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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
This episode of The Juicebox Podcast is sponsored by insolate, makers of the AMI pod and Dexcom, makers of the G five continuous glucose monitor. You can learn more about dexcom@dexcom.com forward slash Juicebox Podcast and you can find out more about Ardens insulin pump at my Omni pod.com forward slash juice box

okay, this is episode 121 of the Juicebox Podcast. Thanks so much for tuning in. Today I'm going to speak with Kelly and she and I are going to talk all about insulin. Initially, Kelly wanted to come on to talk about Basal rates and Temp Basal rates, but the conversation just blew up from there. I'm telling you this episode is crazy, informative, genuinely helpful. I think you're gonna love it. I think it's gonna have a big part to do in how you handle your blood sugar's every day. Listen, here's the one thing though this episode was recorded like six months ago. So you may you know, if you listen to every week, you may hear me say things that seem a little out of I don't know, you know what I mean out of order. But trust me that's not in any way going to add mess you up. As far as the podcast goes, Kelly's great, she's the mom of a kid with type one diabetes, you're going to love her. You're going to remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise. This is going to be one that you share. You're going to tell a friend about this one, I guarantee it.

Kelli 1:34
My name is Kelly and I have a type one diabetic daughter who is almost 12 and was diagnosed in May of 2015 2015. May.

Scott Benner 1:46
The year and a half about a year now. Yeah. Okay. So you confuse me when you talk to me sometimes through text because you mentioned your daughter, but then I sometimes you say your granddaughter and son grandson, excuse me. And then I see you in an image the other day and so don't look like you're old enough to have a grandson. So do you just what do you do you just click people on the road as you're driving down the road you take take them in or what's the deal?

Kelli 2:15
That's my husband said we had kids when we were 12. So we started early. No, I'm 43. Okay, that makes my grandson is he was actually born a month after my daughter was diagnosed. So he's about 18 months old. Oh, no

Scott Benner 2:28
kidding. Wow. That's odd circumstances. Yeah, so that's, you know, there. Wow. See, that's interesting to know, because you have a very, and I don't know what to call it. Exactly. It's not an average situation. Right. So. So you say you, your daughter or son has a son? How did that end up

Kelli 2:47
working? My daughter, my oldest is should be 24 on Saturday. Okay,

Scott Benner 2:53
so your 24 year old has a baby. As a baby. You're all like, yay. But your son has type one diabetes. Oh, my daughter, your daughter has si si Kelly. Here's the funny thing. Let's go backwards to go forwards for a second. You and I have set a record for the podcast. We have been trying to get you on for seven months.

Unknown Speaker 3:12
For a long time.

Scott Benner 3:14
We have scheduled and rescheduled. So I'm going to do my feeble minded favor, and I'm gonna write down daughter,

Kelli 3:21
daughter. I have two daughters, 124 and one almost 12.

Scott Benner 3:26
All right now I don't usually take notes. But this one has been so long. I genuinely have to read I have to go back over again. And so anyway, so seven months ago, you reached out and you were talking about puberty. And yeah, and type one diabetes and like, Oh, we're totally gonna talk about that. And that was September into the 60s.

Kelli 3:46
Yeah, we still don't have it figured out. So it's good.

Scott Benner 3:48
I was gonna say is your daughter a woman now maybe we don't have to talk about it's been so long. Why don't you tell me a little bit about what happened and how it's been going. Trust me, I'm pretty much in the same situation. Arden is 12 She just turned 12 Five months ago so I think we're fairly you know, in similar spot. So go ahead.

Kelli 4:12
A little bit of what happened with

Scott Benner 4:15
how the question of puberty came up and around type one diabetes and and what legend asked that, you know,

Kelli 4:21
her blood sugar's just I'm kind of noticing, like, I'm still noticing. They have like a monthly pattern, not necessarily monthly, maybe more like six weeks, where we go two weeks where she's so high and can't get her down no matter what. And then two weeks where she runs really, really low. And we won't even change anything during those times.

Scott Benner 4:44
And that's my sorry, I'm sorry. That's not something that's happened consistently. It just began at about what age

Kelli 4:52
it was. Probably four or five months after she was diagnosed. She was 11 she was 10 to 10

Scott Benner 5:00
Okay, all right. So all right. So you might say in the, you know, the onset, maybe you were in a honeymoon period that that went away. But it doesn't make sense if it's continuing on two weeks on two weeks off two weeks on. And so it's pretty consistent, like all the there's, does it? Is there any indication? Or is it just suddenly you have to kind of dial back via insulin, or dial it up?

Kelli 5:23
I still haven't been able to notice like a consistent pattern, like, some months, it will happen some months, it won't. And we'll also have like, two months, it'll just or two weeks, it'll just be perfect. That's where I mean, it's kind of more like a six week cycle. But it's not 100% consistent, but almost, would you makes any sense?

Scott Benner 5:44
Nothing makes sense. Because the diabetes, so that's fine. But it's so I would ask you this, like, as you're explaining it to me, I wonder, is it possible, there's no real pattern to it? But you're, you're, you're in firing pattern on it? Does that make sense?

Kelli 5:59
Um, I actually kept track for a little bit, the endocrinologist kind of had me keep track when I brought it up. And there was a pretty consistent pattern, but we would have like a random, you know, week or two thrown in there where it was just chaos.

Scott Benner 6:14
And so what do you do in that situation? We, let's say, you said sometimes things are perfect. So say you leave a you know, a perfect and by perfect, I'm assuming you mean, you use insulin, it acts the way you expect it to, etc. Right? And then let's say it all of a sudden, everything seems low all the time. But how do you handle that?

Kelli 6:34
Give her a lot of juice boxes. I haven't dared to change anything, just because I know that the lows won't last. So that's kind of why I reached out to you to try to figure out do I make like a temporary basil program that lasts for two weeks, and then another one for two weeks? Or do I just mess with it as it happens?

Scott Benner 6:55
Yeah, I you know, and it's funny, I think as you're saying it, I know what you're getting like, it would be difficult to say? Well, I'm definitely going to set up this Temp Basal rate for two weeks, because I've seen that in the past. And I think that's where maybe we all of us have, at some point or another, gotten hooked into the idea that there is a pattern to this. And we can just say, Okay, this two week, low things happening now. So I'll just set up a Basal rate for two weeks, I don't think that exists, I think that you could say, well, we're in this kind of space where loads are happening. So I'm going to set some temporary Basil is up, even if they're just for the next six hours, you know, like just to see if that does it. And if it does, and at the end of six hours, she starts going back down again, when the basil kicks back in, well, then, maybe I have to keep it going longer. But I think you're in a case by case situation, I don't know that you can, I don't see a way where you would be able to say I'm absolutely gonna set up a new Basal rate for the next 14 days, that doesn't seem like like it would be possible,

Kelli 7:53
or seem logical, but

Scott Benner 7:55
at the very least, you don't have enough actual data to make that kind of decision, like, you know, for the exact amount of time it's going to take, you know, like, you know, you're randomly saying 14 days, what if it's 15 days? What if it's 12 days, you know, like, you know, so, I mean, in my mind, so then it brings me to this thought, which is that some people are really uncomfortable making adjustments to their pump settings. And do you fall into that category? or No?

