like, priorities are different. And yeah,

Scott Benner 18:47
you gotta keep doing this. Right. Okay, so you don't feel like you just like let's go backwards for a second. You just want to be a good person. Yeah, that's kind of my big goal. Have you not accomplished that goal yet?

Anonymous Female Speaker 19:02
I mean, I hope I have but I don't know if I'm the person to be the judge of that. So are

Scott Benner 19:06
you like, shy?

Anonymous Female Speaker 19:10
I'm not shy. I'm kind of like an introverted I'm like an extroverted introvert. If that makes sense.

Scott Benner 19:18
It doesn't pay you for tell me more about it. I will understand it better here an extroverted introvert. So the process of dealing with people is tiring. But you enjoy the idea of

Anonymous Female Speaker 19:29
love talking to people, I love making connections with people. I find it so neat to like hear people's story and like find ways to help people and stuff like that. But at the end of the day, like I do kind of just like, come home, I go for my run. I decompress. I train and like that's

Scott Benner 19:43
that. Yeah. Wow. That's lovely. You living with your parents? Are you on your own?

Anonymous Female Speaker 19:48
I am. It makes me feel kind of like I'm not a real adult. But I moved back home a little bit ago. So

Scott Benner 19:56
are you still volunteering or working at the fire department? So

Anonymous Female Speaker 20:00
I since I moved out of that area, I'm not running right now with them and I miss it a ton. I go up every once in a while just to run a run a few calls, because I do miss it. Yeah, but I'm, I'm working now at like an indoor office and I love that. So, okay,

Scott Benner 20:16
I want to hear about that in a second. I volunteered for three years. And as a fireman, and I was there one day visiting, there was a fire and somebody else your gear still here. And I was like, I was like really? Like, yeah, I was like, alright, so I put it on and I went and it's like riding over trying to remember all the things that I need to do. You know? I'm praying nothing was really on fire. I was like, let this just be like something simple. Like 95%

Anonymous Female Speaker 20:45
of the time. There's like no real fire. But yeah, anyway, yep. That's fun, though. So

Scott Benner 20:51
you you just went out in the world. I mean, I'm assuming we're like, got the first job you applied for right?

Anonymous Female Speaker 20:58
Yeah. So like, I had no idea what it was doing my first job interview, I biked down a highway in the pouring down rain, and then like dried my clothes on a hand dryer in the basement of the hospital. Somehow got the job. I'm convinced this because they were desperate. But it worked out. You

Scott Benner 21:16
believe she showed up on a bike? I didn't have a car

Anonymous Female Speaker 21:19
and I had to get it was.

Scott Benner 21:23
It was something did you tell them that? Did you say? I biked here? No,

Anonymous Female Speaker 21:28
no. Like, I got there. And I was like, I don't know where to do. I'm soaking wet. I look like I just walked out of the shower. So I'm like stumbling around in this hospital. I find this bathroom. I like because I show up ridiculously early. The thing is, it's just how I am. And I didn't have time to like make myself look presentable. I like walk into this room with a bunch of like men who were like 20 years older than me. And it worked out. But like I was terrified.

Scott Benner 21:52
I'm sure they saw something in you. I don't know. But it worked out so good for you. And it's not it's a hospital merit. It's part of a hospital. Yeah, the hospital. Okay. So you sent me a note, one day, not so long ago, I feel like and I was really touched by it. So, but you are now I'm seeing now that I'm speaking with you. The note makes more sense. Why did you reach out to me? Like what was the give me the whole genesis of that of that thought in your head? Because I don't think it started where it ended. Is that correct?

Anonymous Female Speaker 22:26
Yeah, no. So I got this job. So my end goal is to be a diabetes nurse practitioner. Like that's kind of what I want to do. It's not kind of that is what I want to do. And so I'm working in this editor's office, and I love it. I love my job. And I love patients, and I love every bit of it. What I really hate is the advice like I can't, it drives me insane. Like, I pull up a I was working on something yesterday and I pulled up a chart note yesterday that said patient is incorrectly treating hyperglycemia with one glucose tab. And I wanted to like read my computer screen off of the monitor. Like it just it's these little things that like people want to do well, and they're trying to do well. And they get this advice. Like you know this, everyone who's listening to this podcast knows this, like, you get this advice that sets you up for failure. And it drives me insane.

Scott Benner 23:20
And you're very passionate about it, too.

Anonymous Female Speaker 23:23
Yeah, no like it, it really blows me because like, I go home at night, and I think about these people who want to do the right thing. But they they're given advice that like it's it's like this is supposed to be the person who's supposed to lead you down the right path. And I mean, like, everyone, like I said, everyone who listens to podcasts knows that that's not what happens. And I I think that's something I didn't even realize until I was working here is like the group of people that hear things like this and the group of people who have access to things like this, it's it's so much of a smaller group than we know. And we think like, I have not come across a single type two diabetic on insulin in our office who is not on a sliding scale. Like no one has a carb ratio of our type ones. I'd say that probably more than 50% are on a sliding scale. And like you think like standard of care is gonna be that carb ratio. And people are not on that. And it drives me a thing.

