#1254 What Kind of Influence

July 16, 2024Scott Benner

A mother shares managing her 8-year-old son's recent type 1 diabetes diagnosis, discussing the challenges of maintaining tight blood sugar control while balancing her husband's more lenient approach and the impact on their family.

You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon Music - Google Play/Android - iHeart Radio - Radio Public, Amazon Alexa or wherever they get audio.

+ Click for EPISODE TRANSCRIPT

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

Scott Benner 0:00
Hello friends, and welcome to episode 1254 of the Juicebox Podcast.

Today I'll be speaking with the mother of a type one who is also the wife of a type one and her husband's not great about taking care of himself, and she's worried it's going to rub off onto her child. 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. When you place your first order for ag one with my link, you'll get five free travel packs and a free year supply of vitamin D. Drink ag one.com/juicebox Would you like to help people who have type one diabetes maybe even yourself? Will if you're a US resident who has type one or is the caregiver of someone with type one, filling out and completing the survey AT T one D exchange.org/juice. Box will in fact support type one diabetes research. T one D exchange.org/juice box complete that survey you'll be helping after you fill out that survey save 30% off your entire order at cozy earth.com with the offer code juicebox get yourself the same joggers I'm wearing right now. The sweatshirts the shorts the shorts are saving my summer can be serious for a second cozy Earth shorts are saving my summer get 30% off with the offer code juicebox at checkout. Did you know if just one person in your family has type one diabetes, you're up to 15 times more likely to get it to screen it like you mean it. One blood test can spot type one diabetes early tap now talk to a doctor or visit screened for type one.com For more info. Today's episode of The Juicebox Podcast is sponsored by Omni pod and the Omni pod five. Learn more and get started today at Omni pod.com/juice box.

Emily 2:05
Well I'm Emily I am a 43 year old mom to a type one and new type one diabetic and wife to a type one diabetic as well. I'm also a full time nurse practitioner specializing in nephrology.

Scott Benner 2:22
Okay, so let's get my notes here. She said you're 43

Unknown Speaker 2:26
I am.

Scott Benner 2:28
I've turned 50 yesterday. She doesn't look Thoreau says you say you're 43 your husband has type one. He

Emily 2:35
knows how long have you guys been together? Say we met as ER nurses and 2006 and we got married in 2009. Okay, so

Scott Benner 2:47
20 years, about 18 years.

Emily 2:51
I'm on my lunch break. I'm not doing that.

Scott Benner 2:56
See? 1820 years you guys been together? Has he had type on the entire time?

Emily 3:00
He has not. Ah, would you actually you want to start with that story? Yeah, please. Okay. So like I said, we were both ER nurses. When we met actually, I believe he was a nursing student. He's a little younger than me. Oh, and he is 40 now, but he we were planning on getting ready for our wedding. And we were both Night Shift Nurses and he was starting to lose weight. He was working out. He was drinking lots of water. And I noticed he was urinating a lot. And I'm like, you know, you're dropping away pretty fast. Like I've dropped one pound you dropped in what's going on? And he's like, oh, you know, it's purposeful. I'm drinking lots of water. One of the bathroom a lot. Well, the night of our wedding shower, which my bridesmaids had made cookie thing. I noticed he was just urinating like crazy. It was like two or three in the morning. Like cleaning up the kitchen making room for all the new kitchen things and I'm like, You have got to check your blood sugar. And he was like, No, I've just had a lot of water and I was like this is more than a lot of water. So his mother at the time had it was a pharmacy tech and whenever things get expired in the pharmacies, they tend to throw them away which is probably a whole other podcasts we could talk about. So we had accrued multiple glucometers that were just like expired and opened that she had brought to us so I come up in the cabinet get one out check his sugar in it read high and he's like no it's expired. It's not any good. So I checked mine and it read like 80 and he so he's 26 years old at the time I don't think I mentioned that check his with a different one. Like I said we had a crude multiple ones. And again at red hot and I was like alright, let's you know put clothes on we're gonna we're gonna go figure this out. So he was not in DKA he had a blood sugar somewhere and the for hundreds, I don't remember exactly how hot so they basically made sure he wasn't in DKA checked his labs. It was we we went to the ER we worked at, and they gave him some IV fluids, and we called endocrinology the next day and started insulin.

Scott Benner 5:14
Before we keep going, is your microphone on a wire? It is not, is that you're using the one on the laptop?

Emily 5:23
No, I'm using headphones

Scott Benner 5:25
using headphones. But there's a microphone on it. Can you put it closer to your mouth for me?

Emily 5:28
Yeah. I can also find me to just

Scott Benner 5:32
feels like you're turning, it almost feels like you're turning your head away from the mic at times. And it's you're kind of going

Emily 5:38
I am fidgeting a lot. So that's okay.

Scott Benner 5:41
Just fidget towards the microphone. Did you at any point during this process? Think I'm gonna take my brand new Cuisinart and get the hell out of here? Or did you love them by that?

Emily 5:49
You know, I don't it never crossed my mind. Really thought like, alright, you know, it's one more thing. We're medical professionals, we can handle this. It's not a big deal.

Scott Benner 5:58
Okay, so did it end up being a big deal? And could you handle it?

Emily 6:03
I could handle it. So it's really funny. He had a horrible, horrible diet, he would say he was raised on cocoa and Little Debbie. So I'm very much a type A person. So I kind of kicked in that type A personality started controlling all his meals. Because a Wednesday went from I want to say it was summer 1214. down to six, something about the next check. But shortly after that I released control because I had a your I like to tell him this on a regular basis. You're a grown ass man and a medical professional, you can handle this. So that was the last time we saw a six something a one see, he

Scott Benner 6:42
can handle it. So I'm still I took a note here from your husband was like, if I just drink a lot of water, I'll lose 10 pounds. That's what I learned. Yeah,

Emily 6:51
no, that's not how that works. No, unfortunately.