Kelli 8:21
Um, I'm getting more comfortable. I'm uncomfortable making any drastic changes. And I tend to just completely forget that I can do a temporary basil at all, or, you know, or stop a basil or

Scott Benner 8:36
you don't have that. It doesn't occur to you immediately.

Kelli 8:40
No, I forget completely.

Scott Benner 8:42
I understand. So do you have you guys use any kind of a glucose monitor?

Kelli 8:46
Yep, she has a Dex calm and she wears Omnipod.

Scott Benner 8:49
Okay. All right. So okay. I think that and if you've been listening to the podcast for any amount of time, I think that basil is more important than we have given it credit for historically, not that some people don't understand it. But I think that widely spoken about in public, not a lot of people talk about, Hey, your blood sugar's 120. But I'm afraid to Bolus because I think I'm gonna get low. Why don't I just up my base a little bit and see if we can bump it around a little bit. I don't think that gets spoken about a lot. And I repeat myself a lot here when I say that. When I excuse me when I interview people about their artificial pancreas and they started talking about how their artificial pancreas makes more adjustments through Basal insulin than it goes through Bolus insulin. That was just like a that was a watershed moment for me like that turned a big bright light on in my face. And I was like, wow, why am I not being even more so active with that? And then then you start thinking about your body and in general, right, like, there's no way you know, I don't have diabetes. There's no way that the amount of insulin my pancreas gives off moment to moment, all day long, is exactly the same every day at the same exact times. And so we've said have sort of this manmade situation where we said, look, we don't know how to let you know, I don't know how to fluctuate this, I'm not a paying race, I'm not getting signals from my body that says a little more, a little less. So we've picked an idea that, okay, we'll just put in this much at eight o'clock and this much at 10 o'clock. And that's going to be enough. But it really is just the beginning. You know, so from there, I think you need to train yourself a little bit to think about the Basal insulin a little more, which I'm sure you can do with no problem. And then from there, I think it's just a matter of how much time and effort you can give to it. Because, you know, you could spend your rest of your life moment to moment being your daughter's penguins. I don't think that's reasonable. But there are moments you know what I mean? Like, there are moments when you could more aggressively use Basal insulin to to make differences and changes. Does that feel logical to?

Kelli 10:55
Does it does I, and I will remember, like, two hours later and think, oh, I should have done a Temp Basal. But we're getting better slowly.

Scott Benner 11:05
For sure. And I will tell you this too. I hope this makes you feel better. It didn't. It's not like I flipped some switch on and started doing it. I forget sometimes. And I, I don't, it doesn't occur to me and other times, and there's just like you, there's, you'll look up 90 minutes later. And you're almost like, Why did I not think to do that? You know, like it would have been such a simple thing to do right here. And that the answer to that is, is you're not Oregon, you're a person, you know, I mean, it's, it's, it's fine. But at the same time, if you can make it part of your, you know, your day, I think it really does have a really grand effect on on blood sugars and stopping flux, like grand fluctuations. And I just use grand twice in two sentences after not using the word for 10 years. So she was kind of odd. And so what you know, I guess let's let's ask this, like, what do you think? Is it just life that gets in the way? Like, why? Why don't you think of it?

Kelli 12:02
Yeah, life, I think I'm busy. I just don't I mean, she's my youngest of five children. And I've got a grandchild that I babysit all the time. And I'm running around all the time, and it's never occurred to me, and I'm tired. I'm tired diabetes, mom.

Scott Benner 12:19
I'm exhausted as well. As everyone listening. No, I mean, listen, that makes sense. So maybe do this maybe say, I don't know, maybe, maybe kind of resolve yourself to start slowly. Like, definitely think about it for meals, you know what I mean? Then maybe start start with dinner and breakfast or something or something that you can, you know, something you can get ahead of, and when it doesn't work out, like don't beat yourself up over, you know, I tried to get up and look at Arden's blood sugar an hour before she wakes up. Because why, right, because you figure if she's, you know, if she's 150, and I mean afford to be 80, I could get her to 80 in an hour. If she's, you know, if she's 60. And I want her to be more like 90, I could probably cut her basil back or give her three quick sips of juice and banger up a couple of points and have her good waking up in an hour. Right doesn't always happen. You know, there are times that I wake up like everybody else can with timezone with. You know, and that happens. You know, so I wouldn't I wouldn't feel badly about I definitely wouldn't beat yourself up about it. I don't think there's a failing in any of this. I just think it's, I think you got to pick a spot where it's most valuable and start there and then see if it doesn't become part of just the natural way of how you think about things until one day 10 Temp Basal 's are like walking and you you're doing it you don't realize you

Kelli 13:37
were really good at doing a Temp Basal for soccer and track. So I've got that down.

Scott Benner 13:43
Okay, how do you do that? Tell me about it.

Kelli 13:45
Um, for her soccer practices, she tends to drop. So we Temp Basal her insulin off about 45 minutes before soccer practice. And then I turned it back on when she goes and she's usually okay. For a soccer game, her blood sugar goes through the roof. So I actually give her about 50% More starting about 20 minutes before her game, and about a half an hour into her game. And it doesn't always work. But we're still working on that one.

Scott Benner 14:16
Yeah, I mean, I think that I think that a Temp Basal to control what you think is going to be a spike. I would probably start sooner than 20 minutes. 20 minutes. Yeah. Because, I mean, honestly, I don't know what kind of insulin you're using to NovaLogic. So do you have a feeling for how long that insulin begins to work in her? Like when you set a Temp Basal at home? say she's, I don't know, say her blood sugar's 150 And you don't want to Bolus and you set a Temp Basal How soon do you start seeing that that does the Dexcom tell you she starts dropping?

Kelli 14:49
You know, it depends on the time of day in the morning it takes forever.

Scott Benner 14:53
Okay, well so then if it depends then if soccer is a specific example then 20 minutes so far hasn't been enough. I would start you know, some people will tell you an hour. I've heard you know, some people do an hour some people do 30 minutes and you'll trial and error, obviously. And hey, you know what, Kelly? Let's do it right here. Nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise Always consult a physician before making changes to your medical plan. Now we keep going. And so favorite part, it's got an basil story. That's pretty much most of the emails, I love hearing the dog snore, and makes me feel like I should just put a microphone in the dog snoring and start a different podcast. So but But nevertheless, like, you know, you can hold on a second gonna do Arden's pre launch Bolus with me. Hi,

Kelli 15:43
it's lunch for you. And we just ate breakfast.

