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Scott Benner 0:00
Hello friends, welcome to episode 1149 of the Juicebox Podcast.

Today, the person we're calling Veronica is a 47 year old type one. She was diagnosed at 12 years old and she works in a doctor's office. Today's cold wind is particularly chilling, as Veronica will talk about how the doctors in her office were drunk and high and dispensing drugs that were outside of what you might expect from an endocrinologist. 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. The T one D exchange is looking for US residents who have type one diabetes are are the caregiver of someone with type one. All they want you to do is go to T one D exchange.org/juicebox. and complete the survey. That's it. It'll take you about 10 minutes it'll help people with type one diabetes. It will help you and it will support the Juicebox Podcast T one D exchange.org/juice box. If you're looking for community around type one diabetes, check out the Juicebox Podcast private Facebook group Juicebox Podcast type one diabetes

this episode of The Juicebox Podcast is sponsored by the only implantable sensor rated for long term wear up to six months. The ever since CGM ever since cgm.com/juicebox. This episode of The Juicebox Podcast is sponsored by us med U S med.com/juice box or call 888721151 for us med is where my daughter gets her diabetes supplies from and you could to use the link or number two get your free benefit check and get started today with us MIT. This episode of The Juicebox Podcast is sponsored by the Omni pod five, Omni pod.com/juice box. My daughter Arden has been wearing an omni pod every day since 2006. And it has been a constant friend in her life with diabetes, consistent tubeless and worryfree Omni pod.com/juice box. So let's find out a little bit about you. Do you have type one or do you care for somebody? Who does?

'Veronica' 2:44
I have type one?

Scott Benner 2:45
How old were you when you were diagnosed?

'Veronica' 2:47
12

Scott Benner 2:50
Okay, about how old are you now?

'Veronica' 2:53
47.

Scott Benner 2:55
Seven. Okay. 20 230-240-2035 years ago? Yeah, that's a long time.

'Veronica' 3:04
It's been a hot minute time flies when you're having fun.

Scott Benner 3:07
Are you having fun?

'Veronica' 3:08
The first couple decades were rough.

Scott Benner 3:12
last 15 years, it's really coming together.

'Veronica' 3:15
I mean, honestly, yes. The technology has made things much, much easier. My highest agency was 19. Oh, wow. And that was 10 years after diagnosis. So I mean, I knew better.

Scott Benner 3:30
Yeah. And 20. That's just 25 years ago, which makes it like 1999 2000 ish around there. Yep. Yeah. Wow. You know, I just saw I get when people leave comments on things like I get notes about it and stuff like that. I just saw somebody leave a comment on like a YouTube video. And the person's like, you know, I've had diabetes for a really long time. And I was very accustomed to blood sugars and the 300 words and a one sees like, as high as 12. And then I got an Omnipod five, and the person's like, you amazed at what's happening. I'm waking up my blood sugar is like 115 in the morning, like that kind of stuff. And then I read that 20 minutes ago, and then you literally came on and said everything was a hot mess till technology got better.

'Veronica' 4:13
Well, I got a pump in 2001. And but I hate finger sticking like that is the worst. And so and I didn't like those early CGM that forced me to prick my finger. So

Scott Benner 4:27
I kind of avoided it.

'Veronica' 4:30
Did you try it? At least or no? So I got a pump in in 2000 2001. And I've worn a pump since then. And my agency was probably 1011 until the Dexcom G six came along.

Scott Benner 4:44
So walk me through how that happens. Is it partially because you don't want to test your blood sugar? Is it apathy, like where do you

'Veronica' 4:51
it's apathy but like so when I was diagnosed, I was told there would be a cure in five or 10 years and I think at that point, I just kind of decided I don't want to live five or 10 years with this disease. And I didn't make many plans for the future. And I got to the 10 year mark, and I was like, What do I do now? I mean, there's just a lot of stuff but so on with G six, and pumping, we were probably at eight, nine. And then with the control IQ, then it's like six, seven.

Scott Benner 5:21
So if you have access to the data, with a G six, for example, and you have a pumps, you're not shooting insulin all the time. So it's, it's as easy as pushing a button. And eight or nine a once the C still says to me, I'm not really counting my carbs. I'm not Pre-Bolus and meals, I'm not correcting highs Is that about right?

'Veronica' 5:39
Yeah, I still I'm not great at Pre-Bolus meals, I just, I struggle with that. And so, and there's a lot of other things that have happened, I struggled with depression for a very, very long time. diabetes, most of us know comes with a very generous side serving of depression. So and but I was able to mask it very well. And about five years ago, I had my first TMS treatment, transcranial magnetic stimulation. And that was pretty life changing, but it unmasked the ADHD that has always been there. But the depression always hit it. And so now I'm learning to like, I can finally identify the ADHD and know why. I'm not good about Pre-Bolus thing I just forget, like, I'll just skip a meal altogether and not even notice. So skipping. Bolus is like child's play. Like that's just how I roll

Scott Benner 6:37
when you said you could mask the depression. How did that work? How did you like nobody

'Veronica' 6:41
really knew the extent of the depression like I, if you meet me face to face, I'm happy I'm like, but there was still just this bone deep. And there were times that it would get a lot worse where I just couldn't get out of bed and couldn't function. But all of my energy would go into my work. So there was not any energy for anything else.

Scott Benner 7:08
Do you have a thyroid issue at all?

'Veronica' 7:10
Absolutely. That's the other side surfing.

Scott Benner 7:14
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'Veronica' 9:55
I don't remember much prior to diagnosis. I don't believe I was depressed I also believe that my elementary education was unique and could easily mask ADHD. Then I went on to middle school and sixth grade I get diagnosed. That's a whole nother story. That sounds crazy. How

Scott Benner 10:16
is it unique,

'Veronica' 10:17
your that education piece that would mask ADHD. So I went to a public school. And it was a special program that I got to choose my teachers and my classes. And there were no letter grades. I just wrote a letter home to your mom and dad, this is what I've been working on. So the mornings were split up between language arts and math. And it was a very tiny school that were for teachers when I started there. And I was there for five years. And then the afternoons the teachers would do two to three week units, teaching something that they were interested in which let me tell you, it makes a huge difference in education when the teacher is passionate about it. I didn't. This is crazy to say, I did not know the difference between science and social studies until I was in middle school. Because get this it's all connected. The

Scott Benner 11:10
what hippie part of California you from exactly. It was in the Northeast? Oh, it wasn't California. It was not California. All right. I got it. I see what's happening here. Yeah, so not hippies, high minded intellectuals.

