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Scott Benner 0:00
Hello friends and welcome to episode 1145 of the Juicebox Podcast.

Erica Forsythe is back today Eric and I are going to kind of button up the parenting series with an episode about transitioning care. So we're talking about going from you being the one making all the decisions to handing that off to your child. While you're listening today. Please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your healthcare plan. We're becoming bold with insulin. If you're interested in learning more about Erica, she's at Erica forsyth.com. How would you like to help people living with type one diabetes and maybe help yourself? T one D exchange.org/juice. box, fill out the survey completely become part of the registry. And just like that, you've helped T one D exchange.org/juice. box now they're looking for US residents who have type one diabetes or are the caregivers of someone with type one. They're looking for everybody, but have a real focus right now on men, men of color, and of course, parents of boys. If you fit the bill, which is pretty much everybody, please reach out T one D exchange.org/juice. Box. completing the survey helps type one diabetes research helps the podcast and it will help you one day two T one D exchange.org/juice box. It takes about 10 minutes and they won't ask you one thing you don't know the answer to this episode of The Juicebox Podcast is sponsored by the insulin pump that my daughter wears Omni pod. Learn more and get started today with the Omni pod dash or the Omni pod five at my link Omni pod.com/juice box. This episode of The Juicebox Podcast is sponsored by ag one drink ag one.com/juice box. When you use my link and place your first order, you're gonna get a welcome kit, a year supply of vitamin D and five free travel packs. This is the transition of care handoff episode for the parenting series. Right? Yes. Okay. Do you think this is going to be the last one? Or do you think we're going to add anything else to this?

Erika Forsyth, MFT, LMFT 2:23
I think we could probably add more as we think of more ideas or we hear feedback or some more ideas.

Scott Benner 2:31
Let's call this the last one for now. Yes.

Erika Forsyth, MFT, LMFT 2:35
That sounds good.

Scott Benner 2:37
I get stuck too many times making series and I come out they make these definitive like this is the last one. And then like three weeks later, I'm like here's another one. I apologize. I didn't realize. So anyway, what would you like to talk about today? Okay. Well,

Erika Forsyth, MFT, LMFT 2:52
we're going to continue our conversation of we started in our last episode, overcoming parenting challenges. And we thought there would it would be significant enough to have this episode focused on the transition of care, and have the handoff, so to speak, and talk through some ideas and tips and suggestions. So

Scott Benner 3:16
are you telling me that in your mind transition of care, that handoff is a parenting challenge, but it's so meaty that it didn't we couldn't give it a little bit of space, and that other one it needed is an entire episode of its own?

Erika Forsyth, MFT, LMFT 3:29
That's what I'm saying, Scott. Okay.

Scott Benner 3:33
Well, I agree. So let's get going. You want to read through your ideas? Or do you want me to ask you questions? How would you like to? Well, I

Erika Forsyth, MFT, LMFT 3:40
thought, as I was thinking about this episode, I was I had that vision of a relay race of you know, for runners, but thinking about the first runner to the second runner handing off the baton. And in this analogy, it works. In some ways, it doesn't work in other ways. There is a start line diagnosis, the finish line, we don't have a finish line yet. But I think in this analogy, maybe thinking about this is the finish line everyone both parent and child feeling competent, competent in the management. And in this, when you think about if you've watched a relay race, there is a period of time in which the runner can hand the baton off to the next runner. There's like a there's there's markers. Yes. And also, this analogy doesn't really work because there are no rules right around when this baton when that line in real life should be passed on to your child. But let's just pretend in this scenario, every runner and every team does it differently like that once they pass that first marker line. A runner might hand the baton off immediately to the second runner. Some runners will hold the baton a little bit longer between the first and second runner and then some handed off right before that. Last kind of a marker where you can pass the baton off. And so I think it's important to hold that kind of image as we talk about this, because every family is different when they are handing that baton off every personality of the child and the parent is going to be different, different comfort levels. But we all all families will go through this transition time. Yeah.

Scott Benner 5:22
Do you think that, generally speaking, parents want to do this? Or do you think it's the thing that they eventually realized that they have to do? Or I guess maybe there are a lot of different personality types. In my heart, I've seen, I've seen my wife not want it to end. Like she doesn't want this leg of the race to be done. You know what I mean? And I am in the middle, I'm upset and saddened by it, when when there's a passing of the baton. But at the same time, I see the bigger picture, not that my wife doesn't see the bigger picture. I think it's just emotionally harder for her. But I wonder if there are some people who just don't want that separation? And if there are some people who want it too soon. And I hate to talk like that, but I do. I do sometimes see people that seem like they didn't really jive with parenting. You know what I mean?

Erika Forsyth, MFT, LMFT 6:15
Yes, I think I've seen and heard and read all different types of be their parents are, as you're saying, maybe wanting it too soon. But maybe that's because the child is really demonstrating independence. But I also hear a lot of parents talk about the guilt, like if your child is diagnosed younger, you are managing it as the caregiver. But then some parents feel guilty that they know eventually, it will need to be passed on to their child. So I think it really comes with as we talked about it so many different layers of emotions. Yeah,

Scott Benner 6:52
because it runs that gamut from, you know, basically saying, You're old enough do it yourself, which I've heard said at ages that it seemed, seems too young to me. And then there are some people like you said, who were just there, they are really helicoptering and they're not letting go. And And where does that happen? So it's much more about, it's the balance, right? It's the balance of your comfort and their ability. Does that make sense? Yes. Okay. I think the caveat here, that makes this difficult is the expectation for outcome. So if you don't know how I can explain this, then I'm gonna get out of your way and let you talk. But But what I, what I see happen so often with people with type one, especially for parents, for kids, is that they don't know all the time the successes that they could be having, right, they might get started with a doctor who tells them, Oh, your eight is a great a one, C, and then they get stuck there. And they don't think of it or they you know, they they cling to that. If it goes to 300 and comes back down, it's fine. Like that kind of stuff. Now, suddenly, that kind of management is what they think is normal. And they're not putting that much effort into it. Because nobody's given them any tools. And they figure the kid can do this. Like it does count these cards up, push the buttons, they get high, they come down, they get low, they drink juice, if they're low, that's the end of it, they're not actually focused on quality health, probably because nobody's told them how to accomplish it. So I bring this up, because I've had so many conversations with people in their mid 20s. Later 20s on up, that will tell me stories about like, oh, you know, I was 13. So I was old enough. And, you know, when I was 18, when I was diagnosed, so I was an adult, like, I don't know, like, that's a lot for a younger person to do. And the parents sometimes unknowingly even are just like, well, here, you're doing a good job at it, you're pushing the button when you're supposed to, and they don't even look at the outcome and then that kids off on a on the wrong path. Anyway, I've seen a lot of that. That's what always pops in my mind. First, when we talk about transition.

