#143 Facebook Live Q&A ptII
Scott takes your questions...
I had some free time and so I jumped on to Facebook Live to try and answer as many questions as I could about type 1 diabetes.
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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 0:06
Everyone, welcome to Episode 143 of the Juicebox Podcast. This is the first episode of 2018. Happy New Year. I hope you had a great holiday season. Let's get back to let's get back to learn about Type One Diabetes together. Guys, did you know that in 2017, the podcast had just a few hundred shy of 250,000 downloads a quarter of a million downloads in 2017. And the podcast is just growing and getting stronger. Thanks to all of you for sharing. I really do appreciate it. Okay, let's get right into it this year. This episode is a Facebook Live Chat where I went on my Facebook page, and people asked a bunch of questions about diabetes, and I did my best to answer them. I think you guys are gonna like this. It's a great way to get started for 2018. It's a great way to remind yourself that you can do these things you can be bold with insulin, you can make a big difference in your agency, your variability, your day to day blood sugars. And eventually that this all can get very, very easy for you. That's that's everyone's goal, right is to keep your blood sugar where you want without taking up all of your life. I think we can get to that for all of you. Please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise. Hey, here's a big announcement. Very happy to tell you on the pod and Dexcom are back as sponsors in 2018. If you want to learn more, go to my omnipod.com forward slash juice box or dexcom.com forward slash juice box and you guys go to those links or click on them in the show notes. That is what keeps the sponsors coming back. So I do appreciate that. Okay, guys, here we go. Facebook Live q&a. Number two, we've done one before. Okay, you guys, type your questions. I will go into a stream of consciousness. Hopefully. I will say something you understand. It looks like Trevor asked a question. I'll start with that to get kind of warmed up said he's only been listening to the Juicebox Podcast for a little while. He wants to know which ones I would recommend they get a good overview about how I make bazel. bolus decision. So right off the bat, Trevor is assuming that I'm in anyway, well planned out enough to know the answers, things like that. But I think people seem to like Episode 11 bold with insulin. Texting. Diabetes seems to be one that people like anything with Jenny Smith in it, right? The CD who we talk about stuff with that seems to be really popular. There are links up here in the description of today's Facebook Live that you can listen to the podcasts on Apple podcast, Spotify, online, Google Play anywhere, really any podcast app you have. But I think mainly and I don't know if people agree or not, you guys can chime in a little bit. But I think that the conversations and the podcasts are probably the most valuable. I don't know that there's topics that are like, Oh, that one. That's perfect. I think it's more about listening to people talk about different situations, and how they do them, which is what this is going to be today. So hopefully, that answers Trevor's question. And then he said, How did I know when the honeymoon stage was over? I needed more insulin, Trevor, and tips for the honeymoon stage. You had to stay on your toes? Basically, I think that, um, you know, I think things can go back and forth. Robin saying, hey, Robin, how are you? That's pretty much it. And he also wants to know, this is interesting. What are the things that I've done to help Arden that she likes and things that she did not like? So I think he's looking for that might be a better for you people to talk about because I'm very northeast, I don't really care what my kid likes as much, you know what I mean? But I would prefer if she just did what I told her to do and didn't argue very much. I can tell you that. Joking aside, I think that we would try to be just very compassionate, and don't get lost in the day to day kind of BS of diabetes, you know, try to flip your lid, stuff like that, but it happens. Trevor, in the end, I think you just need to do what you need to do. Do it as well as you can and support your kid as you go. I think that's pretty much it. All right. So guys, we have a fair amount of people in here now. And nobody's asking questions yet, but I'm gonna kick it off. Right. So I think that one of the keys to managing Type One Diabetes is to understand the limitations of the insulin. And by limitations, I mean, how quickly is it start to work? Does it peak, when does it peak? You know, you need to understand what it's going to do not just what it's supposed to do not this just sort of bland idea that Oh, I'll put the insulin at and my blood sugar won't go up. You need to really understand it for yourself. Because
Because I think that most of managing type one and those of you who are here and are going to come back you know and listen to this later. You guys are here because you're probably seeing peaks and valleys that you you don't have highs and lows. And I think there are simple ways to, to kind of maintain a stable most of the time, right. Thank you, Sarah for asking any questions while you bail me out? How do we handle spikes that come two hours after a high fat meal that can seem to last forever, like restaurant food? That doesn't happen to me, Sara, it's not gonna happen to you anymore. Anyway. So do you have a pump, and you have a CGM? We do. So that's pretty much how I deal with things. My goal to how to handle a spike is to never let the spike happen. And I think that's manageable in a few ways. So first of all, you have to Pre-Bolus the insulin, the insulin needs to begin working before the food does. So. Jen, Sarah has an Omnipod index. Um, so do we, and this is going to be simple. The The point is what I was just talking about the timing advance on how the insulin works, you have to understand that when you put your insulin in, does it start working right away? Does it you know, take a little bit of time, you know, is it 15 minutes is it 20 minutes is a half an hour, are you starting with an elevated blood sugar already Are you not? And so that you can handle these handle these situations, just the way you want to write. So I'll talk about it the way I do it with Arden, which is, depending on the situation, let's just pick a number, let's say Arden's budget was 120. And it was 1130. And she was gonna eat at 12 o'clock, probably around 1140 1145, I would decide how much insulin is are going to need for this whole meal. And let's say it's 10 units, well, I want to give her enough to turn the 120 into an 80 by the time she starts eating. So I'd like to see at kind of diagonal down when the food starts, because the food's gonna hit her pretty quick most of the time, right. And so I want to see a drifting down blood sugar with some active insulin. And then when the food hits and starts to grab, hopefully the rest of the insulin kicks in while the foods trying to help and then you get into this sort of tug of war. And this tug of war, you have to try to imagine it like like a real tug of war with a flag in the middle of the of the rope, and the carbs are on one side and the insolence on the other side. And you don't want either of them to win, you don't even want one of them to get a head start. So the pulling of the carbs and the pulling of the insulin need to start at the same time, sort of have the same power going through and give up at the same time. And I'm going to tell you that if you go on my blog, you'll see like real representations of that, like breakfast is with all kinds of foods that you wouldn't expect or Arden's blood sugar never goes over 110 because the insolence timed against the food, even when she started to graze, we just add a little more. Now, you say well, it's not going to cause a low later, if she never peaks then because it writes are in your mind, you give this insulin the peak happens and then you end up low later, you must have had too much insulin. But that's not the case, you may have had the right amount of insulin, you might have had a little too much. But you might have had the right amount of insulin and it was timed wrong. So once her stomach empties and the insulin still behind. Now it's now it's on a freefall, right? Because now the insolence pulling against nothing, there's nothing resisting the insulin in their side. This whole thing is just about lining up the the pulling of the insulin and the carbs at the same time. I don't want to say it's simple. But once you figure it out, it is sort of simple. Does that answer your question? If she gets low later, then I would say in my mind, it's it's a simple concept. I would rather stop a falling blood sugar or a low blood sugar than I would fight with a high one. Like I would much rather have to give a juice box for a 75 diagonal down two hours after a meal, then been staring at a 300 and just not know what to do. Don't need more insulin. Should I wait? Waiting turns into five hours, sir, you know what I'm talking about? Like so. As we talk here, you're going to hear the little things that I do that kind of bring that all together. When says we are having a really tough time with managing highs at night. It seems like the food is hitting three or four hours after she sleeps. When What if I said How old is she? Is she growing? And are you getting up and bolusing at night? Because that is necessary sometimes. So I think that's another thing to really remember, which is that none of this is going to be like a light switch situation. Right? We're not going to ever be in a situation where like, I just do 15 carbs in 15 minutes, and blah, blah, blah. And it all just works. I'm sorry, didn't shave. By the way. I'm starting to realize I should have shaved. It doesn't go up every hour went home
