#1164 Cold Wind: Problems on Both Sides

"Aurora" is an E.R. nurse.

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DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.

Scott Benner 0:00
Hello friends, welcome to episode 1164 of the Juicebox Podcast

Welcome back to cold wind. Today we're going to be speaking with someone who we're calling Aurora. She has type one diabetes is a pediatric nurse in the ER we talk about all kinds of stuff about the hospital, including how parents bring their children in constantly for unnecessary reasons. What is this note here? Also, much to your surprise that a lot of children come into the ER with either fentanyl or marijuana overdoses. Oh, I remember her telling me this. Oh, you're gonna find this interesting. 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. How would you like to help type one diabetes research? Well, if you want to, it's easy. T one D exchange.org/juicebox. Finish the survey. It takes 10 minutes and you've helped. That's it. US residents only you have to have type one diabetes or be the caregiver of someone with type one. Bonus points. If you're male, or the parent of a boy. They're really looking for those people right now. But everybody is welcome. T one D exchange.org/juicebox. Don't forget to save 40% off of your entire order at cozy earth.com. All you have to do is use the offer code juicebox at checkout. 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 to get your free benefit check and get started today with us met. Today's episode is sponsored by Medtronic diabetes, a company that's bringing together people who are redefining what it means to live with diabetes. Later in this episode, I'll be speaking with Mark, he was diagnosed with type one diabetes at 28. He's 47. Now he's going to tell you a little bit about his story. And then at the very end of the episode, you can hear my entire mini interview with Mark. To hear more stories from the Medtronic champion community or to share your own story. Visit Medtronic diabetes.com/juice box and check out the Medtronic champion hashtag on social media. This episode of The Juicebox Podcast is sponsored by the ever since CGM. Ever since it's gonna let you break away from some of the CGM norms you may be accustomed to no more weekly or bi weekly hassles of sensor changes. Never again, will you be able to accidentally bump your sensor off. You won't have to carry around CGM supplies and worrying about your adhesive lasting. Well that's the thing of the past. Ever since cgm.com/juicebox. You're leaving it to me to pick your name. Oh, yeah. You know, I can't I'm not good at this homozygous. I'm gonna say randomly female name Alright, 1234 you are. Alright, well, we don't want to make you overall I do we

Aurora 3:34
sure we're not. She's a princess.

Scott Benner 3:36
Okay. Aurora. Aurora, what do you do for a living?

Aurora 3:39
I am a pediatric. Emergency Department nurse.

Scott Benner 3:45
Pediatric peds? Er? Nurse? Correct. Okay. Size of the hospital. Big small medium.

Aurora 3:57
I mean, it feels big. I don't know what other pediatric hospitals are. Okay.

Scott Benner 4:01
There's a distinction for the ER right, like trauma levels which what is yours?

Aurora 4:07
I don't know that answer. We are not a truck. We are not a level one trunks and not a level one trauma center. Okay, we are nationally ranked in pediatrics that I know for sure. nationally. So the thing is, is our emergency department is too far from the operating rooms. So we therefore cannot have like a higher standing as an emergency or like,

Scott Benner 4:31
oh, that's how that that's how that gets measured. Like literally.

Aurora 4:35
That's one of the that's one of the measurements is how far the emergency department is from the operating room. Okay, as well as which overnight, providers you have on call in the hospital are within a certain knowledge. And so because we work with three other hospitals within my area,

Scott Benner 4:59
they just did take them there if they think they need that level. No, no,

Aurora 5:02
our providers can be anywhere, our endocrinologist or our endocrinologist, but like, say we need for something like say you come in and your kiddo who has type one has Therapeutics is perfect. Right? So

Scott Benner 5:16
did you just say the name of a hospital?

Aurora 5:18
I'm going to sorry.

Scott Benner 5:22
Oh, sorry. Well bleep that

Aurora 5:22
out. Yeah. So that could be at any of the other hospitals in the area that they could be servicing. So it's not, it may take a little bit of time, if they're not there. Or if there's a weird surgery situation,

Scott Benner 5:34
would they redirect an ambulance to where your thing is more easily helped whatever's wrong with you at the moment? For

Aurora 5:42
pediatrics? It depends. So we don't take traumas. traumas will go elsewhere.

Scott Benner 5:47
If I broke my leg, that's not really a trauma and I end up in a ambulance, would they take me to a certain hospital?

Aurora 5:53
They would take you to us? Okay. Okay. Otherwise broken. A broken leg could be a trauma. If it is, if your bone is coming through your leg, I think the skin is open. Right?

Scott Benner 6:05
Okay. All right, that makes sense. So how long, you know, roughly, have you had this position?

Aurora 6:12
I have been in this position for a little over a year and a half now, year and a half.

Scott Benner 6:18
And prior to that, what did you do?

Aurora 6:21
I was I worked in the same hospital and the medical portion patient side for several years. Okay, too long.

Scott Benner 6:32
So just tell me the progression of education. You leave high school? What do you do next? Yeah,

Aurora 6:39
I leave high school. I start taking prereqs for nursing school. And that takes me oh, gosh, seven years to finish prereqs because I was working full time. And going to school part time because I had to pay for my diabetes supplies. Okay. And so it took me a very long time I finished prereqs summer of 2019. And I was not able to get into nursing school ended up starting a different degree. While I was waiting because nursing school in my area can take several years to get into. And COVID hit. I got in to the program, August's 2020 and graduated nursing school in 2022. May 2022. Okay. started in September 2022. And then emergency department. Yeah.

Scott Benner 7:39
So you basically take six or seven years, you're almost you're probably 25 ish when you get done with your prerequisites. Yeah, yeah. Okay. Then hard to get in because there's only so many slots then COVID etc. But by 20 That's a lot of time to try to get to something. And then okay, so then by 2022, you're a nurse, and you're working right away in ER or No, not right away, right away. Okay. And why did you choose that? today's podcast is sponsored by the ever since CGM. Boasting a six month sensor. The Eversense CGM offers you these key advantages distinct on body vibe alerts when higher low, a consistent and exceptional accuracy over a six month period. And you only need two sensors per year. No longer will you have to carry your CGM supplies with you. You won't have to be concerned about your adhesive not lasting, accidentally knocking off a sensor or wasting a sensor when you have to replace your transmitter. That's right. There's no more weekly or bi weekly hassles of sensor changes. Not with the ever sent CGM. It's implantable and it's accurate ever since cgm.com/juicebox. The ever since CGM is the first and only long term CGM ever since sits comfortably right under the skin and your upper arm and it lasts way longer than any other CGM sensor. Never again will you have to worry about your sensor falling off before the end of its life. So if you want an incredibly accurate CGM that can't get knocked off and won't fall off. You're looking for the ever since CGM. Ever since cgm.com/juicebox.

Aurora 9:27
I come from were in the hospital I was working I would have up to 15 patients a day in the role that I was on and on an acute care floor so like med surg II floors, or cancer care or acute care, so I knew going in the nurses only had three to four patients. And to me, I was like, I'm gonna be so bored. So bored. Right Take these patients for 12 hours a day, three days a week, a lot of them can be chronic, you know, we would have patients on our units for two years at a time. And then they'd come back and forth, or whatever thing going on. And I was like, I don't want to do that. I don't the emotional, social, like, the relationships are great. And you can have really great relationships with that. But it can be, wants to be really taxing on the nurses,

Scott Benner 10:27
being too emotionally invested in people's health.

Aurora 10:31
Yeah, or, you know, and I mean, for most people is like a trigger thing. Like, we don't think in our culture about children dying, and children do die, children get really sick, and they die. And you know, we do everything we possibly can, but a lot of the time, that we really just prolong it. And it's painful for the patient. It's painful for our family. It's,

Scott Benner 10:54
I have a friend who's a NICU nurse. And they, when they first came out of school, and we're working, they'd find themselves being invited to funerals by families. Yeah,

Aurora 11:06
yeah. And, I mean, I'm not saying we shouldn't prolong the life that we shouldn't try to do everything that we can medically, to have let this child become an adult and have a faint, you know, like, and do all the normal people things that we do. I'm just saying that, that to me,

Scott Benner 11:22
it's a lot when you see people die.