Erika Forsyth, MFT, LMFT 9:01
How the management starts, has an effect on the transition, obviously, yeah. And I think it's also important to note too, when you are newly diagnosed, I know we're talking about transition of care. I think the one of the things I was going to mention later on, but I can say it now is that a 12 year old, who's diagnosed as a 12 year old may act and look and function very differently in their management versus a 12 year old who was diagnosed at age two, and, and might be just thriving and managing independently because they've got 10 years under their belt.

Scott Benner 9:38
They've got more time in the simulator, right? Yes, they're doing Yes.

Erika Forsyth, MFT, LMFT 9:42
And in the beginning. Yes, you might go out of the gates with, you know, either not the right education or not really knowing having the tools, and you're overwhelmed with all of the things and the grief and the processing. But there's also still hope for the parent to learn and read remembering as the parent who is then as you're transitioning the care that you had a period of time of grieving of learning. And as you hand that off to your child, they might be going through that too. Even if you're like, 10 years into

Scott Benner 10:13
it. Yeah, I was just gonna say it doesn't matter. Maybe if you're at this for a long time, you've still been there helping or maybe doing all of it or most of it, now, suddenly, you're giving it to them, it's a new burden for them. Mm

Erika Forsyth, MFT, LMFT 10:25
hmm. Yes, to expect that, that they might have that an emotional response to it, even if they if even if you feel like they are ready. Sure.

Scott Benner 10:35
Oh, no. And they could they could be ready and still have that response? 100% Yeah, no, for sure. Wow, this is a lot, honestly. So like, go ahead, let's go through what you have here on our notes, and we'll pick through a little bit. In 2015, I needed support to start making this podcast and Omni pod was there. They bought my first ad, in a year when the entire podcast got as many downloads as it probably got today. Um, the pod was there to support the show. And they have been every year for nine seasons. I want to thank them very much. And I want to ask you to check them out at Omni pod.com/juicebox. There, you'll find out all about Omni pod five and Omni pod dash, you'll figure out why a tubeless insulin pump is probably right for you. And there are links to get started. Everything's right there at Omni pod.com/juice box. My daughter has been wearing an omni pod tubeless insulin pump since she was four years old, and she's about to turn 20. It has been a friend to us. And I believe it would be a friend to you, Omni pod.com/juice box. And of course, taking care of your health isn't always easy, but it should at least be simple. That's why for the last three years, I've been drinking ag one every day, no exceptions. It's just one scoop mixed in water once a day every day, and it makes me feel energized and focused. That's because each serving of ag one delivers my daily dose of vitamins, minerals, pre and probiotics and more. It's a powerful, healthy habit that's also powerfully simple. Before I was taking he wanted to get that brain fog in the middle of the day, and I just couldn't seem to get on top of it. But now that doesn't happen anymore. By starting my day with ag one I found focus and a renewed ability to perform at my highest level all day long. Drink ag one.com/juice box when you use that link, you're supporting the production of the Juicebox Podcast. I drink age you want in the morning, but you could use it as a coffee replacement before workout or in your smoothie. If there's one product I had to recommend to elevate your health, it's a G one. And that's why I've partnered with them for so long. So if you want to take ownership of your health, start with ag one try ag one and get a free one year supply of vitamin d3 k two and five free ag one travel packs with your first purchase exclusively at drink a G one.com/juice. Box. That's drink ag one.com/juice box, check it

Erika Forsyth, MFT, LMFT 13:09
out. Okay. Yes, emphasizing just like your parenting style, just like we've talked about attachment. We've talked about so many different things that it's really important as you're entering this stage of wondering should I should my child be taking on more? Is my child ready? Am I ready to focus in on your family? I think we it's really easy, particularly you know, when you're online comparing. And so seeing your peers, your caregiver peers, you yourself as a type one looking around saying, Well, gosh, my friend can do it. Why can I or as a caregiver, wow, that that kid is doing it. So just being really in tune with. Every family is different, and that's okay. And there's no hard and fast rule about when this should all happen. I think there are there are certain human you think about like milestones of your child like when should they learn how to brush their teeth on their own? When should they learn how to dress like there are some normal developmental milestones that your child should be hitting. This one, we often think about, like teenage years getting ready for you know, in high school going off to college is usually about the time. But again, your eight year old might be managing perfectly. So

Scott Benner 14:29
there's little things that I've done along the way. You know, Arden's 19. Now she's almost 20. But little little things like I talk out loud when I'm doing diabetes stuff with a younger person. Hey, you're about to eat. Now. That plate looks like wow, you know what I think I think the role is 25. And let's not forget there's some protein in that burger. So let's just throw in a couple more there and then these fries and there's fat in the fries, you're gonna get higher later. So I'm going to put this in here and then a little later I'm going to do that or I'm going to do a square wave Bolus or an extendable Whatever you call it, something like that, I'm gonna tell the algorithm, you know, whatever, whatever your management style is. So she hears it over and over and over again, Arden counts carbs, exactly like I do, we have never spoken about it directly. Like we look at a plate, she's always a couple carbs heavier than I am even. And so we're right in line. But that's just because I just would voice it. I wouldn't tell her. Here, watch how I'm doing this. It was never instructional it was just happening in front of her so that she'd pick it up as time went on. Same thing with filming stuff and changing things, I would just talk her through it like, Oh, we're gonna take this off now, because this is peeling on the corner. And so that one day, she'll seal peeling on the corner, and she'll think, oh, that shouldn't do that. Like, you know, I just think that's the way to go. But as to the age, I guess I'll save till the end how I did it. But it's tough to put a parent in charge of a decision like that, because like you said, you are knowingly given the kids something to do for the rest of their life, I've had that thought on my own, like, Oh, when I pass the baton completely. It's on her, like, I'm done, almost, you know, and that feels terrible. Like, I don't want that for her, it's different than go pay your rent, or buy your own damn cell phone like that, you know, like something like that. It's much different than that. And it can stop you. But I also know that there are some parenting styles that will allow that to completely slow down the process, if not grind it to a halt. And there are some parenting styles that will say like, you know, throw them out of the nest here and see if they can fly. I always said to my wife when she's defending our kids too much. I always go. Are you their attorney?