Scott Benner 6:56
So he goes, so you put it, you know, I mean, listen, I'm not saying put it on him like you put it on it. But you know, he gave his control back to him. Yeah, he didn't do well with it. From the very beginning, your kids mean everything to you. That means you do anything for them, especially if they're at risk. So when it comes to type one diabetes, screen it like you mean it now up to 90% of type one diagnosis have no family history. But if you have a family history, you are up to 15 times more likely to develop type one, screen it like you mean it because type one diabetes can develop at any age. And once you get results, you can get prepared for your child's future. So screen it like you mean it type one starts long before there are symptoms. But one blood test could help you spot it early, before they need insulin, and could lower the risk of serious complications like diabetic ketoacidosis or DKA. Talk to your doctor about how to screen for type one diabetes, because the more you know, the more you can do. So don't wait, tap now or visit screened for type one.com to learn more. Again, that's screened for type one.com. And screen it like you mean it

Emily 8:17
has moderate control. And I think a lot of it, he doesn't listen to your podcast, I feel okay saying this was it was such a lifestyle change, which I know everyone who experiences diabetes at any time. Once you accept it, you realize that but he truly had a the best way I can say it isn't like mortality kind of kicked in. And he had a lot of you know if something goes wrong in the world or whatever, like, that's it like if I don't have this insulin. That's it for me. And it has been I would say that still in the back of his mind, you know, almost 20 years later that this is still making life a little less easy.

Scott Benner 8:58
You're saying that he's fearful of a flood coming? Power outage? Zombie, something like that. Yeah.

Emily 9:05
It's hilarious that you pick zombie because he had a zombie fear when we first met.

Scott Benner 9:12
You just data them anyway.

Emily 9:14
Yeah, why not? Yeah.

Scott Benner 9:16
I don't know. Emily, we're gonna start wondering about you in a couple of minutes if this story keeps going this way. No, I that's interesting. Like that feeling because I see people talking about it online all the time, like that fear of like, what if something happens? And I just recently said somewhere that my daughter and I had this conversation because she asked me at one point, you know, what if something happens, like what if the world gets upside down? I was like, Oh, you'll be dead pretty quick. And she, you know, did she's like, what I was like, come on, you know, right. And you know, she was older when we were having the conversation, but I think it was valuable for her to hear. And I actually told her I said if this really happened, we you know, manage with your insulin as long as we could. We'd stretch it out. Start aiming for higher blood sugars like you know, start thinking about like light including a life, that kind of thing. you'd stop eating carbs. And I was like, but eventually one day if we ran out of it, yeah, I mean, that'd be it, you know? Yeah. And so, but I don't see her hanging on to it and worrying about it. But you think it's something that's with him?

Emily 10:12
Yeah. And it may be maybe the age thing, I don't know. Or it may have been his personality to start with the kind of doom and gloom. But I definitely hoard things like not insulin as much as I can, but also like, beef jerky, and things that if we did have an emergency that he could eat, and now our son,

Scott Benner 10:34
yeah, so so it's been a while now he's had type one for a while. I mean, the are you comfortable sharing what his a onesies are generally? Or do you not even check in with him?

Emily 10:42
So yeah, I actually know his most recent one from last week, it was eight. Okay,

Scott Benner 10:46
and now for you. If we put you back in charge of him, you okay with an eight? No, I'm not okay with that. And then your son's diagnosed when

Emily 10:56
he was diagnosed this past August, recently. Okay,

Scott Benner 10:59
so that's not long ago, six months ago, maybe? Okay, how old is your son?

Emily 11:06
He's eight. Now he was seven when he was diagnosed.

Scott Benner 11:09
Do you have any concern that your husband is going to impact him to an aid agency? A lot of people in my private Facebook group talk about their love for Omni pod five. Have you seen those posts and thought, Well, I wish I could have that experience with an insulin pump too. If you answered yes to that you might be experiencing FOMO FOMO FOMO. Yeah, you guys got me all twisted up on this one? I think it's FOMO fear of missing out on Omni party. It's FOMO. All right. I'll keep going. Symptoms of FOMO may include but are not limited to wishing you could wear outfits without pockets or dreaming about walking past doorknobs without getting your tubing caught. Maybe you fantasized about jumping into a swimming pool without disconnecting from your insulin pump first. Good news. You don't have to suffer from FOMO. any longer. You can see what you're missing by trying Omni pod five for yourself with my link Omni pod.com/juicebox. No longer should you have fear of missing out on Omni pod?

Emily 12:12
Um, yes, it's a complaint argument that we've actually brought up to his pediatric endocrinologist in the past, because we do argue about tight control versus the fear of low blood sugars. And apparently, it's very common for type ones who have experienced the roller coaster and the frequent lows to fear the low and wear me specializing in ethology and knowing what it will do long term to the kidneys. I want tight control, good steady control. And he is more willing to let the blood sugars to get much higher for much longer than I am. And it I wouldn't say it's a battle, but it definitely can, can bring up. You know, we're still new to it with our son. So it can bring a lot of what do we do we treat this do we watch this? What do we do for this? There's a lot there's a lot more discussion than probably most parents actually have.

Scott Benner 13:08
Yeah, well, that's really interesting. So the diagnosis of your son did not take your husband's perspective and change it. He just shifted it onto your son. So while you're out there going, I think we should maybe do better. He's saying no, this is okay. Correct. How long do you think it'll take? Because this is your husband is is embroiled in a psychological turmoil right now? Yeah, you will eventually get out of but I will say that the most common thing that I hear from people is that I finally did better for myself for someone else. Like right for like, I love my wife. So I did better. I didn't want my kids to see this. So I did better. Like that's what really commonly hear from people. So you're just very new at the moment. Why did you find this podcast?

Emily 13:56
Again, that type A personality the minute he was diagnosed, I went online, I started Googling from tic TOCs Instagrams app, just sort of following people left and right type one moms, type one kids, like how can I make this better for him? And went on podcasts because the pediatric hospital that we took them to was about an hour away. So immediately, I started looking for podcasts just for the drop, and found it.

Scott Benner 14:22
I mean, what's your son's a one, so you can I ask?

Emily 14:25
So he was 7.9. And there's a little story behind that. But he had the flu last month, so we had a lot of a lot of trouble keeping him down. In December

Scott Benner 14:35
while he had the flu, that was he managed with MDI or a pumper, and that's for both of them. He's

Emily 14:41
NDI right now. My husband has Omnipod but he has been MDR My husband has was in the eye for a long time he was on the original Omni pod. And believe it or not, even as medical professionals, our insurance is pretty crappy and the cost of Omni pod was I think we still owe the money to be perfectly honest, it was outrageous.

Scott Benner 15:02
Like we still have the money. But does he ever CGM?

Emily 15:06
He does right now for a long time he was on labor, right? We were paying like $75 a month for the labor. Right? And then now they're both on Dexcom sixes.

Scott Benner 15:16
Do you guys work for the same hospital? Still? We

Emily 15:19
do not. My nephrology practice is actually privately owned. And we are consultants at hospitals. And he currently is at a different hospitals system for an urgent care in the same town. Well,

Scott Benner 15:30
so you, you both are medical professionals, but your insurance doesn't cover, like, give you good coverage for devices.