Aurora 11:26
It is. And I mean, it was just, I didn't think I would be happy. I didn't think I would find like but growth. And also at my hospital. So nurses have a variability of autonomy based on state based on institution and the policies and autonomy, and then kind of like the breadth of their scope of practice, right? In patient, they do not have a good breath for autonomy for a scope of practice. And I've watched several, you know, so many doctors just snap at nurses for no reason, like an just, I don't do well with that. So the emergency department I did my senior practicum in, I really liked it. And I said, Okay, it's either going to be it's going to be critical care all the way. Because I love to use my brain. I love looking at labs and looking at the patient, how they look and their vital signs and putting it all together and being like, Oh, wow, this is what's going on. And I know what I need to do. Now I know what I need to ask for. Whereas cute care, you don't really have that.

Scott Benner 12:27
Yeah. So you like the speed of it? You like the challenge of it, you like that there's more patients in a shift so you don't get too attached to people? Yeah, if

Aurora 12:40
a patient is in my emergency department room, and I've had them for four hours, I walked into the room and I'm like, I'm sorry, you're seeing my face again. We're trying to figure it out. Like I want them gone by like four hours, because nobody wants to be in an emergency department for that long. Yeah. So

Scott Benner 12:55
what made you want to come on and do this recording?

Aurora 13:00
I don't have a good answer. Let's go with that. But it's perplexing. The things that I hear people say, or the inequalities that I have seen in patients with diabetes who are coming in, and it's not just patients with diabetes, it's all but I mean, this is diabetes podcast. So that's what we're talking about.

Scott Benner 13:25
I'm happy to listen to, to whatever you want to say. It doesn't have to be about diabetes, specifically, what do you mean your it's confusing what people say?

Aurora 13:34
Not it's not confusing. Like it's surprising the crap that comes out of my coworkers mouths, like,

Scott Benner 13:40
Okay, you want to give me some examples? Um,

Aurora 13:44
okay, so yesterday, I was hanging blood. And this is a scary thing, right? But a couple of weeks ago, I had a nurse who was about to give a, a pen injection for insulin, right? And she's like, I'm always so terrified to get insulin. I'm like, why are you terrified? She goes, because it's such a high risk medication. I was like, your body makes insulin. So it's not scary.

Scott Benner 14:10
How long do you think that person had been? A nurse has been here a year? Are there a lot of new nurses right now? Because of the shift after COVID? I'm

Aurora 14:21
gonna say yes, but I know that. This emergency department would always take new grads. Okay, so I don't know the comparison. Okay.

Scott Benner 14:31
So there's there's always new nurses coming.

Aurora 14:35
Oh, always. And if they're not new nurses, they might be new to the IDI or their travel nurses. You know, there's always a variability of like, but I mean, we have staff members who have been on staff for 20 years and in the emergency department for 20 years nursing. So the

Scott Benner 14:49
combat side is their turnover, but not with everybody. Like some people come and go and some people stay long term. I guess once you get there if it's really right for you, then you might settle into it. Yeah. Okay, so something as simple is like, I'm scared to give insulin because it's a dangerous medication. Yeah.

Aurora 15:07
Which is understandable. But I was like, Hey, your body makes insulin, it's, it's totally fine. I was like, if they go low, they go low, which is not at the Met error, right? If they do, but if they go low, you get more juice, I'm not fine. And we do not give enough insulin whatsoever in any form of this hospital to actually make a patient low unless you are way overdosing and not properly getting my insulin. Or there

Scott Benner 15:33
are other things that co workers say that would be off putting, but you're not personally attached to it. Like it sounds like it sounds like a little bit of your response to that was as a nurse, and a little bit of your response to that was as a type one. Like, like you and me, like it almost feels like a little bit. You're like, oh my god, like you don't understand diabetes at all. That vibe, like how did it make you feel when when they said that? You weren't pissed? You were just No, no, just like this another person who thinks that

Aurora 16:04
we give insulin a week of insulin we have. We don't have a day where we don't have a diabetic in the emergency department, whether it's a new diagnosis, or somebody's in sick day or somebody's in decay

Scott Benner 16:14
every day. Every day type twos type ones every day. We don't really have type twos. Type twos don't come to emergency. Not not pediatric. Okay. Oh, I'm

Aurora 16:25
sorry. Usually, like, yeah, they don't usually have type two. Yeah,

Scott Benner 16:29
it's interesting. So you're a pediatric er, nurse. The place isn't just for endocrinology. But there is a good endocrinology department there. So you see a lot of these people is that about how that works. Right now we're going to hear from a member of the Medtronic champion community. This episode of The Juicebox Podcast is sponsored by Medtronic diabetes. And this is Mark.

Speaker 1 16:51
I use injections for about six months. And then my endocrinologist at a navy recommended a

Scott Benner 16:57
pump. How long had you been in the Navy? Eight years up to that point? I've interviewed a number of people who have been diagnosed during service and most of the time they're discharged. What happened to you?

Speaker 1 17:07
I was medically discharged. Yeah, six months after my diagnosis.

Scott Benner 17:11
Was it your goal to stay in the Navy for your whole life? Your career was? Yeah,

Speaker 1 17:15
yeah. In fact, I think a few months before my diagnosis, my wife and I had that discussion about, you know, staying in for the long term. And, you know, we've made the decision despite all the hardships and time away from home, that was what we loved the most.

Scott Benner 17:28
Was the Navy, like a lifetime goal of yours? lifetime goal.

Speaker 1 17:33
I mean, as my earliest childhood memories were flying, being a fighter pilot,

Scott Benner 17:37
how did your diagnosis impact your lifelong dream?

Speaker 1 17:40
It was devastating. Everything I had done in life, everything I'd worked up to up to that point was just taken away in an instant. I was not prepared for that at all. What does your support system look like? friends, your family caregivers, you know, for me to Medtronic, champions, community, you know, all those resources that are out there to help guide the way but then help keep abreast on you know, the new things that are coming down the pipe and to give you hope for eventually that we can find a cure. Stick

Scott Benner 18:06
around at the end of this episode to hear my entire conversation with Mark. And you can hear more stories from Medtronic champions and share your own story at Medtronic diabetes.com/juicebox. diabetes comes with a lot of things to remember. So it's nice when someone takes something off of your plate. US med has done that for us. When it's time for art and supplies to be refreshed. We get an email rolls up in your inbox says hi Arden. This is your friendly reorder email from us mid you open up the email to big button that says click here to reorder and you're done. Finally, somebody taking away a responsibility instead of adding one. US med has done that for us. An email arrives we click on a link and the next thing you know your products are at the front door. That simple. Us med.com/juice box or call 888-721-1514 I never have to wonder if Arden has enough supplies. I click on one link. I open up a box. I put the stuff in the drawer. And we're done. US med carries everything from insulin pumps, and diabetes testing supplies to the latest CGM like the libre three and the Dexcom G seven. They accept Medicare nationwide, over 800 private insurers and all you have to do to get started is called 888-721-1514 or go to my link us med.com/juicebox using that number or my link helps to support the production of the Juicebox Podcast. Yeah, okay.

Aurora 19:44
So a lot of pediatric emergency departments are split with main emergency departments, adult emergency departments. We are not we are a self standing pediatric emergency department. We get an adult there's something wrong with them. We ship them out as soon as possible. Okay,

Scott Benner 20:01
what do you see people most for DKA? Yeah,

Aurora 20:04
I want to say DKA new diagnosis, and we service for different states. So if there is a severe enough new diagnosis, they come to us, as well as the hospitals in the area, even as far as you know, 200 miles across the state well, either lifeflight or to you to

Scott Benner 20:29
a place where there's a nurse who's afraid of insulin, because you guys are the specialists,

Aurora 20:33
as the artists. Okay, we are the pediatric specialists. Yes. And I mean, it's, it's not something to not be afraid of it is a rite of it. They should be well, but yeah,

Scott Benner 20:43
I mean, Aurora, I'm not going to argue with that. But if I mean, that would be like a mechanic being afraid of a lug wrench, wouldn't it? I don't know. I mean, you use it all day long. Every day, it's in your hand constantly. How can you be can be used by it? Well, there is

Aurora 20:57
a portion of it to is like, huge. So you have to take a glucose, right? You put the glucose, there's a freaking calculator. You also have to make sure that the residents because we have med students, we have residents, and they have what three years of residency, then we have a fellow who is above them, and then we have an attending, okay, but the low man on the totem pole is the one putting in the order. So the ones calling into crime. So you have to trust that your resident is putting in the correct order, then you have to double check out their orders are correct. Doing that you're putting in everything correctly, you also have to check the ketones, which we call a bomb because it's a finger poke. So you have to check the ketones and whether or not the ketones are medium, small or large. You have to put in and we have a thing for that. And then it'll calculate, let's say if we're on sick day, what if it's one and a half or double the dose? Right? So you have to make sure that that is all correct. And so that could happen. What she was saying, being scared of getting it. Yeah.