Erika Forsyth, MFT, LMFT 16:43
Oh, I bet she really likes that. She's

Scott Benner 16:45
thrilled with that one. Yeah. So oh, she loves it when I say that. But there are times where I'm like, You're defending them? You're not thinking about them? And that's, you know, I don't know. Anyway, keep going. Sorry.

Erika Forsyth, MFT, LMFT 16:59
Yes, it's the question is, you know, when I think it's we're trying to kind of define, but it's, you can't really define it, you know, when does this transition happen? Yeah. And I think it's partially yet maybe starting with age and stage and comfort of management. But also, I think, if you're like waiting for this moment of like, okay, I think my kid can do it now. That there might not be this, you know, aha moments. And so starting slowly, like you're you were demonstrating, you know, verbalizing what you're doing. They might be asking, you know, some kids, and a lot of, you know, teams I work with, they want more of that independence and freedom, freedom, really in autonomy with their life in general, because that's their developmental stage. But and then they want that in their diabetes. So as you're hearing your child ask, and or kind of wondering, maybe they should start to have more independence in their, in their management, checking in, okay, why, why am I resisting this as a caregiver? Am I fearful of relinquishing control? Is there grief in that process? Like you said, there's like a sadness. And that's all really normal to say, Oh, this is really hard. I need to grieve this.

Scott Benner 18:16
I also think it's possible that grief comes out in different ways. It's not as easy as they look sad. It could be rebellion in little ways, like just not doing it. Forgetting putting it off, yelling about it a little bit. I'm just going over the things that I've seen from Martin over the

Erika Forsyth, MFT, LMFT 18:34
years. Yes, yes. You know,

Scott Benner 18:37
I think you would listen to this podcast and think, Oh, this is amazing. That guy's daughter's got an agency and the high fives and I think right now, it might be again, I think it's five nine right now. And it's not a lot of effort. And you know, they know what they're doing, etc. But that's hard fought, like getting to that point. Took a lot of a lot of time. And it wasn't, it wasn't because Arden was like this simple kid who just loved it, like she's been on a couple of times. So I think people recognize that she's not that kid who's like, Oh, my God, daddy diabetes, I'll do it. That's not where she came from. Like, and I know, you're talking about that, that specific, like style of art, the way kids brains work, maybe. But I've also heard from adults who will say I was precocious as a child, and I was like, Let me have it. And they're like, I didn't really know what I was doing. But as soon as I said, Let me have it. My mom disconnected. That gets sent to me a lot. Like they just shut off. And there I've also heard from people who asked for the control from their parents, but not because they thought they were ready for it, but because they did not want to be involved with their parents about it. Yes, and that's a hard I mean, as you're sitting there, listen to this. This is a hard pill to swallow. Like, you know what I mean? Yes, imagine, you know, I'm sitting here I'm thinking what if my kid was like, I do not want to be involved with you. And so

Erika Forsyth, MFT, LMFT 19:56
they want to they want to cut off completely and do They're on thing. And that would include, you know, can can mom or dad follow me on the follow?

Scott Benner 20:08
That's a non starter for me. Yeah. Anybody who wants help Going to college is is, is getting fouled on their Dexcom that there's a simple rule for me. That's how I get paid back. What happens though Erica, though, when the kid wants the autonomy, but they really, they don't really want to do it, they just want to shut you out. I mean, you grew up with diabetes in a different time, right? You forge some diabetes logs in your in your day? Yes. So what happens when they say I got it, I got it, I got it. But on the other side, the agency is up and up and up.

Erika Forsyth, MFT, LMFT 20:38
I think that's going back to okay, if if your child is saying I want to manage this, I want to be more independent. I think if you are if you have that parent child relationship, to say, Okay, we are going to do this on a trial period, you have to earn it, like you have to earn the right to stay out later for curfew, you have to earn the right to drive or whatever other you know, stipulations you have to earn that trust, they have to you have to give them the opportunity to to earn it and then they have to prove it and continue that cycle.

Scott Benner 21:15
I find some of the hardest blending here comes because what we're talking about is not apples to apples, and you say like, Hey, listen, if you want to drive, you have to take the safety course first. Right? Right. But because diabetes is a safety issue, it's a safety issue. It's a health issue, but then it's also a personal issue. And it's an autonomy issue. And it's things you're not even thinking about which we've covered in some episodes. But you know, what's the most outlandish example I can think of, oh, if you're the child, if your child is young right now, and has type one diabetes, you're not thinking about the day that their blood sugar goes up when they're masturbating, and you come knocking on their door, and they're like, Get away from me like, like, there's that is going to happen like that. There are so many, like, human things that are going on with all of us. But now you're monitoring them. I don't think any human in history of humans has felt good being monitored. And so you're right. It's not it's not a human trait to just go Yeah, sure. subjugate me, because that's what it's gonna feel like, though, as they start getting older and older. So what the hell do you do? I

Erika Forsyth, MFT, LMFT 22:26
was even I noticed that, like, it's such an interesting thought around being a teen now being followed. Multiple people know your blood sugar at all times. Some people use lifescan, 360, or live 360. Where are you? All right. You know, where you are. As a parent, you know, your child is all the time you're being constantly monitored. That raises anxiety levels, I imagine most of the time for one or the other. Do

Scott Benner 22:54
you think people are really stalking their kids? I know, I can find my kids phones, but I don't. I did. Once when Cole moved away the first time first job, I, oh, my God, I want on his first day of work. He was driving through Atlanta to go to work. And I knew he was leaving. And it got in my head. I wonder if he's on time. And I opened up my phone, and I could see that he was driving. And then I got very melancholy and watched him drive. I've watched the little stupid icon drive the entire route through Atlanta. Alright, I'm sorry. Oh, God, I hope he never hears that.

Erika Forsyth, MFT, LMFT 23:32
But does he did he make it on time?

Scott Benner 23:34
I don't remember that part. I just remember thinking like, like, if the car keeps moving, he's alive. Like is how it felt? You know what I mean? And so, and I don't know why I feel like he's a great driver, who's 23. Anyway, but do you think some people are always looking? I guess they are right. And then the kid knows that. Because you know, people say, like, I saw you went here and look at my phone, and then then you're feeling judged about every decision you make that impacts your blood sugar. Got it?