'Veronica' 11:23
It was a nice combination of the two. Gotcha. But so for example, if we were studying monarch butterflies, we were looking at their migration patterns and how the weather affects it and the geography of where they go and calendars of when they when they migrate and their lifecycle. And so everything is connected. And that's why when I talked to people I talked about, well, we can look at the science of history, and we can look at the history of science. And so that's why those two things have have always been they're all interconnected. There's not any difference in my brain.

Scott Benner 12:00
All right. So is there any chance that well, let me ask first, when did the thyroid diagnosis come?

'Veronica' 12:08
I was 17. Do you can manage that? Well, it's okay. It goes up and down. And I, you know, I'm not great about being super consistent with my doses. Right now I have it set to where the doses set. Well, I just changed insurance. So I have to switch to unit three. So that's going to be a cluster of confusion. Yeah, I the dose is set so that I can miss every once in a while and not see a big impact.

Scott Benner 12:38
Or do you have as much trouble with that as you do with the insulin?

'Veronica' 12:42
Not as much? I don't think okay. I mean,

Scott Benner 12:45
so high blood sugars, and an unmanaged thyroid could easily give you depression? Yeah, yeah. But there's a doctor ever tie that together for you. Like, hey, Veronica, if we take our insulin and keep our blood sugar from being high, you'll avoid this cloudy feeling you maybe you'll feel better, your head will be clearer, you'll be able to, like live easier, like that kind of stuff.

'Veronica' 13:08
Not in relation to the depression, you know, lack of energy in my late 20s and early 30s. They're always like, it's your blood sugar. It's your blood sugar. It's your blood sugar. And I'm like, I'm doing the best I can with what I've got. Like, I don't know why I can't do the things I need to do. And so it was always get your blood sugar under control. And I never really believed them. I was always like, that's just a line. Like, there's gotta be something else.

Scott Benner 13:33
But the man is just trying to get you to do what they want to do. Yeah, they're

'Veronica' 13:37
trying to manipulate. But now that that my agency is better, and like, I'm feeling more energetic, and my husband and I joke, and we're like, we're in the prime of our lives right now. Like, who needs your 20s or 30s? Like, this is this we're loving life.

Scott Benner 13:55
I see your knees don't hurt too bad. No, no, no, here you go. Wait a lot of sores. Okay, so you just said I'm doing the best that I can like referring back to the past. In hindsight, were you doing the best that you could? I'm starting to take it for granted. I am I'm starting to take for granted that Ardens diabetes supplies just show up. But they do because of us med us med.com/juice box, we get an email that says you know do you want to refill your order? And you click and say yes, and then it just comes to the door. There's not a lot to say when things are done well yeah, I could stand here and tell you us med carries Omnipod five Omnipod dash Dexcom G seven G six tandem x two libre three libre two. I mean, they've got there's so much. I'm not even listening at all. I should be. I will at the end. I promise. My point is this. It just works and we Don't talk about things enough when they just work us med.com/juice box or call 888-721-1514 Get your free benefits check and get started today with the white glove treatment offered by us med us med here's what they got. FreeStyle Libre three and two. They got it. Omni pod dash. Yes. Omni pod five, aha, tandem? Yep. What about have they served a million people with diabetes since 1996. They have better service and better care is what you're gonna get from us med but you're also going to get 90 days worth of supplies, and fast and free shipping. They carry everything from insulin pumps to diabetes testing supplies, the latest CGM, and they accept Medicare nationwide. Find out why us med has an A plus rating with the Better Business Bureau at us med.com/juice box or call 888721151 for not the best that there is the best that you that you had available to you did. Does that make sense? The difference? Yeah,

'Veronica' 16:03
yeah. Like I'm gonna be really generous with most diabetics out there. I honestly believe that most people with diabetes are doing the best they can with the information they've been given, and they are sorely under educated. And you are as well. I don't know that I am. Like, I am able to pick things up and piece things together. And so in my role, currently, I talk a lot to people. And I'm a big advocate for experimenting with yourself. You know, I'm like, especially with the type twos and putting them on CGM. I'm like, experiment, see which foods drive it up. And then and I'm not about saying don't ever have that food again and like, minimize it, reduce it, don't don't use that as much. If you notice that rice makes you go up every day, then, you know, you got to change that has to change or find a good substitute. But I think most I mean, honestly, when I was, I don't know, 13 I had a week of inpatient education at Joslin diabetes Center in Boston. That was when insurance would pay for such wonderful things.

Scott Benner 17:18
But it didn't I mean, you still struggled right out of the gate though, right? With giving yourself insulin you didn't like the the fingerprint looks like I didn't like

'Veronica' 17:26
the fingerprints. So alright, let's go to the diagnosis story. I had an afternoon paper route. And the day before I was diagnosed, my one of my teachers said, NAME you're not looking very well. Are you okay? And I said, Well, my mom thinks I have something called diabetes, but I don't know. I'm going to the doctor tomorrow. I do remember drinking a ton of water. In fact, I felt like it. I would drink water. It would just still come out cold. right through me. It's

Scott Benner 17:56
a funny way of saying it went right through.

'Veronica' 17:57
Yeah, it was it was ridiculous. I finished up my paper out that afternoon, grabbed a snack at home before my dad took me to the doctor. And my mom ran a home daycare. And so the snack of the day was fluffernutter on graham crackers. And so that's peanut butter and fluff. Marshmallow Fluff. And I took an entire sleeve of graham crackers with and made them into the peanut butter and fluff sandwiches and ate the whole thing before going to the doctor. Oh my gosh. So yeah, my blood sugar was 800 or something.

Scott Benner 18:33
How did your mom know you had diabetes? She knew

'Veronica' 18:36
somebody that had it. And so she had grown kind of concerned I was losing weight. When I was diagnosed I was 95th percentile for height and fifth percentile for weight. And I think her cousin's kids had it as well. diabetes, I had never met them. I still don't think I have kids.