Scott Benner 21:55
So that's why I was getting that like so it's possible that she's not weary. She's worried that the person telling her what to do is messing it up. Oh,

Aurora 22:03
oh, yeah. All the time. Every order that comes in whether it's anything it doesn't, it's not just diabetes orders.

Scott Benner 22:09
Yes. Why am I worried that the orders coming in? might be wrong?

Aurora 22:12
Human error?

Scott Benner 22:14
How often does it happen, though? Oh, all the time. Like, per patient? Or how do we want to break it down? Is it like, every person that walks in there, somebody's going to make a mistake about them? Or in every shift? I'm gonna see a mistake.

Aurora 22:30
No, I'm not saying like a mistake I'm saying, within orders that come in, as a nurse every order that comes in for me to do something I take a look at. And I'm gonna say at least twice with every patient that I have. I have questions on orders, and one or two of them is incorrect. And they have to put it back incorrectly. We

Scott Benner 22:53
can't call that a mistake, a bad order from a doctor or residents not

Aurora 22:57
a mistake, because we're catching a learning process.

Scott Benner 23:01
Yeah, there baby. Sorry, sorry. Yeah, there's a legal distinction. But okay, so you stop it from actually being a problem, but a mistake was made. That gets caught down the line. I say nurses,

Aurora 23:12
the last hand is the last the last person to do anything to touch that patient. So therefore, the nurse is the last stopping point. Okay.

Scott Benner 23:22
Yeah. All right. So I understand. So the resident who's maybe the least qualified is making the decision. And then the nurse is double checking those decisions to make sure they're not messing up. But in your words, twice with each patient, you might find something that needs to be readjusted. No, if I'm being generous. Oh my god. Okay, that's fine. So if I get a nurse that doesn't know, and a resident that doesn't know, that's when I'm in trouble. Yeah. Do they try to pair them in a way that that doesn't happen? Like more,

Aurora 23:55
but the hospital is really good at our my charge nurses are really good at managing patient load. And if you don't, we do have a culture of like, everybody's learning. And there's never there's never a stupid question. There is never, you know, don't not ask the questions, ask the questions, you know, ask for help. And it's there. Yeah. So, you know, giving us insulin. Insulin is always a double check. We go through, she's like, I've already gone through it can go through it again. Let's draw it up. Let's give that insulin right. Okay. Yeah, no problem. And, you know, usually it's totally fine. Getting all of those steps in to be able to do that

Scott Benner 24:30
because it goes through like channels like the residents send something down. It's not right, you catch it? Is it a thing that you put back into the computer? Or do you like grab them on the side and go, Hey, this isn't right.

Aurora 24:42
Yeah. Yeah, or call them or I call their attending? I mean, the good so the residents do talk to the fellow and to the attending as well as the nurses as well. So we all we all sit within, you know, we're in the emergency department. Our providers are not in a room half across the hospital. They're there. bear with us, right? So we can easily say, hey, this order is wrong, please fix it. Right? This is why it's wrong. And they all do talk together. It's not just their residents making the decision, but like the residents, the one putting in orders.

Scott Benner 25:12
What would you be most comfortable coming into your ER with a child with? Like, what do you think? What do you guys do great. Like, you know, you go to five guys that make a great burger. When I come to your ER department. If I brought my kid in there, what would I be best bringing a kid in there with? What do you guys do? Well, I think we do a lot of it well, okay. So is this just a fact of the situation that things get dropped? And other people catch them? Yes. You're not saying this is bad. You're saying this is how it works? Yes. Okay. Are you comfortable? Would you be comfortable taking your child to that? Er, yeah.

Aurora 25:52
Children, I don't have children and I can't have children. But yeah, you'd be comfortable going there. I'm also a nurse myself. So that's a hard question to answer. Like, I wouldn't take my child until they were absolutely dying. You know, why? Why? Because a lot of things don't need to go to the doctor For not

Scott Benner 26:11
because they would do a bad job once you got there. All right. So is a lot of the backup in the yard. Just people go into the yard when they don't need to. Correct. What are things that people go to the ER for that they should have stayed home for?

Aurora 26:25
Your kid has a fever, they have had a cough for two days. They're not eating?

Scott Benner 26:31
Do people ever come in with those concerns that it turns out to be something

Aurora 26:35
very rarely, I feel like in an emergency department, we have levels for care and what you're going to need. So when you get triage, your nurse assigned you it's called an ESI level. That's fine. Do an ESI level. So one is you are back in our recess room and you have you know, four nurses on you all the doctors available a respiratory therapist, and we are putting in lines, we are drawing labs, we are getting scans doing all of the things at once, right? This is the like, Grey's Anatomy, you're crashing? Okay? That's an ESI level one and that can be a breather that can be like a medically complex child who is just like looking like absolute crap. Diabetic who is having cerebral edema. We've had that a couple of times. You know, kids who are coming in seizing and the seizing is not stopping fentanyl overdoses, those sorts of

Scott Benner 27:30
things. But fentanyl overdoses with little kids? Oh,

Aurora 27:34
yeah. Cardiac arrest. That's another one respiratory arise.

Scott Benner 27:40
In the course of a shift. How long is a shift 12 hours? Well, how many heart attacks do you see in 12 hours in children.

Aurora 27:48
It's very rare to have a heart attack and a child they would usually have some form of like birth defect or something maybe react problem or it's a middle of the night they went into cardiac arrest or while they were sleeping. Like I said situation and so we're really reassessing them to get LifeLock. So they come and go, there's not a specific amount in a shift

Scott Benner 28:11
in a month. How many fentanyl overdoses 232 or three in a month. And how many shifts you work a week. Three 312 shifts two or three overdoses.

Aurora 28:26
Yeah, or marijuana overdoses. Which parents please. I know the like marijuana comes in great packages and gummies and stuff, please put them up in your cupboards Far, far away. Put them in a lockbox. Kids get into them. They don't realize your kid comes in and we think it's meningitis. And we find out it's marijuana.

Scott Benner 28:43
Oh my god. So more frequently than I would imagine. Kids get into gummies of their parents. Yes. As kids your eyes, they bring them to the emergency room.

Aurora 28:54
And they look like they're dead. Yeah. Oh, cuz they're like overdose on marijuana.

Scott Benner 28:59
No kidding.

Aurora 29:00
Yeah, we've had three in the last week get really bad.

Scott Benner 29:04
Seriously? How come? All right, hold on, we're not gonna go down the wrong path. But how do people not know not to leave that where their kids can find it? I guess they're high too. Maybe they don't know.

Aurora 29:14
I don't know. I'm just it's a PSA, please.

Scott Benner 29:17
What else should people hit? Maybe this is the road to go with you. Or what? What else do people do where they they shouldn't be doing? Like what else is very preventable that you say? We

Aurora 29:27
get a lot of nausea, vomiting, abdominal pain, or teach teaching kids how to pull their nose, please. I know we went through COVID I get we're not supposed to cough. You can cough into your shoulder. You can blow your nose where people aren't going anywhere and people aren't blowing their nose, children. I have an eight year old who didn't know how to blow his nose and I taught him how to blow his nose. He kept vomiting. We call it post vomiting. If you're coughing, and then all of a sudden you vomit right? Because you get all that mucus that's going into your stomach, the mucus that's going into your stomach from your lungs. problems when you cough it up is an irritant to your stomach and it causes you to vomit. You're

Scott Benner 30:04
saying if your child is vomiting because they can't blow their nose, and everything's backing up down their throat, maybe you should reevaluate your parenting skills. Yeah,

Aurora 30:15
you should teach your child how to blow their nose. Do you put the tissue on their nose? And you block one nasal passage, and you say, now try to close your mouth, but act like you're blowing out a candle? And oh, my gosh, they can blow their nose. Do you think people don't know that? Absolutely. Oh,

Scott Benner 30:34
my God, that's upsetting. Okay, Jesus. All right. So they don't know not to leave weed near their kids. The edibles? Kids aren't eating the actual flower. Are they to the what? The flower the bud? Like? Do they actually know? It's the gum? gummies? The gummies? Right. Okay. And worse, the kids get the harder drugs sometimes.