Scott Benner 24:22
You're saying half the people you meet are on a sliding scale if they have type one. Yeah, yeah, that's crazy. And that makes you nuts. It drives me absolutely bonkers. Yeah, no, I love that about you. That's one of the things I love about you. So yeah, no 100% I We need like motivated people like you to do things for masses of people who don't know they need it done for them. And I agree with you, wholeheartedly. I mean, I'm very proud of how many people the podcast reaches. As a matter of fact, yesterday was Sunday, and Sunday is usually my lowest day of the week. That makes sense. And yesterday Today was the most popular Sunday by Triple Bottom knees, the best one ever. And I was even like, what's happening? I started asking quite I went on Facebook and I put a poll up and Mike did a bunch. You just start listening to the show recently, or like, I was trying to figure out what

Anonymous Female Speaker 25:15
I saw that I was like, and it made me super excited because I've been listening since I mean, I've been listening since I was diagnosed, I felt like super excited clicking like, more than a year ago, I was like, I'm gonna be Oh, geez, you

Scott Benner 25:25
are? Yeah, some people were like, I felt like it. One woman said, I started listening in episode four. And I was like, wow, I have to be honest with you back then. There were maybe maybe 1500 people listening? And yeah, you know, and I'd be surprised if there's not 1500 downloads while I'm talking to you. So that's,

Anonymous Female Speaker 25:45
that's just like, that makes me so excited. Because if people would just hear this advice, like they would be able to fly it. And I know that sounds cheesy, but like, this is what people need. And this is what people don't get? Well,

Scott Benner 25:58
I'll tell you why I don't think it sounds cheesy, because I got an email from Jenny the other day, let me see if I can find it. So sometimes when Jenny meets people who I don't get to meet, and they talk about the podcast, she'll send me a note and say, Hey, I talked to you, she keeps it pretty generalized. You know, like, like, you know, you sometimes talk about Yeah, good. All right, you just talk around that a little bit. And it's, you know, somebody who had had diabetes for I want to think it was a, if I'm remembering, right, a woman who had had diabetes for a number of years, and she found the podcast, and God, like out of the sevens, like she was just stuck in the sevens forever. And got out, got her agency down into the lower sixes. And very crazy, and she said it was from the Pro Tip series.

Anonymous Female Speaker 26:47
And like, it's so true, like the bat, that is the core of it all. Like, it's all right there.

Scott Benner 26:53
Yeah. And it's just it's, I mean, look, I hate saying it like this, because I know, diabetes is really difficult. But there really are these kind of core tenants. And if you get them even close, he wants he drops pretty quickly. You know,

Anonymous Female Speaker 27:08
it's so true. And, like, I know, it's, it's hard, because like, there's the medical advice piece of it. And then there's the like, real life piece of it. And like so we know, it's possible for providers to give that advice. So as an example, we have like a satellite. So we have our main office, and then our one nurse practitioner, who is like, the most amazing human being ever, she, she has type one and she runs our like diabetes clinic at like the maternal fetal medicine, part of our like, hospital. And I kid you not all of those patients are in the fives, like all of them are in the fives or the low sixes. So it's possible it's possible for a provider to get those results by giving the right advice and they see it and I'm like, she like I just I want to tell her like, can you just see every patient? Because it's so possible,

Scott Benner 27:58
you get to see the results from different providers. Yeah, and so you, you really, that's interesting. So you know, when you look at a person, you can look them in the face and think if you were just seeing a different doctor, your agency would be lower.

Anonymous Female Speaker 28:12
It's the worst feeling ever. So I love data. And I ran the numbers for our practice and I have all I ran all the numbers and I have a one C average a one c by provider average day when c by diabetes type everage. AMC by if they're on a CGM or not if they're on a pump or not. And the numbers it's so clearly the biggest one is CGM makes a huge difference. Pump makes a huge difference and provider, which is unfortunate. But it does. Yeah, yeah, it's it's it's a stark difference.

Scott Benner 28:43
Next time you mess with the numbers. Do CGM users by their high alarm?

Anonymous Female Speaker 28:49
I would love to do that. It's just the only thing is with 1000 patients, I'd have to pull each one of their reports.

Scott Benner 28:55
That's a shame because I guarantee you that the lower their high alarm is the more stable and lower their agency. Yeah, no, I 100% agree with that. Yeah, that's really cool. So when we're going back and forth one day, then you sort of just asked me like a big question. Right. So what were you wondering?

Anonymous Female Speaker 29:12
I guess the question was, if we could get this to providers, this info, right.

Scott Benner 29:18
And I said, Yes. And then you apologize. That would be me. But so we we got off on you know, we went back and forth a couple times. And I could feel your excitement like I can. It felt like we were like standing in a doorway together. I was on one side, you were on the other. And you were like, I'm gonna go find out right now and just ran away. And you know, and then I didn't hear from you for a little while, which is reasonable. And my wife's like, what are you doing? And I said, I said, there's a girl and she goes, Okay, and I said she works in a practice. And I think she would like me to come speak to the practitioners. And I said, I don't know if that so a lot of people say that not many Have them get it worked out. Yeah, it becomes there's a lot of hoops to jump through and you start getting down to like, you've probably heard the episode with Kathleen. Right? The Endo. Yeah. So you get down to like, you really start getting down to brass tacks and you're like, Will Will 30 People sit in a room and listen to some guy who shows up and says, If I was you, I would talk about it like this, you know, instead of the way you're doing it? Yeah. So I just thought like, I'll never hear from you again. Maybe other than for you to go. I'm so sorry, this didn't work out. But you sent me another note. And you're like, hey, this might be working out for real? Like, are you sure you want to do this? So can you tell me a little bit about what you did in the office to try to get it going?