Scott Benner 15:46
The time zones. So Arden had a really strange day, she got up in the morning, and we had to change her insulin pump. And she kind of hung out here for an hour doing. I mean, I'm not embarrassed, she was doing homework that she just couldn't get to last night. And so it was a good time to change her pump. She had a big bowl of cereal this morning and everything and so her blood sugar is good right now she's about 100 But she had a gym right before lunch at school. So So So anyway, so she loses her signal in the last like, eight minutes of gym so I can see it up until about eight minutes ago, but I'm a little concerned like I want her to test here. And then I'm gonna say test and she's gonna say Dad, I'm trying to get back to gym, something like that. Let's see what she actually says. I said tasks is going to be fun. Let's see how close I am to the truth. But you know, she got a significant amount of insulin this morning for the cereal and for partly because we ate cereal after a pod change so I was extremely aggressive you know there and, and so far so good. Like I said she hasn't gone over? Well, since we did the pod change. She hasn't been over about 120.

Kelli 17:02
Wow, you find when you change the pod, you need to use more insulin. Is that why you're saying you're aggressive?

Scott Benner 17:08
I say that? Yeah, I say that when you not just not just an Omnipod by the way, but when you change an insulin pump you stop the insulin for why like even I'm gonna go back at some point and say to you when you temp the insulin down for soccer. You're You're shutting it completely off. I would love to see you shut it mostly off but let a little bit run. Oh, she actually did test look at this without an argument. You know why? I think we got our tickets to something she wants to do. So she's like, I'm like super good behavior right now. Now we're gonna Bolus 10 units. Stand on a podium. Let's see. I'm going to put in Oh, I'm sorry, her blood sugar was 165. So it is go it has gone up since she got to school. So we're going to Bolus 10 units. And I'm gonna do 50% of it now. And the other 50% Over a half an hour because she won't actually get to lunch for 15 minutes.

Kelli 18:13
I'm always so impressed with how you do that.

Scott Benner 18:16
You just I'm on let me tell you a secret everyone listening should know I'm almost an idiot. This is just the one thing I figured. So otherwise, I bumped into walls and tripped over my feet and things like that. I'm going to ask you to text me from lunch. But she won't do it.

Kelli 18:36
This is the other thing as I listened to you do this all the time since my daughter is close to the same age and she's got her cell phone but she ignores me is a direct phone. She has an iPhone, she

Scott Benner 18:47
doesn't find my phone sends the most piercing irritating signal. And children do not like to have that go off at school it sets them right really quickly.

Kelli 18:57
I send that to my 18 year old son all the time.

Scott Benner 19:01
It really embarrasses the hell out of them. And so

Kelli 19:05
she's at school she's more she's okay with people knowing She's diabetic. She doesn't she doesn't need to hide it but she doesn't want to be interrupted. So we're still working on that and I've actually had her listen to little sections of your podcast and go see Listen, his daughter's the same age and she stopped and she did with her dad said Yeah,

Scott Benner 19:23
well two days ago I spent the entire day sending find your iPhone signals to her and she's like I'm not getting my texts and she wasn't I don't think like the delivered signal wasn't coming because the school has some pretty bad spots for cell coverage but there are times when I get the all caps what back when I'm talking like hey, how are you? And she's like, what number jeez, I'm already married. I don't need you yelling at me too. It's time to spend a couple of minutes with the wonderful folks who support the Juicebox Podcast by buying these advertisements so don't skip through them. Cut these guys a break their foot in the bill. First up on the pot can Say enough loving it right now more than ever. You're actually going to hear me tell a story at some point today in this in this episode about how Arden's kind of wavering about her softball, love, but that was six months ago. Right now she is in the middle of playing for the New Jersey State Championship in Little League for the 12 year olds. They're trying to get to the Little League World Series. It's very exciting. It's very hot, long days, doesn't matter on the pod is right there with her on her belly on her thigh. She wears it everywhere. And it is not in her way while she's whipping the ball around the field, and it's constantly delivering insulin. No matter what we can Temp Basal down we can Temp Basal up we can Bolus while she's playing. This thing is a lifesaver and it's out of her way. I can't tell you how important it is to be able to leave your insulin pump on while you're involved in a sport. It is super, super, super important. If you want to learn more about Omni pod, and I genuinely think you should, they're going to offer you a free no obligation demo pod. All you have to do is go to my Omni pod.com forward slash juice box you put in a tiny bit of information the next thing you know the demo pod is going to be arriving at your door and then you're going to be like huh Scott was right about this thing is magnificent.

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My daughter Arden is 12 years old actually she's going to be 13 next week, and she never sits still between school and playing right now in the Little League World Series tournaments trying to get the Little League World Series. She is running around with her friends when she's not doing that. The kid is out of her mind everywhere. She's always doing something. But even with her busy schedule, keeping track of her glucose levels could not be simpler. The Dexcom share and follow features allow us to be alerted whenever Arden's blood glucose levels leave the range that we set. That sense of calm and fantastic blood glucose control the Dexcom CGM helps bring into our lives is absolutely invaluable. So please don't wait. Go to dexcom.com forward slash juicebox or click on the links in your show notes to find out more. I cannot say enough about Dexcom. It is crazy how helpful it is. Let's go over this one more time. Softball school hanging with their friends. Moving moving moving, busy, busy busy, keeps track for glucose levels no matter what.

So when you're finished listening to the podcast, please go to dexcom.com Ford slash juicebox to find out more about the Dexcom CGM. And then after you do that, go to my ami pod.com Ford slash juice box to get your free no obligation demo pod. My gosh, lots of good stuff coming out of this podcast including my conversation with Kelly, which is going to resume right after this snappy music ends.

Back to soccer, I think you could do a longer one because you know in case anybody hasn't heard his talked about it before. What you're expressing by when my daughter goes to soccer practice her blood sugar falls when my daughter goes to a soccer game, her blood sugar rises might not make sense to some people, but it's adrenaline, adrenaline, and for some people, especially like I don't know if you would describe your daughter as you know, competitive by right. So when she's at practice, she's not trying to win She's practicing. So it's very anaerobic and her blood sugar's falling. When she goes to play a game, it's still anaerobic, but she's also trying to kill something, which you know, puts her fight or flight in and the adrenaline pops up. And adrenaline needs insulin. And so the big excuse me, the biggest problem with bolusing adrenaline is, is the minute the adrenaline leaves, the need for the insulin is gone almost instantly. So I've had some experiences with Arden where she's competing in something and we're bolusing like a significant amount before a game like bolusing not just baseline. And it holds your blood sugar at bay. It holds the debate holds it at bay, the game stops and we need carbs immediately. Yeah, really soon afterwards. Yeah. And so you know, you can hear that and see set say that that sounds like it's not a good plan, but it works. You just have to pay attention to it. You can't end the game and then just forget you know, you have to say okay, now I'm going to be watching again, having a glucose monitor. You know this that having a Dexcom makes all this much simpler because then you can be aggressive at the adrenaline. Keep a blood sugar closer to where you want it. And then when the fall starts happening, you can add a couple of carbs to catch it without overcompensating and etc. But but the other side of it is when you're talking about the lows for practice, I would say this, if you can find a way to do a temp, a decreased Temp Basal, that doesn't completely eliminate the insulin for practice. In my mind, that's better because you're in my body always has insulin happening. Right? So and so you know, if it works, it works. And don't get me wrong. I've cut Arden's insulin at times, sometimes I've made big boluses. And I thought, wow, that's way too much. And I'll shut her basil off for an hour to compensate for it. But if she's just out exercising and her button, her muscles are going and everything she needs a little insulin. So maybe instead of an I don't when do you set the office before practice how far before

Kelli 25:49
I kind of base it on where her blood sugar at a time, because her soccer practice is a horrible time of day. It's at dinnertime. So she usually has a pretty good snack before and then she'll eat dinner after so it's just kind of depends on where her blood sugar is. Sometimes I just set it off 50%. That's beautiful, you know if she's already running kind of high, but I typically try to do 30 minutes to an hour before practice. But then we turn it on. Her Basil is back on while she's practicing. Oh, I

Scott Benner 26:18
see. So you sort of you sort of restrict the insulin to cause an upswing in her blood sugar, and then put it back on to catch the upswing and hold her there through practice. See, what do you say you? You watch me do it and you're in your that was way better than what I said? What do you think?