setting it all it doesn't always work. Like when saying shoot when you might get three months where it sucks, you know, and you're up more than you're used to being, especially when you're coming away from a little kid sometimes the little kids before they start growing and everything. It's a little easier. You know, but as they start growing, it could get more difficult. It sounds like to me when if she's high, then you need more bazel overnight. And so that gets to something very slick. Let's go say this first. Nothing that I say here is advice. And you should not take anything like say as advice, talk to a doctor. But as long as we're chatting, real simple concept. If your blood sugar is high, you don't have enough insulin, or you have missed time to or a combination of the two. And if your blood sugar is low, you have too much insulin you've Miss timed it or a combination of the two. There are no other real factors. I mean, there's a lot of factors. But as far as the insulin goes, if your blood sugar's high, your blood sugar's low, it's because you have too much or too little insulin, or you're using it at the wrong times. So overnight, if she's just been high lately, you might have to crank some bazel. You know, pick a percentage and get going and see what works and keep trying and sleep during the day while you're driving and things like that, Sarah, hey, Scott, thank you for guiding us on your journey. Oh, please. You've given us great info. Looking forward to your podcast. Thank you, Sarah, the podcast is getting more and more popular as things go and really warms my heart, you guys sharing it is a huge thing, because I am not capable of getting it out there the way I need to when had her bazel up, but then she was crashing, or four or five. That's fine. Um, so the bazel is going to be like, like the boluses. When you got to, if she's getting high at 11pm, you can't start cranking the base level at 11. You maybe have to do it an hour sooner to stop the high. And the same thing as you got to get out of that bazel rate in enough time to stop the low. You're it's what you're talking about is timing. And there are going to be other things. I mean, I don't want anyone to misunderstand. Arden has to drink juice in the middle of the night. Sometimes I have to change basals and boluses. I bought this overnight. It's not perfect, but it is this effort that you have to give, it doesn't stop because you're asleep or you're tired or it's Christmas or like getting anything like that. Like it just that's what sucks about it is this effort is constant sunlight, you get these great nights, you know, just like some days you see a blood sugar that doesn't move all day long. I always just think the dexcom is wrong though. And I test but um, you know, sometimes that goes good and some days it doesn't try to nap a little bit. Get your husband to help you a little more. You know, don't get too exhausted because that'll really kick your butt. Okay, Justin said before we started listening to the podcast a once he was 8.2 after listening 6.7 Justin, Justin was on the podcast too. I don't remember if Justin's been posted yet. But if you haven't heard us on the podcast, you will at some point.
Unknown Speaker 12:46
Monica, how do
Scott Benner 12:47
I split for foods that I know will hit later. I am so good at this Monica. So I'm glad you asked Arden this year for lunch. This is going to apply to you man, I could just hold tight for a second. At lunch at school Arden needs to Pre-Bolus at 11:20am for but she's not she's still in class. When that happens. She doesn't actually start eating till like 1140. It's 20 minutes later. Hold on pile. We'll talk about breakfast in a minute. And so let's say Arden's blood sugar's at at 1120 I still need to Pre-Bolus even though if I give her 11 units that she needs for lunch, she'll be dead by 1140. So I can't do that. So what I'll do is I'll think all right, probably going to get a little high later because I'm not my timings not perfect Temp Basal increase 30% 40% for an hour and a half, two hours, however long I think her lunch might really sit in her stomach. And then I do a bolus, but it's an extended bolus. So if I need 10 units and her blood sugar's at, you know, I still need some of the insulin working in 1140, but not a lot, because I don't want her to get much below 65 before she starts cheating. So I may do 10 units extended zero percent. Now, the rest over a half an hour. So that 20 minutes later, the first my math here is going to fail me but the first two thirds of the insulin are at some version of becoming active or in her body. Right. And so that way when she sits in eat Maybe her blood sugar still 70 on the Dexcom. But there's insulin that's happening so that food doesn't get a head start. Now I might have missed a little bit because I couldn't be as heavy handed as I wanted because she wasn't going to be in class. But I've also added Temp Basal, and I can always text her and say hey, you know what, cancel the extended balls and let's bolus the rest of it right now. Let's get it all in right now. You're just talking about timing. In a real world situation that's not quite at school. The answer Monica is how do you split it up? You split it up the way you need to you need to figure that out like there's no like cookie cutter answer for that. But if you I can tell you this if you Bolus for food, right, and it's pizza, say, and 45 minutes later, blood sugar starts shooting up. And it you know, it levels off at 250. And then you end up adding a unit and a half. These are pretend numbers. And that brings it back down, then in my mind that unit and a half belonged in the initial bolus somehow, or as a part of an extended bolus, your blood sugar's high, you don't have enough insulin, or you've missed time that Robin says that Justin's blood sugar, he, once he went from seven, one to 6.0, in three months, she's saying thank you, I'm sure Robin, you did all the work, you just took these silly things that I'm saying these little things, and they let me rattle a couple off. And then I'm going to look at some of the first one, you have to be bold with your insulin, you absolutely cannot be meek, you do have to respect that. But she can't be scared of it, fear is going to kill you. If you're afraid of insulin, you're never going to get these things straight. Again, like I said, at the beginning, you have to understand the limitations of the insulin and how it works. Here's a big one. You need to be on the offensive, if that makes sense to everybody or not. But you when you
Unknown Speaker 16:03
you can't
Scott Benner 16:05
react, you have to attack, right. So when you wait for diabetes to attack, like you're always going to be on defense, and then anything it does isn't going to make sense. And you can't take anything actionable from it. You really, really, really need to not think of things that go right or wrong as things that go right or wrong. They're just data coming back to you. I did. It's the simple formula, I did this, this happened. I wish this would happen next time I'm going to do this. And and if you make a move, if you punch first, then you'll know that what happened, you affect it. But if you're always standing and waiting for diabetes to do something and chasing it a that's how you end up on the roller coaster. And be that's how everything that you're learning these these experiences you're having, you can't make sense of them. Because there's too many variables on the outside you need to take over you need to cause what's happening.