Anonymous Female Speaker 30:38
So I kind of forcefully convinced a few of our providers to listen to a like, it was like probably, it was the beginning of this year touched by type one did that thing where you did like a really quick presentation for like an hour? Yeah, I recorded that. And I showed that to them. And because it kind of like it kind of puts all of the pro tips into like one hour, if that makes sense. Because yeah. And then I do that to our medicine physician, and they gave it to our CDE. And I talked to our practice manager. And he was like, this guy, we need him, please. Wow.

Scott Benner 31:17
And they watched it. And so first of all, that our talk, which I've never given the same way twice, but in my mind, it's a primer to the podcast. Yeah, it should make you want to go listen to the Pro Tip series. That's the that's the best I've been able to figure out given a short amount of time. And keep in mind, usually I give that to people who are fairly newly diagnosed. And my goal is really just to make them believe that there's better that better is obtainable. And that they could take the steps that would be necessary. That really is that's my whole goal with that. And then hopefully, they go listen to the Pro Tip series. That makes sense. And then I think of it as like, then they can slowly implement it on their own time, if it's something they're interested in. So you gave it to three people did, did you get any bad? Feedback?

Anonymous Female Speaker 32:07
No, not at all. Excellent. Not at all, like, and I think the thing that really, so the biggest thing that really cued me into the fact that this could be super helpful is like everything that has been effective for me and is effective for this entire, like Juicebox Podcast community is oftentimes the opposite of what's done in like an endo office. So if a patient calls in and says, like, this happens all the time, a patient will call in and be like I had a low blood sugar, a low blood sugar might do like not like a pattern of lows, a singular low blood sugar. And there's certain providers that will hear that, and I'm not trying to, I'm not trying to point fingers, but like, there's certain providers that will hear that and will completely change everything. For one low blood sugar. And mind you they're considering a low blood sugar like

Scott Benner 32:51
an 86. Right, and they take away their Basal, right,

Anonymous Female Speaker 32:55
exactly. And that's, that's what I was gonna say they don't adjust the carb ratio, they cut off the Basal, and then they're on a roller coaster. And it's like, I was like, hey, just like listen to this. And it's like, we're basil like focus on the basil get the basil, right? Because that like like you say, that's the foundation and whenever someone has a low the first thing that I feel people cut out is Basil. And then people were on this horrible roller coaster of they can't get anything. Right,

Scott Benner 33:19
right? Yeah, you so for me, I look at the graph. And if if the balanced times like away from food and away from away from mealtime, insulin or correction insulin if those times are fairly steady, but higher, I think, okay, the basil might not be high enough. There are people who look and then see the lows and right away think oh no, the basil is too high. It's dragging you down. And so you're just overcorrecting for the lack of basil. And it's probably that you're overclocking that don't get me wrong. Sometimes people's Basil is way too high. And they do a homeless curse. I don't know, why have you made me want to curse. They do a terrible job of Bolus thing their meals or they don't Pre-Bolus at all. And so the hi basil tries to fight with the meal and just can't and they can't win. So you get higher but then eventually the meal is gone. And the bait the two high, basil's left hand drops you back down again. But on a on a chart on a graph, they almost look the same. Yeah. And I really don't know how to put into context that they aren't like when they look differently to me, but I can look at them and most of the time think I know which one this is. And I do that by asking a very simple question of the person whose graph it is, which is, do you find yourself more frequently feeding the insulin or do you find yourself more frequently trying to impact a high with a correction?

Anonymous Female Speaker 34:44
Yeah,

Scott Benner 34:45
if it's, you know, and that's your answer, usually. Exactly.

Anonymous Female Speaker 34:47
And like I think the coolest thing for me like working in there's offices I get to look at like, I nerd out over this stuff I like I get to look at like all sorts of cracks graphs all day every day and it's like Do you see these things? And like the hardest part for me now is like, I'm in school. I've not done with school one day, but I sit there. And I'm like I just wanted, I just want to say this. I just want to suggest this, but I have to shut my lips and

Scott Benner 35:12
let the provider say anything. Yeah, yeah.

Anonymous Female Speaker 35:15
And that, like, I had a situation last week where a provider was honestly going to cut away, like, a ridiculous amount of a patient's Basal rate for compression well, and I said to them, I was like, this is a compression low, and they had no idea what that was. And it's like, it's just things like that. So I'll get off my rant now.