Scott Benner 18:58
I got it. So she had seen it before a little bit and then recognize some of the symptoms from other conversations she's

'Veronica' 19:05
probably had in the past. Yeah. And she didn't take me to the doctor my father did. Because she was at home with the kids watch. at the daycare. Yeah. And so they he took me to the doctor and the doctor said, okay, she's got type one diabetes. This is not a death sentence. Life still goes on. So continue with your normal activities. My dad took me over to the hospital and they started an IV. And he left to go home to get mom because they only had one car. Because this was the 80s Yeah, that candy striper came around and asked if I wanted a candy bar. I was like, oh, yeah, and and then she looked at my chart and she's like, you can't have candy ever again. I was devastated. So what are you talking about? So my mom came that night. This is where it gets tricky. The the doctor had said don't change you know your Plants life isn't ending life goes on. So keep your plans. The next day, my mom flew halfway across the country, to her parents on a trip that she had planned. And so I was in the hospital, she was still away. My dad learned to give me the injections and brought me home from the hospital on a Friday and gets

Scott Benner 20:22
tricky because you felt abandoned or why? Yeah, I

'Veronica' 20:25
mean, like, What parent does that?

Scott Benner 20:30
I mean, is this a thing we have come to expect from her over time? Or was it a one off like, weirdo thing, whereas the doctor said, Don't change your life? And she's like, well, I have a trip planned. So I guess I'll take it.

'Veronica' 20:40
She's never been real involved with the diabetes care, and partly probably from the beginning. And and you know, we joke about the abandonment issues now. But I still got a lot of work to work through with that. But that's just my work

Scott Benner 20:53
to parents still together. Yeah, yeah. And she didn't leave you leave you she just went away on this trip and came back. You went away on

'Veronica' 21:00
the trip. She didn't tell her parents before she left. And then she got there. And they could see something was wrong on her face. And they were mad at her for going. But they were auctioning off the family farm that had been in the family for 150 years. So I mean, I don't know, like, what would I do as a parent? I don't know. Like, you don't know. Do

Scott Benner 21:20
you have kids? Yeah, I

'Veronica' 21:21
have one. I would probably stay with her. Make sense. Which is funny, though. Because I, in our family on the hands off mother, my husband works at the school that she goes to and so they commute to and from school together. And, you know, he's was a teacher and so he's more hands on with the homework. And then I am is that

Scott Benner 21:44
because of how you were raised? Do you think you are you mimicking what your mom did?

'Veronica' 21:48
I don't know if I'm mimicking I just I know that the way that it's set up that they spend more time together. I also know that the elementary school experience that I had doesn't lend itself towards understanding her elementary school experience. Now that she's in high school, you know, we we compare, you know, we we talk Latin, we talk, biology, whatever she's taking, and, you know, work through the whole the homework, so,

Scott Benner 22:17
but you're not you're not emotionally disconnected from her though. No, no, just some of the day to day stuff falls more toward your husband. Yeah, I gotcha. All right. What do you do for a living now?

'Veronica' 22:29
So currently, I am. My title is point of care specialist. I work in an endocrinology office for a small distributor slash pharmacy have diabetes technology. And there have been some changes in the office since I've been there. But when I started, I was paid mostly by the company I worked for and a little bit by the doctor's office so that I could fall under the pump training contracts. And so I'm a certified Omnipod, and tandem trainer. And so I start people on CGM EMS, I get their orders going into the Alright, was doing prior authorizations. The doctor has since been acquired by the hospital and now I have no access to records at all. So it's changed but it's really it's been good. Okay. So

Scott Benner 23:19
you work for a company that we does distribution? Yes. Okay. So they're

'Veronica' 23:24
both DME and pharmacy, mostly Medicare, but soon to have some changes to that. So that's going to be good.

Scott Benner 23:31
And what's your educational background?

'Veronica' 23:32
Oh, gosh, um, I found a five colleges five, I don't know four or five. And I have an associate's degree in general studies. And I have that's an AE in General Studies. And then as in nuclear medicine, technology.

Scott Benner 23:48
Okay, what did you do before this?

'Veronica' 23:50
I worked with a homeless for a year and before that I was at another Endocrinol office as front desk, but ended up being their pump trainer and doing pretty much what I do now. So that job prepared me for what I'm doing now. But it was a Worcester house. So. So that was during COVID. So that was right when COVID started. And they work from home for a year and a half. Everything from home. And so I went into the office every day through COVID, collecting co pays, and doing punk trainings and all of that, but they also Hindsight is 2020. I didn't always see it while I was there, but pretty sure there was some pretty heavy drug use and a lot of drinking and

Scott Benner 24:36
for I'm sorry for you or for them for them. Okay, so are you talking about the people running the office?

The providers? Oh, okay. So

the doctors were involved in a lot of heavy drug use and drinking. Yes. I think he's your endocrinologist. Yes. Ah, geez. How did that impact the practice? They were were

'Veronica' 25:00
able to hide under the cover of COVID. And so a week before I was fired, one of them was like, Oh, we love you so much. We want you to stay with us forever. You're going to be such a wonderful diabetes educator level, blah. And I just smiled and nodded. I was seeking an exit plan at the time. But I also had a home refinance in the works. The day that I got fired, the phones went out and I was in and out of the office, trying to fix that. And I came back in and I could tell she was not happy with me. And she just started screaming in front of a room, waiting room full of patients get the eff out of my office. You have no I top of and then her husband had, it was a married couple that were the two providers in the office. And he had she charged at me at one point, and he had to hold her back. And I was like, I'm gathering my stuff. And I'm out. And I still to this day don't know why that happened. Were they both using? I am not sure. I suspect okay.

Scott Benner 26:02
Did they do it in the office? Like were they hired drunk? Like during the day,

'Veronica' 26:06
once they came back from COVID, there were a number of days that we had to send her home, quote unquote, sick. And he would he would cancel his day too, and take her home and care for her. And Hindsight is 2020. And I'm like, Oh, my. So yeah.

Scott Benner 26:26
Do you think that impacted the care they were giving to people?