Aurora 30:55
Oh, yeah. I mean, like, they're people who have drugs and, you know, obviously code on cocaine in their homes and their children. Get around it, you know, and it's really sad.

Scott Benner 31:06
No kidding. You ever seen a baby? Like, really injured from that? What do you qualify as injured? I mean, you know, they just stare at a wall for the rest of their life, or they're dead, something in between those things?

Aurora 31:17
I don't know. Because we don't. I mean, I them after, that's when I was upstairs, we would have like, abuse from those that were afflicted with addiction, we would hurt their child. I don't know about the children are seeing now because I don't tell social situations. Gotcha.

Scott Benner 31:38
But a number of the things you see in the ER are would be preventable. But somebody with an IQ over 80

Aurora 31:45
is somebody who didn't have social determinants of health that were ruling our life. Yes. You're very polite. Okay. I mean, I truly believe this is what that's what it boils down to is social determinants of health like it. And I know other people who have our health care workers that have come on for this, I've talked about it. But it surely is, if you don't have access to your phone to be able to go to my chart and message your provider or can't get into the provider, because they can't see you like, just a PCP visit in my area right now is for monthly time, I have been needing to see a specialist for a new autoimmune disease for five months now. And I'm still one more month away from this new appointment. It's ruining my life, like it's making absolutely terrible, and you can't get on.

Scott Benner 32:33
Yeah, no, I want to talk about that. But that's not what I was kind of what I was getting. And I'm saying like, we don't need to be any special kind of intelligent to keep weed away from babies or make sure they don't get an oxy or something like that.

Aurora 32:45
No, yeah. I mean, like, how do you how do you stop addiction? How do you stop that social determinant of health? What what started that addiction? What NSSM is causing this to be an in product, what percentage

Scott Benner 32:59
of your day is wrapped around stuff that if those problems didn't exist for people, you wouldn't see these people? Like how many people out of every 10? Is it avoidable and not a health like not just a flat out thing that went wrong with their health that they couldn't stop? Does that make sense? My question, yeah,

Aurora 33:17
I'm trying to think, to three to

Scott Benner 33:21
two or three out of every 10 people if they just had better skills, or opportunity. They would not be in the ER. Oh, no, Simon, then. Oh, okay. I wasn't sure how clear I asked at first. That's why I kind of restated it. So three of 10 are like my appendix pop. That was nothing I could do about that. Yeah, I fell over. I broke my leg. There's nothing I could do about that. But the but seven out of 10 are things that if you put a person with common sense, and a reasonable start to life, this probably doesn't end up happening to them. Yeah. Is that frustrating as a nurse,

Aurora 33:58
it can be okay, not all the time. Sometimes it's, you know, new parents coming in. This is their first baby. They've never been around a child and the child was sick for the first time. Okay, sure. Got this not aspect. Patients not breathing very while they're not wanting to eat, they're a little sleepy. You know, we unwrap them. We suction them really nice and well with our vacuum suction. And, you know, we let them eat. We give parents education reassurance, hey, you're gonna suction every three hours, you're gonna section before they eat. And if the warming breathing gets worse, we give them a pamphlet, like this is what we want you to this is where it's looking worse, because you're getting a lot of information out at once. Put it on your fridge, right? So when you have that question when it comes back up, it's right there. You know where it is. And then you can either come back in or you can be reassured by your baby's looking fine, right. So like, that is absolute really needed. That is probably one of my funnest things that I do is like giving those parents that education because it can prolong them not coming into the emergency that they can prolong them not being worried. So

Scott Benner 35:15
what I'm calling common sense, you're calling determinism. I guess this is just me judging things from my perspective. But you've described a number of things so far, that I think with like three seconds, a clear thought I could figure out, but people are ending up in the ER over it. Yeah, yeah. Like, I've had children. And sometimes you're right, like, they get sick, and they get all snotty, and they gets blocked up, and then you like, clear it for them? Yeah, that's it. It's not that hard. But I guess it is, if it is, right.

Aurora 35:46
I don't know what it is. I don't know if it's because we have such a good pediatric hospital in the area. And so everybody's just like, go my hospital. Right. But isn't it expensive to go to the hospital? Well, our our hospital has, everybody can apply for assistance, and then it's based on income. So whatever level and whatever's leftover from the hospital visit, what uh, how did they determine it? I don't know. Okay, but a lot of it's uncompensated incompetence care. I don't know one

Scott Benner 36:18
time when Arden was little, she'll be very embarrassed. I said this, but that's her problem, not mine. She's very little. And she was in the bathroom. And she didn't like the way it smelled. So she rolled up toilet paper and stuck it up her nose. Solid. Yeah, I issues like, I don't know, she was not that old, like two or three years old, right? But this one little wad of toilet paper got stuck so far up her nose. We couldn't get it out. Yeah. And so I sat her down. And I looked at her and I thought with my thinker, and I thought we tried one thing that I'm embarrassed to say that didn't work. We tried, like putting like a funnel on the end of the vacuum cleaner hose to see if we could like grab it that way. Like so there was like a little funnel tip that was being sucked on by the vacuum that didn't grab it. And then it hit me what to do. And I blocked up one of her nostrils kept my mouth over her mouth blew and filled her filter up with air. And the thing shout out and hit me in the face. You can also do that with mucus. Yeah, I'm sure it can. Now, point is, is that at no point during this like, show, which it was? Did I think I'm gonna go to the hospital. But you're saying people would come to the hospital that? Yeah. Oh, I say. All right. I don't know what to do. So you're not here to tell me that the people at the hospital don't know what they're doing. You're here to tell me that the people coming to the hospital don't know what they're doing. Yeah, well. So let's be honest. Let's be honest. So, again, the limiting factor here is people. Yeah, somewhere along the line, someone I don't know, is overmatched. I guess that's the simplest way to say it for whatever reason. And they end up needing help from someone else who eventually sees this so many times over and over again, that they become a little numb to it. And then another person comes in with an honest to god problem. And you don't see people like that anymore. You see, like, you see the confusion and the repetition. So when like the only me like because that's my always one of my, my bigger questions is like, what happens when someone's actually in there with an actual problem?

Aurora 38:35
Oh, I mean, all the resources go towards them, and everybody else waits. That's how it works.

Scott Benner 38:41
But how do they miss things that are actual problems? In the beginning, they miss them because most of the time seven out of 10 times it's nothing? Is that it?

Aurora 38:49
Okay, so can it express? Yeah, so pediatrics, like kids are really good at compensating their body is really good at compensating. And like so there'll be like mail coming a little crummy, little crummy, little crummy, right? And then they just we call it a nosedive. They're on the edge of the cliff and something that just pushes them down. And they're crummy looking. Right? And so parents know. And sometimes those like spidey senses are going off at a time that possibly is not that. And then sometimes they go off a little too late, you know. And so it's just like, there's no balance to it. But of course, if your kid is sick in the event, second week, and let's say they've had the flu, and we know the flu is going around, even though they've been sick all week. And you notice the flu parents don't bring them in and say fix my child. I'm sorry, it's a virus. We can't fix your child.

Scott Benner 39:44
Do you think people get panicked when the illnesses start going on for many days and they think oh, God, something worse is coming instead of realizing that you had to write this virus out. Yeah. And that sometimes people actually do have honest to god problems and everybody thinks that's happening to them. Um, yeah,

Aurora 40:00
let's say that they had a virus and now all of a sudden they're coming in and they have diabetes, then that's an emergency, right?