Kelli 26:40
Well, we have that one down. Practice is pretty good. It's the game that we struggle with. So

Scott Benner 26:46
that's amazing. So don't listen to me. First of all, that's all and I would say, so. So what you know about how you handle practice? I think you just need to reverse engineer for other times. Right? Like, and you know what I mean? Like, and so I think the biggest impediment for any of us is believing that what we think is going to happen is going to happen. Right? Like how many times have you not Bolus and then an hour later thought I knew this was gonna happen. You don't even happen. It's constantly it's like I knew this was gonna go up, how do they not do something and that's a, you know, I think that's a hurdle to get past is to start trusting yourself and believing that what you're seeing, or what you've seen traditionally is probably going to happen again, and then lean on the technology a little bit if it doesn't happen, you know,

Kelli 27:37
with it with your daughter's game. My daughter plays competitive soccer. So the trick that comes with the soccer game is they practice for 45 minutes before the game starts. And sometimes she will drop during that 45 minute practice. So that's why I waited, you know, give her the insulin that I know the adrenaline spike will cause so that's where we have the

Scott Benner 28:01
even big gap right there. Yeah, it's

Kelli 28:04
the trick. The tricky part is that 45 minute warm up I was doing giving her the Temp Basal to make up for the adrenaline in the game, but she was dropping because of that practice beforehand. Sometimes,

Scott Benner 28:18
what's your what's your goal for blood sugar while she's playing? Like, what do you weigh? If it was if it was right where you wanted it to be? And you weren't afraid of it rising or falling? Where would you want it?

Kelli 28:28
She plays the very best when she's like 90 to 120 I mean, it's okay if she's 150 to 180. But she plays beautifully when she's 90 to 120 you can

Scott Benner 28:39
see her body working better and like running and like all that seems smoother and

Kelli 28:44
doesn't get tired. She says she plays defense so she never comes out. She plays the entire game. So

Scott Benner 28:52
difficult. I mean, listen, pardon play softball. And that's not the same. You know, it's the softball is more about the heat and the, the the amount of hours that go into it. Sometimes they play, you know, a good portion of a very hot day. And it's funny that we're sort of talking about puberty and that the sports are coming up to because because in my house very recently, I've been hearing the I don't know if I like playing softball, like chance, a little bit. Oh, wow. And so she really is changing like Arden is is, is turning into a lady. And so, you know, I think that it's possible that a lot of the things in her life are going to change, not just physiological stuff, but you know, where her likes and dislikes Dave and she, you know, she was telling me, she's like, I love playing softball, but then she started saying, I don't like going to all these wintertime practices. And you know, and it's, you know, it's this conversation about, you know, when people I mean, sometimes I think people hear you or I or other people say like, Oh, my kid plays a competitive sport. And they're probably like, my kid plays a sport and it's competitive and what you mean it's not record? Ah, all right, it's, it's, it's more intense or more time can consuming or

Kelli 30:06
the buffer is two to three times a week. 12 months out of the year, we do not get a break. And in between there, she plays basketball and she runs track. She's very athletic, loves her sport.

Scott Benner 30:18
Yeah. And it's funny because it's exactly how I would have described Arden four months ago, right, and she loves it. It's, uh, you never have to ask her to go. She's always excited to be there. She's happy while she's there. And she loves playing. And now it's she loves playing. But I think she wishes she could show up at the field five seconds before the game starts warm up and play. Like, and, you know, it's not that she thinks she's special or she's great. And she certainly isn't. And, and I think it's just that her her. You know, her interests are fragmenting and and so I do wonder if puberty how much puberty doesn't have to an effect on that, you know, and so but but but to her blood sugar's in puberty, it really is back and forth. I think we're very close to, you know, a time where we've that I've been, I'm hoping not to ever see, I think. I think that's I think that's coming. And I just mean it for blood sugars, not for anything else. But you know, I think it's coming in so far, you know, as I see her growing and developing, and she has out of nowhere required much more insulin, you know, for days at a time. And, you know, in a significant amount more than I've ever been accustomed to giving her in the past. And what I can say is this is that, whether there was one growth period where I think we went into an endo appointment in the end of September, and then we went back. Maybe it was the beginning of October, like mid October, because when we went back, it was in January. And in that period of time, Thanksgiving happened, Christmas happened. And Arden grew an inch and a half in 90 days. And I kept her a onesie at like 6.1. I mean, I'm telling you that when I got there, I sat down, I looked at endo straight in the face. And I said we're not the end, we never get to see the end of the nurse practitioner. And I looked her straight in the face. I assume Arden has an endocrinologist. I looked at nurse practitioner straight in the face. And I was like this is it. Hurry, one seat is going up. And I started telling her about besides all the holiday stuff, and the running around and being less focused on you know, bolusing and basil and things like that. I said, Arden has been growing like crazy, and her insulin needs are insane. And I think I figured out what to do too late. I told her she's going to take a drink. I said I think I figured it out too late. I think I haven't now but I figured it out too late. And she's like, Well, what do you mean, what are you doing? And I say I am just being ultra aggressive with with the insulin like, you know, I said if if the diabetes is aggressive with me and I'm, I'm twice as aggressive Brack with it, I'm just not accepting a rise. I'm not accepting a high blood sugar, it's high and sits there. And that's when I started really thinking about the idea of it being simpler to stop below than it is to affect the high and like that's when that all kind of hit me. And then she got her a onesie back. And it was the same it was six months. Yeah. And she she was just like, I can't believe that through a growth spurt over a holiday, you kept a one see where it was. And we just had

Kelli 33:29
that same situation last week. And but it did not turn out as lovely. Well,

Scott Benner 33:34
but you're also 18 months into it. When I was 18 months into it. Let me paint a picture for you. And this is for the person who texted me the other day or sent me a message the other day and said that sometimes the podcast makes them feel bad. So let me let me be very clear about how perfect I'm not 18 months into diabetes. I got artists a one C to move from like 9.1 to 8.9 that effort caused me to embrace the nurse practitioner in the lobby of the office and cry. So that seemed that was such an I was like I did it moved. And then I felt like I wasn't killing her and then all of a sudden I'm like, you know it so I've been a stay at home dad now for 17 years. It is it is always me and a bunch of ladies wherever I am during the day, you know, and so they're I'm in the lobby and my nurse practitioner is like Do you want a hug? And I'm like, I think so. And so there have been plenty of times. I mean, I won't if you're comfortable telling me what it didn't turn out not so great means to you. I think the picture I'd like to paint if I'm, if I'm right is is that you're probably literally years and years and years ahead of where I was at 18 months. So what happened?