Correct? Oh,

that's nice. You know, that's a decision that your employer makes.

Yeah, yeah.

Have you ever tried talking to them about it? So

Emily 15:50
once I finally got my son, so my husband carries his own insurance, the rest is on mine. We've recently crossed covered him on both of ours, but my son's CGM got covered completely. Once I've thought the insurance company because they originally had denied it. But my husband was actually working for an emergency department and the coverage was horrible. That being said, I don't know how much work he I don't think he put any work into calling the company and getting the prior authorizations and things that probably should have been done that I did the minute I got the denial. So a lot of that I put on him. I don't know how much is what the insurance problem is versus what just the lack of

Scott Benner 16:33
work. You said, Do as I say, not as I do example.

Emily 16:38
I was gonna say he's a do as I say,

Scott Benner 16:42
Well, if you would tell him he would do it, by the way, but you stopped telling him? Yeah,

Emily 16:46
I think I've told him more than once. And you know, back to the euro grown ass man. situation. So I'm

Scott Benner 16:51
letting it go that You've robbed the cradle here. Emily, I'm seeing what's happening here. You guys have just the one kid? Are there others? No,

Emily 16:58
we have an 11 year old daughter. Oh, okay. So

Scott Benner 17:02
is that autoimmune running your husband's side of the family? He

Emily 17:05
has a cousin who was type one, I do not know of any other family members with autoimmune problems whatsoever. Now I have celiac, okay. And multiple family members who also are celiac. And actually, when we were pregnant with our oldest, he had asked the OBGYN You know, what are the risks of our child having type one? And she said that since I was not a tough one, it was a low risk.

Scott Benner 17:34
About that. Yeah, maybe what she meant was, Oh, you already had sex made a baby. Why are we talking about that? too? I know. It's too late now. Exactly. Oh, my gosh. Interesting. So my first thought here is if your husband and your son's a onesies are matching. So specifically, my expectation is it's just the rhythm of your household that leads to that eight,

Emily 17:56
they have completely different diets really? Well, my son started at an agency five months ago say once he was 12.9 I believe. Now it's still coming down. It's still coming down. And his his endocrinologist doesn't want us tightly controlled yet, much to my dismay.

Scott Benner 18:14
Does he think he's honeymooning? Yes, he is honey money. Okay, fair enough. But, but listen between you and me a seven, nine and just turn up the basil a little bit? You know, maybe it'll be a seven.

Emily 18:27
He does have a very weird insulin. I don't know, I just thought a reaction, but I'll go into it in a minute. But um, it's weird. So I play with insulin a lot. And there was no chronologist as far as like her again. But I adjust it based on what he's doing on a regular

Scott Benner 18:43
basis. Good for sure. The algorithms are adjusting constantly. Yeah. I mean, from a basis of a good of a, you know, a starting point of a good setting, of course, but they're still adjusting up and down all the time. It's it's almost never ending. So you know, to say, Me my experience, raising Arden on MDI and then just the pomp and then eventually a CGM became a thing. Like, it's not like I got it. Finally, it's like it came into existence. And then, you know, we started doing that. Then it took me a while after I had a CGM to like, look at what was happening and make sense of what was going on. But, you know, even once that was all together, you're still you know, I mean, there's a pretty big aspect of the Pro Tip series where I talk about Temp Basal going up and down and, you know, bumping and nudging because all I was really doing back then was I was being my own algorithm. You know, I was taking it away to all those. Yeah, right. That's all you're doing. So like, now I watched the algorithm do it on my Ha, sucker. Let him do that. Not me. Yeah, that now that him has a little app on her phone, you know, right. It sounds like you'll get there. But my question is, how long are you going to not say anything? Once hubby starts saying stuff that goes against what you want to do for your kid. That's gonna be a bad day.

Emily 20:06
So the I won't let me think of an example

Scott Benner 20:11
I'm gonna hold it in and go Axe Throwing, what is it you're gonna do, I'm like, because it's gonna happen, like, you're going to titrate his agency down, right? And it's gonna get into the sixes. And then you're going to you're going to know though, the work that goes into that. And then one day, there's going to be a rise in a blood sugar. And you're gonna say, How come you didn't Bolus and he's gonna say he's fine. And then you're gonna go, Whoa, and that's gonna be the end of it, then fists are not fists, you probably won't hit anybody. He seemed like a nice, but like words, at least, or upsetness. Like, it's like, I want to get ahead of this for you is what I'm saying? Well, okay,

Emily 20:41
so it's already happened. So sorry. I don't even know how long ago this was. It was maybe October, November. So he was diagnosed in August. So I had actually slipped away my husband, I believe was at work. And I had gone off to do something and my daughter comes up to me, and she says, Ben's alarm is going off. And he keeps ignoring it and saying it's fine. And so we've taught her kind of everything that she needs to know to help out. She's very bright and very helpful. Firstborn. So she knows she knows what to do in an emergency. She knows you know, what an alarm is, like, what? She just knows everything that needs that she needs to know, at 11 years old. So I came out of out of my room, and I was like, you know what's going on, but and he was like, it's hot. No big deal. It'll come back down. And I was like, huh, ha ha, like, What do you mean, it's hot. And I snatched my phone up, and it was high 210 to 300 arrow up, and I was like, okay, so what did you eat? Why did you eat without insulin? And what do you mean, it's fine? And he said, well, that says it's fine. He does. This is not a big deal. And I was like, Well, absolutely not. So I made it like, that night. I was like, Look, Bill, Ben's already assessed my son, this name has been on the bins already picking up on your behaviors. So you're gonna have to change him. For this. It's going to be a much bigger battle.

Scott Benner 22:06
Yeah, I don't think he's going to enjoy living in the garage at all. But if I was him, I'd shift now. Yeah, he's just all I could think of when you were talking about like, this is where this is gonna go. And someone's gonna win and My money is on you. So

Emily 22:22
yeah. So my husband's a Wednesday, you know, I don't, he doesn't need for all the diabetics listening, do not take this as advice whatsoever. He works 12 hour shifts and frequently drinks coffee and does not eat at all and a 12 hour shift. He says his blood sugars are better when he fast and but then he binges once he gets off work late in the evening. And that is why his control was poor, in my opinion, if he would schedule regular meals and have a routine, because he doesn't work every day. So that's not a routine, I think that control is much easier.

Scott Benner 22:57
See Pre-Bolus thing is meals.