Scott Benner 40:06
Where you end up doubling up, like you get bronchitis on top of something else, or you start having two problems at the same time. So I don't think he'd mind me saying this. My brother had to go to the emergency room a couple of weeks ago. And he had very terrible pain that, you know, right side pain. And he gets there. And they hit him with the drugs first, because he actually said, my brothers had some pretty, like, painful things happen to him. And he's like, I couldn't talk like I needed like to numb this before I could even explain to them what was going on. So he gets, you know, they, they, they make him comfortable. And he explains everything. They do all the tests, they can't come back with anything. But in his history, my mom has had diverticulitis in the past. And so they kind of ignore all that go over him. And then he said, there was this moment where they told him that even though he was in intense pain that was only being managed by some significant pain meds, there was nothing wrong that they could figure out and he had to leave. He did have a raised white blood count, but they just, they just kicked him out of hospital. So he went home. And the next day, he texted me and he said, I can't take it, I gotta go back. So he goes back again. And he has to stop them from basically just repeating what happened 24 hours before, he has to say, no, no, we just did all this. If you need to see it, there's, I'm sure it's in your computer, but we just did all this. I'm back because the pain is unbearable. You know, even with the medication you gave me everything else sees there for another couple of hours. They're not doing anything. He's texting me. He's like, Scott, nothing's happening. I'm just they're gonna just sit here and stare at me for a while and then tell me to go home again and go see a doctor. And I'm like, right. So I said to him, did they redraw your labs? And he said they did. And I said, tell me if the white blood cell count is still elevated. And he looks and says it's elevated. It's higher than yesterday. I said, grab the nurse and say, Would it hurt anything if I got an IV antibiotic? You know, because my white blood cell counts elevated. It was elevated yesterday. Now today, it's higher. My mom had diverticulitis in the past. She goes, hold on, I'll find out. She leaves talks, the doctor comes back. Doctor will be in to talk to you a little bit. So my brothers are Hey, doctors texted me doctors coming to see me. He calls me afterwards. He's laughing. My brother's laughing. He goes, Hey, I know what's wrong with me now. And I said, well, they figured out he goes, I have diverticulitis. And I go, what? He goes, Yeah, I floated the idea to the nurse who floated it to the doctor who came back and pretended that he had the idea that I had diverticulitis, and they're gonna give me an IV antibiotic and antibiotics to take home with me. And I was like, so I diagnosed you. And he goes, Yeah. Like, I'm the one through a text message. Who told my brother manipulate the nurse. So show manipulate the doctor so you can get the antibiotic? Because obviously, we don't know what's going on. The only thing we see is a rising white blood count. You clearly have an infection somewhere. Let's take care of it. The IV antibiotics not going to hurt you anyway, if that's not the thing, why is this not worth a try? And by the way, three days later, he was fine. Yeah, I did that

Aurora 43:18
manipulations, a good word. A lot of manipulating network. Yeah,

Scott Benner 43:24
that's what I did. I manipulate the nurse through a text through my brother so that she would tell a doctor and then but I think the fascinating part that should not be lost on this is that an hour later, the doctor walks into the room as if he's had the idea. Yeah. And then repeat to my brother. What I told my brother to tell the nurse. Yeah, jump out a window. That's the only thing I can think of when I hear stuff like that. Just give up. Yeah.

Aurora 43:50
That's my every day. Yeah.

Scott Benner 43:53
But you don't see it as bad. You see it as part of the learning process. Oh,

Aurora 43:57
no, that's, that's what I've been conditioned to. Oh,

Scott Benner 44:02
because I see it as bad. I just want to be clear.

Aurora 44:06
is like, awesome. It's hard for me because I had so much experience in our hospital with this population for a very long time before I came down as a nurse, right. So like, I was above and still am. A lot of the nurses, a lot of the nurses who have been there a long time. And I've been told that by management, which is fine. I have a very blunt personality. I'm very, like, this is what we're doing. And we're doing it right. And doesn't go over well with everybody. And so, I have been told you just have to play dumb. Which some days I comply with. Most days. I do not say the smart people say play dumb. Yeah, because you have to ask things in a way that will get the providers to think what you're wanting them to think or give you the orders you need. Yeah. Right you are advocating for for the patient. Yes. I

Scott Benner 45:08
mean, listen, I don't know what to say. I in the last year, my brother and my daughter have been in the emergency room and I have been the attending physician for both of them. Yeah. And without me, nobody helps them. They pretend to help them, they medicate them, then they throw them back out again. Aurora, my daughter was in the ER for 12 hours. And they didn't check her blood sugar while she was there.

Aurora 45:32
I know. I know. I was I listened to the podcast

Scott Benner 45:35
ever once. They never even stuck their head in and said, Hey, how you doing? How's your blood sugar?

Aurora 45:41
And that, to me is surprising. But that's an adult emergency department. And I know I know the nurses get busy. I know there was I saw I am triage train. Now I'm I'm a full fledged emergency department nurse. So I triage patients. I triaged a patient literally a couple days ago, who came and she has type one diabetes, okay. She goes, I don't feel well. I can't keep anything down. I think she came back with a virus. Okay. Not abnormal. Usually it's a day. And she I can't remember she was like eight to 11. Somewhere in that age range. I can't remember. Which, exactly, it doesn't matter. So she's like, my blood sugars have been, you know, two to three hundreds. We can't get them down. Well, the Lantus isn't working dad knows nothing. Nothing about her diabetes, nothing about her care. And she goes, this is how much insulin I take. This is how much you know antiseptic. She goes, but this abdominal pain. It feels like the last time I was in DKA. And I was like, I got you, girl. I know. I know what that feels like. I know the pain you're talking about. And so we got her back to her room, immediately her glucose, they attacked her glucose in the first check in area and it was above 300. I hand her off to the other nurse and the other nurse is supposed to get all the labs and stuff. So they got the lab she was in DKA. At that time by our senior she was in DKA. Endocrine said she's not in DKA do sick day, for whatever reason. And I don't know what happened. You know, a glucose wasn't checked two hours later. And they went in to go do Sick Day and insulin three hours later, and she was further into DKA. And so then we had to start the GK to bag insulin system.

Scott Benner 47:27
Listen, the only direction my brother got in the first day of the hospital. He's my brother has type two diabetes, which is managed very well with diet exercise, and ozempic. So my brother's a once he's in the fives, mid fives from the sevens with ozempic. He's lost, like, I don't know, 35 pounds in the last year or something like that, like everything good about my brother's health right now is coming from his GLP medication. He's in the hospital, they do the tests, then they go, Oh, we don't say anything. And then the doctor says to him, we I think maybe we should take you off the ozempic. And my brother goes, why? And he goes, he goes, I've been the guy. His words were I've heard like, almost like I was I was listening to a you know, podcast, and I heard that they can cause like intestinal blog. There's a lot of problems with intestinal blockages lately. And my brother goes, I don't have an intestinal blockage. I took a shower this morning. And the guy goes, he's like it's on there. My you asked me when's the last time I went to the bathroom went to the bathroom a couple of hours ago, like I don't have an entire not blocked at all, I promise you. And the guy says, I don't know, maybe we may we should take you off of this. So my brother goes, I'm not stopping that medication. So the only medical direction he got was come off your GLP which would have raised as a one C backup two points. And no one ever came back to say to him, Hey, don't do that. So now my brother's a bright enough guy. And he's got me to bounce it off of and other people in his life. Right? So, but there are plenty of people who would leave that hospital that day. And what they would remember is the doctor told me to stop taking the ozempic Yeah, they would have stopped. It

Aurora 49:10
had. Honestly, I don't know if that's because we come from a background of having a chronic illness or taking care of someone with a chronic illness. I'm like, No, you know,

Scott Benner 49:25
how do you not understand it, though? Like, how can you say I don't know, in medicine? And I don't know what I mean, what might be one of the most popularly understood drugs in the world right now. Like everyone that's on everyone's lips. Everyone knows what it is. And yet, you are just guessing based off a thing you might have heard once and then you give somebody medical direction about it, then find out that definitely not what the problem was. And don't go back to them and say, Hey, by the way, I know I told you to stop taking the ozempic but don't do that. Like it's fascinating. Like no wonder people have so many problems. You don't I mean, I think

Aurora 49:59
me It's just the oversaturation of patients to do providers, just too