Kelli 34:49
Well, it was actually better than I expected but it did move. Our scenario was we went on a cruise right after Thanksgiving and her blood sugar's were I mean, we had probably a 24 hour period where we were fighting 300 on that cruise and I still don't know why we were aggressive with the insulin, but it just would not move. And the whole Cruise was kind of like that even when we got off the boat and exercise. And then we had Christmas and she in Utah where we're from, I don't know, if this happens everywhere, but we have year round school. So they go to school for nine weeks, and then they're home for three. So it's kind of like a summer, and you know how their blood sugars are different during the summer. So she's also off track, and she's home. So we've got high blood sugars there, and then we got no candy from Christmas and all that anyway, she went from a 6.4 to a 7.1. So it wasn't bad, but I was expecting like, a nine. So I was happy it was gonna be

Scott Benner 35:49
23 You're like, that's it? It's over. Yeah, so

Kelli 35:52
we accepted 7.1 7.1 is still great. Oh, lovely. Yes. Yeah. But it did go

Scott Benner 35:58
up. I think that when I hope people don't misunderstand, I'm sure that some do and some don't. But when I say that Arden's a one, C has been between five, eight, and like six, two for three years, that the number is not important. To me, it's the consistency that I think is important. Right, right, like so because, like I've said it before, like, you know, I tell people like if you have a CGM, please don't set the high threshold line too high. Because, you know, then you're up and down. And there's too much variability, you can't react quick enough to stop the variability. And so when I say that her blood hurry, once he's in this space, my point is, is that once you get it, wherever it is, you can keep it there. But you know, like, when her blood when hurry, once he was nine, I had no trouble keeping it at nine, whatever I was doing was keeping it around nine, when I got it to eight, whatever I was doing a capital eight, when I got the seven, whatever I was doing, kept it there. And now that it's down to where it is, whatever I'm doing is keeping it there. And so it's a bigger idea. And at the same time, a very simple thought, like, you know, wherever you are, once you figure out how to stop the variability, the up and down, you can stay in that space, no

Kelli 37:08
matter what we're still struggling with. And I'm blaming it on puberty, that maybe I shouldn't be. Okay.

Scott Benner 37:14
So it's not puberty useful. But it is gotta be somebody's fault. Dammit, Kelly,

Kelli 37:24
not mine. Story of my life right there. No, so you know, we'll have a great blood sugar we are going from typically we go from a six. And then three months later, we're in the eights and then we go back to the sixes and the eight. So I was happy that we were just at a seven Sure. But I think it's part of it that I don't dare to make the big changes. And I don't that two weeks that I see those crazy highs. I'm scared to give her too much insulin, I'll give her you know, I'll give her more but I'm afraid to give her too much.

Scott Benner 37:56
Okay, so then that's where I would say to you not to oversimplify something, it's so complicated. But you do have to start with this simple notion. If your blood sugar is too low, you have too much insulin or you've mis timed it. And if your blood sugar is too high, you have too little insulin or you have mis timed it. It pretty much I mean, you know don't get me wrong if your pump falls off your blood sugar is high, because you're not getting it out. But within the in the in the concepts of this idea. When she's Hi, she needs more, it doesn't matter why. Like, you know, I watched this, I'm going to click on something I'm sorry for clicking while we're talking because I want to, I want to get something that I posted online until the directly talked about it. But But I saw someone speaking one time and they're like, I don't understand why my daughter's blood sugar is high. And she's talking and talking and talking about it. And I finally got on and said, it doesn't matter why figure that out later. Like I know you don't want it to happen again. But in the moment, it's too high. There's not enough insulin, whatever the reason is, is unimportant. And at this moment, like you know, we'd like to know, you know, for the future so we can stop it from happening again. And I think you're in that situation you get into a high sustained high blood sugar and you don't want to it sounds to me like you don't want to do the wrong thing and have a go the opposite way too far. But to that I say start with half. You know what I mean? If you're already doing half do a little more like big mix a Temp Basal increase with a Bolus, I find that can sometimes be a valuable way to move a high blood sugar.

Kelli 39:29
Yeah, I gotta start using those 10 Basal.

Scott Benner 39:31
Yeah, yeah, like because because think about it, right, like so say, like the the point we made earlier in the podcast, which is, let's say that you need a half a unit as your Basal insulin an hour at three o'clock in the afternoon. It's always like that, but all of a sudden, your blood sugar's really high, but you haven't eaten anything where you needed more Basal insulin then. So now you've got this high number, your bolusing at it, but you haven't addressed the Basal. So now the Bolus is just making up for the Basal it's not affecting In the high blood sugar, that I know makes sense to you, you and I have been talking long enough. Now you know more about this and you're giving yourself credit for I can tell ya. And so I would end up telling you, though I don't give advice on the podcast, if I was going to give you advice, I would say something to you after talking to you for 37 minutes and 48 seconds, I will tell you something that I ended up telling most people even when I speak to them privately, you really should trust yourself more. Just trust your gut a little bit. Like like that. And if I told you that, that ends up being the thing that I say to more people, and it ends up being probably the best advice they ever get. It's just at some point. When you're seeing something that doesn't make sense. And either what you've been told or what you're scared into believing or what your doctor has said, is conflicting with with the common sense of what you're seeing in the moment. You need to trust yourself at that moment. I sincerely believe that and when you have a Dexcom CGM, you can you can be a little more risky, right like because you've got a little bit of backup and can always leave you didn't have a CGM. You could test more you could there's things you can do. You don't have to sit and stare to 300. What do you think of that? You think you could do that?

Kelli 41:13
Oh, no, I couldn't do that. Yeah. Kelly, you

Scott Benner 41:17
had a baby. When you were 10? You could definitely do that.

Kelli 41:23
I'm from Utah, what can I say?

Scott Benner 41:26
So let's digress for one second. I'm from Utah. What can I say? So did a boy just woke up to and go Hey, you. Let's do it. And you were like, right, let's let's get married. Have a kid.

Kelli 41:37
Oh, they just say those people in Utah get married young?

Scott Benner 41:41
Well, I guess is it the mountains? What is it that what does it exactly? Do you think? It'd be the thin air? So okay, so I posted something online. I'm gonna go back maybe a week or so ago. And I totally put it up because I just I hope people feel more emboldened. Right. And so it is the 14th day. I don't know if you use the little mobile clarity app for Dexcom. But I love that little app like you open up the app. I'll do it right now.

Kelli 42:11
Let's I mean, on your computer on

Scott Benner 42:13
my phone, it's this little app, it's called, it's Dexcom. Clarity. But it's It's this small, kind of like, it's not the one for your computer. It's a companion app.