'Veronica' 26:29
Oh, absolutely. People, the patients absolutely adore them. Absolutely adore them. In fact, she was my provider before I got fired from working at the office. And I enjoyed her. But I knew there were some things that were off. But like, it's a very codependent relationship, they will tell patients with patients want to hear and do whatever the patient wants. And, but, and if the patient has any problems with the front desk, they'll say, Oh, I'm so sorry. The front desk let you down. And I can't go and say to the patient, I have messaged her 15 times every day for the last 15 days and she has not responded. She is not doing her job.

Scott Benner 27:15
And then puts it back on the people working out front rack

'Veronica' 27:18
she'll she'll put it back on the people working up front and then play savior. So she's, she's making this problem and then saving the patients from it so that they never abandon her.

Scott Benner 27:30
Oh, you think that's on purpose? Like, do you think she created the problem to save the problem?

'Veronica' 27:36
I don't think she knows any other way of operating. Okay. Okay,

Scott Benner 27:41
I see what you're saying. Maybe somebody was pretty bad to her raise and her is what you're thinking of? It's quite possible. Yeah. Gotcha. Well, gosh, I wonder how many people ever wondered if their doctor was drunk? What kind of drugs do you know?

'Veronica' 27:58
Everything except ketamine.

Scott Benner 28:01
So heroin?

'Veronica' 28:04
I don't know if that was happening while I was working there. Okay. Coke. I don't know what was happening while I was working there. I know that hindsight, and from the wine I've seen in the office and the the pictures of of the alcohol consumption for COVID. I know there was alcohol and highly suspicious there were other drugs. She is flat out admitted to, to me that she's used everything except ketamine. I see another girl in the office that constantly had to heroin not like another employee. Yes. Like it like out front or a nurse in the back or something like that. The medical assistant? Yeah,

Scott Benner 28:45
I guess it's easy. But

'Veronica' 28:47
I grew up fairly sheltered. I didn't. I didn't even know what we'd smelled like until the job after that. Which is hysterical to me. After that. I went and worked with the homeless for a year and I absolutely adored that. So that's where I learned about weed.

Scott Benner 29:06
That's the homeless tell you about weed? Yeah, doctors more high end liquor and things like that. Yeah. It's nice. Holy crap.

'Veronica' 29:17
Oh, that's just the tip of the iceberg. Keep going. Like, that's that office. That pretty much sums. Oh, well. I mean, the other part of the story is, I can't make a report to the state or anybody about that, because I was fired. And then because it would be retaliation. But my dentist is in the same building. And every time I go to the dentist, he says, Oh, I started stumbling to work again today. And I say, okay, I get that. I can't report her, but you can make somebody has got to report her. But he says, oh, no, that's her husband's job. Okay, whatever. How long

Scott Benner 30:00
as that I mean, that practice been up for over a decade, probably

'Veronica' 30:03
a decade or less. Okay. They've, you know, they've made the rounds in our area in different hospitals and groups, and then they made their own practice together.

Scott Benner 30:15
Do you think you have to work there to know that about them? Or do you think that's common knowledge and people just ignore it?

'Veronica' 30:20
I think you have to work there to really understand it. But if you look on the court records, you can see the DUIs. Oh, I see. Gotcha. Oh, and felonies, I'm sorry, felonies for assaulting a police officer.

Scott Benner 30:36
Oh, you can't do that anymore. What's the World Cup? Oh, my gosh, I wonder how people can go about looking into their physicians. You don't I mean,

'Veronica' 30:48
I mean, other than knowing, like, if I look up the NPI, there's nothing. It's not until I look on the court records that I can see. I say,

Scott Benner 31:02
did you notice any like, was there a decline in care that they were offering people? Like I know, you said they basically just did whatever people wanted. You call it a code to pay? Yeah, between her and the.

'Veronica' 31:14
I mean, like, I will say that was the first endo practice I worked in. There were a lot of testosterone patients that were having to go to the one blood, because they will probably say keenetic. Which means if I'm not mistaken, that just means you're given way too much testosterone. The other thing was like, they were like, Oh, we don't need to palpate a thyroid, because the changes are so minuscule that we're just gonna send them out for for ultrasound anyway.

Scott Benner 31:53
So they may be overmedicating testosterone patients. Yeah. Yeah. And then not doing the physical checks on thyroid that that are called for. Yeah. And then if that if patients pushed for something, whether it was medically necessary or right or didn't matter, they would just kind of went with the flow to keep everybody happy. Keep everybody coming back.

'Veronica' 32:16
Yeah, well, I mean, he's, he's practicing as an endocrinologist. I don't think he's a board certified endocrinologist. But he's prescribing a whole lot of controlled substances for an endocrinologist like I don't in the other practice I'm in they're not prescribing. Other than testosterone. There's no controlled substances prescribed. What

Scott Benner 32:41
are some examples of stuff you saw prescribed out of their

'Veronica' 32:45
oxy code on from

Scott Benner 32:47
your Endo? Yeah.

'Veronica' 32:51
In fact, one patient, she wasn't real old, she passed away. And apparently, he joked to one of the other people in the office that it could have been his fault.

Scott Benner 33:02
That's something her third third hand, third hand, okay. Like, hey, I might have given her too much of the Oxy

'Veronica' 33:11
might have over medicated or, I mean, like she was, she was drug seeking. Like, like, Yeah, but when you're using yourself

Scott Benner 33:20
in the game, yeah. game knows game. I see what you're saying. Yeah. Oh, well, that's that's something. Yeah. This is usually the time in the interview when I tell everybody give up. Oh, my gosh, I never know what people are gonna say. So this has been something that's an adult endocrinologists office. Yes. So I'm assuming plenty of type two patients. Yes. Now these people, if they're going there for good help, they're not going to be finding it.

'Veronica' 33:53
They care. It's just such a weird thing. I don't know how to describe it because like I was her patient, and I, you know, she did what I needed her to do and was helpful and some patients are getting okay care and other patients are iffy. And it really depends on

Scott Benner 34:12
if your oxy buddies or not.

'Veronica' 34:14
I don't know. I have no idea. Like, holy

Scott Benner 34:18
hell. Now you're at a different doctor's office now. I am okay. And do you see any wrongdoing there? Is that a good experience?