Scott Benner 50:07
many people searching for help. And it's more than a person can keep straight in their head. Yeah, that makes sense to me, by the way. Yeah,

Aurora 50:16
I have a friend and she's very lovely. I went to nursing school with her. Her son was diagnosed with type one diabetes last May. March, somewhere in there. Anyways, I texted her and I was like, Hey, happy birthday. And she goes, Oh, my God, I was just thinking of you. We are in the emergency department. Not near me, because I went to nursing school in a different states. And she goes, we were just diagnosed with type one diabetes, I was like, Oh, I'm so sorry. And so they like, went home after some insulin because he was fine. And then did training the next day. And so she's calling or texting very frequently, that first few weeks. And in the first two weeks, I was like, listen to this podcast, this is going to tell you more information than they're ever going to tell you. And I was like, get the insulin from the doctor get what you mean, I was like, but do not listen to the doctors. Like they don't know what they're doing. They don't know anything about diabetes. And they're telling you, I'm going to say all the wrong things. Right? She is a nurse. Yes, she has patients with diabetes, she gives insulin on a daily, okay. And so I saw her a couple of months ago, and we went out for breakfast. And she's sitting there and she's complaining about like, these diabetic orders that she had the previous week, and they were completely wrong. And it took, you know, hours upon hours to get them correct. And then she was like, I just don't understand what they're doing. And I was like, um, and so how's your son's able and see, like, what's going on there? Because like, we kind of just stopped asking questions. And I was like, what's going on? She was like, over high, and this is going on, and like, he's taking meals to correct because we can only correct every three hours. And then it's just causing bigger spikes. And I was like, What are you doing? Because, hey, I love you. I love your kid. But I told you a year ago, do not listen to the doctors. So for a year, it goes on like that. You just told me from your nursing experience. You did not listen to the doctors and do not trust the doctors. But

Scott Benner 52:21
when she got put into a position she did go back. Yeah. So there's a person who should know better and didn't, I'm telling you like, what if my brother would have believed that guy? Now all of a sudden, it's six months from now he's back it is his general practitioner guy goes well, I don't understand what happened. You're, you're a one see one way back up again, what's going on? And my brother goes, Hi, I stopped taking ozempic Because the ER doctor told me to stop taking it because I might have a bowel obstruction. It just it's fascinating. By the way they had scanned him to within an inch of his life. His bowel was not obstructed. They knew that. And then the guy still said it out loud. I don't know what I'm listening. I know people are just people and you you know you go to school and you do your best you become a doctor. It doesn't make you a magician doesn't make you a god or a deity or anything like that. But isn't it incumbent upon you to know that when you're talking that I'm just the guy, I'm just the girl. And I don't know everything. And whatever I say out loud, this person across me is going to take like gospel. Yeah, like it's important not to seriously, it's important. It's nobody seems to understand lead. That's the thing that I find fascinating. The older doctors can get it but they're so damn tired. Like, it's like either had people with energy that don't know what they're talking about are exhausted. People who know what they're talking about. It can't bring themselves to do it anymore. Yeah, yeah. So what's the answer? How do you fix it?

Aurora 53:47
We all die eventually.

Scott Benner 53:50
It was gonna get you anyway, Scott. Yeah. So there's no answer. Right? This is just a this is a gray area within living and society that is probably working as well as it can and not working badly. I mean, it's obviously not. It's not where it could be. But there's no answer about how to get there. As far as anybody I've spoken to. So far. I've never had one of these conversations at the end said to somebody, what do you think we should do? And they all have a great idea. They all go I don't know. That, you know, it's the Insurance insurance fault. It's the time that doctors have with them. It's doctors egos. It's, you know, that there's too many people. You know, in

Aurora 54:26
nursing school we learn about in, I think it was the early 1900s. Okay. Nurses would go to people's homes, they would check in, and I'm not putting this on nurses because we already do everybody's job. But nurses would go to they would have a set amount. This was in New York, I believe, that amount of patients that they would see within a week, within a day, right? They had these families that they were like, the mama bear of okay, she would go in and make sure that the moms were getting enough Food so she could breastfeed, they would make sure that the patients who needed the dressing changes would do the dressing changes and make sure that like people, even if they don't have enough money are getting adequate food and just kind of like, being a part of the community that they were that they were supporting. Right. Okay. They were, they were in the community, they lived close to these people. This was their, you know, like, this is what they did, right? There was federal funding for that. And then something happened and that federal funding was lost. But in that timeframe, the health, the disease rates were better people were, you know, like, not spreading sexually transmitted diseases, because they were learning not to, you know, you know, do those things, whatever.

Scott Benner 55:43
You want to stop, go and do something. Yeah. Yeah, I do that. I'll be here. I feel like she was getting ready to say they don't let take your time. Make sure you're okay. I'm fine. I'm just drinking. I was telling the people when you walked away and felt like you were about to say, people do not to let dirty near them. And then you were like, I'm gonna stop for a second. Is that what you're gonna say?

Aurora 56:06
No, no, no, my phone is on. It's on. I put it on airplane mode, or whatever that is, you're not disturbing. So it was just a little alarming me. I was I was,

Scott Benner 56:16
Oh, you got confused in that. In that sentence? You got the alarm? Because you paused I was like, Oh, she was gonna say something hard. And she stopped yourself. But your alarm went off? What's your blood sugar 64. Most people get high when they're being interviewed.

Aurora 56:29
I did initially and I gave myself a Bolus,

Scott Benner 56:33
little too much.

Aurora 56:37
To do. No, I've calmed down. And so I'm no longer speaking adrenaline to keep keep it up. Anyways, so they had these wonderful nurses who would do the actual community outreach. And it was that of course, it was for funding. And we've never gotten back to any state close to that. And I honestly believe we, as a country were to do that. A, our nurses would be so much happier and find so much more fulfillment in what they're doing. And then our we would have less hospitalizations, we would have less heart disease, we would have less type two diabetes, right? Like

Scott Benner 57:19
you think the answer you think the answer is one on one, care with somebody who can talk you on your level and isn't rushing around and actually understands the thing. So especially like they understand the thing they're talking to you about because they don't have to know everything. They only know a few things. Not even just a few things, but like, the things that come up. Yeah, yeah. Yeah. I mean, not a bad idea, right.

Aurora 57:46
I honestly believe that. I would love it's public health nursing is what it is. I would love to do that. Okay. But public health nursing now is not that.

Scott Benner 57:57
Yeah, everything gets bastardized, eventually. Even like, walk in clinics, right? That take insurance, like, you know, eventually they become a like a grind like a mill. Yeah. And but when they first opened up, it was great. It was like you'd show up somewhere. And the doctor would be like, sitting there waiting for you and beg Hi. And now as time goes past, they seem a little more, get them in, get them out. I mean, at least there's a little more time for them, because they don't have as many people there as a as an emergency room. People seem to live, learn how to use, you know, those clinics a little bit, but you can also get a bad one. I've been in one with my son when we were in Florida. And he got sick. And my god, like it just there's just confused people everywhere. And I mean, working there, and very unhelpful. And then there's one near my home, that's actually really good. Actually, there's a type one that works in it, and she's terrific. And if I go there, when I'm sick, I'm like, is she here? And you know, she's really great. Maybe even that's a little bit about what you were talking about earlier, just your opportunity and your availability to good help and good ideas. So maybe I just live in an area that, you know, I don't know, has a better a better emergency clinic to go into not even attached to a hospital. Who knows? It's by like your idea, though. Like, what did what did you call it? community nursing? Yeah,

Aurora 59:18
it's public health nursing with like community specific outreach.

Scott Benner 59:22
They probably can't charge for that. Well, though. I don't know. That's probably the problem. So basically, it's like having a like a Facebook community, but where an actual nurse shows up and helps you. Correct?

Aurora 59:33
Yeah, I see. Which is like it's you know, you become a nurse and like, you get all these text messages from people and they're like, Wow, about, you know, how many phone calls I've gotten in the middle of the night where my sister's kids are doing something funky or they're screaming their head off and she's like, I need your help. She lives halfway across the country. Okay, let's FaceTime them. I'll look at them. Okay, they're okay. This is what you should look for. This is what you should give. If they start are doing this then go to the emergency department. Okay. Yeah. really concerned. Yeah, call your PCP tomorrow and try to get in. Right? But not everybody are good and social determinants of health, like nursing school is very expensive. Having a doctrine family, not a normal thing. Who are you going to call? Right? If you live in an A? In a lower class? Population? If that's where you are? How do you even reach that? How do you have a nurse? And your phone? To know?