Kelli 42:22
And we all have no idea that existed. All right, I'll put a link

Scott Benner 42:25
in the show notes. So you click on it. And you say I want to view my data view PDF, and it creates a PDF file of the last 14 days of your blood sugar. So it gives you some information, right. And so when I, I just I just generated a new one, but the one I put online was from the December 22 to January 4 2016 to 2017. And Arden's estimated a one see in the app was 5.8, her average glucose was 119, give standard deviation, how many times I calibrated during you know, on average, the percentage amount of time she stayed in range and high, she was high 13.1% of the time she was in range 74.7% of the time she was low 12.2% of the time, it considers low, anything under I think 70 Because that's where I set it. And so I put this thing up, and I said, Look, I think you just need to remember a few things, be bold with insulin, bump and nudge blood sugars, Pre-Bolus. And then I added something that I just think is a new part of my mantra for me about diabetes. And in the end, what I said was I think diabetes is understanding the limitations of manmade insulin. Like I think it might be more that than anything else as I consider it. So if I don't understand what insulin will and won't do, then there's no real way for me to use it effectively. And that's a bigger idea. But you get that information back every day when you're using it. I did this and this happened I did this and nothing happened. You know, like, I Bolus now but her blood sugar didn't start moving for 25 minutes. And even though it seems like there's this endless, endless, you know, deluge of, of ideas that can change why things are happening, you know, different inputs that ruin you know, what you think is gonna happen? I think in the end, after you've done it enough times, it really does begin to make sense, you know, at five o'clock in the afternoon, it's different than visit eight o'clock in the morning that it is at two o'clock in the morning, etc, etc. But you do it enough times. And you just know, you know I walked into her room last night and her you know she had a tough time doing her homework before she went to bed and she was upset and her blood sugar started going up. And even though she was falling asleep I was aggressive with it. I stopped the arrow from going up I and I leveled off her blood sugar and and you know I got her back to like, I think it was 101 last night it sat overnight at 101 for a while. All right, about an hour and a half before she got up and started going up again, I thought I think this pumps done. You know, you know, I think the infusion sets done. And that's something to remember right that if you go all the way back to, I never talked about this, but I mean, I had Aaron Kowalski on from the JDRF, a long time ago. And in the middle of a very long conversation, at some point, he makes this, he makes a point to say that the cannulas aren't what they need to be. And he was talking about the industry in general, we need more research to make better cannulas because that's where so many problems come from. I was like, wow, it is where you stick this cannula in from from your pump. And at some point, you know, we call them family, we say they get occluded, or, you know, or whatever ends up happening that the the your insulin will crystallize inside the tube and block the flow, whatever the reasoning is, at some point, that cannula stops being as effective of a delivery system. As you know, as it was the minute you put it in, which is true across the board for every insulin pump. And so when I see Arden's blood sugar starting to go up for literally no reason that I can tell, and her pump site is going to expire in nine hours or eight hours or seven hours. I started thinking maybe it's that, and I'll give a big Bolus. And if it doesn't move the way I think it's supposed to boom, we're changing the pump. That's it, like don't mess around. But it took me years to get to that point. You don't I mean, like it just, it's not something I figured out overnight, you don't yank insulin pumps off like willy nilly, you know, in your first 18 months, they cost too much money, it costs money, and there's insulin in them and blah, blah, blah, and I don't want to and I don't want to poke my kid any more than I have to and all the other reasons that go into it. But eventually, you'll get to this calm place where you're like, look, the insulin pump cost money. But if I have to use three extra ones this month, or three extra infusion sets this month, to avoid a day and a half of high blood sugars, then what's what's the point? Of course, I'm gonna do that, you know? Right, right. And so and so that's it right there. I mean, I'm going to sit and talk in an episode coming up soon about that idea. But in the end, we have to understand the limitations of what we're using, whether it's the limitation of the cannula, or if it's the limitation of your insulin. But I think the biggest point of this, right now that I've hit on is it's it's the limitation of the insulin, like, if you don't understand how it works, then you're not using it as effectively as you could be. And so and you and that's a trust your gut situation. Yeah. Right. If you look at what you know, and believe it's going to happen again. And that's

Kelli 47:41
why I'm still trying hard to get there with that. But I think I just always, you defaulted to, oh, we must need to change the pump. And I default it must be puberty, puberty. Puberty is doing this, because we see those random rises that just don't make any sense to me. And I think is that puberty? Do I need to change this basil every day? Do I need to be taking note every day?

Scott Benner 48:08
And so what going back to what I said before? In that moment, short term, I think the answer needs to be doesn't matter why it's hard. There's not enough insulin, right? And if there's not enough insulin, because she requires more basil, because of the time of day, or because of the food you ate, or because the activity she's doing think even more if it's not enough insulin, because it's being restricted by the little piece of tubing that delivers it in then do it if if they the pumps been out in the heat, and now the insulin is not as effective. So you need more to make it work, then, in the end, the answer always is I need more insulin, right. And the reason is, in the moment meaningless. And to think that you're going to in that moment, go through all of these data points and make complete sense of this for the rest of your life is unreasonable. What I'll tell you is that over time, it will just all start making sense. So don't spend your time in this moment, trying to figure out something that, that in that second, you don't have enough information to come up with an answer, to keep living, keep collecting data, until one day it just all magically make sense. And I haven't said this on the podcast in a while, but I'm gonna go back to it. If you go at this diabetes thing with good intent long enough, at some point, just like in the matrix, which is now probably such an old movie that no one's ever seen it. I'm old. So I've seen everything slows down. And you have time to move out of the way of the bullet before it gets to like it really is it really will slow down at some point. And and you can't spend now beating yourself up about it to the point that by the time you get down that road, and you would have had all this this time in the simulator and this knowledge that you could have used that you've so beaten yourself up about it, that it's all lost on you at that point.

Kelli 50:00
You know, yeah, it all makes complete sense. The living in the moment part, you know, fixing it in the moment, but at what point, you know, with your daughter, you look at it and go, Okay, there's been seven days of this or eight days of this, I think I need to make a Basal change, or I wouldn't change the ratio.

Scott Benner 50:21
Well, so I would say this, then my answer to that is, I wouldn't go more than to make an actual change to a basil. I wouldn't let it go for six hours. I might not make it, I might not make a static change. I might not go into her settings and say now from eight to nine, it's this. Right? I might, I might just temp I Temp Basal con almost. I mean, a lot. A lot. Yeah.

Kelli 50:47
But to make that constant change to the Basal, you know, go into settings and fix it. Would you look at, okay, six days, you know, at 5am, all of a sudden, her blood sugar just started going up. So we must be having a growth spurt or as I don't know, whatever happens is 6am. Trying to make a change.