Unknown Speaker 16:58
When you find yourself bolusing
Scott Benner 16:59
too often, your basals probably not right, and you need to adjust your base. All right. You think of some other things to tell you that you might care about and I'm gonna get to some other questions first to drink.
Unknown Speaker 17:12
Okay,
Scott Benner 17:13
I don't count carbs, and I don't listen to what my pump tells me. So I know how much a meal takes because of those experiences I was talking about. For instance, if I know like I sent Arden to school the other day, she had a full size bagel. You guys are gonna flip out to Oreos, a banana, a small bag, a grab bag of chips, grapes, and a mixed fruit cup with no added sugar. How many carbs was it literally have no idea. But I do know it takes 11 units of insulin for and I do know what needs 20 minutes of a Pre-Bolus I those are the things I know. So when I look at food, I don't look at food and count carbs. I just look at food and go. I know how much this takes for my experience. And it looks carb heavy or it looks sugary like it can hit a real quick if it's going to hit a real quick I want to get more insulin in. If it looks carb heavy like it's gonna sit in your belly like a bagel. I might need to stretch the insulin out a little bit. Alright, more questions are here. Hi, Deepa. How are you? You're welcome.
Unknown Speaker 18:13
Okay,
Scott Benner 18:14
I was gonna say something really important here. My daughter is worried about lows. And she gets in a panic mode. She says if she's if she's 50, or she's at 80 is not low 80s A when you've wanted 80, if your blood sugar is 80 it's sitting there, he doesn't have time to panic, you just time to dance. That is a happy dance blood sugar. Here's the thing. At and falling that needs help. At and stable, you've won, you guys are so used to the idea that you're going to get low at some point that you're scared of lower numbers because you think what it's not going to give you enough time to react to do something. But once you do this for a while, here's what you're gonna learn. If you can keep your blood sugar stable 200 you can keep it stable 150 if you can keep it stable 150 and keep us at 120 and if you can keep it stable on 20 you can keep it stable at 90 the only difference between this 80 that she's talking about, and 180 is your fear. That's it. And so it might not be an actionable idea for today. But it's going to come and you'll get to that spot. Don't panic is is the best thing I can say if you need a little bit of insulin or or juice or whatever it ends up being just don't overdo it. You know don't don't get yourself on always bumping nudge or does everybody remember we talked about bumping lunch on the podcast all the time. You see a 90 and you're a little worried about it. Don't eat anything cut your bezel off for a half hour see if it drifts to 100 or 15 minutes or down 50% for half an hour, whatever it ends up being for you. Just don't panic. Don't eat a banana because you're 90 and you want to be 100 you know just like if you're 120 and you want to be at don't ball nine units, just bump it a little bit, maybe raise your at once or your base a little bit. Just see if you can get a drift to happen. Just by nudge and bump and nudge. Holly said we are on the fifth day of the only pod partially thanks for listening to you and are struggling with the same things earlier mentioned. timing of high carb high fat for example, a birthday dinner last night. He had Fettuccine Alfredo. Well hold on a second high carb high fat cakes actually gave him all the insulin ahead. Pre-Bolus we thought we had nailed things who's between 95 and 100? That's very good Holly and from 730 when we ate until 11 then while we were sleeping when he started to drift up over 300 he didn't eat anything after dinner. Holly your overnight Basil's were they Okay, when you weren't eating? Or the you know, it is? It's a complex car, but it could sit that long. It seems odd to think it would sit for five hours but in that situation, here's I'm going to ask you how I need I need you to tell me give a CGM. I'll get back to you after you tell me that. Lacey said my daughter was diagnosed at 21 I told her from the beginning this disease would not prevent her from doing what she wants in life. She really is making me want to eat my words Now as she says she plans to co do mission work in Guatemala that's cool Lacey. She's 25 now does need permission I find it hard to envision she can survive in a poverty stricken she can survive anywhere. Lacey, if Arden came to me at 25 that same idea. First of all, I would say I don't know what I would say 25 Why don't you have a job I might say at 25. But but but I still like this. Okay, this is this is a good thing. Listen, if she's got a dexcom you can you can, you can be a follower and you can maybe help her a little bit. If she needs it. Maybe she'll need a little remote help. But if she's well controlled here and not doesn't get into scary situations, I don't see why Guatemala would be any different. As long as she has access to her insulin, she can keep it cold. And she remembers to take care of herself and she has the the supplies she needs. I think Lacey This reminded me of a story right? Where the the way I was able to be more aggressive with Arden at school, like we talked about earlier, was this simple kind of like aha moment where I was sitting in my in my living room. And Arden was upstairs in her bedroom. She was little I don't remember maybe second or third grade, second grade probably. And I and I looked on my my Dexcom. And I could see that I thought she needed some insulin. And so I texted her and I said, Hey, Arden bolus a half a unit. And she said, okay, and I just was like, Oh my God, that's amazing. Like I just remotely gave Arden insulin sort of right. But then I realized I wonder why I can't do that while she's at school. And I realize I can and the only thing again that was stopping me really was was my fear. Like what is the difference between art and being upstairs or art and being at school, and me help air. My fear is the only difference and in some small way. Arden being upstairs aren't being in school aren't being in Guatemala. It's sort of the same thing. Lacey, there are amazing people doing amazing things with diabetes. I talk to them on the podcast all time guys cross country skiing in the Olympics. Professional Baseball players, actors listen to the Victor Garber interview left home when he was like 15 years old with diabetes. He's like he's in his 60s now he's fine. She'll be okay. Your fears the issue. That's what you need to work on. I think