Scott Benner 1:00:30
Yeah, the guy you know, to help you when you know, when you you need? When you need a I know a guy situation, the guy you know, maybe not a doctor. And then yeah, then that. All right.

Aurora 1:00:42
I mean, like, I've literally like, my sister has a running tab of how much money she owes me, because I'm like, $30, every time you call me with a question, because this is ridiculous,

Scott Benner 1:00:50
you know, but is it? Is she calling you because she's overmatched? Or she calling you because she really doesn't know. And she'd be one of those people in the ER, if she didn't call you? What do you think? I think a little bit of both a little bit of both taken advantage a little bit and a little bit. She doesn't know what she's doing now, which

Aurora 1:01:05
is why I literally told her and her husband this last week, because I was there visiting. I was like, $30, I'm not kidding. Because my brain and my availability is not just free to you, because I am related anymore. You got a year and a half. No more, you

Scott Benner 1:01:22
got three kids. Now, I know a doctor. And he said that's, you know, it's one of the worst things is that, and when you know him, you have to stop yourself sometimes because you're like, Oh, my God, I could just ask real quick, you know,

Aurora 1:01:32
I mean, I think it's really appropriate to set a boundary. And I mean, I gladly will do it like, sure. Of course, she's not ever gonna pay me. But, you know, like, good. People don't have that. Yeah. We didn't have a nurse in my family until i i became a nurse. You know, we didn't have anybody who graduated high school until I graduated high school. Like, really? Don't have it. Oh, yeah.

Scott Benner 1:01:57
Oh, no kidding. Oh, good for you. Congratulations. Good for your family. So if

Aurora 1:02:03
you come from a background like that, what do you do? Well, you go to the emergency department, and you sit there for four hours until you can see a doctor who's going to tell you? I don't know. I'm back if you need to.

Scott Benner 1:02:13
Yeah, all right. Well, again, I appreciate the conversation. I'm afraid they're all going to mostly go the same way. But everybody's bringing something new and different to them. Your perspective was different than others so far. So I really appreciate you taking the time to share it with me. I'm sorry, you got low in the middle of it. But thank you very much. It's it's interesting. And I will say this, because I say this all the time in these episodes. If you have an emergency situation, just go to the emergency room. Oh,

Aurora 1:02:42
for sure. Please do don't don't act like I'm not saying don't go to Superman, like kids get like I said they fall off cliffs. So go if you think you need to go go. Right.

Scott Benner 1:02:53
And it's better safe than sorry. I mean, correct. For certain, you know, it's just there's a difference between, like, you know, that old like, oh, I shot 10 units of fast acting instead of my Basal insulin, what do I do and and right away someone online, I'd be like, go to the emergency room. And I'm like, you could figure out what your carb ratio is and eat the food. Drink a bunch of juice? Yeah. Like, there's other stuff you can do. And then you'll say, Oh, that's a good idea. Like, yeah, yeah, you don't have to run to the emergency room immediately that that panic that some people have is, is interesting. Like, you know, I'm not saying if you can't get ahead of it, if you you know, if you're, you know, you shot 30 units or something like that, like I get it, you know what I mean? But you got to think for yourself a little bit once in a while, I guess, I guess, unless she can't, and then maybe you need somebody to do it for you. But that just means that people like Aurora are going to be like teaching your kids to blow their nose. And you're going to be using up the finite amount of she has to give before she falls apart in our child like really? Right, like, eventually, you're just going to run out of things to give and then yeah,

Aurora 1:03:58
and then it comes in and dies and you just like actually lose your marbles. Because who knows.

Scott Benner 1:04:06
All right. I'm gonna say goodbye. And thank you very much for your time. I appreciate it. Thank you.

Mark is an incredible example of what so many experience living with diabetes, you show up for yourself and others every day, never letting diabetes to find you. And that is what the Medtronic champion community is all about. Each of us is strong, and together, we're even stronger. To hear more stories from the Medtronic champion community or to share your own story. Visit Medtronic diabetes.com/juice box. Don't forget, we still have Mark's conversation at the very end. It's a terrific kind of mini episode about 10 minutes long. That goes deeper into some of the things that you heard Mark talking about earlier in the show. A huge thanks to us med for sponsoring This episode of The Juicebox Podcast, don't forget us med.com/juice box this is where we get our diabetes supplies from, you can as well use the link or call 888-721-1514. Use the link or call the number, get your free benefits check so that you can start getting your diabetes supplies the way we do from us med. I want to thank the ever since CGM for sponsoring this episode of The Juicebox Podcast and invite you to go to ever since cgm.com/juicebox, to learn more about this terrific device, you can head over now and just absorb everything that the website has to offer. And that way you'll know if ever sense feels right for you, ever since cgm.com/juicebox. Thank you so much for listening. I'll be back soon with another episode of The Juicebox Podcast. And now my full conversation with Medtronic champion, Mark. Mark. How old were you when you were diagnosed with type one diabetes? I was 2828. How old are you now? 4747. So just about 20 years?

Unknown Speaker 1:06:08
Yeah, 19 years?

Scott Benner 1:06:10
What was your management style when you were diagnosed? I

Speaker 1 1:06:13
use injections for about six months. And then my endocrinologist at a navy recommended a pump.

Scott Benner 1:06:18
How long had you been in the Navy?

Unknown Speaker 1:06:19
See eight years up to that point?

Scott Benner 1:06:22
Eight years? Yeah, I've interviewed a number of people who have been diagnosed during service and most of the time they're discharged. What happened to you?

Speaker 1 1:06:30
I was medically discharged. Yeah, six months after my diagnosis.

Scott Benner 1:06:34
I don't understand the whole system. Is that like honorable? Yeah. I mean,

Speaker 1 1:06:38
essentially, if you get a medical discharge, you get a commensurate honorable discharge. I guess there could be cases where something other than that, but that's that's really how it happened. So it's an honorable discharge with but because of medical

Scott Benner 1:06:48
reasons, and that still gives you access to the VA for the rest of your life. Right?

Unknown Speaker 1:06:52
Correct. Yeah, exactly.

Scott Benner 1:06:53
Do you use the VA for your management? Yeah, I

Speaker 1 1:06:56
used to up until a few years ago, when we moved to North Carolina, it just became untenable, just the rigmarole and process to kind of get all the things I needed. You know, for diabetes management, it was far easier just to go through a private practice.

Scott Benner 1:07:09
Was it your goal to stay in the Navy for your whole life, your career? It was?

Speaker 1 1:07:12
Yeah, yeah. In fact, I think a few months before my diagnosis, my wife and I had that discussion about, you know, staying in for the long term. And, you know, we made the decision despite all the hardships and time away from home, that was what we love the most. So that's what made it that much more difficult

Scott Benner 1:07:29
was the Navy, like a lifetime goal of yours or something you came to as an adult,

Speaker 1 1:07:33
lifetime goal. I mean, as my earliest childhood memories were flying being a fighter pilot and specifically being flying on and off aircraft carriers. So you know, watching Top Gun in the ad, certainly a

Scott Benner 1:07:45
weight was a catalyst for that you've taken off and landed a jet on an aircraft carrier.

Unknown Speaker 1:07:50
Hundreds of times.

Scott Benner 1:07:52
Is there anything in life as exhilarating as that? No,

Speaker 1 1:07:55
but there there's a roller coaster I rode at. I think it was at Cedar Rapids up in Cleveland Sandusky, and they've got this roller coaster rotation from zero to like, it's like 80 or something, you go up a big hill and you come right back down. So the acceleration is pretty similar. I would say to catapult shot,

Scott Benner 1:08:13
I'm gonna guess you own a Tesla.