Scott Benner 51:05
I see what you're saying. I definitely do. What I can tell you is this is where I'm not very helpful to people. Because

Kelli 51:12
you just have a really good memory. I

Scott Benner 51:13
think, no, my brain doesn't work like that. Like I wouldn't say I can't look back and go I know this has happened over and over. And it's just a vibe. It's a feeling. It's like it's that idea where like, hey, this has been going on too long. You don't need me like I'm done. I'm done with this. And I've shortened my like, I've I think I've shortened my ability to to accept those high blood sugars enough that it hits me pretty quickly. I'm like, You know what, this has been two days of this. It's not the pump. It's not the insulin, she doesn't seem sick. Any of that all the myriad of reasons are out the window, she needs more insulin, it seems. Oh my god, excuse me, I embellished in a way that I'm pretty sure I'm gonna edit that out later. I'm I really don't edit much at all. But people if you hear like a gap of silence a second ago, I cut out a Berk. Excuse me. I just don't take I won't accept those high blood sugars. And by that I mean when she needs more insulin, I give her more insulin if it makes her low four hours from now I will deal with that four hours from now. I just

Kelli 52:20
how often do you go in and and change the settings in her pot?

Scott Benner 52:24
Across the board? PDM setting changes a couple of times a year.

Kelli 52:31
Oh, wow. So you just mess with the basil all the time for her even her

Scott Benner 52:35
insulin to carb ratios. Like, you know if I Bolus or something, you know that she's eaten before. And I don't get the same response out of it. And it happens again and again, then I just adjust her insulin to carb ratios to say that there's some sort of formula for how I do that would be an actual lie. So I just go in and I'm like, huh, her blood sugar was this, she ate this, her blood sugar went up 60 points higher than I thought it was going to. It took another I don't know, unit to get it back to where it supposed to be. So in my mind, that unit should have been in the initial Bolus. So how do I need to change the insulin to carb ratio, so that next time she has 50 carbs, there's an extra unit in it. So I use my I use my kind of data from the past to make a decision about that. I don't say that, you know, because a doctor will tell you, we'll move it 20% or move it 30%. Or we'd like to say that you should move at 8% or there's like, that's just guessing. Right, right. Like that's all just random guessing. Well, based on what I tell most of my patients all who's a one Cesar nine and a half, you know, we move at 8%. We move at 10%. Well, does that really work? Not really. But it's at least it's not too much. Yeah. Well, I don't want to move it too much either. And I'm not suggesting you should either. I'm suggesting that you know what happened? You Bolus X amount of insulin, they ate this meal, their blood sugar ended up at this high number. It took this much more insulin to bring it back down. Hence, that's the amount of insulin you needed. Somehow upfront. Maybe it was split between Basal and Bolus. Maybe it was just Bolus that's for you to decide. But that's the answer. Right?

Kelli 54:21
I want I think you're the diabetes whisperer. Yeah,

Scott Benner 54:24
not really. If, if I told you how I flunked out of eighth grade algebra, you would never listen to me because I just set up basically an algebraic formula about diabetes, right? If then this that, that kind of stuff. And so you know, take this in the parenthesis and put it over here, but it's really not that it let's let's simplify it down to dummy terms. Which is why people love my podcast because I sound like a moron when I'm talking. And so let's dumb it down, right? If your blood sugar goes up, you didn't have enough insulin. If you gave yourself more insulin, it went back to where it belonged. That's the total amount of insulin that that moment required, will need to add. Right? That's all just now what happened? You miss timed it. So if you put 10 units in for a meal, and they end up at 200, and you use two more units to get them back to where you want it, well, then the meal needed 12 units, you use the 12 units. And in the end, you got what you wanted. But had you timed the 12 units better? You never would have been up to 200. Right? That's it timing. It's simple. We've turned something it and now people are throwing their iPhones now, I don't mean it's simple, like, Hey, if you don't have it, it's simple. How do you not have it? It took me a really, really long time to come up with this. Like, this is not something I just sat down one day and said, Hey, my daughter has diabetes. You know what I think I think this, this, this and this, I It's why the podcast is important than me. Because because we do this all the time online. We give people just enough information for that one moment, then we put them into another problem later, no one ever just comes out and says, here's the collection of my thoughts. And that's why I think this is great. You know what I mean? Like I really do I, I'm genuinely thrilled when I get emails from people that like, hey, Ira, once he went down to points, like three months of listening to a podcast, or Elance, he went down two points. I feel so good about that, you know, in the end, to paint a really flowery metaphor. You know, we're all walking down the same path, and it's unlit. Some of us started before others. There is no reason why the people up ahead shouldn't turn back and yell down the path. Hey, there's a you're about to come up on a hole in the road walk to the left. You don't even like what that's just sense. It just it's common sense. It's, you know, I used to say this thing, always when I was younger, and I was philosophizing in my 20s I would always say and it's funny, it comes up with you, I would always say like, how many times does a 15 year old girl need to go on Maury Povich before 15 year old girls realize getting pregnant when you're 14 is not a great idea. Right? But, but the problem is, is that it's the problem. And it's the beauty of humanity is we reset every time every time there's a new generation, we reset we start over again, a baby comes out and don't know anything. And it's taught by the people who parent it. And they forgotten things or didn't learn some things or learn more than you know, think one things more important than another. But in the end, you don't get this complete data. You don't start with this imperial, you know, a book of lessons to start with. It doesn't work that way. But, and that's how life works. And that's acceptable. It doesn't have to work that way for diabetes. But if you stop and look at it does, you sit down with an endocrinologist who has been an endocrinologist for 10 years she's got a nurse practitioner has been at it for three years, she's seen some things that work and some things don't. But she hasn't really lived with it much. And she gives you this sort of scattered amount of information. And then you're supposed to weave it all together and turn yourself into a diabetes guru. And that's all well and good when I'm growing up and learning about the world and deciding if I want to be liberal or conservative or care about you know, people's feelings. Or if I just want to be out for myself or anything you have a whole life to figure those out. You do not have a whole life to figure out diabetes you need to you I want people to fast forward to the part where they go, oh, yeah, that makes sense. Let's do that. That's all that's the whole goal of the podcast. If everybody in the world that has diabetes emails me and says they have it, I'll stop putting the podcast. Until then,

Kelli 58:28
we're gonna do it's gonna take good luck. Good luck with that. Oh,

Scott Benner 58:33
well, it's a big goal. But you know, in the end, like, I do know that I hear back from Endo. Sometimes you're like, hey, I listened to the podcast. And that makes sense. And I don't know why I hold back that information from my patients, or I didn't know that or, you know, it just there's, it's no one's fault. And I hope I don't feel like I'm saying that the wild variability of being alive and having a having this disease and manmade incident blob and all these other points, right? But, but I just hope that I just hope that you get off the phone. You're not on the phone, but I hope you get off the podcast and you say, You know what, dammit, I'm going to do it. And then just do it. Because really, it's the only thing between you and that there's a next step. You're right there. Like I've spoken to enough people like you to tell you that you are on the other side of a paper door. All you have to do is walk forward and you'll be on the other side of it. But honestly,

Kelli 59:29
I'm gonna do it. I'm gonna remember the basil, Temp Basal. Well,

Scott Benner 59:34
everything, just boom, just keep the consistency of be bold, use the technology. You know, understand the limitations of the insulin. You know, when you figure them out, apply them. Don't accept high blood sugars. Be careful the lows test when you're not sure. It's, it's pretty much it, you know? Just do it. Do it. We can't say that because I believe that's copyrighted. But probably, yeah, that guy with diabetes podcast rips off Nike

Kelli 1:00:11
do it. How about that?