'Veronica' 34:29
I enjoy this office that I'm working at now. I like it a lot. I'm not sure I could find another endocrinologist to work with that would understand my perspective the way this doctor does, okay. Because he has type one. And so there's a doctor in the office and there was a nurse practitioner. And at one point after Easter last year, I had my desk drawer are full of stale Easter candy. And the nurse practitioner came in and was like, Do you have any snacks? And I was like, Yeah, and I opened up my drawer and sheets. Her eyes got wide and she's like, Oh my gosh, you're so bad. And I'm like, normally when people tell me I'm a bad diabetic and like, you're not my doctor, leave it between the doctor and I. But I like, I was flummoxed. Like, are you kidding me? And so

Scott Benner 35:27
you took that you took that as a bad diabetic, not just like, oh, my gosh, you have so much candy in a drawer. Yeah, yeah,

'Veronica' 35:33
you're bad diabetic. I mean, I've heard it called patients that diabetics frequently so to their faces. Oh, no, behind their back. My mantra is, there are no bad diabetics, we're all just trying to keep ourselves alive. There may be some that are actively trying to kill themselves, but they're on the installment plan, if you will, but she went and got the doctor and was like, You're not gonna believe this. Come look at this. And he picked his head and looked in my desk drawer and looked at me and goes, No wonder you're so happy. And I was like that right there is what makes a good provider that understands that life is not over. I still have my favorite candy as long as I'm eating it in moderation and not going hog wild. Which I'm not always great about between the ADHD and just having a dysfunctional pancreas. But, so yeah, I

Scott Benner 36:30
like he overtreated a lower two.

'Veronica' 36:34
I've retreated some lows and maybe even some highs.

Scott Benner 36:40
overtreated highs with candy?

'Veronica' 36:42
Well, you know, you crave sweets when you're hot. Yeah, that's interesting, until you get too high. But he gets it. However, he's been in practice 30 or 40 years. He's not done anything for himself in the practice. What does that mean? I'm sorry. Like, he doesn't do the prescriptions. He doesn't like the the MA's, write the prescriptions, okay, and send the prescriptions and everything. So he just signs off on everything. He doesn't understand how the pump technology works. And so even the other day, I gave him a pump start order form. And it was completely blank. And I just got it back with a signature on it. No, you're supposed to fill it out. He's like, Oh, I trust you to do that. You got this, you know what you're doing? And like, that's all well and good. And I certainly would not trust him to do it. But that's not in my scope of practice.

Scott Benner 37:38
Is that lazy? Or is it just inadequate understanding? He understands

'Veronica' 37:42
because he wears some that he kind of wears the technology he wears, he wears a five but in manual, so he understands early pumping,

Scott Benner 37:52
there's an endo, who has type one diabetes, doesn't really understand how to use the technology. Exactly. And is basically like what, like, I don't know, like just the person who like comes in and waves and says the nice stuff to you and then sends the nurses chips, and then tells the nurses take care of the rest of it. Yep. Have you ever heard him give people advice as he helpful to people with

'Veronica' 38:17
their diabetes? Um, it depends on the day. He can be. And he has some things that he says that I think are helpful, like, I can't take your diabetes away. But I'm gonna have you talked to NAME, and she'll help you with some of the technology that can ease the burden a little bit. Yeah, diabetes sucks. Like, I've heard him say that a number of times. So he, he gets it from, like, having lived with it. He's also trying to change the practice a little bit now that it's been acquired, doing less with diabetes, and more in some other endocrine areas,

Scott Benner 38:54
because they're more they make more money on it, or,

'Veronica' 38:57
Oh, I still can't figure that out. It's weird. Because people I mean, endos for diabetes are hard to find very hard to find they're horrifically under compensated because, and this is the thing that we're finding since the acquisition is that the managing diabetes from a provider standpoint is very labor intensive. It takes a lot of time, if you're going to pour over the data the way you should and that type of thing. But not just pour over the data, forget the data. If you're talking about DME orders, ongoing prescriptions all the time, it is way more labor intensive than any other. There's there's nothing else like it. Yeah, even CPAP supplies aren't that labor intensive. I

Scott Benner 39:48
understand what you're saying. I didn't think of it that way honestly prior but there's more to understand there's more to explain. There's more paperwork to do more getting people for on the devices. Send, make sure they have their insulin and all this other stuff that and you're not being paid for that. Right?

'Veronica' 40:05
Yeah. So that's why the company that I work for puts these point of care specialists in the office to free up the time, so the doctor doesn't have to explain the CGM. I go in and do that for him. And we'll even put it on if I've got a sample to put on. But he relies on me for all the education. And I'm not trained

Scott Benner 40:29
for that. What do we really need the doctor for? I mean, maybe except for oxy. But like, what are we? What are we? What are we really, if they're just glad handing you coming through and then somebody else in the office is doing all the work on the paperwork side and training you on the stuff? Is the doctor just there because they need to be because we need that degree? Yeah. That's all very uplifting. I cursed the moment I thought to make this series by the way.

'Veronica' 40:55
I'm sorry. Like, there's there are glimmers though. Go ahead. So there's there's glimmers of positivity and hope. Of course, my story hasn't given many of those glimmers. But like I there's some other things I'd like to see change. For example, diabetes educators, from what I understand of the certification process that they have to go through. They're only tested on some very antiquated medications. And most of it is about type two. They're still talking Pio glitter zone, they're still talking NPH and regular

Scott Benner 41:37
wait in the States. Ca

'Veronica' 41:41
for the series, CDC is exempt from what I have heard, I haven't taken the exam yet. I'm also in school for nursing degrees, so I can become a CDE. But that's a whole nother story. I mean, because I'm pretty much doing it. Now. I add live as I go, which is really wonderful. But that's part of the reason I'm all about experimentation. And I say find what works for you. Because each and every person is unique. Each and every body is unique. And so we know what works in general. And the doctor says this all the time. We know what works in general, we just got to find out what works for you. And that's why he's pretty laissez faire, when it comes to Oh, it doesn't matter what you put on the pump start, you know, it's close enough, we'll fine tune it as we go. But when we're talking diet, I'm talking to people and I'm like, figure out what food does to you. And then I say, okay, so figure out if eating your food in a different order helps your blood sugar. And I then I got the glucose goddess and say, Okay, try this and see if this works. And they look at me like, Where

Scott Benner 42:48
have you been all my life? Yeah, just changing my digestion might help this like my god. Thank you. Yeah, yeah. Are you in nursing school right now? Like, where are you at in that, in that time?