Speaker 1 1:08:16
I don't I I'm a boring guy. I got a hybrid rav4 I get made fun of I get called. You know, my wife says I drive like a grandpa. I'm a five miles per hour over the speed limit person. No more than that. So yeah, in the car. I'm boring guy. So

Scott Benner 1:08:30
you've never felt a need to try to replace that with something else. You

Speaker 1 1:08:34
can't replace it. It's you're replaceable. That's what I thought. So up until the point where someone you know, buys me an F 18 or allows me to get inside a two seater and fly it you can't replace it. How did

Scott Benner 1:08:45
it make you feel when you saw or maybe you haven't seen? gentleman named Pietro has his large aircraft license. He's flying for a major carrier. Now he has type one diabetes. Does that feel hopeful to

Speaker 1 1:08:54
you? Yeah, it does. You know, when I when I was diagnosed, that wasn't a possibility. The FAA prohibited commercial pilots who had type one diabetes, but I think it was 2017 when they changed their rules to allow type one diabetics to be commercial pilots. And part of the reason I did that was because of the technology advancements, specifically in pump therapy and pump management. So I don't have any aspirations of going to the commercial airlines, but one of my sons who has type one diabetes very much wants to be a commercial pilot. So, you know, in that respect, I'm very hopeful and thankful. Yeah.

Scott Benner 1:09:27
Do you fly privately now for pleasure?

Speaker 1 1:09:30
I do. Yeah. One of my favorite things to do is fly my kids to the different soccer tournaments they have all over the southeast us so last week, my wife and I and two of our boys flipped to Richmond for their soccer tournaments up there and Charlie who's my middle child has type one diabetes so you know if I can combine flying family and football and one weekend to me that's I think I've just achieved Valhalla.

Scott Benner 1:09:54
So then it sounds to me like this diagnosis was a significant course correction for you. Can you tell me how It affected your dream.

Speaker 1 1:10:01
Well, I you know, if I guess three words come to mind first, it was devastating. Everything I had done in life, everything I'd worked up to up to that point was just taken away in an instant. And I was not prepared for that at all. The second emotion was, it was scary. I hadn't thought much about life outside the Navy, certainly not life as anything else, but a fighter pilot. And Heather and I were getting ready to move to France, I was going to do an exchange tour with with the French naval air force. So we're taking French classes. So pretty quickly, I had to reinvent myself. And then probably the most important thing at the same time that all that was going on, I had to learn how to deal with type one diabetes and how to manage it effectively. The third thing that pops into my mind, I guess, is challenging, you know, new daily routines, I had to establish first with injections, and then eventually, you know, through pump management, and then learning how to count carbs and recognize highs and lows, how my body reacts to blood sugar trends based on exercise and stress and those types of things. And my goal at that time, and it still is today is to leverage technology and make sure my habit patterns are effective so that I take diabetes management from the forefront to the background.

Scott Benner 1:11:08
Have you had success with that? Do you feel like you've made the transition? Well,

Speaker 1 1:11:12
I have I mean, I believe in continuous improvement. So there's always more to do. I will say the technology since I was diagnosed specifically with pump management, it's just, it's just incredible. It takes less of me intervening. And it's really done by the pump itself and by the algorithms through the CGM is. And to me again, that should be the goal for everybody is to not have to focus so much on the daily aspects of type one, diabetes management, you know, we should let technology do that for us.

Scott Benner 1:11:41
What else have you found valuable? I've spoken to 1000s of people with type one diabetes, the one thing that took me by surprise, because I don't have type one, myself, and my daughter was very young when she was diagnosed. I didn't really understand until I launched this podcast, and then it grew into this kind of big Facebook presence. I heard people say, I don't know anybody else who has type one diabetes, I wish I knew more people. But until I saw them come together, I didn't recognize how important it was. Yeah,

Speaker 1 1:12:10
I think similarly, I didn't know anyone with type one diabetes growing up as an adult up until when I was diagnosed. And then all of a sudden, people just came out of the woodwork. And when CGM is first hit the market, certainly within the last five years. It's amazing to me and my family, how many people we've noticed with type one diabetes simply because you can see the CGM on their arm. I mean, I would say, a month does not go by where we don't run into someone at a restaurant or an amusement park or a sporting event or somewhere where we see somebody else with type one diabetes. And the other surprising aspect of that is just how quickly you make friends. And I'll give an example. We're at a soccer tournament up in Raleigh, this past Saturday and Sunday. And the referee came over to my son Charlie at the end of the game and said, Hey, I noticed that you're wearing pomp. And he lifted up a shirt and showed his pump as well and said, I've had type one diabetes since I was nine years old. I played soccer in college, I'm sure that's your aspiration. And I just want to tell you don't let type one diabetes ever stop you from achieving your dreams of what you want to do. And this gentleman was probably in his late 50s, or 60s. So just having that connection and seeing, you know, the outreach and people's willingness to share their experiences. It just means the world to us and just makes us feel like we're part of a strong community.

Scott Benner 1:13:30
So would you say that the most important things are strong technology tools, understanding how to manage yourself and a connection to others? Yeah,

Speaker 1 1:13:39
technology for sure. And knowing how to leverage it, and then the community and that community is your friends, your family caregivers, you know, for me, the Medtronic champions community, you know, all those resources that are out there to, you know, help guide away, but then help help you keep abreast on you know, the new things that are coming down the pipe, and to give you hope for eventually, you know, that we can find a cure. You

Scott Benner 1:14:01
mentioned that your son wanted to be a pilot. He also has type one diabetes, how old was he when he was diagnosed?

Speaker 1 1:14:07
So Henry was diagnosed when he was 12 years old, was just at the start of COVID. We are actually visiting my in laws in Tennessee, we woke up in the morning and he had his bed. And several years before that, we had all four of our boys tested for TrialNet. So you know, predictor of whether or not they're going to develop type one diabetes and whether or Henry and one of his brothers tested positive for a lot of the indicators. So we always kind of had an inclination that there was a high degree of possibility he would develop it, but we always had at the back of our mind as well. And so when that event happened, at the beginning of COVID, we had him take his blood sugar on my glucometer and it was over 400 And so right away, we knew that without even being diagnosed properly by endocrinologist that he was a type one diabetic, so we hurried home to get him properly diagnosed in Charlottesville, and then we just start Did the process first grieving, but then acceptance and, you know, his eventual becoming part of the team that nobody wants to join? How old is he now? He's 15 years old. Now,

Scott Benner 1:15:13
when's the first time he came to you? And said, Is this going to stop me from flying? Almost

Speaker 1 1:15:19
immediately. So like me, he's he always had aspirations of flying. In fact, he out of all four boys wanted to be in the military, that was a difficult part of the conversation and maybe something that we don't talk about as a community. But there are some things you cannot do as a type one diabetic, and that's a hard fact of life. And unfortunately, joining the military is one of those hard and fast things you cannot be you cannot join the military as a type one diabetic. So it was very difficult for him and for me and my wife to get over. Then we also started talking about being a commercial pilot. So I saw that same excitement in his eyes because like me, you know, he can be an NFA teen or a 737 or a Cirrus SR 20 That I fly, be just as happy. So he still has that passion today and still very much plans to eventually become a commercial pilot.

Scott Benner 1:16:04
I appreciate your sharing that with me. Thank you. You have four children do any others have type one?

Speaker 1 1:16:09
They do? My oldest twin Henry has type one diabetes, and my middle son Charlie has type one diabetes as well. The boys are twins. The oldest two are twins. One has type one diabetes. My middle son, who is not a twin has type one diabetes.

Scott Benner 1:16:23
I see. Is there any other autoimmune in your family? There isn't

Speaker 1 1:16:26
I'm really the only person in my family or my wife's family that we know of with any sort of autoimmune disease, certainly type one diabetes. So unfortunately, I was the first to strike it rich and unfortunately pass it along to to my sons with celiac thyroid, anything like that. Not about nothing. We're really a pretty healthy family. So this came out of nowhere for myself and for my two sons. That's really

Scott Benner 1:16:51
something. I appreciate your time very much. I appreciate you sharing this with me. Thank you very much.

Unknown Speaker 1:16:55
Anytime Scott.

Scott Benner 1:16:56
Learn more about the Medtronic champion community at Medtronic diabetes.com/juice box or by searching the hashtag Medtronic champion on your favorite social media platform. The episode you just heard was professionally edited by wrong way recording. Wrong way. recording.com

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