Julie and I haven't really ever talked about on the pod static because it doesn't happen to us. But I know there are some people online who say like putting a piece of duct tape over it might help. I've seen people take dryer sheets and rub them all over themselves and stick them in their pockets. I think it all just needs it's it's how dry the here's what I think about that. It sucks. But you know hot air heat dries it out. When the pod thinks it's got a problem it shuts itself down for safety reasons I try to think of when stuff like that happens within the pod is thinking okay, other pumps don't have static issues, but I've never caught my tubing on a doorknob but then on the pot so everything's not perfect. Justin ever heard about LASIK eye surgery with type one? I don't know anything about that man. I'm sorry Deepa, curious to know on what do you think would be a good age let the kids decide on dosing. He wants to try. I don't think the age is right. And it gets up to the kid. It's up to the kid pill. You're welcome. I think that if, if they're ready, they're ready. practice at home on the weekends. You know, when you're when you're gonna go do something, get it in your head, how much you think he needs? And then they ask him how much do you think this is what I do with art and all the time? I'm like, Hey, you need insulin? How much do you think you need? And she's really close sometimes. And so recently, I think after school, I said that she was having a snack and I said seven units. And she's like, I think it's a I was like do eight because what's the worst that can happen? Like 786 and a half seven not gonna kill them over a unit and pay attention to it. Right? Holly? You said yes to the Dexcom going back to Holly's. Okay, so Holly, I might say that you're, if overnight basals right seem great. Unless he has hard carbs over then this is something you need to just be ready for. That's it, you know, if you're going to do a high carb meal at seven o'clock Can you know what's going to make him high at 11 o'clock, then at 10 o'clock, even if you're looking at a 110 blood sugar, you sort of have to have the balls. Do you know what I'm saying, Holly to crank up his bazel, then here's a big thing everyone should listen to us. It's not just for Holly. We're going to start today with our longest sponsor on the pod. There's two different situations here, maybe you're a pumper already, and you want to change to the tubeless insulin pump that everyone loves on the pod, maybe you're doing the injections, and you need to get on a pump. Those you're probably used to situations here. If you are those people, I have such a deal for you, you're going to go to my on the pod.com Ford slash juice box, put in just the tiniest bit of information about yourself and on the pod is going to send you a free, no obligation demo pod. Now, let's go over the important parts of this. It's free, and there's no obligation, it's going to come to your house where you can try it, you can wear it and see what you think you can put it on your child and see what they think and get a real good feeling for it, leave it on for a few days, when you were the army pilot, what you're going to find is that you almost don't even know it's on. I just worked demo pod recently. And to be honest, I completely forgot that I was wearing it. Now, once you've done this, you've done the demo, and you think yourself, hey, I'm going to do more, you just keep in contact with Omnipod. And they're going to help you get started, if that's what you want. And if that's not what you want, whatevs, nobody's gonna pressure you don't use the army bot, if you don't want to be like that. Don't have tubeless insulin pumps have a big tube insulin, pump, a tubing wrapping all around your face, like spaghetti, or keep using injections if that's what you like. But at least you're going to know that this is what the Omni pod is. And maybe, maybe this is what I want. Try the demo today by going to my on the pod.com forward slash juicebox. Or click on the link in your show notes. You just never going to know until you try.
Everyone should listen this. It's not just for Holly, so much of this. It's a convoluted sentence. So listen to me closely. So much of this is knowing that what you know is going to happen is going to happen and believing it's going to happen. Because you can't make those decisions. always hoping, like, oh, his blood sugar's 110. But he's gotten hired 11 o'clock every time he's ever had fettuccine, but let's hope this time it doesn't happen using Holly's as an example. It's going to happen you've seen it happen over and over again. So you have that information now act on it. I think that's sort of it you kind of have to have the nerve to act on what you know is going to happen is gonna have you have to trust it. Now once in a while. It is diabetes. Once in a while it never works. Which is fascinating, isn't it? Like it happens seven times that are like this, then on the eighth time, nothing happens. There will be a time that Holly's gonna crank up her kids base. All right after fettuccine. His blood sugar's gonna go like this cost of doing business, would you rather be low once in every seven times a week, fettuccine, or high six of seven times. Trust that what you know is going to happen is going to happen. Make your decisions based on that. Lindsey says any advice, Lindsey nothing you hear on the Juicebox Podcast is ever considered advice, medical or otherwise, on getting my son to try a new spot for his next calm. He's only ever done the back of his arm. I bribe him with money or things. children seem to like things and money. It's tough. Arden doesn't like to move around either. So there's places like art and wear shirts on our hips, like between the bone over like our hip bone or pointer and sort of the roundness of her butt cheek. There's a kind of a flat spot on or in between and we go back and forth and back and forth. You're welcome, Holly. It's gonna be fine, Holly, just keep going. You're doing great. That's those boluses and Pre-Bolus as you're talking about for that fettuccine are amazing. You just got to get the back end of it now. You can do it. You know what you're doing? It's obvious from your from your question,
Unknown Speaker 28:56
Lindsey. I
Scott Benner 28:57
think seriously, I know it's gonna sound flippant, but their kids bribe them. I would I've given art and money to move her pump somewhere else before. Because you know, once they get it there, then she's like, Oh, I like it or I don't but at least you tried. Lindsay you're full of things here. Let's see also sleep over advice. Ah, sleep overs. Everyone hates sleep overs. Not even just because of diabetes. It sucks. My son used to love sleeping his best friend's house but now you're not comfortable with it. A question starts in my mind are the best friend's parents idiots. Are they reasonably bright people? If you think this is something you can explain to them you have Dexcom you can put maybe Dexcom on their phone, set them up for alerts that would let them sleep. Right. But but would remind them if something really went wrong, and you and your son could text back and forth you might not get a lot of sleep. So Alright, so they're great people I'd have a conversation with explain the tone. I it's I've done it in the past and it works out really well. I also will still sit up a little bit and watch our instex calm while she's sleeping over but she I handled on our own at this point, we handle it literally just how she is at school, we text back and forth. And when I get to a spot where I'm comfortable, she's going to be good overnight, then I kind of go to sleep and I rely on the Dexcom a little bit. And I rely on the fact that I've spoken to the other parents and that they have alerts set up on their phones. Alright, Robin, I'll talk about Expendables more in just a minute. But Lindsey said, I force him to where's the expert, he is so nervous to try a new spot. Totally bribe him. And you know what I tell Arden all the times, don't worry your next time if you don't want to, we'll just test your blood sugar 15 times tonight. And that pretty much shuts her up. And Lindsay, no one wakes up to alerts. That's why you have to sit up you got to find something on the Hulu or Netflix that you love. While the kids have to sleep over and you chill out and power through about seven episodes of something keeping the kid alive with your your phone. Monica i calibrate when it asks me to calibrate. And that's it. Where if I see that it's incredibly off, but the arrows not moving. If that does happen, everyone's watching but anybody ever had one of those days where you're like, You're welcome, we'll see where you're like, Oh my god, this is great. Her blood sugar has been 95 or seven hours. I never trust that I always test that. Robin extended bolus is just another way to, is to stretch things out. It's the it's