'Veronica' 42:57
Finishing up my prerequisites for a nursing program. Okay, so I haven't gotten in yet. But I've been feeling pretty positive about it. Good for

Scott Benner 43:06
you. And then how long will you be in? In the nursing program? Oh,

'Veronica' 43:10
I'm just, I'm all about collecting the associate's degrees. So it'll be an Associate's in nursing. I should I mean, I'd had enough hours in this endocrine clinic that

Scott Benner 43:20
should be eligible for the CDC ces test, right? Well,

'Veronica' 43:24
I think you have to work in nursing for like, two years. So I'll have to, you know, put around and do something until I can sit for it. I can't. I like I feel like we could have a lot of other people encouraging people with diabetes. Not maybe not necessarily CDC es, but people with diabetes have a lot of knowledge. There are no dumb diabetics.

Scott Benner 43:46
You do pick up a lot as you go. That's for sure.

'Veronica' 43:48
You pick up a lot as you go. But there are no dumb diabetics. Unfortunately, it is a game of survival of the fittest. And if if you're not able to, to make the right choices for your blood sugar, you don't really last as long. The

Scott Benner 44:05
fittest you mean as much as being able to, like do the things over and over again, every day that you need to do. Well,

'Veronica' 44:11
I mean, like, what I mean is the fittest from a, a smarts standpoint, if you're not smart, you're not surviving. Oh,

Scott Benner 44:21
I think I get what you're saying. So, if people are challenged by the process of managing diabetes, like intellectually challenged by it, yeah, and they can't rise to the task, then they're gonna have more outcomes that are or are bad, and that really could shorten their existence. That's what you're saying. Absolutely.

'Veronica' 44:39
I mean, I knew guy. I don't. I don't know how much of the story I really know. But he got it from when I was growing up. He was having a low blood sugar and thought it would be a good idea to unfreeze his pipes with a blowtorch

Scott Benner 44:56
during his low blood sugar. Yeah, let's

'Veronica' 44:58
just say that didn't end well.

Scott Benner 44:59
I don't understand what's alright. Well, what the hell? I mean, I'm really stuck back on the drunk Doctor handing out the oxys. Like, it's really crazy.

'Veronica' 45:12
It's wild. It's, it's been a wild ride. But what I would like to see back to the CDC, yes, I would like to see some more specific certifications. So when I became a nuclear medicine technologist, you got your certification, and you were a nuclear medicine technologist. A few years later, they came out with some specific certifications. So you could specialize in cardiology, or PET CT, you had these areas of specialty. And I would love to see that with the CDC. Yes. So that you have people who are a diet specialist, or an exercise specialist, or a technology specialist, or type two specialists where you still have to qualify for the entire thing. But it's an extra step to prove that, you know, more than the average bear about these different topics.

Scott Benner 46:03
Yeah, that would be a big shift in how it works. Because then you have to find a way to build for those things, too. Right? Because that's what I mean, they don't, not the doctor, I'm saying that the industry itself, like, they'll come up with new subsets of, I don't know, job titles, if they can bill for it, you do see that moving that way, a little bit with like, nurses, right, like they're more training some nurses for in very specific things. Yeah, you know, so that they can say, oh, you know, this person needs this attention from a will have that person go through and do the training or whatever with them, then that's the thing we can build for. If that is really kind of how they think about it. They think about services as as billable time. Right. Yeah. I don't even know. Like, that's, you're pretty far away from getting that accomplished. But I know, I know. And I've

'Veronica' 46:53
been told that you reminded me of something that the first provider that I worked for, she had prescribed me Jardiance. And so as we came out of COVID, I had an incident where I was just, we were coming out of COVID. And I went outside and was outside all day. And but it was one of those cases where you can't take your mask off your face. And so I was way under hydrated, and I ended up in New glycemic DKA I had no idea I thought it was having a heart attack. And because she had put me on this, and she had told me but I completely forgot. I do think that when Doctor, or any provider prescribes something that's off label that they need to reiterate at every appointment. Don't forget, you need to stay hydrated, or you need to Don't forget you're using new 500 and a pump, you know, because those reminders, save lives. So

Scott Benner 47:52
you were on Jardiance which made being dehydrated, more dangerous. CHARNY

'Veronica' 47:57
it's is contraindicated in type one, especially when you get dehydrated it It lends itself to you, glycemic DKA. Why did she give it to you? blood sugar control and weight loss. And it was great for both of those. But I forgot to stay hydrated. And I honestly thought I was having a heart attack. But then when I got to the ER and the doctor was like, Oh, you're in DKA. And I'm like my blood sugar's to 12. Like what gives? And it wasn't until a month or two later that I put two and two together and was like, oh, it's the Jardiance that's what it was. But I bought myself a heart cath because my when when you're in DKA, or you leaked your opponent's, which is a thing that's released when you have heart damage, and so I leaked your opponent's and because I went in with heart symptoms, they were like, You got troponin, so we got to do a heart cath. But I've been worried about my heart for years and so I got the plane Bell health on that. So I was I was thankful for that whole experience in the end. Did

Scott Benner 49:00
a doctor you know it's so funny. I find myself saying that a doctor tell you but the more of these that I i do I'm like ah, it's a difference. But But did the doctor tell you that the Jardiance had was the reason behind what happened to you is just something you suppose I

'Veronica' 49:16
don't remember if I've had a discussion with her or anybody else about it since but the hindsight is 2020 and I go oh no, I know that that's exactly why that happened. Because I was warned about it went both way before it happened that if if you're not hydrated enough, you can go into DKA and you won't even know because your blood sugar will be fine. Yeah

Scott Benner 49:38
10 Side effects of Jardiance medication commonly used to treat type two diabetes and some heart problems common giardia and side effects include UTIs fungal yeast infection on your genitals that's fun, more serious giardia and side effects include dehydration, low blood sugar and serious infection. ketoacidosis too much acid in the blood is also possible but rare. When

'Veronica' 49:59
I had that 19 A one C, I had a low while in the ER with the dka. And they didn't believe that it was low. And my doctor, my endo at the time was nearing retirement and how only seen that, like two or three times in his career, and he's like your body is just majorly stressed out. And so my body does seem to want to boot me into DKA quicker than most. But that was my first time since being on a pump that I went into DKA. So it's not bad for 24 years of something. Oh, how do

Scott Benner 50:36
you knowing what you know, and having seen what you've seen in doctors offices? How do you moving forward take doctors seriously. I realize that everybody's not like that. And probably like, a using Doctor giving up is probably not the norm. I'm not saying that. But like, every day, you know what I mean? Like, how do you make the leap then?