Emily 23:00
Not in the way that you think of it. I don't think he Pre-Bolus Is anything because he doesn't plan. Because usually by the time he gets home, you know, we're all asleep, even though it's 839 o'clock at night, but you know, he may go back Chipotle and get a burrito bowl or something. And then he'll sit down and he might give himself a few units and kind of see what happens. But then he'll get up and get chips and salsa or something like that. And then he'll give himself a few more units while he's eating that. And then I'll get up at four o'clock in the morning and I will hear his Dexcom going off on his phone almost every morning alarming. And I'll be like, Is it is it higher or is it low? And it's 95% of the time it's high. So

Scott Benner 23:43
taking us take out for a minute that you're I'm assuming you love him and you know that you care for him and all that stuff and you don't want there to be a bad influence for your kid. Go into your training, though, isn't nephrology? You know, in nephrology, like, are you not worried every time it happens? This is like not eating you up inside.

Emily 24:01
So actually brought home a urine just in the fall. Or maybe it was late summer and I was like there's I don't know if you know this. You probably do but protein in the urine shows up a lot of times as bubbles. I had noticed bubbles in the toilet. And actually I think it was coming from our son, not him because it was pre diagnosis. But I said there's bubbles in the urine and I want you to do a 24 hour urine before you're one of my patients. He ended up not doing a 24 hour urine, completely ignoring me and I got mad and threw it in the trash. Yes, I watch his lab. They'll watch his kidney labs very closely. And I tried to explain to him as I do all my patients that that sugar is damaging even at good control. You know you're gonna have some damage from the ups and downs and it's delayed. That lab result that we're looking for is behind the ball. By the time it's telling us something's wrong but He pretty much it's like, my labs are fine. It's not a big deal. My labs are fun. And I'm like, today they are.

Scott Benner 25:04
I heard a person recently say they wanted to get in on top of their health, this person does not have diabetes, but they are significantly overweight, like, twice probably what their bodies should be carrying. They were like, I'm gonna get on top of this. And they went to the doctor and came back and said, my labs are great. I don't know that that matters. Like your weight, your weight, your weight over 400 pounds. Like, I don't care if your laps are okay, but and they took my labs, okay, I don't need to do anything. And that was the end of it. You'd

Emily 25:35
be surprised the amount of people who you could look at and go, there's no way you're not a type one diabetic type two diabetic, just from the morbid obesity alone, and then they're a onesies normal, and all I can think is your liver. It's something holy.

Scott Benner 25:47
I'm not I'm not even equating it to diabetes. I'm just saying that when something is so like, obviously not. Okay. That people will write it off. If they get a test back. Test payment. Fine. It's okay. Don't worry about like, you know, like, you know, have you tried, Emily, listen between you and me. I've been married a long time. Have you tried just putting a pillow in the middle of the bed and saying we can move this when you're a one sees under seven? Because I'm a boy, that will probably work pretty quickly on me. You know what I mean? So honestly, I think you're overthinking the whole thing.

Emily 26:17
That's hilarious. It's hilarious. I didn't want to tell the story of how my son's diagnosis came to be if you have time for that, too. Please, please, I'd love to. So my son was a little overweight. At seven years old. He loves Legos and hates to sweat. We, we always say he has a whole lot of lazy in him. And so actually last April, and I will say we are very pro vaccine in our family. So my kids are always vaccinated. But last April, he had gotten the flu, and he got flu B. And he was sick for about two weeks and dropped about 15 pounds at that time. But he wasn't eating and he was really overweight. And so we didn't think a whole lot about it. He looked healthy, with losing 15 pounds. And over the summer, I said this is enough. And so every morning before I left for workout would make them come outside and go for a half mile walk to start their day at 730 in the morning. And so he dropped about 10 more pounds during the summer. A lot of people commented, you know, he looks like a new kid. He's lost so much weight. And we're like, Yeah, I mean, he was sick. He lost weight, the weight loss stop. Walk down summer. Yeah. You know, yeah, I mean, he's lost weight. He's normal now. And he got to where he was eating nonstop. I mean, like more than my husband. And I was like, son, you're I mean, you're eating more than a girl man. Like, I think you've had enough. And this is right about the time school started back in August. And he's like, but I'm just so hungry. And he was starting to sneak food. And he was drinking, I would say he was drinking a lot. But he and I both typically drink a lot of water. So I didn't really think much about it. Because it wasn't, didn't seem excessive, necessarily. And so my husband and I had actually met, I had a little break in my schedule similar to today. And we met for a walk. And it was on a Thursday. And I had said, you know, Ben's circles under his eyes, which he's always kind of had a seem a little darker. And he said, Yeah, what are you concerned about? And to say I have anxiety is to minimize the problem. But I said, you know, what, if it's leukemia, and he was like, Why do you always go straight to me? And I said, I don't know, you know, he's just gotten so thin. And he's got these circles. While we're to we'll give it a few more days and see, kind of see how the week plays out. So, Friday morning, he got up and he had wet the bed, which was unusual. And he kind of just said, my, my husband said in passing been, you know, wet the bed last night. And I was like, Oh, that's weird. So Saturday morning, then gets up early as it is to about 6am. He said, You want to get up with me? And I said, Yes, we got up. And he said, Can you get me a glass of water and a bowl of cereal and a glass of water with cereal? That's weird. So I said sure. And he Cinnamon Toast Crunch, which is you know, lovely. And then he said, By the way, I wet the bed again last night. Dad put a blanket over it. Can you wash my blanket? And immediately, I went and woke my husband up and I said we have to check his sugar. And he was like, What are you talking about? And I was like he's wet the bed twice. That's not normal. And he just asked me for water. So we checked it. It was about 450. I immediately started solving. Yeah. Because I said he's not my blood type. He can't have my kidneys if you need

Scott Benner 29:45
them. That's where you went to right away. Immediately immediately.

Emily 29:48
I said Norris my blood type is our daughter. He's not he's your blood type and y'all can't share kidneys. You know, what are we going to do? And so we just got him dressed. And my husband I took him to the Children's Hospital an hour away in Atlanta, and I took my daughter to volleyball practice and then came home packed bags. And by then he took them to the hospital. He was in a mild DKA. He ended up on an insulin drip for about four hours. That was a Saturday afternoon, we were able to get all of our diabetes education convinced them we knew what we were doing and lead by Sunday afternoon. We assume it was triggered by the flute. My husband, we don't know exactly what his trigger was, unless it was just the stress of getting married. But it was very, it was very overwhelming.