really all it is. It's just um, if giving all the insulin up front is not a good idea. But you know that all of the insulin is going to be necessary, like in a situation where pasta sit in your stomach for hours, you may need to, you may only need 15 units, but you may need five of them as a Pre-Bolus and three of them over the initial hour. And you know, four more of them in the next the last 90 minutes or so. It's it's just a way to extend it. It's 30% now and the rest over an hour. And then you understand that the 70% of it gets split up into little bitty bits and spread out over an hour. So you have insulin constantly going in for an hour. And it's constantly becoming active at different times I talked about that sometimes is like it's like carpet bombing with insulin like you're covering everything with insulin. Lacy said I'm correct. Of course I'm correctly see. Now I'm just kidding. Your fear is the problem. I feel my knowledge, the ability to help her is very limited since she was diagnosed as an adult. But would you like to adopt her while she's in Guatemala? Sure. That'd be great. I'll watch your kids blood sugar while she's in Guatemala. I mean, look at me. I'm getting plenty of sleep. Extended as necessary for pizza and Mexican. Jason absolutely not Mexican. Listen. I am completely proud of and I almost did it earlier than I stopped myself. But on my blog, which now that there's podcasts, I don't know if people even care about blogs anymore. But I have to blog posts that I think you guys should look at. And one of them is called Sorry, I'm clicking while we're talking about the anatomy of a high carb breakfast. Okay, we should definitely look at this one. Because it's got like visual helpy in it. And there's another one about Chinese food. Where is it? Oh, here it is. YouTube and Bolus for Chinese takeout. It's all about the timing of the insulin right amount at the right time. It's all it is. All of this is the right amount of right time. All right, let me see what else I got over here for you. While you guys are thinking of other stuff to say, Oh, the weekends. Anything you want to test is always better to test on the weekend because you're home, right? So if you are nervous about Pre-Bolus sing at school practice on the weekend, make a school lunch for lunch on the weekend and Pre-Bolus and on Saturday. And if you get close, but not quite right, look
at your kid and go, Hey, tough luck. You're gonna have this again tomorrow because mommy is going to try again. Because it takes away variables. And the more variables you can take away while you're trying to learn how to do something, the more you can trust that the data you're getting back is doing what it's doing for reasons you kind of assume are right? Seriously, you have to learn how much time your insulin takes to work. It's going to affect how you use Bolus and bazel. And keep this in mind too. I was interviewing somebody one time about artificial pancreas. And it turns out that a lot of the insulin that artificial pancreas uses is actually bazel. And that's fascinating because it doesn't Bolus as much as we do. But what can the artificial pancreas do that we can't do? It can't imagine the future. But if you have a Dexcom it's you sort of can't imagine the future. I hear people talk all the time about the two hour warmup periods. The scariest time I used to think that I don't think that anymore, because
Unknown Speaker 34:43
I now
Scott Benner 34:44
I don't know about you, but I can imagine what Arden's blood sugar is most of the time without looking and that's because I've had enough experience and one day you'll have enough experience to and during that two hour window. You'll actually see on one of those links I shared I think it was the Chinese link that door in Chinese food Arden's pump Dexcom needed to be restarted. And so I was blind for two hours. And you'll see that during Chinese food or blood sugar, we're still like one time afterwards, I think only tested one story in that everything. Because I could I knew what I had done it before. I knew what was going to happen. I trusted that what I knew was going to happen was going to happen. Okay, here we go. I didn't scroll. Jason, you don't extend pizza anymore. Take Oh, no kidding. So the pizza takes that long to hit you. And then you just put all the insulin in at once. That's fantastic. See, there's something Jason's figured something out. He doesn't need the insulin for the pizza. When he starts, he needs it an hour later. That's going to be different for everybody. But it's a fascinating example of after enough experiences, you'll figure it out. Monica, do I use correction formulas anymore? Oh, like my pump says, My blood sugar is 150 you use this much insulin. Never. I don't look to my pump for ideas. I couldn't tell you what our insulin to carb ratio is. I'm a little aware of what her basal rates are. When I when I see her get high for a few days in a row. And I can't find a reason why if I see like she's looked like she's gained some weight or she's growing. I just bumped her her basal rate, however much it occurs to me usually I do 30%. But that's just what I found works. And the same with corrections and things like that. If Arden's blood sugar is 200 and it's you know, been three hours and she ate, then there's an amount of insulin I think that would take but it had been two hours and she ate it. It's situational. You don't always need the same amount of insulin to move a number from one place to another. It depends on the situation. What's in your body. outside influences like stress, anxiety. I mean, we Bolus when our employees used to play competitive basketball, I'd have to Bolus for the adrenaline. So she needed like all this insulin. This this is an interesting story. So Arden would used to she'd go in to play basketball or blood sugar be good 110. And then she stopped playing and like 20 minutes later, a bunch of was 210 it was going up and I'm like, Whoa,
Unknown Speaker 37:07
what happened
Scott Benner 37:08
to eat anything while she was playing basketball was the adrenaline right. And so I started getting to the basketball game and bolusing an amount of insulin that I knew a juice box could stop. I know that doesn't quite make sense. But I figured if the anxiety hits the way I expect it to she's going to need that insulin for the for the adrenaline, excuse me. But if it doesn't hit her, then I've got a juice box to stop it. I'm just basically Pre-Bolus in a juice box. Somebody told me once that was incredibly helpful information to have so I've now shared it with you. My daughter is such a super slow picky eater, when you could trade her in for other children probably I Pre-Bolus. But I can't always give a full amount since I don't know how much surely. So I start with 20 carbs and wait till she finishes give the rest. It is frustrating. But that's a that's a great way to handle it. You are basically doing a manual extended bolus some now some weight or some Now, let me ask you a question though. Does she usually finish the food? Or does your anxiety that she's not going to finish the food which isn't there? Hey, Kelly, has Arden hit crazy girl emotional puberty and kind of refuse to deal with the and yeah. I don't get life isn't fair. And I hate diabetes from art. And I just sort of get like a that's like a Death Stare. Like, sometimes I look at art. And I think one day she's gonna make some lucky guy really unhappy. But but so I get what you're saying. Right? So I don't know. Like, if that happens to me where she just blatantly says no, it's a tough call. Like it really is like, I know, some people say just let them write it out. And some people will tell you, I'm not gonna let her blood sugar jump all over like this, I would probably I would