Scott Benner 35:34
Oh, I love your rant. You're right, it makes me excited. So you're one of the people who like, and there's a lot of people who do this that are probably all gonna hear this the same time and laugh, but you're one of those people who like, purposefully by mistake bumps into people in hallways, gets up to them, because Juicebox Podcast, and then walks away from them, kind

Anonymous Female Speaker 35:51
of like so I get to do this kind of cool. The role I'm in right now is like an interesting mix of random things. But the my favorite thing to do, and you can ask any of my co workers as they come to me when they have one of these, but starting a patient on a CGM, like that is my favorite thing in the world. Because I get like my, like 20 minutes where it's just mean a room and I can impart on them like anything I want. And it's always like, this is not just a way to, like not stick your finger, like use this to not get high rather than to know when you're wildly high. And listen to the Juicebox Podcast.

Scott Benner 36:25
Oh, thank you. So I have to say I get a lot more. The Where do you when people come into the private Facebook group? There's a couple of questions to answer. And one of them is like, where did you hear about the podcast? These two answers are becoming more and more frequent, which I'm super excited by one of them is from my health care provider. And I'm always like, yes, that's cool. And the other one that I really love is everywhere. That's the one I love. Like where did you hear about the Juicebox Podcast are like everywhere. It's everywhere I hear about all the time. I'm like, ooh, like that

Anonymous Female Speaker 36:58
just made me smile. And I know that sounds so stupid, because it's your it's your project. But like, I just like, This is how you succeeded have died. Like Pete my coworkers obviously asked me they're like, how is diabetes? Not like your entire life, because you work here and you have diabetes. And I was like, You don't understand. Like, I don't think about diabetes. When I go home. I don't think about it. Because I know that I'm going to know if I'm under 65 and over 120 Like, I'm going to know this next I'm going to tell me and I'm going to fix it and I'm gonna go on with my life. But it's like this is how diabetes doesn't run your life.

Scott Benner 37:32
Well, that's what the episode I put up today with Arden. You know, she she came on? And um, there's no way you heard it yet. It's literally just went up a few hours ago.

Anonymous Female Speaker 37:40
But I saw it was up. I was like, I need to watch this. But I was like running from from work. So no,

Scott Benner 37:44
I'm just saying that. I assume you haven't seen it. So are her, excuse me. But she just says the same thing. She's like, I don't think about diabetes very often at all. Now, she doesn't think about it at all, because I live here. You don't I mean, not because she knows all the nuances of it. But she's also 17. And she's had it for a really long time. So she's in a different scenario. But I like that feeling the feeling of she's like, it'll be fine. Like, I'm like, Well, what if you get low at college? She's like, I'll be alright. Like, it's yeah, that vibe. I'm sure it's gonna happen to her. I'm sure I'm gonna get a note one day where it's like, hey, wow, oh, last night did not go well, you know, but like, she's on an algorithm. I expect her to continue on with an algorithm I expect her to go to on the pod five at some point. So, you know, I don't think she's ever going to get like, I mean, not that it couldn't happen. But I think generally speaking, she shouldn't have too many incredibly dangerous lows. She doesn't have them now. She does know what she's doing. My wife reminded me. My wife listen to the episode that Arden did which by the way, she's so sarcastic and it's interesting to listen to. My wife reminded me that we started to tell a story in that episode that we didn't finish the the finish to it was that my wife had gotten sick, she had gotten a kidney stone. And for the two days after she got back from the hospital, I wasn't around and only Arden was an ardent exclusively took care of herself for 48 hours plus, and she was I didn't know I was somewhere else and remotely. I could not tell on her CGM that, that I wasn't there.

Anonymous Female Speaker 39:19
Yeah, that's awesome. And like she knows what she's doing.

Scott Benner 39:22
But if you ask her to explain it, she has no idea. What's

Anonymous Female Speaker 39:26
kind of like speaking English, like you know what you're doing, but you don't know how to explain it. You know what I mean? Like, it's just any so I guess that's like, that's a very good sign of just being intuitive.

Scott Benner 39:34
I felt so too. And at the same time when I said to her, what's the name of your insulin? And she's like, I don't really know. She told me she thought for a long time that it was AMI pod. One day she heard me say it like Omni pod and she thought I was mispronouncing the word. Or I asked her what version of the G CIG were version of the Dexcom Ashiana. I had no idea. And when I asked her how to use her glucagon, she said, I don't remember. And, and, and I was like, I used it. I use the brand name of it. And she's like, What? What is it? And I was like, the G voc hypo pen, and she goes, what is is that the thing in my purse? And I'm like, Yeah, I'm like, you know, you have glucagon, right? And she goes, Oh, yeah, she goes, I take it everywhere. And I was like, okay, there you go. And I have a trainer. Like it's been on my desk forever. It's just a plastic trainer pen. I pulled it out. And I was like, it's like this. Yeah. Pop off the cap. On the skin, it clicks Once it clicks twice. And you're all done. You remember me showing you this? Right? And she goes vaguely, or something like that. And I'm just like, so yeah, so I think it would have been easy for some people to hear it and go, Oh, my God. See that? That girl? She doesn't know what she's doing. Like her dad does the whole thing, but it's not true. left on her own. She does really well.