Scott Benner 30:33
For everybody, for you specifically, probably

Emily 30:37
from a specific oil, you handled it differently. I'm mainly went to Oh God, how can I keep him off dialysis. And my husband went to a different place have this as my fault. So we actually did the trial net testing my daughter and I at one of the juvenile diabetes walks. And because like I said, I jumped all in. So I got a team going, we went and did all that. And she and I are both negative for antibodies. So even my son recently got mad at my husband and said, This is your fault. You gave me this diabetes. That

Scott Benner 31:10
sucks. I feel I feel bad for your husband. That's terrible. Yeah. It's horrible. Do you guys have any thyroid in the family? Multiple

Emily 31:17
women in my family? I do not know if I don't know of anyone on his side of the family. And I do know that there's another trial that for antibody type thing that will test for the celiac. My son is negative for celiac currently. Yeah,

Scott Benner 31:33
but you and your husband are like a, you're like a perfect storm. Really? Yeah,

Emily 31:37
we really are. Yes, my mother had Graves disease. My grandmother has Hashimotos. So it's something that I'm keeping an eye on. I'm not convinced my daughter's not celiac now, but she does not feel the need to be tested and does not feel like it's important enough to her right now. So I'm letting her enjoy easy. Carbs.

Scott Benner 31:58
I can hear all the celiac people yelling silent celiac at their, at their iPhones, right? Yeah. Or Spotify.

Emily 32:04
I mean, it took me it took me many years to convince a doctor what was wrong with me with celiac. So I'm prepared to battle for her when the time comes. But

Scott Benner 32:13
well, so I don't know where to go from here. Wait, I do know where to go from here. I'm sorry, I apologize. You are having a really interesting, but not uncommon experience. And I know this because I've spoken to a lot of nurses who have children have been diagnosed or have been diagnosed themselves or had a spouse done, what have you. And they start from this very basic understanding of diabetes, because if you're if you're inpatient or your emergency, like your understanding of type one's pretty basic, and you don't really the way they manage it, I mean, to call it management really is. I mean, that's a loose interpretation of what's actually happening. So if

Emily 32:53
you could only if you could only say the way this my hospital managers talk, or diabetes in general, as an inpatient, I'm doing

Scott Benner 32:59
a series called cold wind, I'm getting a good feeling for it from anonymous healthcare workers. So don't worry, I horrible Yeah, I know what's up. But that's, that's your level of understanding. And then now you it's in your own life. You know, originally with your husband, you were like, if we do this, we'll be okay. His agency was very good under your tutelage. And then not so much when he's out on his own. He's impacting your son in a similar way, you are coming from a different perspective. And, and, like, how do you see this shaking out? Because in my heart from a third party, I think what are finds the easiest path? So your son's going to follow your husband because it's easier.

Emily 33:44
And we already have times where even the doctor was like, what happened on this day, thanks to Dexcom clarity, you know, they can pull up all these charts. And I said, Oh, that day, he snuck I think, apparently because I had the same exact question about that. She goes, okay, okay. Maybe

Scott Benner 34:00
that's my point is that if if you're preaching, health and wellness and you know, Pre-Bolus thing and that stuff, and your husband saying it went up, it'll come back down. It's okay. Like, I don't see how a an ammeter a young child's going to go for harder. You know what I mean, when they're making a decision, and then that's going to leave you in a bad spot?

Emily 34:23
Yep. Yeah, I'm okay with being the bad guy, though. So

Scott Benner 34:26
you're the bad guy. Well, I don't think you're the bad I don't that doesn't make you the bad guy. But I but I understand what you're saying it. It seems really unnecessarily upsetting to me, you know, because, because at some point, I mean, we are ignoring what an eight a one C means. Right? And he's got it now. Right? Your husband has to know, he understands. And so now we understand it's happening to him. He's understands it's gonna happen to your son. And I don't really know what my next question is, other than to say it's a really bad situation. Hello, I'm wondering how you're going to handle it. So

Emily 35:02
my first step is to convince my son which has been very difficult to try the Omni pod. He hates adhesive. And we finally, this last Dexcom change, got a routine that was not painful and I was able to get that bad boy just slide right off. So I'm hoping by the time we do our pod prep class in February that we will have him convinced to give it a try. Because I mean, he's used to snacking and eating what he wants. And while I still wish I could get him to rein in that sweet tooth. I know from treating diabetics day in and day out that they can't help but crave sweets at times more. Not necessarily more, but I want him to understand the balance of he can have really whatever he wants in moderation with insulin, and he still has honeymooning so it makes it a little more difficult because there's so much he can have without insulin. He goes all day he eats an omelet in the morning school. He eats a freeze dried strawberries, Atkins chips, ham and cheese, no sandwich just ham and cheese every single day he eats this, and he doesn't need insulin. So then he comes home. And I give him insulin for dinner. But he's still very much. I don't know, accepting understanding, fearful. I mean, there's so much emotion for a child who remembers life before and is still trying to adjust to life now. It's difficult. But like when he had the flu, this past December, he started, his blood sugar started going up. So I took as long acting he's on 10 of ones. So I took them to 11. And the next night, he was still high. I mean, like I'm insulin, dosing him every two hours was short acting to keep him at 200. He's thought take him to 12. And he's still hot, though, I take him to 13. Because I was like, we gotta get this down. Luckily, he didn't have ketones. And His correction factor was 90. So I took it to 80. And he was supposed to round supposed to round down on his insulin, which I disagree with around that bad boy up. And then I just got to where I just added half a unit every time if he needed to. I gave him two and a half y just to try to keep him at 200 for a minute. And I mean, it worked, obviously, but an eight year old can't do that for themselves. And unfortunately, I do work full time and can't be there all the time. So

Scott Benner 37:27
you're thinking about an algorithm? Yeah. Okay. I mean, let's you can sell it. It's no more shots. Yeah, no, we've tried that. He's like, I don't care. It'll be easier to eat what you want. If you go on that route?

Yep. Yeah.

Have you tried therapy? Actually,

Emily 37:47
yes. His provider has integrand ologists. We've established with a psychologist, they have two in their practice that are diabetic, trained, or one of them, I believe, is a diabetic themselves. So yes, we're in that route, as well to kind of break through some of these. And what's really funny is, my daughter is tight control my son, when he had the tiniest, tiniest injury in the whole neighborhood knew. And, but when it came down to this, he's been a real champ about it. So I try to give him as sure as much credit as I possibly can.