Erika Forsyth, MFT, LMFT 24:04
Yeah. And while all of this data and technology increases, support, you know, safety and hopefully reduces long term complications and the risks of lows. I'm talking about the follow up, but also even the follow up, you know, find my and live 360 Those are all great things, but I think as caregivers that just will raise anxiety and and as a teen I think having these types of conversations to have an understanding of like, okay, can you if you are going to follow my app and if that is a non negotiable if you're going to follow me on on the decks or whatever other CGM. Can we not talk about it constantly. I think I'm sorry, we're kind of going back and forth here. But as like the if the child is wanting that independence, and you're saying okay, let's do a trial period of Okay, so you're but I'm still going to follow you. It's your then maybe the freedom in that 24 hour period is you aren't saying okay, your your rising 50 points, correct? Correct. Correct. Or you're going low. I mean, obviously, there's, maybe you have a, an emergency, if you're going to such and such a number to arrow down, we're gonna do something. But everything else,

Scott Benner 25:22
you gotta have to let go a little bit, just like, Oh, yeah. So I've learned to do that. Over the years where if Arden's blood sugar gets above where I think it should be where I know, like, I'm looking at them, like, we could fix this in two seconds. But she's in class, and she's not thinking about it right now. Like, what's the last thing in the world she wants is a text from me that says, hey, you bump your blood sugar down a little bit. I do save it for moments when I think it's a big deal. You know, safety moments are one thing, but I also think of high blood sugars as safety as well. You know, if a couple of hours go by, and she's one, I don't want people laughing at me. If she's like, 150, or 160, like for a couple of hours, Arcus like, Oh, my God, oh, my god. I'll say to her, Hey, like, you know, is that algorithm suggesting any insulin? Because give it, you know, and, and we've come to a place, it's okay. Now, like, I don't say too much. And she accepts it when I say it. Like, it's the I think I've demonstrated the value of my words, by having an economy of them, if that makes sense. Yes, yeah. And I

Erika Forsyth, MFT, LMFT 26:34
think before going back to the initial stages of your child is wanting to be independent. And I think going back to your question of, is your child wanting to be independent? Because they don't want to be in a relationship with you? I mean, I think that's that can happen for a lot of teenagers for a season? Or are they wanting to take care of their diabetes by themselves? Because they feel like they can? I honestly don't know if that really matters in the beginning. Because they're wanting that independence. Yeah. And to say, okay, here are the boundaries, let's give it a try for six hours, 20, whatever, whatever our amount that you both agree on, and then have that okay, when can I, as a parent, suggest, you know, we have the safety boundaries or safety protocols? And where are you comfortable with? And maybe 24 hours? You guys agreed to do nothing? I don't I don't know. It depends on what you want. I think it's important to listen to your team in those initial requests. I'm saying team, but it could be younger. Anybody? Yeah. Yeah, Arden

Scott Benner 27:38
and I have a shorthand, where if she just ignores something completely, or she really screws, the pooch, somehow, then all of our niceties go out the window. And she's accepting of that, too. Like, I will sometimes be like, you know, so I'll see that her schedule has her in class all night, right. And I can see her pump has kind of 15 units left at it. And I look and I go, she's going to try to get out, go through class and come out of class. Without changing the pump. She's gonna want to do it afterwards, right? And I'll say, maybe, hey, listen, I think you might save yourself a lot of trouble here by changing your pump in the afternoon. And then she doesn't do it. And then the night comes along, and I'm now seeing there's a unit left in the pump. I'm like, Hey, now's the time, we're gonna go change the pump, like no more, I'm going to try to make it I'm going to do like, it's over now. Like, you're not going to be without insulin, like like now. And then she'll go hard, or I'll do it. Or like, the other day, I sent her a text and I said, I need just to change your insulin sensitivity. By one point, make it one point weaker overnight, because you're getting these little lows overnight, and I think this is gonna fix it. I mean, she's using Iaps right now. But I just wanted to just adjust the tiniest bit. So the next night when I was woken up in the middle of the night and had to text her. I was like, she didn't make that change. But it didn't say anything, then because it was three o'clock in the morning. And that would have been ridiculous. And I waited till the next night, which was last night. And we were actually sitting and talking about something else. She was showing me something she was working on. And at the end, I said, Hey, how did it go change in your insulin sensitivity the other day? And she goes, it went great. Then she smiled, and I went, you didn't do it, right? Just I did not. And I was like, Okay, I said, Well, can you do it now for me, please? Just while I'm just getting ready to jump out, I'm going over this lab and I'm gonna do some drawing with somebody. And I was like, That's great change in sensitivity. That's it because it was like late night, Friday night, and I was like, it's going to your thing's going to switch to 11pm and then I'm going to be up at 3am If you don't make this change, and she's like, okay, okay, okay. I'll do it. And I wouldn't do it now. And she's, I can't I'm rushing out send me a text and I went, come on Arden and she goes if you text me I'll do it. I was like Okay, so I sent her a text now, we'll wait another night and see what happens. And then I'll ask her if she did it again. And that might throw a lot of people be like, Oh my God, that's so much like just turn the dial kid. But that's me trying to do what you're talking about. Let her be your own person. Not forced things in though I mean, she's not like, she her blood sugar is not 20 overnight, like, it's like dipping under 70, you know, and I'm like trying to make a little adjustment to it. I honestly think that most of what we're talking about is alleviated, or at least made much easier. If you go to the Pro Tip series and learn how to use insulin. I know that that might be sounds like me trying to get people to listen to the podcast, but I 100% think that if you are making decisions that are ending the way you expect, then it's a lot easier to say to the kid like, hey, go ahead, give it a shot. I know that, you know, one plus one equals two, like we're good. I think a lot of the concern comes when people don't know what they're doing. And they're like, oh, I don't know what, you know, the kids high all the time. They're low all the time. They you know, that kind of stuff is scary and dangerous. And isn't that the place where you have to put your foot down no matter? What, if they're high? I mean, yeah, I mean, if we're like just ignoring thing, like, you know, if a day turns into a week, turns into a month turns into a year. And the next thing you know, you look up into kids, a one says 10. And they're going I can do it? They can't. Right. So what do you do there?