Scott Benner 1:00:13
I think it's just this Be bold, like, just be bold. And you know what to? We're coming up on an hour. And I've talked way more in this one than I intended to, and I apologize for that. But I haven't done this in a few weeks, I get a little. Yeah, I get a little, you know, I talk too much. But I heard from somebody recently who said, I'm with it. I've been bowled with insulin as an adult, not a parent. And but they had a low, like a scary low from it. And, and I said, Are you going to be able to keep going? And there's like, I'm figuring it out right now. And that's a different world when you're when you're an adult, living alone. It's different. You know what I mean? Like it is it's different? Like, can I be that aggressive? If there's no one here to be my backup? And I don't know the answer to that. And I think maybe the answer is, it's more difficult. Or no, or I don't know, it's, it's not my situation. But I get that that's the situation. But when you're in this, in this space, where you're the caregiver of somebody with type one, what my hope is, is that this aggressive nature, will carry you through to when the technology can now make these decisions for you. And I do think that's coming. I mean, probably sooner than later. But you know, the idea of artificial pancreas or you know, an omni pod and a Dexcom CGM working in Congress with each other, to keep your blood sugar from getting too high or too low. It seems to me from everything I've seen so far, that that's a very real, not not a long off idea, you know, so until then, let's, let's let's not accept, like poor health, you know what I mean? Like, let's do our best not to accept that it happens. Like you said, you dust off and you keep going. But you don't, you don't have to sit and stare to 300 blood sugar and just say, Well, I don't know what to do. My my endo said to wait three hours and Bolus and test again. Like, I don't know what that means.

Kelli 1:02:07
You know, that's actually that was one of the things I was going to ask because when I just went to the endocrinologist last week, you know, when they pulled up on my data, and they're looking at it, and they said, Why did you correct after it had only been an hour and a half since your last correction, because I'm trying to be bold with insulin, we were stuck at 312. I remember the exact number. And then an hour and a half, we had not moved. So it makes sense to me to give her more insulin. But I got a little lecture on that while I was there. Why do you think I just said, you know, the insulin was stuck at 300. It hadn't moved. Why would I wait another hour and a half for that blood sugar to come down? But she gave me a little lecture, but I I did ignore it. I just ignored her.

Scott Benner 1:02:51
We can't say outright that it's okay to ignore medical advice. But I think you did a great thing. And so yeah, I listened. I ignored

Kelli 1:02:58
her for the situation that we were in because I knew what I did was right. And I think that that's where we're at. I have I mean, I love our endocrinologist and I love the diabetes educator, but they just look at the data that's printed in front of them. And I can remember the exact situation. You know, they looked at one morning, it had been my husband who had done it and they said, Well, why did he give her a unit and a half, he should have only given her a half unit. And I said it well, because she'd been high all night long and it hadn't moved.

Scott Benner 1:03:28
If we follow what you're saying. We might as well just give up now. But thank you. And it's just listen, they're not there. Yeah, sure. I don't have diabetes.

Kelli 1:03:39
She does not one of the diabetes educators that we meet with does but the other two I've met with,

Scott Benner 1:03:45
do you think that are what it tells you? Why do you why did you Bolus again? Probably

Kelli 1:03:49
not. Okay. This is actually the first time anybody has ever really questioned why we have done but I have gotten a lot bolder with insulin in the last little bit because I'm tired of the highs and she's tired of them. She doesn't feel good when she's high.

Scott Benner 1:04:06
Now, listen, you have to be cautious and careful. Well, I mean, I could it's not my job to put a disclaimer everywhere in the insolence dangerous, you know what I mean? But it's also the situation you're in. So I mean, he, I think you need to make the better of it. And not, maybe I'll never make the best of it. It's not that easy, but, but you can't just it's just a strange idea. Like, I don't know. I got my foot caught in a bear trap. But the guy said he's gonna be in here in five minutes. Take the bear trap off. It's been an hour but I mean, you know, he said he's coming, but he just literally I don't know what what are you saying? Take the trap off yourself. reach down and grab it and pull it off yourself. Like why? Why? Because it might snap back and cut your finger off though. It's already cutting off your foot. Like, you know, we're acting like there's Everything's perfect. And you know, it just doesn't work like this. It really doesn't. I wish it did. I wish the diabetes was something that someone could give you static information about It would always make sense I wish it was you have high blood pressure take this pill in the morning.

Kelli 1:05:05
And you know when I when I left the hospital when my daughter was diagnosed that's what I thought. I thought okay, the ratios are this the basil is this we got it. This is easy. I woke up from that dream world in about 24 hours.

Scott Benner 1:05:21
All right, so keep stay awake, and, and keep going. I really should ask you if there's anything else you want to say since I spoke over most of your time.

Kelli 1:05:30
I think we covered it all. Excellent. Everything on puberty? Puberty. You've got your title right there.

Scott Benner 1:05:41
Yeah, I might. I might go. That's not bad. Because the other idea was it took me seven months to get Kelly off podcast to go with

Kelli 1:05:49
that, too. I know. I'm just gonna stay at home mom was nothing to do. But yeah, I'm kind of busy.

Scott Benner 1:05:53
There was so many moments where like, oh, we can't do it here. We can't do it there and can do. I'm having shoulder surgery. This happened in my life that I was like, this woman by the time she gets on don't get a cure diabetes.

Kelli 1:06:04
That would have been nice.

Scott Benner 1:06:07
All right. Well, listen, that moment they carried on have you back? Okay. Well, thank you so much for doing this. I really genuinely appreciate it. Yes, thank you. This episode ended up being so amazing. I can't believe it took this much time to put on seven months of trying to get Kelly on the podcast. Then I recorded it and I sat on it for six more months before I put it out. I feel I feel bad. But there was other stuff that had to go up first. If you're enjoying the Juicebox Podcast, please tell a friend the most valuable thing you can do to help the show, tell a friend show them how to get a podcast show them how to subscribe. Now beyond that, if you're really feeling good about the podcast, go to iTunes leave a rating and a review for the show. But I just can't say enough about how difficult it is for some people to find podcasts. So if you can share on social media, hey, I was listening to the Juicebox Podcast said with a link you can link to juicebox podcast.com. Or you can link back to iTunes or link back to Google Play or wherever you're listening. That would be monumentally helpful, and I would really genuinely appreciate it. Thank you very much Dexcom and Omni pod for sponsoring the show. You can go to dexcom.com Ford slash juice box to find out more about Dexcom and their CGM. And you can go to my on the pod.com. Forward slash juice box to find out more about the world's only tubeless insulin pump. One last thing I tried very hard to respond to everybody's emails and notes on Facebook and Twitter and everything and I think I get you all but in case I don't. I just want to tell you how much I genuinely appreciate hearing about your successes. Your good feelings about the podcast all that stuff means the world to me, please keep sending those notes. I really do enjoy getting them. All right. We'll be back next week with another episode of the podcast. Hope you guys are having a great summer