Scott Benner 38:25
So it's all very new. I'm not I'm not saying it's gonna be perfect right now. I just think you have specific challenges. I mean, his age, you know, his general demeanor on this, you know, the influence from another parent. Those things are on pill. I'm sorry, I'm sure he's a great guy. I'm not like I'm not on them or anything. But like, you know, it's just like it is what it is. There's plenty of people with type one walking around with a one season, they can do whatever they want. I'm not telling them to do differently. But you have a perspective. And you're saying I don't want that. And these forces are going back and forth. The kids obviously seems like personality wise might be more like your husband. Sounds like your daughter might be more like you. That seemed fair. Yes. Yeah. So you're he has a lot of uphill battles there. And then you're going to be the the only way Listen, I don't want to be the Ghost of Christmas Future. But the only way this is going to work is if your husband spearheads it. Yeah, and not just listen to your mom. Yeah, like because that's not going to work either. Like he's going to have to like get himself a CGM manage himself. See, see what's really possible and then pass it on to your son.

Emily 39:31
Yeah, that's all and I mean, he. He's tried like, he's got the Omni pod. And so he'll say like, you want to pull this off my son, you want to help me? You're gonna press the button to start it and Benjamin's like, Absolutely not. I have no interest in that whatsoever. So

Scott Benner 39:45
I see what you're doing. You're trying to soften me up.

Emily 39:47
Yeah. I'm not doing that.

Scott Benner 39:50
I mean, listen, I know there are people who slather oil on them, they get into they slide off like all kinds of stuff. I always just hold on I'm like just grabbing yank it off and it'll hurt For a second Yeah, be done with it. That's

Emily 40:01
my husband's philosophy. Yeah, grab and yank baby oil and a bathtub slid right off. So I

Scott Benner 40:08
have such an inappropriate joke. I was gonna say that's gonna be his philosophy about a lot of stuff if he doesn't get this together

sorry. Yeah, I don't know. Like you're in a really weird position. And I don't know that it won't come together. Actually, may I be honest? It probably will. Yeah, what I think will happen is that some times gonna pass and your husband is going to have his come to Jesus moment. And then he's going to write himself and he's going to do it for your son, and then he's going to drag everybody along with him. And that's what's gonna happen. I think you're in the middle of two different adjustment periods right now. I think you're in the middle of your son's diagnosis, from his perspective, and he's not looking to be, you know, wearing a bunch of stuff right now. Right? And you're looking at your husband gonna have to get past the guilt, and then get on to the being a parent part. Yeah. And he's gonna end up saving himself by mistake while he's saving your son. Yeah,

Emily 41:04
that would be wonderful. What?

Scott Benner 41:05
What I see happen all the time. And people. It's very common. It's something human that, you know, it just happens over and over again, people just don't do things for themselves. I don't understand it actually, like, look at you, you're running around for your kids. You know, you you know, your husband, your husband's like, I know what to do. I

Emily 41:24
wouldn't say we had an unhealthy lifestyle. But we didn't have the most healthy lifestyle until COVID hit. He was actually working in the emergency department at that time. I was in nephrology, and I was like, Well, I'm not going out with that. So I immediately quit drinking wine as a coping mechanism and started exercising. And I was like, I've got to be a good example for the kids. I've got to be healthy. You know, we're not dying, working in a pandemic, this is ridiculous. And so they, they see that, and they can appreciate that. But it's really weird. They don't do it for themselves. So it's a battle, would

Scott Benner 41:58
you catch a glimpse of yourself in the in the cabinet door with a glass of wine at three o'clock in the afternoon during COVID? And you're like, Oh,

Emily 42:05
I was like, Well, what I what I tell everyone was I drank the first month away, and when that didn't solve any problems that decided to try something else.

Scott Benner 42:14
I don't remember. I don't remember March of 20. Oh, that's something I listen. It's life. You know, it's a process you're, you're going to come up against things and find ways over under and around and some things you're going to meet head on. This is going to be one of those things, it's going to come to a head in less he finds a way around first, because you're going to get pissed at some point.

Emily 42:38
Like, a lot.

Scott Benner 42:39
I'm just telling you like the I've lived through the I've lived through the feeling of giving every minute and second of your life to making sure that a blood sugar is where it's supposed to be and then seeing somebody else come in and get up. And you're like, Whoa, what are you doing? It's like someone walking on your freshly mopped floor times a million. You know, you're like I just got done fixing this blood sugar. What are you doing? Oh, yeah,

Emily 43:04
I mean, even his school nurse will use two of them. They have two of them in their school that alternate. And one is just like, like, I'll call her up. I'll be like, Hey, did he have something because he went from 120 to 200. Like what's going on? And she'll be like, Oh, he wanted a dumbed down soccer and I just couldn't say no. And I'm like, cool, but no, your sugar. And like,

Scott Benner 43:27
who couldn't say no, I'm sorry. The school nurse school nurse, what do you mean?

Emily 43:34
And or they'll call me and go hey, he's 200 But he's about to get on the bus. So do you just want to fix this when you get home? And I'll be like, I mean, is he 200 own up? Is he to me? How

Scott Benner 43:44
long is the bus ride? Yeah, yeah, I

Emily 43:47
mean, like, where are we at here? And so they worry about and honestly and his elementary school which is quite a small elementary school there are four or five top one kids right now so and he's the most recent one so it's not new for them this in the nursery is very lenient is actually a very well established he was an emergency department nurse she was a flight nurse like she's got a lot of experience. I don't know what why she doesn't want to treat his blood sugars or

Scott Benner 44:18
why she's unable to say no to a lollipop

Emily 44:22
I find them and it's brought back a lot he brings them home a lot I'll say that

Scott Benner 44:25
from the sugar from the sugar pusher this

Emily 44:29
from and I hate it I mean you know he's in second grade so they they reward the kids with candy so often and it seems you don't think about until it becomes a problem. So you know once a week coming home with a sucker not a big deal earning a Skittle every so often for getting a correct answer, not a big deal. When they're diabetic and they're in five Skittles, you know, it can be a big deal. So,

Scott Benner 44:53
Emily, I'm gonna say that I could probably find a couple of psychologists and line them up and tell you that rewarding children with candy is probably not a good idea. That's Oh,

Emily 45:02
yeah, they do it though. It's it's an N I've always said like you don't you don't need a starburst. Like I don't understand get a sticker.

Scott Benner 45:09
It can't they have a sticker where I don't know how good grade. Yeah. How about an A, let's just go with that. They used to give us pluses and minuses and then we could trade them for, you know, you made a little currency. Okay, you build up 100 pluses. You could buy, like a half a letter grade on a thing or something like that. You know, they mean, like, yeah, yeah. I'm just picturing your children's educators lobbing Skittles at them when they're getting math problems, right. One plus one is what two Oh, right. Here you go. Let's see if we get in your mouth. Yeah,

Emily 45:38
it's pretty close. Oh, Jesus.