Erika Forsyth, MFT, LMFT 31:27
I know, that happens that that situation is out there. And I know, it's so, so heartbreaking and painful. And so you know, as a caregiver, you experienced such a sense of powerlessness, and also really grief because your child is demanding. You've Allah and you've given and they're now they're 20, and they're don't know how to manage, I would then attribute that to a bigger issue, right? Is the child is that now your child is an adult or whatever age? Obviously having an emotional response, a lot of feeling with the diabetes, it's not. And I would also look at, you know, how are they functioning and other areas of their life? Are they thriving in every area? And they just aren't don't really know how to manage their diabetes? Or are they really struggling across the board I would be looking at is there a lot of baby depression, anger, trauma around having the diabetes that maybe hasn't really been properly addressed? And so it just feels easier in the moment to ignore it.

Scott Benner 32:34
I think my my quandary is, I'm a tough love person, like, generally speaking. But if tough love means you're going to, like lose your eyesight when you're 35. Then what do I do? Like, do you mean like the sink or swim comes to mind, but it's such a, it's not like, it's not like I said, go to college, and you said, I want to work at McDonald's. And I was like, sink or swim. Like, you know what it means like, you'll still you'll have a job, you'll be working in McDonald's, and you'll probably buy, there's jobs pay pretty great at this point, you're probably doing fantastic. But, but this is a different thing. Like in my mind. You know, if you don't, I have to say this, the harder decisions that I've made about transitioning ordens diabetes over the years, have always been fueled in the back of my head by the idea that I really only have like, till she's 22 to get it accomplished. Right? Like I can hold on 1819 20. Like, you know, like, I'm paying for college, like pay attention. Like, you know what I mean? Like that kind of stuff. But after that she's gone. Or whatever I gave her and whatever she decides to do is the only thing she's going to do. I mean, I've seen adults, adults who are parents of children with diabetes, and their kids have gotten older, and their kids cut them off from knowing about their blood sugar's and it's heart wrenching to them, because they assume that they're not okay. Because if they were okay, they would tell me they were. So they're not. That's why we're not talking about it. And then you worry for the rest of your life. Eric, I don't want to worry for the rest of my life. I just want a couple more years left. Just want to relax. It's a bigger that it's a bigger problem. It's not it's very much unlike all the other parenting issues that come up with children. And it's why you see so much hand wringing about it online. And And isn't it fascinating how it hits people right away? Like if their kids are two years old? They're already worried about it. Yes, yeah.

Erika Forsyth, MFT, LMFT 34:35
Thinking Yes. About the independence about their next stages of life, adulthood, you know, children. Yeah, it's I know, it's easy and painful to go there. And you mentioned worry, are you going to worry the rest of your life and, you know, I haven't personally launched my own children. But I think as going through that, those stages myself I think there's a sense of knowing that your parents trust you. They've done what they've could. And they are watching you. And that's that. And it's, it's hard.

Scott Benner 35:13
I think for the great many of us, this is what's going to happen, and it's going to be okay. I really do believe that I genuinely think for most people, it's going to be okay. But there are plenty of people listening right now. They're like, look, my kid is a mess, you know, and they have diabetes, and they show no interest in it whatsoever. And I don't see how that's going to change. Those people are in a they, gosh, it almost makes you feel like they have a child that they're never going to completely be able to separate. Yes.

Erika Forsyth, MFT, LMFT 35:41
And I know that that can happen. And there's often you know, this sense of, is it too late to help my teen child adult child take responsibility. And, you know, I don't want to say sometimes maybe it is at some point too late. And then they as adults, they are going to have to figure out how to accept, grieve, accept, manage independently. And I don't know, there isn't like an exact timeframe. But I know that that that can happen. And that's a really, really challenging place to be as a parent,

Scott Benner 36:15
through a lot of our conversations. I'm always struck by the kind of core idea that it seems like it's impossible to make somebody care about something they don't care about. Yes. It just really just seems like there's no amount of teaching or trying or showing, that can just change someone off of something that they don't find important. It's one of those like human things, that eats, like inside of my chest, I think about it all the time. Like, you know, because of kind of what I do for a living honestly, like, there are plenty of people who will say things to me, like, I don't learn well by listening. And I'm like, so why I'm like, like, you're telling me that, like, it's hard for you to listen to a podcast, I understand that some people don't learn well, by listening. But you're also saying, on the other hand, my agency is nine, and I'm really in trouble. And I want to do something. And I've heard that you have this thing that helps people and I go Yeah, listen to these 25 episodes, I think you'll be okay. Oh, I have trouble listening to things. Well, okay. And then I try another way to explain to him like, well, I have transcripts, it's a lot of reading, I'm like, No, okay. You know, like, like, in that same way with kids, like, you can tell them something 1000 times, and if it's not something that they jive with, it's not something they jive with, but then it's this thing, and then what's coming next is really coming, you're not going to avoid it, that's for sure. You can't wish it away, you can't put your head down. And at the same time, as I'm being a bummer, I really do want to say I think for the grand majority of you, it's probably going to be okay. You know, if someone came into your office and had a kid who just like was a wall didn't care wasn't doing anything. Would you think that something like that I let pump would be a good midway point like, hey, look, this pump just, you know, it's only going to keep your agency in the sevens, but all you have to do is tell it it's breakfast, lunch or dinner? Small, medium or big? That would be a good idea in that situation, don't

Erika Forsyth, MFT, LMFT 38:16
you think? Yes, yeah. Yes. If, you know, obviously, if the if that child is open to having the pump on them, but I think that would be a wonderful alternative than either, you know, not injecting or not, you know, giving the carbs or whatever it is, I think that's a really nice option for people to really minimize, or just reduce the amount of decision making an action you have to do. Yeah, yeah, I think that's a I haven't read a ton. But I know I hearing more and more people start to use the pump that I love pump,

Scott Benner 38:50
I mean, I let pump is they're saying in the sevens, I'm saying, if you're going to ignore your diabetes, you're going to be in the nines and 10s 1112 13. Like, I mean, just take the seven and don't know what you're like, there's got to be a point I'm not saying the eyelets give up. But in a situation like that, you know, stop thinking you're gonna get down the sixes or the fives and just go with healthy and, you know, and, and happy to, you know, at some point, it's not, it's not your life to live. Obviously, it's a hard thing to say, right? It's not your life to live. But the thing that I would always be concerned about is, is the child decision making process being impacted by these lower higher or vacillating blood sugars? Like maybe you're not really talking to all of them? You know what I mean? If their blood sugars are bouncing all over the place too.