Anonymous Female Speaker 40:53
Yeah, and she knows what she's doing. And she's going to be just fine. Ya

Scott Benner 40:58
know? So we're going to do some more episodes where we're going to talk through, like some of the, you know, the bare bones stuff that I think she'll need to know like things like if I was dying tomorrow, things I would sit down and tell her about her diabetes. Although I gotta be honest, we're only a day left. I'd be like, Listen, if you just go listen to some of those episodes, I have very limited time.

Anonymous Female Speaker 41:17
You've got like, all she's like you said this in the recent episode. But like, this is like, kind of like the vote of like, your connection with her. But like, Honestly, though, it's like, anyone can find this and be chill, and like, if we've all succeeded, like clearly Arden's gonna be just fine. Like she should.

Scott Benner 41:31
I mean, she listens to me say it to her all the time. Yeah, just, I would think that Arden would benefit from this podcast more than anybody, because she's already primed for it. You know what I mean? Yeah, my wife actually said something to me the other day. And we were talking, like, when you get older, you start talking about weird stuff. And, you know, she's like, if you died, I was like, Oh, sounds like I'm gonna get murdered in my sleep. But okay, go ahead. She's like, if you died, I would go listen to the protests right away. And I was like, good. That's what you should do. Yeah, I was like, that would be fine. You'll do that. So if I die, if I die, I make an error. She's gonna pillow No, it's not a sweet idea. She's gonna kill me in my sleep. Pretend I like had sleep apnea or something like that. And then stage it perfectly hide all the evidence. I'm worried about saying it out loud. Now, in case this gives you the idea, honestly. Good. Yeah. But anyway, so do you think it's gonna happen? Do you think I'm going to come to your hospitals or your practice and speak to the practitioners?

Anonymous Female Speaker 42:31
Like, honestly, 100%. The only hard part is like, when you are like, This, to me is like the most exciting thing that's ever happened. But unfortunately, management, like the higher ups who like give us schedules and dates and calendars, like to them. It's just like another event, they have to find dates for it. That makes sense, which is unfortunate. So it just takes time. But I have no doubt that it's like, you really think it's 100%? Cool, like not no doubt in my mind. It's just the semantics of like right now just like waiting for dates and availability. And wow.

Scott Benner 43:01
That's great. What did I ask how much time? Did I ask for? Two hours? Two hours? I think that's right. Yeah. I think we talked for a good hour, I do a high level overview, like you would have seen in the video, and then just answer a lot of questions. Look at a lot of graphs, and let people bring up scenarios and answer questions. I don't see the practitioners as being any different than speaking to a person with type one or speaking to a mother of a kid who's had it for six months or something like that.

Anonymous Female Speaker 43:30
Yeah, it's honestly the exact same thing. And I think that if anything, it's like, more valuable because for the most part, they don't live it. Like our super awesome nurse practitioner. She has type one, which is, I mean, I shouldn't say that. That's why she says super awesome, but like, they don't live it. And it's hard to expect someone to be able to, like, finesse something when they don't see it all the time. Oh, yeah. But at the same time, like, honestly, I there's this one provider, and I really shouldn't say this, but she considers anything under 100 hypoglycemia, and in the office, she gave a patient 64 grams of carbs to treat a blood sugar of 98. I was like, I literally wanted to like, leave work. I was like I can't right now. I was like, I can't believe I'm watching this right

Scott Benner 44:17
now. Depending on the scenario, I may have made a small Bolus for an IDA.

Anonymous Female Speaker 44:22
Oh my god. 100%. And then the the icing on top is that she in her after visit summary for this patient? She puts your diabetes is not meeting your goal of XYZ percent. And it's like okay, if they're not at like an agency, that's our goal, it's because you just treated their low to 250 they're low in quotation marks to 250. And now that they're 250 You're gonna tell them that their agency is not at goal. I

Scott Benner 44:46
was gonna say 64 carbs for a 98 blood sugar makes you like 222 50 Probably yeah,

Anonymous Female Speaker 44:53
yeah, this patient ended up like, it was like 250 something and I'm like cringing the entire time. I'm like, Please don't leave it. is all just a bad injury? Do the

Scott Benner 45:02
patients notice that's wrong? Or just some of them go? Okay. So

Anonymous Female Speaker 45:08
I have an unfortunate amount. I don't know any better. I did have one. I think I told you about this guy. He was like he was, I think he was like 85. Newly diagnosed, I got into like, they do a CGM kind of teaching with him. I gave him my two cents of wisdom, listen to the Juicebox Podcast. And then in his next office visit he was in and his blood sugar was like 85. And as he's walking out the door, this provider asked me to help them treat a while and he looks at me, he goes, I'm not doing that, because I'm not well, and he credited it to the Juicebox Podcast. So that was like, That is awesome. Like, there's people who do know better and who, who succeed. Granted, this cable is next office, because they got told that his average of 120 was fake because of his lows,

Scott Benner 45:52
because it was the 85 lows. Yes, because which

Anonymous Female Speaker 45:55
I wanted to scream, but I just had to sit beside that's myself on my little desk and pretend they don't hear anything. Well, doesn't

Scott Benner 46:00
that make you wonder how many other people in your situation are sitting in other offices around the world, doing the same thing?