Scott Benner 45:39
You know what? I can't I can't tell you that this conversation has left me very upset. And I feel very hopeless. I feel very hopeless. I keep searching for like the bright light here. But you're not up to it yet. So it's not completely up to you. So Oh, wow. Well, here, tell your husband this. When my daughter was diagnosed, her endocrinologist pulled us aside after like the second, it'd be like our second visit. And she shooed our kids out of the room and told us that she goes, Hey, you too. The instance of divorce is one and two. But when you have a chronically ill child, it goes to two and three. And I was like, right on. Thanks. Right. Yeah. And she said, You guys should probably go to therapy. And then like, she kicked us out of the room. It's going to be one of those things like your mama bear things not going to like it's not going to go away. Yeah, yeah. I had it. It's hard to get rid of. I've said some terrible things to my wife when she's gotten in the way of me managing Arden's blood sugar in the past. So especially after you've, you've been at it for a full day, with a to my daughter was two when she was diagnosed. You know, I can imagine, yeah, you got everything rolling along. And then somebody comes in the door with like, a sack full of crappy food. And you're like, what enough? Are you doing? Like, I just got this together? You know, I spent my whole day getting this blood sugar stable. I didn't know what I was doing back then. You know, so there's a whole day's worth of effort. And then somebody just walks in. They're like, Hey, it's me. I'm the seafood fairy. And you're like, No, I can't, I don't. And then they feel bad. Like they're not doing it on purpose. You know what I mean? Like, so? This doesn't happen anymore around here. But like I'm saying in the past long time ago, I know how much anxiety and turmoil it brings up. So I wish you luck. It sucks. And you're are you doing this on your lunch break? For me?

Emily 47:30
I am. Thank you. Actually, I usually have a pretty, pretty long lunch break, because I do dialysis rounds on my lunch break.

Scott Benner 47:37
Oh, geez. How did you get into this line of work? By the way,

Emily 47:41
I was an ER nurse for 12 years. And then I was a hospitalist for a couple of years as a nurse practitioner, and I got recruited by the nephrology group from the hospitalist work, you're likely to find it rewarding. I do I always swore as an ER nurse that I would never work with dialysis patients. But you know, never say never. So I actually enjoy it a lot. But the

Scott Benner 48:06
I guess you get to know people too, right? Because they do. Yeah, they repeat people home dialysis is that if I can ask couple questions about it. Yeah. Is it the same? Are you getting the same bang for your buck as you are if you go into a dialysis center,

Emily 48:20
and it's actually better, you can do it more often for less time. We can control not control things a little bit better, but you have less of the roller coaster building up of toxins pulling along while building up on the mountain. So home dialysis is actually the best option. And is that there's actually a huge push for it right now. But you know, just like with any other chronic medical condition, patients are scared to do things by themselves. So getting over that hump is

Scott Benner 48:52
difficult. Once you're on dialysis, is it? Is there a average amount of time you can make it without a new kidney? Or it could go on forever? Or does it vary?

Emily 49:03
I have some patients who have been on dialysis for more than 20 years, who will not get a kidney they don't qualify for a transplant or who you know, had a kidney. It lasted 10 years, and they've been on dialysis for 20 years. But then we've had some transplants who've lasted. I had an older lady, she was in her 90s. And I want to say her transplant had lasted over 30 years. Wow. Yeah, so admit, but it just takes diligent just like anything else, taking those meds, getting those follow ups, doing what you're told to do. And that's hard for so many people. It's

Scott Benner 49:38
not just diabetes or in other states. It's just getting people to do things. repetitiously is tough. Yeah. And isn't it true that once they start feeling better, they forget about the thing that made them feel better? Yeah.

Emily 49:48
Yeah, even notice that Yeah. And so many of them will say like, well, I didn't feel good today. So I didn't come to dialysis. And I'm like, But why do you think that would make you feel better?

Scott Benner 49:59
You didn't feel good today because you need to come to dialysis. Yeah,

Emily 50:03
like if you were, if you were sick gi related things, for instance, I can provide IV fluids and Zofran and things like that with dialysis, like I can help you out. I mean, if you can't get off the toilet, then I can't help you there. But there are a lot of things I can help with. Or I can always come look at you and say, All right, yes, we, you know, here's what we can fix about this sitting at home, I can't do any of that. So, but convincing people of that is so very difficult. It usually takes me I tell everybody, I need you to give me six months, because you're gonna feel worse before you feel better. Your body has to adjust to this. Usually, and it's always a battle, I always tell people, I'm not going to push you on it or encourage you to do it. Unless I have to.

Scott Benner 50:44
Everybody who gets dialysis, they end up with a fistula, right? Like a port somewhere.

Emily 50:50
A fistula or graft, I mean, some have a tunneled catheter, because they refuse or they, they've been doing it so long that they just don't have vascular access to do anything else. But of course, you can start with PD and peritoneal dialysis in the belly. But that does eventually burn out.

Scott Benner 51:06
What are the real life impacts of people who are on dialysis? Like, what are they going through day to day? You

Emily 51:12
know, depends on the type of dialysis and kind of what how rigid they are with what we tell them to do. I have one gentleman, he's been on it 20 Something years, he says, I feel great. I do everything you told me to do. Come to my dialysis, I never miss I feel great. I have no complaints whatsoever, comes to dialysis for hours, three times a week. And I have other ones who should be there three and a half hours three times a week. And they may show up once and they're in and out of the hospital nonstop. And it can be very frustrating. And I have some who gain two kilos between treatments, which is average and okay. And I have some who gained 10. And I'm like, do you understand how many pounds 10 kilos in three days? Like, what are you doing? You don't know what you're doing to your body? And it's, I call it 51st dates? Because I just say the same things over and over and over again.

Scott Benner 52:02
But what are they experiencing? Like privately like, what are they nauseous? Are they like, what do they go through when they're not?