Erika Forsyth, MFT, LMFT 39:41
And yes, like how can they be in a grounded place to say, okay, isn't ready to take it on or I don't want to take it on if they aren't feeling good, physically, and emotionally.

Scott Benner 39:54
Okay, is it fair to say that having a really high blood sugar for a long time can make you feel foggy? Yes. right is that is it akin maybe to being up for like 20 hours straight and being exhausted, but trying to keep going or something like that like, is that when you'd ask your kid about a thing? Like, do you know they mean like, right? But if their blood sugars are high all day, and you're like, You got to take care of this on your own, you're not getting the full capacity of their brain back, you know? And even bouncing blood sugars. I don't know, if everybody realizes that going low and high and low and high over and over again, we have a whole episode about it. I think it's called altered mind about how vacillating lower or higher blood sugars change your ability to think and perceive things. So 100%?

Erika Forsyth, MFT, LMFT 40:36
And it's yeah, it's super fatiguing. You feel very lethargic,

Scott Benner 40:41
I guess my point is, is that I really do think if you understand diabetes, even a little bit, and you've got some stability, most of your kids like Eric has been saying through this whole thing, there's going to be a certain time for them. And you'll see it right, you'll you'll hold that baton out. And you'll feel well, it's time to let go. And just make sure you're not the one who's screwing up the transfer.

Erika Forsyth, MFT, LMFT 41:04
Or holding on too tight. If they're ready. Yeah, because it

Scott Benner 41:06
falls on the ground, everybody kicks it, and then somebody falls in those little shorts. And it's very painful.

Erika Forsyth, MFT, LMFT 41:12
Yes, and I think in that if you are fearful of letting go as the parent, you know, is and you truly feel like you're you have, you know you're competent in the management, your child is learning and understanding it, but you just can't quite let go. And that happens, right? Because you're fearful. And there's you want to protect your child? And does this feel like you're not protecting your child by letting go of the baton? I think going back to basic reality checking up, okay, we have the app when he knows how to correct he has his snacks, all the people know around him, like really doing the basic reality checking of because the fear is, you know, I don't want my kid to go low and have a seizure die. And I don't want him to have long term complications, right? Those are I mean, that's what we're talking about when when we're when we're boiling it down. Yeah, that's what we're talking about, right. And so really, and having to remind yourself, write it down, pin it up on your mirror, but if it's the, you know, when it's the child who's not wanting to hold on, or wanting to rip it out of your hands, I think just going back to this is like these are logistics, these are management styles and tools. And I think having the understanding, knowing how to do it is really significant and important in this process. But also reminding yourself, there's so many emotions involved. And is it a matter of acceptance, has your child not truly accepted it? Here, that's okay. Give them that give them the skills, the tools, the support to do that, in addition to the logistical management,

Scott Benner 42:47
right. And I'll just say if you happen to be a person who is just disconnected from this, and, you know, I don't think anybody would probably admit this out loud. But if in the back of your head, you're thinking, I can't wait for this to be over. And for this to get off of me and beyond somebody else, at least do them the favor of teaching them how to take care of themselves well, before you before you do that. And I even understand that I'm not judging anybody. But you know, if it's too much for you, as the parent, offloading it, and hoping they figure it out, I mean, you couldn't figure it out, right? So what are the odds, take them somewhere to a doctor, let them listen to podcasts, like do something like try to get them to a better place, don't just set them out on their own, and say, I don't know, walk West, you'll find it, you know, because that's, that's not gonna work out. You're also this conversation is reminding me that Arden has been back at college for a week now. And I have to send her the text that says, Please refill your vitamins. And if you haven't been taking your vitamins, please start taking your vitamins. I only asked her to take like two. And I'm like, just take these two vitamins. She's like, I will, I will. But the last time she came home with her little vitamin thing. And I she was unpacking and we were helping her on pack and I was like, This is how I left it when I left it with you last time. And she's like, I didn't take those. So I was like, oh, Arden so and she's 20 in easy to get along with. So 1920 years old, she's easy to get along with. And those vitamins sit right next to her bed. They're staring at her. I think it's an act of will not I think it's probably more work not to take the vitamins than it would be to just take them. But I do wonder if sometimes if that's not a little bit of trying to find control, it's something don't you think?

Erika Forsyth, MFT, LMFT 44:39
Having control or just feeling maybe also loaded down with everything else and just like I can't I can't open the container and pop the pills because it just is one more thing and I get to choose. But yeah, having that sense of like power control of what I can and can't do and that's that's normal and And maybe, if that's the one thing she's choosing not to do, maybe that's, that's okay. But I know you want her to take, you're like, No, she needs to take vitamin

Scott Benner 45:10
D to be high enough. That's all. Vitamin D, little bit of magnesium oxide. That's all I'm looking for it not a ton of facts. I'll tell you right now, what you're making me think of. If you have sent one of those kids off into the world, that's not doing a good job for themselves. And they're partnered up with somebody, I don't know that that's a terrible way to attack this, which is maybe go to the partner and say, hey, look, this is none of my business, they're going to be definitely pissed if they know I came to you about this, but there's some certain things they're supposed to be doing. And, you know, if you can find a way to learn about it a little bit, and just over, you know, just look over their shoulder once in a while and see if this is happening, you're going to be helping them. I know, that's probably not a good thing to bring up like, psychologically, but it popped in my head. Because the only thing that I've ever seen change a person is the desire to do it for somebody else or some other thing. That's the only thing that I have consistently seen work in humans. Right? I'll do it. I won't do it for me. I'll do it for an unborn baby. I'll do it for the idea that we're going to get pregnant. I will do it because I looked over at my kid one day and realized, oh, hell, that kid needs me to pay for stuff for the next 20 years. I'll bring my a onesie down. Like that's the only time I see it. I talked to so many adult type ones. I just started using a pump last year. I'm like, why? Just last year? Oh, you know, my daughter was diagnosed, she got on a pump. And she didn't want to get on it. So I did it too. So she would be and I'm like going, how's it going for you? Oh, I should have done it years ago. You know, like, so? Those are two things I know for sure about people, it's you can't make somebody do something they don't want to do. And the only thing I've seen change people's minds is the desire to do something for another person. Love is actually the thing that I that I would say if I had to narrow down to one thing. Yes,

Erika Forsyth, MFT, LMFT 46:59
change is hard. And finding the motivation to change is even harder. And it may be it is just that sense of love for somebody else. To make the changes for yourself to be there for them. Yeah, it is.