probably say, um, I would probably eventually do what I gave someone a vise to do one time, and they told me that it worked for them. So there was a person who told me about something similar one time. And I said, If I was you, I would just pull them aside and be really brutally honest with them and say, Look, the way you feel about diabetes, I gotta tell you, I feel that way too. This is incredibly frustrating. And I understand that you don't want to be involved in it as much but but this really is the situation. We are going to need to get past this. But for now mommy or daddy or work, I'm going to help you I'm going to get more involved. I'm going to I'm going to cover the parts you can't handle. But you can't give up on me we have to do it together. You got to realize that I feel the same way about this as you do that we're in this fight together. I'm gonna I'm gonna pick up a little more of it for you right now. Because I think that, you know, I think that you need it, but you we're going to get you back to a spot where you can take care of your, you know, more of the way we were. In the end. I just think it's, you know, I hear people some people say I just you know, my kid does it all the time. But if you listen to the interviews that I do on the podcast that people who are like in their 20s adults who can remember being 14 and 12 and 11 Diabetes. I have never once heard someone say, hey, my parents were like you go get it all by yourself. It'll be fine. And it really worked out. Well. Most of the time. This is a lifelong disease. It is difficult. I don't understand flopping it onto a kid. It's weird. So the way I do it is I just I keep, I do things with Arden, I think one day, she's going to take a little more, take a little more, take a little while, I just feel like it's a really slow handoff, hopefully getting her into high school where she'll I'm assuming she just won't want me involved that much. And maybe that'll help her take over a little more on when your kid usually doesn't finish. Okay, well, then that's what you know, then instead of looking at the plate and saying, Oh my God, if she finishes this, it's all this insulin. Why don't you just Bolus Pre-Bolus and Bolus for the amount you know, she's gonna finish like reasonably No, she's gonna finish. And then if she should eat more than add more, so plan for success on less food, not the plate, and then readdress if you have to, again, that link I put in for the breakfast thing. It shows how Arden had this sleep over one night and all the kids came in and they wanted french toast there was like fresh fruit and French toast and I forget all it was there was so much stuff. And I just had to keep, like adding a little bit and adding a little bit. It was timing, still, but based on moments that she ate, maybe you just have to think I know it's such a pain in the butt. You just want to sit down and eat dinner that sucks. I'm sorry. We're about two thirds of the way through this episode. There's still a lot of great questions coming up. But for a moment, I want to tell you about something that some of you know about. But some of you don't know about its continuous glucose monitoring
with dexcom. Now this turns out to be one of those things that everyone in the know knows about right away, you say Dexcom and they have these warm thoughts of being able to see blood sugars and how fast they're moving and understanding trends better. More importantly, you find out Hey, my blood sugar is about to leave the zone I want it to be in and I can bump it nuts. You're hearing us talk about this today bumping and nudging it making these tiny little decisions that are based on the information that comes back from Arden's dexcom continuous glucose monitor most of what I do, I couldn't do without that information coming from from art Instax comm there's just there's no way around it. Today while I was editing this episode, I was watching Arden's blood sugar while she was at school. And we are right at 85 most of the morning and all of a sudden she started to drift a little lower and a little lower. And I didn't have to panic because I could see sure she's going a little lower than I wanted to, but it's not happening quickly. So the first thing I did I cut back or bazelon son, and it helped beautiful right. And now we're five minutes away from giving Arden her insulin for lunch and her blood sugar's 92. She didn't have to eat a whole bunch of food this morning to stop a falling blood sugar I just do in time. I said, Okay, this is what's about to happen. I'll just restrict her insulin here a little bit, everything's gonna be okay. And it was there's just a small example of what Dexcom can do for you. And I was able to see it on my follow up, because Dexcom Sharon follow is available for Android and iPhone. So Arden's phone shares or information on my phone follows that I see her blood sugar in real time, I have not spoken past the music, but let me just tell you this, go to dexcom.com forward slash juicebox, you will not be disappointed. There's also links in your show notes. Alright, let's get back to it. I'm going to ask the first question to get us going again. Do you find yourself accepting blood sugar levels that are higher than you want, because of your fear of insulin? If you do, a lot of people do, but really, really, really, really try to stop yourself from doing that. First of all, if you have a Dexcom, high low threshold, it's important to take your high threshold and push it down. I know people get back open and alarms all the time. But I swear to you if you start doing these things we're talking about here It won't alarm as much. And you can't think of it as this alarm that told you did something wrong. You have to think of it as a warning system. I don't want to know when the tornadoes here I want to know a half an hour before the tornadoes here so I can hide on Arden CGM hers alarms at 130 as her high, but on my side and alarms at 120. So you never 120 straight up and that doesn't happen to us. But if I'm 120 diagonal up little bump brings it right back again. If I didn't know until 150, then it would take more insulin, then I'd have to be harder than by the time they started working. She'd be more than like 200 then it would sit there wouldn't be enough thinking about more insulin and that's how you end up low. That's how this concept comes into play. Highs cause lows because you're using more insulin, and eventually, it gets out of balance. you'd much rather just bump a little bit 120 Oh, here's a little bit of insulin 120 here's a little bit of basal rate. And that way 120 goes boom right back to 110. If you wait until 200 or 250 you are now bolusing like a lunatic and you will get low later. It takes less effort to bump in nudge than it does to ignore. So you think you're giving yourself this time off from diabetes by not being alarmed until it's 200 or 250, or whatever. But all you're doing is creating Three hours later, are you going to thinking nothing about nothing but about this high blood sugar? I'd rather know, every couple of hours, bump, bump, bump, then be steeped in it for three hours. I think think that's just really important. And I think also what's important is the way to accomplish that is to trust yourself. You have to give to really believe when I said it earlier, but you really have to believe that what you've learned from past diabetes experiences is true. And that's it. Just you know, expected. Alright, what else we got anybody else asking questions? Oh, you're welcome. When the emotional girl puberty thing is killing me. Most people say Kelly that I grew out of that by the time they're like, I don't know 27. Robin anxiety Like what? Around bolusing in general, about how you have to address it with insulin.