Anonymous Female Speaker 46:08
I'm willing to bet that there's like a there's a someone who feels exactly the way I do in every single endo office. It's just sometimes the I don't want to say the power dynamics, because that's not it. But sometimes you're forced into oblivion, and you can try to respectfully impart what you want to say. And some people are open to hearing it, and some people aren't. Which is tough.

Scott Benner 46:31
Yeah. So is there a lot of confirmation bias? Like do some sometimes you see a provider say something that's so out of bounds? Does it do you see it make the patient comfortable? Like, oh, I could just leave my blood sugar at 150? Great, like, Does that happen?

Anonymous Female Speaker 46:45
I think I think that there's certain times where it definitely does. If a patient's in the office and like, is sitting in and they'll do like a random finger stick. And it's like in the one hundreds, maybe it's like 190. They're like, Oh, that's not too bad. But then when their agency correlates to an average of 190, they get scolded for it. So it's like, I feel like there's this discordance between reality, and like, like, yeah, a 190 You're not 500 But that's also not healthy, like. So I think it's yeah,

Scott Benner 47:20
thanks for the dual message to 190 is correctly Yeah.

Anonymous Female Speaker 47:25
Want you to succeed, but hey, let's make this more hard, more more hard. Oh, my God, I can't talk more difficult supposed to me.

Scott Benner 47:32
So tell me if I if I gave you the power, and you were able to change one thing? Like, what do you think would help people? Being the providers? I mean, what would help the providers? This

Anonymous Female Speaker 47:44
is gonna sound cliche, because this is exactly what you said that your nurse practitioner has told you guys, but the fear of lows because it's the lows that drive people to this insanity. Like, because providers are so afraid of people having lows, like terrified of lows, like if we get if we have someone call in and they're say they're having a low blood sugar, it goes high priority in our like, in basket, which is our like messaging system. And it's like, yes, lows are important, but like lows or like, lows are part of like diabetes, like, just like, you don't always get an A plus on every test. Like, that's just part of how it goes. And it doesn't mean that like, everything's wrong, your Basal rates are totally screwed up, like a pattern of lows might one isolated well, it doesn't. And there's this just, there's this fear of lows that providers put into patients. And it makes everything so much harder for everyone.

Scott Benner 48:37
Yeah. So apparently last night, I was working late at night. I know. You said you're boring. I was like 11 o'clock working on the podcast on Sunday night. And that

Anonymous Female Speaker 48:48
sounds like something I would do just like homework on Yeah. Oh, we got it. Yep, I believe Arden

Scott Benner 48:52
and Kelly, we're watching Big Brother. Nice. And Arden decided potato chips would be the way to go for a snack while she was watching Big Brother. And I don't think she got the timing of it. Right. So she went up 150 or 160. And then I went to bed and everyone went to bed and a couple of hours later, she was like, you know, 50 because she just she didn't Pre-Bolus Well for the chips, right? And eventually the chips cleared her system and there was insulin leftover and it brought her lower. And so I you know, she tried to treat it herself with the juice. And it didn't work. And so it just she just stayed like she she was stopped what was happening, but it didn't. There was still enough insulin in there and it burned through the juice and she was just now she's stable in like the mid 50s. So I got up and I'm like, Hey, did you do anything? And she's like, Yeah, she's like, I drank juice. I was like, Alright, I said, she's like, I'm hungry. Which once she's low for a little while she's gonna ask for food. Yeah, so I was like, Well, I can get you a banana. I don't want a banana. I was like, hey, Arden it's 330 in the morning. Oh, who cares? Which one? Yes, yeah, this isn't like we're not at a restaurant right now a banana is soft, it's easy. And you can swish a little water in your mouth afterwards and be done with it. I was like, we're getting a banana. So I brought a banana up and I restocked her room with juice boxes, which we don't use much anymore. So I was like, you know, I brought some with me to be sure we had them and shaved the banana. I waited for like two revolutions of the CGM. And I saw a little dip before it went back to 55 again, and I was like, this banana is not going to do the trick. So I said, I need you to have one more juice, and then you're gonna be fine. And she was like, I don't want another juice. I was like, again,

Anonymous Female Speaker 50:40
it's 3am just drinking dangerous, I

Scott Benner 50:42
don't really care. I was like, so she drank the juice, I gave her half of it. I was like, I'll give you half and I'll wait five minutes, I gave her half I wait. And I was like, just drink the rest of it go to sleep, you're gonna be okay. She drank it. She went to sleep. I sat in my bed for 20 minutes made sure that we got the right outcome, which we did. And it was over. And now she's fine again. And yeah, I do not expect that to happen again tonight. Like it was just because of the Miss on the potato chips. Yeah, it's like that's simple. And a provider would see that take away all of her basil overnight. And then her blood sugar's would start bouncing all over the place, and it would ruin weeks, if not months of her life. And no one, no one would think to put the basil back up, because the doctor said the basil was the problem. Remember, we had a problem. And the doctor said the basil was too high. So that gets wiped from your memory now.