Scott Benner 47:15
existentially does that mean that I don't love myself enough to do it? Is that what Freud would say? Yes,

Erika Forsyth, MFT, LMFT 47:21
but yeah, yes. Yeah.

Scott Benner 47:25
But does that even is that true? of everybody? Like do people? Is my daughter not taking your vitamins? Cuz she doesn't love herself enough? No. Yeah. So

Erika Forsyth, MFT, LMFT 47:36
I think it would be hard. I wouldn't make that like as a tried and true statement. I think there's so many there's so many layers to why, like, why am I not taking care of myself or my diabetes? Is it because I don't love myself? Or maybe it's just because I hate the diabetes, but I love everything else about myself. You're

Scott Benner 47:55
punishing the thing. And it's interesting. It's all very interesting. Anyway, did we cover everything? I you put a nice note in here about something that I've said in the past, and we never got to it. So what about the college? Yeah, you know, about the laying breadcrumbs? I said that in front of you one time and you loved it enough to write it down? You did? Yeah. Is it just because I said I leave bread crumbs for art and defined? Yes. Yeah, like ideas of, you know, I just I say things out loud. And I'm like, Cool. She follows that along. I'll drop it off on later and try to keep her going. But yeah, your point about college, we didn't get to it though. Let's

Erika Forsyth, MFT, LMFT 48:32
just say it's not an ideal situation, and your child is wanting to independence, they're going off to college. They're still figuring out how to manage to have maybe one non negotiable around the management piece that their roommate, the floor resident are a person. Anyone else that's kind of in a consistent circle, have your child that they know that that your child has type one they know where the glucagon is for emergency, right? Because your child can do everything independently except for if they're unconscious. Right. I think that's a really important non negotiable for this is like for the child who's leaving, obviously the house for college. Even that might be challenging, right to get to an understanding and agreement to but the hope is that you know, you you want your child to live. Yeah, survive. Arden

Scott Benner 49:25
was very amenable to that. Two of her three roommates follow her on Dexcom they only have the 55 alarm set. So the earth the urgent alarm is the only alarm it's at Arden does not reach 55 with any, you know, reasonable, you know, on any reasonable schedule. So that's there is an emergency. And have we talked about the glucagon fire drills they do? No, I must have talked about it another episode. Oh my gosh. So they do fire drills where they make art and pretend to be having a seizure, and then they run around and get her Chivo type of pen and stuff like that. And they go through the steps of everything before they do it. They are laughing about it while they're doing it to be clear, yeah, these four girls, that was it. So they are just like in that was the girls idea. Like the one day the girls came in, and like we need to, like, tell us this again. Like what is this? You know, because we talked about it like the first try to imagine the first day they moved into college. We took all the girls out to dinner. And we were like, look, you know, a couple of things about art. And she's explained to you. And you know, here's the key imagine you're 18 you're probably like, oh, what I'm just trying to get drunk, like this girl, this girl bite what? And so like, you know, we explained it all to them. They were very nice about it. And then Arden said a couple of weeks later, one of them came in said we should practice with this. And then they were laughing. They were laughing. And they were like lay down and shake, and we'll do the rest. And so like they actually now they do that for fun. turned into a play thing. But I've also talked to people whose kids are in college. We're like, I'm not telling anybody about this. And I agree with you. Like one person needs to understand this. That's it. And also, I need to know how to call your roommates. That was the thing we did. So I have like, Arden's roommates are in my phone. And you know, it's happened, I guess twice now once where I actually couldn't wake her up. And she was pretty low. And one of the girls went and got her and gave her juice and she was fine. And there was once where I, I moved a little too quickly. And then I heard about the next day.

Erika Forsyth, MFT, LMFT 51:40
Like you reached out to the roommate.

Scott Benner 51:41
Yeah. And I heard about from Martin. She's like that was not necessary. And I was like, you want to try being 700 miles away when your blood sugar's 52 with an hour down because it felt necessary to me and you didn't answer your phone. She's like, I was handling it. I was like you didn't answer the text. So they got the call. And you know, now she's better about it. She She's more responsive now. And I think again, maybe to protect her friends. More than ourselves. Maybe you know, maybe. Yeah, interesting stuff. Oh, anyway, yes. Good luck, everybody. Good. Yeah. It makes me

Erika Forsyth, MFT, LMFT 52:12
wonder how did I survive college? I don't know. Well, you

Scott Benner 52:16
know, were you thinking about your mom when you were talking about this? Because your mom raised two kids with type one. Right? So I wonder what she did? We did not have any of this Dexcom we did not have follow find anything? Yeah. I don't know that find your iPhone is my best tip for people who have iPhones. If your kids don't respond, you can send a find your iPhone signal that is piercing on the other? Eye? Yes, I've

Erika Forsyth, MFT, LMFT 52:46
heard that. Yeah, I've

Scott Benner 52:47
done that a couple of times over the years. Did we miss anything? Are we? Are we good? No, I

Erika Forsyth, MFT, LMFT 52:52
think you know, as we as we always hear the like cliche, from upon diagnosis. And then in this transitional period, it is trial and error. But I think we often will be here that we still think like we should nail it and have no mistakes, no growth pains. But like it is trial and error. So they're expect errors. Yeah. And I know that there's like maybe that's not the right term, but in this phrase, you know, expect that there's going to be painful bumps, your child is not going to get it perfectly all the time, just like you didn't as the caregiver learning initially,

Scott Benner 53:31
you absolutely have to step back and see big picture on this one. This is a slow transition really slow. You know, Erica, you might imagine that throughout the years of me doing this, one of the most aggressive questions I've gotten from adult type ones who listened to me talk about this are like, Yeah, you're sure but then your daughter doesn't know how to do this. And I'm like, No, she's learning slowly. And then I would tell them the same story over and over again, I was like, you know, you send your kids off to school on day one, and they come home and they don't know how to add. There's no day where like a bell goes off, and they know how to add it just gets to the end of the year. And they're like, Hey, turn to us for like, oh, it happened along the way somewhere. Alright, so you just keep having those experiences. Like you're you're calling them trial and error, but their experiences, they go one way or the other. You'll learn from them eventually, and you move on. It's why I tell people not to beat themselves up. I would say never spend the time beating yourself up about a decision when you could spend that same time learning from it. That just makes sense to me. We already went through it. We already screwed it up. Let's figure out what we did. So we don't do it again. Like instead of you know, seriously, like whipping ourselves in the background here about it. Like let's just let's just look at it. See, see what it was keep moving. A lot of it's keep moving and then one day you just look up and you know, it works and you don't even know how the hell you got there. So that's life basically. Yes, there you go. Yes, I just fixed your whole life or keep going keep trying I think it'll be fine. And if it's not, I don't know what to tell you

Erika Forsyth, MFT, LMFT 55:07
lost the lottery, I don't know, be kind to yourself.