'Veronica' 50:56
So I have a theory about that, or a sneaking suspicion? I've been trained since since age 12 that I'm responsible for keeping myself alive. And the doctor I currently work for will tell. Well, he told me that caring for type one diabetes is 90%. Patient led and 10% Doctor Yeah. And I would say it's, it's even less doctor and more educator or education. We don't relate to MDS are DEOs like other patients do. And so I've learned that I have to tread very carefully when I'm dealing with doctors and other specialties or PCPs. Because I've been taught that I am responsible for keeping myself alive. I am very attuned to what's going on in my body. Each of my shoulders has been frozen at different points in my life. And both times I went to a doctor early on and said, Hey, I think my shoulder is starting to become frozen. What are we going to do about what are we doing about this? And they're like, no, no, it's not frozen. And then six months later, I go back and see them. Oh, yeah, now it's frozen. Let's get you into physical therapy. I think cardiologists and are used to playing savior, you give the patient this pill, they take it, everything's better. diabetes doesn't work like that. And, and people living with type one have a very different relationship to all doctors than other patients. Does that make sense? It does.

Scott Benner 52:34
And it's something I've noticed, you know, by having these conversations, too, that I just interviewed a doctor the other day, we really like straight, straight guy like good stuff, like straight laced guy like thoughtful has type one is a peds, Endo. And, you know, still, like some of the messaging from him was like, you know, don't expect too much from your doctors. And, you know, it's interesting that the way you put it I agree with it's, you know, most things that you go to a doctor for are sort of finite. It's like, you go for this thing, and I'll give you a pill and it'll, you know, take it for eight days, and they'll go away. Or, you know, you have hypothyroidism take it forever. We'll test your blood sugar every test your blood every six months, make sure we have your dosing, right, like very, like kind of finite stuff like that. Yeah, there's no world where you're like, Okay, well, every day, every time you open your mouth, we're going to change the dose. And you're gonna have to figure that out on your own. So doctors aren't prepared to handle that. Right? So the ones that you get lucky when you get lucky, and you get one that is that's maybe more random than that not? Yes, yeah. Yeah, I hear. And for reasons that you brought up earlier, because there's not a ton of money in it, you need a lot of time to put into something to help them with their diabetes. Maybe they're not going to put that effort in to begin with. Right? Yeah. And some of them are high as a kite.

'Veronica' 53:57
Hopefully not many,

Scott Benner 53:59
what a great story. Franca. Thanks for coming on the show. This is terrific. I really do appreciate you doing this seriously, because my pleasure. First of all, no one listening should be like, Oh my god, I gotta go find out if my doctors you know, smacked out of their mind or not. I'm assuming most of them aren't. But you know, what? Day drinking, you know, alcoholism, functional alcoholics. Definitely a thing. You know, people using drugs to get through their days is a is definitely a thing. And why would it not also include doctors, I guess? Yeah. Doctors aren't immune from. Right. So just another one of those things you'd like to imagine. isn't happening. Yeah, like I get it. When I'm going to get new tires and the kid at the tire place is stoned. I'm like, Okay, I understand it like it's okay. He'll be able to get the lug nuts off. I'm alright with this. You just don't think about it. And you don't I mean, like I know the kid getting the carts at the grocery store is just a little high. I'm okay. Yeah. Yeah. Like I understand that I get oh well. I'll help. I appreciate you doing this very much. Is there anything we left out that we should have talked about that we didn't?

'Veronica' 55:04
I think the other thing I'm I want the whole world to know is that it's not a test. It's just a check. We're not testing blood sugar, it is not pass or fail. It is just information. And it is information about what's happened in the past. The only thing you can do is react and change going forward. You cannot change the past. So keep looking forward. You know, now we've got the arrows with the CGM. And that's great. Can we please stop calling it a test is the verbiage bother you that much to gauge? It really? Does

Scott Benner 55:40
he tell me why?

'Veronica' 55:43
Because it's not pass fail. And I feel like probably I've been called a bad diabetic too many times. And you heard me say it earlier. There's no bad diabetics, we're all trying to do the best we can. And for the most part, the ones that are not doing real well haven't been properly educated by their doctors, and there are a few out there that don't care, don't give a rip. And that's on them. That is their choice. There's no need to shame them for that choice. Like that is on them. Yeah. That is not your responsibility. It's like, if they want to live that way, they're gonna live that way.

Scott Benner 56:23
Is that something you take on yourself, though? Because like, I don't know, I don't own a pool. But if he I know somebody who does, and you have to test your pool water. Now nobody's thinking like, Oh, I'm gonna test my pool water to see if I've passed or I've failed. Like, is that? Are we just not commingling thoughts? Like, I get the idea. I know, you don't want to be judged every five seconds. And that a number is just data. And I completely agree with you. But I mean, if someone were to call it test your blood sugar, like, why would that set you off? Is that because of past experiences you've had you think? Probably.

'Veronica' 56:56
And I just I think that words matter and how we talk about it matters that I don't want to feel like I have to do 10 tests a day if I'm not wearing a CGM. And I feel bad for people that have test anxiety. What's funny is, as I'm in school, I love the tests. I want to know where I'm at. I don't want to know if my blood sugar but hey, when I'm at school, yeah, I want to know how I'm doing. But

Scott Benner 57:23
also Veronica, you know, there are other people who aren't bothered by the word, right? No,

'Veronica' 57:27
I know, there aren't. But I do. I feel bad for anybody who hasn't really thought through it and processed it and start seeing that, oh, it's a test. Oh, I got another I got a test again.