Unknown Speaker 46:08
Let me know. Has Arden
Scott Benner 46:09
tried the fiasco? Mandy? We haven't yet. I don't think it's what I heard was, it might not have been doing really well in pumps. And I was sort of waiting to hear a little more about that first. But I think that once faster acting insulin is a reality that everything we're talking about now just becomes a little easier if it if it works faster and the way they say it's going to Lindsey asks, What do I treat with in the middle of the night my son never had cavities before type one Yak you're gonna get cavities with type one. If you're drinking juice in the middle of the night, that's for sure. We had a problem too. We had a juice that Arden loved but it gave her cavities. And so we switched to a different juice in and that one's been better. I hear some people say they leave a bottle of water at the nightstand and the kid drinks the juice and then they give them a little swish of water. That helps a little bit. But I have to admit, I use juice boxes. I don't know what else to do. If Arden needs food. I don't know how many of you have this experience. Probably a lot of you but I've seen Arden eat a banana in her sleep. Which is fascinating. You just kind of like put it up through our mouth. Like I'm going to use my my cactus pen as an example. I have a pen that's a cactus I don't think you need to judge me. But um, but you take the just like Arden banana and she just takes a bite. And I'm like and she chews it up. I wait till she's done chicken. I've seen her eat. It's fascinating. But yeah, juice, maybe try swishing with water afterwards. Use a fluoride rinse more often. You know, that kind of stuff. Make sure he's brushing right away in the morning and before bed and stuff. It sucks. Lindsay I know. Stacy, I sent you a Christmas card. Did you get it? Everybody? If you like my book, it's because Stacy Martin Dell helped me with it. She's in the chat right now. If you like my book, thanks, Stacy. I took a bunch of crazy she kept me sane while I was writing by sit by letting me get on the phone and say incredibly inappropriate things to her. Thank you, Stacy. Love you. How do I decide whether to Basal or Bolus in regards to being bold with in some situations? You know, again, like I said, if it's if she's 90, or you know, 110 and I wish she was 90, I might just you know, crank a little bazel. But if there was just food, and our blood sugar's heading up, I'll tell you right now I bolus for food. And in 45 minutes after a meal bolus, I see a diagonal up arrow over 130 I bolus more because I figure I miss because if you'll look at the charts when you look at the links, I know I can Bolus in a way that doesn't let arise happen so four eyes is happening I probably didn't use enough insulin or maybe I miss timed it now I've got to use some and I might have to catch a low on the other side. But you know I again I'd rather catch I'd rather stop below or following blood sugar than fight with a hot one. So it's situational Kelly it's just experience Robin I got to go back to what you said Do I have any advice for anxiety you know the only thing I can say not really diabetes issue just medical and safety outside etc hi Michelle. I guess I guess I don't know what you're asking me Robin I'm sorry like anxiety about like having diabetes or just my kids really chill so there's not a ton of anxiety although she used to get interesting pee you know people say I'm talking about pod chain ties when you change your insulin pump your blood sugar gets highlighter took me a long time to figure out that was Arden's anxiety, the clicking that the pod makes was freaking around. So people are like you know people like to say like the pod doesn't deliver the right you know, right after you put on stuff like that. I've learned none of that is true for us at all. I as a matter of fact, just changed Arden's insulin pump while she was at school on Wednesday. We at 1115 changed her pump because it was going to run out of insulin. I get it in the nurse's office. I went over I changed her pump with her We tested, I cranked up a bazel, like 95% for an hour and a half, and we bolus right then in there. And she didn't get high afterwards. But she's also not nervous about putting a pump on anymore like she used to be. When do I plan on handing over bolusing decisions with two are when she's as good as I am? I don't know. When she we talked about a little earlier, Susan, like I think of this as a slow handoff. I think Arden learns as we go. And so the more she learns the more I asked her opinion. We do do. In the summertime, I try really hard to involve her in every decision we make even the littlest ones, but the fact of the matter is, she's 13 she wants to look at Snapchat, she wants to watch One Tree Hill or something like that on Netflix. And you know, she's gonna figure it out eventually. I'm already exhausted looking like, I'm gonna die soon anyway, I might as well go into the ground hard. Susan, supporting Arden But hopefully, um, you know, hopefully she she's picking it up slowly and slowly. If I have to get more I guess Can you guys hear bazel snoring Faisal
stop buddy Facebook Live you know, as she figures it out when she looks like she knows what she's doing. She does more. And that's pretty much it. She's at the movies now with my wife. And they're not having as much success with their blood sugar's they would have had if I was with them, but it's also you have to look at what I'm saying is not success. Like she's, Oh, hold on. Okay, that's not working. She's 141 but to me, that's, you know, I'm not happy with 141 but that's it. Like my wife did a great job. She came out of a she she came out of a little bit of a almost a low situation. She stopped it with the Temp Basal which is cool. And then if I'm looking at looks like she didn't have the nerve to Bolus while her blood sugar was a little lower. So she saw 150 before she got back to 140 but I want you to keep in mind Arden's probably eating chips, nachos popcorn probably has a Slurpee, to be perfectly honest with you. People are texting me think I'm doing a good job. All right. That's very nice. Here we go more. How long do I wait before giving more insulin to stop there? Always listen, when you listen to the podcast, stop the arrow. If you ever Dexcom stop the arrow, you're always trying to stop the arrow. The arrow goes like this. Stop it. It's going like this. Stop it. You don't want to crush it. You want to stop it. It's bumping and nudging. How long do I wait? She's saying if in 15 minutes, the first bolus didn't stop it, then how would you wait or immediately give more when I would 100% trust your gut. That's what I do. I don't have a formula. I'm so sorry. I just think not enough too much. It just it I really don't think about the math of it at all. I'm so sorry. blood sugar's high more. blood sugar's low, less. Pillow 141 is great. It is but I'm telling you, I could have done better, but they're doing great. They're having a lot of fun. There's no anxiety they're out seeing Pitch Perfect three, which I don't know how they got to three of those movies. But they did I did enjoy the first one. But see pebble that's what you're saying is really it's great. Because it's going to lead me into this very childish statement I'm going to make that I find to be true. Moreover, moreover, more often than not, you get what you expect. So expect a blood sugar of 110 you'll get it because your expectation will let you see that arrow and go No no, no. Right like but if you expect that 150 is not that bad then you'll watch that 110 hours ago huh 121 3140 then you get into that I don't know how old everybody is in here but then you get into that you guys know that game from Bob Barker long microphone prices right? And the the like the little Alpine like mountain climbers going to at least going up the thing and you're and you're watching it goes like oh, it's gonna stop. It's gonna stop it's gonna stop and they falls off the side who he didn't stop. How about that. That's those diagonal up Dexcom lines. I hate them because you never know when they're going to stop because you always he always gives you that feeling right here like what's gonna stop. I don't want a bolus, it's gonna stop, it's gonna stop that it never stops. So just give it a little maybe you don't need the whole thing. Use half the amount of insulin you want. crank the bazel up real quick. Do something. But that that mountain climber most often in that game falls off the side. He doesn't usually stop. It does bring up this though another drink. And we're coming up on an hour. There's two different spikes. You see after a bolus, there's this one that goes straight up and then there's the gradual one. This one straight up to me means you probably didn't use enough insulin at first before the meal right because the food one right away. Now maybe your Pre-Bolus was not long enough and that could also be the situation but it gives you An idea straight up like this means you missed pretty big, you're going to need more in some probably, this might mean, maybe I should have started my Pre-Bolus. Five minutes sooner, maybe this would have been this. Maybe it's a little bit of insulin, but the severity of that, you know, if you're if you're getting this, I attack again, attack, don't don't defend don't, when you're reacting the diabetes, you're usually losing, you should be making the first decision, because at least then when it like if the budget is going up like this, and I go, whoo, two more units, which I'll do sometimes like two more, three more and more and more and more. And then and then all of a sudden, the arrow stops and it goes like this real quick. You're like, oh, what I do what I do what I do, but sometimes you just go Okay, think of it this way. So you put in a unit for an up arrow, and her basal rates a unit an hour, well, if Five minutes later, the error levels off. Just shut the bazel off. Just trade that bolus that aggressive bolus you used.