Scott Benner 55:10
See, Eric is still as good advice at the end of it. If it doesn't go your way. Be kind to yourself. It's, you know, I'll finish by saying that when Arden was diagnosed, I almost immediately had the thought that this is not the life, I thought I was going to live. I was just somebody just shifted me drastically out of the lane, I was in into another lane. And it takes you a long while before you realize there is nothing you can do to get out of this lane. diabetes is here. Now. That's it, it's not going anywhere. My kids got type one diabetes, this is where I live, you can be happy in that lane, and fulfilled. And more more than that, like you can do everything you were going to do in the other lane, you can do in this one, too. You just have diabetes, and this stuff comes along with it. It doesn't change the rest of it at all, unless you let it. And I don't usually talk like that. But I do think that's true. Like if you if you can get good management ideas, learn the tools, use them reasonably well. With the exception of some bumps once in a while. You're gonna live the same life you thought you were going to, but it just doesn't feel like it when it first happens is all.

Erika Forsyth, MFT, LMFT 56:23
Yes. And I think you even said in a previous episode, you know, no one delivers a child and expects them to be diagnosed with something or have a hardship. Yeah. And so there is that you know, from from the lane that you had envisioned for your child to moving over to the lane that you envisioned with your child with diabetes. That takes time that can be painful. Yeah, just switch those just switch lanes. And I appreciated that. Yeah,

Scott Benner 56:55
I appreciate you remembering that everybody gets something like you know, I see a lot of perfectly healthy kids on tick tock, flip it over railings and landing on poles two storeys down, I think, oh, not a health concern in the world. Just stupid about that. too, just because your kid doesn't have diabetes. You know, because you can look at that sometimes you can look at other people in the world and say, yeah, they're so lucky. They don't know. But you you don't know, either. Right. Like they might have something else going on. Or just, you know, I don't know. I just think everybody gets something. That's sort of how it seems to me.

Erika Forsyth, MFT, LMFT 57:30
Yes, but you don't live with that necessarily that expectation No, no, be maybe you're right.

Scott Benner 57:36
Oh, no, I really thought I was going to be six, three way about 180 pounds, ever perpetual tan be very handsome. You know, everything I wanted. Money would fall out of the sky on me stuff like that. None of that's happened. I appreciate you doing this with me very much. Yes.

Erika Forsyth, MFT, LMFT 57:53
You're welcome. Thank you. I'll see you next time. Okay, bye bye.

Scott Benner 58:07
If you're living with type one diabetes, and you think therapy might be right for you, Erica Forsythe may be able to help check her out at Erica forsyth.com. I'd like to thank ag one for sponsoring this episode of The Juicebox Podcast and remind you that with your first order, you're going to get a free welcome kit. Five free travel packs in a year supply of vitamin D. That's at AG one.com/juice box. If you'd like to wear the same insulin pump that Arden does, all you have to do is go to Omni pod.com/juice box. That's it. Head over now and get started today. And you'll be wearing the same tubeless insulin pump that Arden has been wearing since she was four years old. The afterdark series from the Juicebox Podcast is the only place to hear the stories that no one else talks about. From smoking weed to drinking with type one perspectives from both male and females about having sex with diabetes. We talk about depression, self harm, eating disorders, mental illness, heroin addiction, use of psychedelics, living with bipolar, being a child of divorce, and honestly so much more. I can't list them all, but you can by going to juicebox podcast.com. Going to the top and clicking on after dark. There you'll see episode 807 called one thing after another episode 825 California sober. Other after dark episodes include unsupported survivor's guilt, space musician, dead frogs, these titles will make you say what is this about? And then when you listen, you'll think that was crazy. juicebox podcast.com Find the after dark series. It's fantastic. When you support the Juicebox Podcast by clicking on the advertisers links you are helped means to keep the show free and plentiful. I am certainly not asking you to buy something that you don't want. But if you're going to buy something, or use the device from one of the advertisers, getting your purchases set up through my links is incredibly helpful. So if you have the desire or the need, please consider using Juicebox Podcast links to make your purchases. If you are a loved one has been diagnosed with type one diabetes. The bold beginnings series from the Juicebox Podcast is a terrific place to begin listening. In this series, Jenny Smith and I will go over the questions most often asked at the beginning of type one. Jenny is a certified diabetes care and education specialist who is also a registered and licensed dietitian and Jenny has had type one diabetes for 35 years. My name is Scott Benner and I am the father of a child who has type one diabetes. Our daughter Arden was diagnosed in 2006 at the age of two. I believe that at the core of diabetes management, understanding how insulin works, and how food and other variables impact your system is of the utmost importance. The bold beginning series will lead you down the path of understanding. This series is made up of 24 episodes, and it begins at episode 698. In your podcast, or audio player. I'll list those episodes at the end of this to listen, you can go to juicebox podcast.com. Go up to the menu at the top and choose bold beginnings. Or go into any audio app like Apple podcasts, or Spotify. And then find the episodes that correspond with the series. Those lists again are at Juicebox Podcast up in the menu or if you're in the private Facebook group. In the featured tab. The private Facebook group has over 40,000 members. There are conversations happening right now and 24 hours a day that you'd be incredibly interested in. So don't wait. So don't wait. Check out the bowl beginning series today and get started on your journey. Episode 698 defines the bowl beginning series 702, honeymooning 706 adult diagnosis 711 and 712 go over diabetes terminologies in Episode 715 We talked about fear of insulin in 719 the 1515 rule episode 723 long acting insulin 727 target range 731 food choices 735 Pre-Bolus 739 carbs 743 stacking 747 flexibility in Episode 751 We discussed school in Episode 755 Exercise 759 guilt, fears hope and expectations. In episode 763 of the bold beginning series. We talk about community 772 journaling 776 technology and medical supplies. Episode Seven at treating low blood glucose episode 784 dealing with insurance 788 talking to your family and episode 805 illness and ketone management. Check it out. It will change your life. The episode you just heard was professionally edited by wrong way recording. Wrong way recording.com