Anonymous Female Speaker 51:35
And that exact phrase The doctor said is it's in. Its it's like impregnated in so many people's brains that like, this is how it's supposed to be. And you've talked about this a million times, but it's that like, it's that there's so much of and I think part of it's because like your your endo is not following your, your Dexcom like part of that, but there's so much I feel like 95% of the advice you get within your undos office is that static diabetes management and to succeed, you have to be dynamic with it, right?

Scott Benner 52:04
It wouldn't, it wouldn't even be terrible. If they gave you that information and said, Listen, this is kind of the basis of it. And you're gonna need to, you know, it's more like a dance, you're gonna have to stay light on your feet here and bob and weave a little bit, you might have to duck a couple of punches and take your shots where you can like, there's more of that going on, then it's not math, it's left with like, it's mathematical. And it's so not, it's

Anonymous Female Speaker 52:28
so true. And honestly, like, there's a ridiculous amount of our patients on pumps who don't even know how to change their settings, they don't know how to manually flick whenever there's like an adjustment. Like, I spent like two and a half hours on the phone to this woman last week, like walking her through how to like change her settings. Because like, the people just don't know how to change your settings. They don't know how to like, press the buttons, they don't know which which process it is because they just don't click, I mess with my settings all the time. And like I like the provider I see is like in our office, but like, she's like, right on, how about it. But like, people, it's a scary amount of people that just don't know how to do that. I

Scott Benner 53:09
was helping someone this week. And I don't think they would mind me saying this much about it. But you know, their kid having it's classic, exactly what we've been talking about. And I, I let her message me for a little while, like to get it out of her system. And I was like, Okay, well, do you want to like, are you looking for my help? Like, you know, I can try to help you. I don't know if I'll be good at it or not, like keep in mind. I'm not a doctor and all that stuff. And she's like, No, I'm just what do you think? And I said, Well, your Basal profile doesn't make any sense to me. It set up like, at least four times a doctor looked at it and said, Oh, are you having a low here? Take away the Basal.

Anonymous Female Speaker 53:48
So 1001 Different Basal rates by our

Scott Benner 53:51
Well, how about one of them is two units an hour and one of them's point three an hour? Yeah,

Anonymous Female Speaker 53:56
that's just that's called like, so that's and that was probably around a meal to compensate for a carb ratio is my assumption.

Scott Benner 54:03
And I'm just like, listen, ya know, if there's no way that two is right, and point three

Anonymous Female Speaker 54:09
is right, absolutely not 100 Some, Something's fishy here.

Scott Benner 54:13
But what would you do? I said, I just shoot for the middle and start over again. And then I did my little thing where I asked how much the kid weighed, which has no real basis in medical theory, I just completely anecdotal from all the conversations I've had. And I was like, Alright, I said, if I'm you, let's set it at this at 24 hours. I said you're probably gonna get a little low overnight. So if that happens, take something away. But the person had trouble making the decision like, like to like take it away and they did it finally, you know, okay, we go back and forth for I just said, like, 24 hours. Now send me another graph. You know, I think we did like three days in a row. And on the third day, I was like, Well, what do you want to do? Thinking Like, you know, she started to get the vibe and she had ideas to do it. And then I was like, Okay, well, I said, if you were seeing a lower sugar overnight at like one starting at one, I'm like, what if you cut the basil back at like 11? And we'll see what happens. And she's like, Well, no, I think he needs it here. So we settled on these, these three numbers, which I was pretty cool with, like, there's a daytime, and overnight and a leading into overnight Basal ring. I was like, Okay, well, she goes to set, set it up in the pump. And she really struggled to set the Basal profile up. Yeah,

Anonymous Female Speaker 55:33
it's like astonishingly difficult for a lot of people because they just never, like, it's a lot of times it's here handed over to the doctor doctor will do it, or the phrase that I hate that I get told a lot is call the manufacturer to find out how to do it like no, no one's gonna do that. They're just gonna sit there with the beds,

Scott Benner 55:53
you've heard a doctor tell a person to call a manufacturer to learn how to change their Basal rates.

Anonymous Female Speaker 55:57
That's what that's what, like us, as assistants in the office are supposed to do, we're supposed to tell the patient to call the manufacturer so I'm like, no. So I'm like anyone who needs to change anything. Bring it to me, and I will walk them through it because I'm not leaving someone high and dry. Because if you told me so I used to slip. If you told me to call Tim to find out how to change my Basal rates, I'm not going to do it. So I'm gonna talk someone through it because I want to make sure that they do it. Not

Scott Benner 56:19
only that is like has the internet, it's pretty popular. Now. It's no one heard. Ya know? It's

Anonymous Female Speaker 56:24
just like, No,

Scott Benner 56:25
there's a whole system of computers, Eva, and they're, I know, fancy. They're connected to each other people's ideas are available. It's really crazy. Check it out. 100% call the manufacturer meanwhile, the manufacturer does not want to be involved in that. And 100% Now isn't allowed to be involved

Anonymous Female Speaker 56:42
in it. Exactly. Because if they make some if they make a mistake, then it's their fault. They're not allowed

Scott Benner 56:47
to give medical advice. No one's allowed to give medical advice. We live in a in a situation where everyone who knows should be saying what they know. And instead, no one will say anything. And like