Scott Benner 57:40
Can I ask a question? If I say to you, hey, Veronica, you gotta check your blood sugar. And then you check it? And then it's 250. That doesn't feel like a failure to you? Because I said check in not test, you know, saying, like, what's the difference? I don't understand that. It feels like just a word to me. But I don't know. Because I also I'm not in your position,

'Veronica' 57:57
I think because it's not pass fail. Like it's not, there's no grade, it's you're just checking to see the status.

Scott Benner 58:06
It's not, you can't just be testing to see the status. So yeah, I don't know. I feel like I'm coming off as difficult. I don't mean to be because I completely agree with you. So yeah,

'Veronica' 58:16
I'm a verbal processor. And I haven't gotten there yet. And you're asking the right questions to get me there. I'm

Scott Benner 58:21
just I don't know, I it just bothers me. It feels like to me that something happened to you at some point. And now you have an unkind relationship with the word in this context. But I mean, there are plenty people who don't. And so that's where we get into this weird thing with like, you see people online, like don't call it diet, like don't say, I'm diabetic. That was the thing for awhile, people like, don't call me diabetic. I'm not diabetic, I have diabetes. I gotta be honest with you. I don't see the difference. So like, you don't I mean, well,

'Veronica' 58:50
I will say that my husband worked with children with autism for a while, and he's like, they are not autistic, that does not define them. I am not defined by my diabetes. So I occasionally I will say, I'm diabetic. But typically, no, I've lived with diabetes for a hell a long time, and I'm over it.

Scott Benner 59:11
I think a lot of those words come down to like intent when the person speaking it to me like, I mean, I can, I can imagine a way where I could call somebody a diabetic in a pejorative way. But to just say that person is a diabetic. I don't know. I mean, I don't know. Like, I am not sure just because I don't know how to like feel like I've been overweight in my life. If you would have said to me, Scott's fat, I would have been like, yeah, I am. You know what I mean? Like, if you were to call me a fat person, I would have said, Oh, that's accurate. I mean, I wouldn't have liked it. You don't I mean,

'Veronica' 59:47
I think there's some stigmas with diabetes that don't need to be there. And and some of those stigmas are more about type two but they get placed on type one. Okay. I'm so sick to death of people telling me what I can and can't eat. And that

Scott Benner 1:00:03
happens in your life the hell up. Yeah. People tell you, you shouldn't be eating something. Yeah, you can't eat that.

'Veronica' 1:00:09
You're diabetic? No, first of all, I

Scott Benner 1:00:12
am a diet badass. And secondly, you're not my doctor. So shut up, do not take them as verbalizing their thoughts. Like you can't eat that. I always expect is them in their brain going, Oh, I didn't think she could eat that she has diabetes, and then it comes out of their mouth that way.

'Veronica' 1:00:32
So I use it as an opportunity to educate and say, No, really, I can I just take a little more insulin for it. And so I do use it as an opportunity to educate but sometimes I do get snarky because, well, it's a pain

Scott Benner 1:00:49
in the ass to hear over and over again. That's Oh, yeah, obvious. Yeah. It's not your job to educate every person who notices you. Right? You know, eating. I mean, I take all your points. I am just playing devil's I hope people know I'm playing devil's advocate. But uh, yeah, get up. Get a note here from somebody's like, it's, you know,

'Veronica' 1:01:04
I love playing devil's. So I appreciate that. Yeah. You know, one of the ways I've described my diabetes is that the first 10 years I fought against it the second 10 years, I was like, Oh, I guess I was kind of resigned to it. Now. I'm leaning into it. And I'm making diabetes, my bitch. And I'm using it to encourage other people for you. That's excellent. So I'm trying, I'm trying. Yeah, no, I'm

Scott Benner 1:01:24
glad you got to that part. Seriously. What do you think stopped you from getting to it quicker.

'Veronica' 1:01:29
So I've blamed the diabetes on a lot. But I honestly now and thinking that the ADHD was, was like a legitimate thing. And I, I had no plans for my future. After high school. I didn't go to college right away. So I had a teacher in high school that said, she was the music teacher, and she was like, I will play at your wedding. If you accomplish a number of things before you get married. You need to travel the world, and you need to have a college degree. And you something else, I don't know what you need to know the person at least a year or two or something. And so I've like, I took that seriously. And I I traveled the world. Before I was 15. I didn't get my college degree ever. She still played in my wedding. So diabetes has not been a it's a weird dichotomy here. It's not been a limitation to me. But it has been such a limitation to me. I've limited myself because of it. But early on, I didn't when I was 14, I said, Hey, Mom and Dad, I saw this thing in this magazine about a mission trip. Can I do that? And they were like, sure if they accept you. And if you can raise the money, and I think they thought I wouldn't get accepted into this mission organization. Well, when I was 14, I went to the Amazon rainforest for eight weeks with a bunch of people my parents didn't know us. When I was 15. I went around the world, most of it on the Trans Siberian Express, flew from the US to Ireland to Moscow, took the train all the way across Siberia, even went in a Siberian prison at one point. And then on the other side from Qatar. It was Khabarovsk flew to Anchorage, to San Francisco and back to the east coast. But while you're doing all that you're not managing your type one really soon. Okay, high school, early years were were okay. It wasn't until I mean, later in high school, that was early high school later in high school, it started to fall apart. First college I went to I ended up in DKA. And, and the doctor in that other state was like, We need to get you on an insulin pump. And I went back to my home state and my regular endo was like, No, you don't have good enough control. And so I went through that for a couple of years until I moved away from my hometown, you know, 10 states away or something, and ended up in DKA, twice in six months. Got myself an endo. Who was like, let's get you on a pump yesterday. And then, and then I got married. And now I'm stuck happily stuck, but stuck nonetheless, in this state, and with a bunch, you know, I've had great endos and not so great. And I was here in my current state, and it's been a

Scott Benner 1:04:23
dream. Well, it's quite a journey. I appreciate your sharing it with us very much. My pleasure, sincerely. Thank you. Hold on for me for one second. Okay, absolutely.

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