Emily 52:11
Feeling? Well? You mean like before starting tile? So

Scott Benner 52:13
once you're on once you're on it? And if it's not, if it's if you're not doing the things you're supposed to be doing, you're not having an optimal experience, I guess? What are some of the things that are happening. So,

Emily 52:23
for instance, if you gain too much fluid, if we pull off a lot of fluid during the treatment, or more than what your body really can adjust to frequently you're going to be weak, you're going to be nauseous, you're going to be sleepy. So they're just like, Oh, I just sleep all the time. I don't have any energy. And I'm like, and some of that's usually when they start their Mnemic we have to get that kind of turned around. And the blood pressure tends to if they're sky high, and they have on five kilos or something ridiculous. We pull off five kilos, their blood pressure drops significantly. So they're hyper hypotensive all day and their diet can be limited. You know, they're on something called phosphor responders. And sometimes those calls gi upsets some constipation, some diarrhea and vomiting. So they have to take that with every meal. There's a hard existence. It can be Yeah, they can be it's just a lot that you have to consider. I mean, it's similar to type one diabetes is a lot that you have to consider in everything you do all day, they have their own food restrictions. They're not allowed to drink, really more than 32 ounces a day, which to me is a nightmare. I drink that in the first hour, I'm awake, I can't imagine and I try to give them empathy for that. Because I know I could not imagine being limited like that. It's hard for some people, for sure. It is yeah. And but at the same time, I'm like, All right. I mean, I can understand, you know, you had a thirsty day you were active. You know, you wanted you wanted to go that Super Bowl party, but at the same time. You've been doing this for five years, it's

Scott Benner 53:54
you knew what was gonna happen next. Yeah. You

Emily 53:57
knew you knew I'm gonna find out your Monday morning. So do

Scott Benner 54:01
most of them come from one disease state like, or is it a very, it's that I'm sure a lot of things, you know, can end with kidney failure. But do most of your patients come from like type two or? Most

Emily 54:12
of them are type two. Yeah. So type two, Hypertension is very common. A few in our area is different. For instance, there's a disease, polycystic kidney disease, and sometimes you see pockets of that, because it's very, it's genetic. And we have a pretty large population of that in our area. So we have a good many with that. And then lupus nephritis can be common for those who do not take care of their lupus early. The same with diabetes. Those are probably the most common. Do you

Scott Benner 54:44
think that people with type two as an example, know that they're there because of their type two? If I'm their provider, they do they understand? Do they understand that? There are there's more damage coming the kidneys there's just what they've seen so far, or is that a or Do people have that feeling of like, Oh, something finally broke? Now it's broke, nothing else is gonna go wrong? Do you know what I mean by that?

Emily 55:06
Yes. So I think it just depends on, you know how much education there have been provided with by the providers. Because for us, I was always taught that if, if the eyes are involved, the kidneys are involved. So even if they don't know they have eye damage, if they've got kidney damage, especially if we biopsy them and know it's coming from diabetes, we immediately are like, you're like your vision, you got to stay on top of this, because it's been affected. So sometimes they know, but I don't think they always grasp the reality of the full picture. And then kind of by the time, especially once they get to dialysis, you do kind of get out well, you know, here we are. Just like the last question. Yeah. And luckily, once you end up on dialysis, because your medications aren't rapidly filtered, or normally filtered, the problem is, a lot of times their blood sugar starts to get really controlled, as that kidney function starts to decline. And so then they get like, but my blood sugars are better. And I'm like, but you're at once he was 14 for three years, like they're better now, because the medicine is lasting longer.

Scott Benner 56:18
And what is better mean? 10?

Emily 56:21
Sometimes it'll even a once he's come to five, they'll go off their diabetes medicines. Really?

Scott Benner 56:25
That sounds Yeah, yeah. Wow. Any heart issues pop up afterwards? Usually? Oh,

Emily 56:31
yeah. Yeah. The correlation between heart disease and chronic kidney disease is it's close, right? Enormous. It's yeah. And then you'd get microvascular disease, especially because you have issues with calcium and microvascular disease from calcium buildup, and it's horrific, really, I mean, just dialysis itself. I mean, you know, you're pulling fluid from the body, and then it builds back up. You can just imagine kind of how it does that to the vessels, they all end up with heart failure, not all of them. But frequently, and that were heart failure. And,

Scott Benner 57:04
well, Emily, like I said, You're a party. This has been nothing but bad news. But I appreciate you doing this very much. Thank you. I hope people don't think it's a bummer. But it's good information. You you have it. So yeah, I appreciate you telling us the personal story. And then finishing off here with explaining some things from your professional perspective, too. Thank you. Yeah. And

Emily 57:22
I wanted to make other parents like, I want them to know that you know, even as to health care professionals, we probably missed the signs for a minute, you know, when it came to our son, and it's, it's very easy to beat yourself up about it, but you just do the best you can every day. Yeah.

Scott Benner 57:36
Now listen, I knew something was wrong with my daughter for a month and she still almost was in a coma by the time I got out of the hospital. So it's hard to see me it's happening in front of us so slowly, you just never put the pieces together, like fast enough. Yeah. And

Emily 57:50
I look at the picture. And I'm like, Ah, like the week before school picture his yearbook picture from this year. I'm just like, oh,

Unknown Speaker 57:58
I might not see this. Yeah, he doesn't matter.

Emily 58:00
Yeah,

Scott Benner 58:02
no, no, my I have a photo of Arden. I mean, she was too. So she's in a diaper running around like a hotel room. And I mean, she looks like Keith Richards in the middle of the 60s. And I don't know how, like, none of us noticed that. You could see her ribs and she look like she was on a heroin bender. Like No kidding. Yeah. You know. So anyway, don't don't beat yourselves up. It's, you know, you're past that now. So let it go. Yeah. All right. Well, Mike, thank you so much for doing this. Would you be able to hold on one second for me?

Unknown Speaker 58:30
Sure. No

Unknown Speaker 58:31
problem Thanks.

Scott Benner 58:39
Your kids mean everything to you, and you do anything for them, especially if they're at risk. So when it comes to type one diabetes, screen it like you mean it because if even just one person in your family has type one, your child is up to 15 times more likely to get it. But just one blood test can help you spot it early. So don't wait. Talk to your doctor about screening. Tap now or visit screened for type one.com To get more info and screen it like you mean it. If you'd like to wear the same insulin pump that Arden does, all you have to do is go to Omni pod.com/juicebox That's it. Head over now and get started today and you'll be wearing the same tubeless insulin pump that Arden has been wearing since she was four years old. If you were a loved one was just diagnosed with type one diabetes, and you're looking for some fresh perspective. The bowl beginning series from the Juicebox Podcast is a terrific place to start. That series is with myself and Jenny Smith. Jenny is a CDC es a registered dietitian and a type one for over 35 years. And in the bowl beginning series Jenny and I are going to answer the questions that most people have after type one diabetes diagnosis. The series begins at episode 698 In your podcast player or you can go to juicebox podcast.com. on and click on bold beginnings in the menu. If you're not already subscribed or following in your favorite audio app, please take the time now to do that, it really helps the show and get those automatic downloads set up so you never miss an episode. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast. The episode you just heard was professionally edited by wrong way recording. Wrong way recording.com