Anonymous Female Speaker 57:01
I think that's honestly what drives diabetes care to be so poor, is because if Imagine if providers weren't afraid of the liability of a patient having a well, like, just imagine, like, I think that would make so much difference, like and so I'm in school to nursing right now. And so I'm spending a lot of time in the hospital and like, I had like a 350 pound patient on 10 units of Lantis and a sliding scale with no base dose. And I was and I'm like this is absurd. And it's because they're like, Oh, well, we'd rather have him be high than low. And it's like he's trying to recover from osteomyelitis like he's got a wicked infection. And despite these high blood sugars aren't helping. And it's like, imagine what things would look like if we weren't afraid of the liabilities of the world we live in. You're

Scott Benner 57:46
telling me a 350 pound person using 10 units of Basal insulin. Yeah,

Anonymous Female Speaker 57:50
it was like That's enough Basal insulin for his toe? Like no, there's

Scott Benner 57:54
a strong possibility that they need. I mean, 5060 like something like that. Yeah,

Anonymous Female Speaker 58:03
it's no a sliding scale with obese those. So like, if their blood sugar's in range at meals, they're not going to get any insulin at all, and what's in range. So a lot of the sliding scales in the hospital are like if they're under 150. They don't get a base dose. But then you're curious why it bedtime. They're like 300 and you have to correct the 300. And it's like, well, it's that exact idea. The insulin for now is insulin that was for leaders like do you just fix the later now? You're curious? Not? Yeah, you can't not give someone with type one. Insulin at me like I'm sorry, like use your brain. Oh,

Scott Benner 58:36
yeah. You're curious is the is the most delightful thing you've said so far today? Like you're curious as to why which meant that was like your like, that was your sarcasm right there. Yeah. Is there anything that we have not spoken about that we should? I honestly can't think of anything? Is there any chance you don't want me to put this up because you think you're going to get fired? I

Anonymous Female Speaker 58:59
was honestly just thinking that I was just sitting here like I've said a lot of things that I probably shouldn't have said yeah,

Scott Benner 59:06
I'd like you to think about this before I released this. Yeah,

Anonymous Female Speaker 59:10
I know. I was I was honestly just like staring out the window

Scott Benner 59:13
and thinking like the very least maybe we should take your name out of this. Yeah,

Anonymous Female Speaker 59:17
it's just honestly though, it just I need if I go down like this, I go down like this, but

Scott Benner 59:23
we're not we're not doing that. You're gonna you're gonna help far more people where you are than at home go and you believe I got fired over that because but yeah, think really think about and if you want to hear it first or something like I'll send it to you so you can hear it. I can take you up on that. I can totally take all your identifying markers out but you are going to be able to hear and we did talk about me coming to your place so it won't be hard for someone to figure out if they're listening. Listen, I enjoyed our conversation. If you and I are only the only ones to ever hear it. It's okay with me. Okay.

Anonymous Female Speaker 59:58
I might take you up on here. Get through first, I definitely don't wanna lose my job. But at the same time, like it just, it's the things that like, just don't. The things that go into the rug, and it's like the deep dark and dirty of what goes on at the end is office and that sounds horrible to say, but it's like, yeah, it's like that like back closet that no one ever opens. But it's so true when you have to, at one point face it. I don't know. Could

Scott Benner 1:00:21
this be the time I put a voice changer on somebody? That'd be great. If you're like a robot,

Anonymous Female Speaker 1:00:26
there's like, it sounds like a squirrely mouse like, I

Scott Benner 1:00:29
don't know. I don't even know how to do it. If I'm being 100% honest with you, I'm not certain I would be able to do it. Okay, all right. Well, let's stop recording and I'll say goodbye, and give me one second.

A huge thanks to a longtime sponsor touched by type one, please check them out on Facebook, Instagram, and at touched by type one.org. If you're looking to support an organization that supporting people with type one diabetes, check out touched by type one. A huge thanks to Dexcom for being longtime sponsors of the Juicebox Podcast dexcom.com/juice box head over there now get started today. I'd like to thank cozy Earth for sponsoring this episode of The Juicebox Podcast and remind you that using my offer code juice box at checkout will save you 40% off of your entire order at cozy earth.com That's the sheets, the towels, the clothing, anything available on the website. If you have a story to tell, or you know somebody whose story would be interesting, please contact me through the website juicebox podcast.com. I would love to tell your cold wind story. If you're looking for community around type one diabetes, check out the Juicebox Podcast private Facebook group Juicebox Podcast type one diabetes, but everybody is welcome type one type two gestational loved ones. It doesn't matter to me. If you're impacted by diabetes, and you're looking for support, comfort or community. Check out Juicebox Podcast type one diabetes on Facebook. And I'd like to take another second to thank Rob at wrong way recording for this awesome edit. I swear I know what the original voice sounds like from this and I don't even think the person is going to recognize themselves. It's really amazing. The episode you just heard was professionally edited by wrong way recording. Wrong way. recording.com Thank you so much for listening. I'll be back soon with another episode of The Juicebox Podcast.