Unknown Speaker 55:59
Go Oh, geez,
Scott Benner 56:00
it turns out I didn't know that and take it away from the it's like borrowing money. You know, I took I put some here, but I don't need it anymore. I'll take it from over here. And I'll get balanced again. I hope that makes sense. Doesn't it take the bazel time to kick in it does. Kelly that's where I can't decide whether Basal or Bolus It's a situation thing. I mean, if if Arden's blood sugar starts going up right now, then it's a it's a bolus. If it's drifting, like, you know, when that arrow doesn't move, but you go from 105 to 110, maybe I try a bazel. Then, when you have more time to wait for the Basal to work, use the Basal or a combination. We haven't talked about this. But if you're trying to affect the high blood sugar, or or beat down like food, high carb food, there is nothing like a mixture of Basal and Bolus. Excuse me, I don't know why it is. I don't know that. Honestly, I don't know the technical reason for any of this. But if I see if I think oh, this Chinese food is going to take 12 units, and ardens Basal rate right now I think might be like 1.7 an hour. Well, then I'll double her bazel for like an hour and a half and think okay, well there's two units two and a quarter units. And now I'll put 10 more in the Bolus. But I like having in carb heavy situations, I like having Bolus ramped up and Basal at the same time, I find that that works better it also if you have a 300 blood sugar, don't just Bolus it. Double your Basal to it'll bring it down faster and smoother. Alright, that's everybody out of questions. There's still a lot of people, you guys really hung out. I appreciate? Did I not answer anything or a couple people here I was hoping would come in that I didn't see. I give you a little bit of a personal thing. I don't know, nobody's asked about it. But if I was you, I would live like a cure to type one diabetes is never coming. I would hope for it in the back of my mind. But I think that worrying about it every day is it's too much to take. Just I live like it's never gonna happen. I never stop hoping but I assume in the decisions I make that it's not going to happen. I think it can be very dangerous to think that you're welcome, Kelly, to think that, um, it's coming. So I don't have to take very good care of myself right now. You should, you should assume it's never gonna happen. Hope it will. You know, I hope it will too. But I don't, I don't expect it. And so we make decisions based on this is what diabetes is. And this is what I have to do. Alright, let's go over a couple of things. Insulin is like fire, respect it, don't be afraid of it. Gotta be bold, you have to be bold with insulin. You have to be there is a reason people emailed me and said please make bold with insulin t shirts. Because it is a mantra you got to keep it in your head. I need to be bold, I need to be bold, I got it I have to beat my fear back always By the way, still test you know don't be Don't be a lunatic but but within reason. err on the side of too much of a top too many times, all of us with diabetes, we err on the side of caution and that always leads to high blood sugars. So be more aggressive You know, when I started doing the more aggressive thing when I started being bolder I started adding in this insulin and I thought oh my god this is gonna be way too much but it wasn't even enough and I was like oh, I need more I thought I needed less like how could it was just my fear so just try more like when people say I don't know how to change my adjustments on my pump turn them up use more try it you're not gonna get you know if your basal rate is one an hour and you go to 1.2 you're not killing anybody over that you might just get low and go I was too much but you're probably not going to it's not that much more insulin just try you have to try things please don't wait to go to your endo. Although those are great. Happy Holidays. Robin How can I was every Merry Christmas Happy New Year guys excited right? I don't know what I'm getting. I'll tell you what I got Kelly though. woman goes to sleep at night a body turns into a furnace and then she puts the air conditioner. On and almost kills all of us. So I've bought this giant ceiling fan that the reviews I say, Tell me are going to literally blow us down into the bed. And hopefully that will keep her cold. I will still freeze, but the children will be saved. So really how long before I cracked Jason, when I think I screwed up? That's it.
I really, I really, as soon as I think Oh God, I did this wrong, I put in more. Because like I said, You it juice boxes is a great example. You can always use the amount of juice box takes and if you're wrong, if you use the insolent you didn't need it. It's like Pre-Bolus in the juice box. If you're right, you win. And so at the very least you get information for next time. And you're able to say Okay, you know what, last time I saw this 140 diagonal up, and I put in three units. But I need to have a juice box later. So next time, I'm going to do a unit in half and see what happens there. It's always that math. It's I call it the Juicebox Podcast math. I did this, this happened, I wish that would have happened. So next time I'm going to do that it's a formula that should lead you to a better and better situation as you move forward. You're welcome when I hope it was helpful. I thank you. Oh, how long? Hold on, Jason. How long before I correct? No, how low? How low? Oh, hold on. You mean, if I'm falling? When do I do something about it? I don't think of origins blood sugar as being low until she's under 60. I start doing something about it at 70. Her lows at 70. So if it's been four hours since food, and she's 70, I might just cut her bazel off for a half hour to see if I can get the drift. But if she was 70, diagnol down, I would do something about that. But 70 and 130. Those are that's the range that we react in most of the time. Hopefully she brought me an electric she doesn't think about me at all, Kelly that that's that's obvious after being married for 21 years. So I'm just here to take out the garbage and take care of the diabetes and stuff like that. See the sparkling Santa Claus in the background? I asked for that not to be put up. There it is. No one listens to me. Time. Rachael Haynes, you just joined except we're getting ready to stop break. Should you have any questions? I'll hang out with her a second. Hey, guys, this is gonna be available on the podcast this weekend. What is it Friday, I'm gonna put it up. I'll put it up like Christmas Eve or the day after Christmas or something like that. So you can go back and listen to this whole thing I've been recording the whole time. Let's see my microphones for the podcast. Actually, before I say that, let me look to make sure it's actually recording it is. I did it. So this would be part of the podcast or you can always come back to the Facebook page here and listen to it again. Rachel, you are late. Do you have a question? Because I got a bail. I'm gonna go. I'm gonna go make dinner. Arden's gonna come over to the movie, and I'm gonna have a whole little thing for I'm hanging out, Rachel, I'm giving you time, Rachel. Yes, did anyone asked about nighttime spikes due to growth hormones, I find them so hard to get down. They are hard to get down because you are not using enough insulin. They're terrible. And they're scary to Bolus. I'm sorry, I'm warm. They're terrible. And they're scary to Bolus for because you want to go to sleep. Everybody just wants to sleep. When your blood sugar is too high, you don't have enough insulin. So you need more. It sucks because you kind of can't plan for it. You don't know when it's gonna happen. It'll happen like two or three days in a row, then it won't happen again. I always just try to wake up in the morning and think at least
Unknown Speaker 1:03:36
she's getting taller. Yay.
Scott Benner 1:03:39
It sucks. There's no rhyme or reason I would use a combination Basal Bolus on something that I knew was going to be really difficult like that. And, and like I've been saying the whole time you can Bolus, you know, you got to be a little aggressive with the bonuses. you'd much rather stop a low because think about what's happening to you with these highs. It's going up and staying up for a long time. Right? That's not the time to be scared with the insulin. If you should get low afterwards. I would much rather address the low than fight with the high online. It sucks. It really does. I'm sorry. The good news is they won't grow forever. It is very hard to predict. Rachel Rachel says it's hard to predict. They don't always happen at the same time. They sometimes will happen four nights in a row and then not happen at all. You have a CGM, I hope and just he just got to react as fast as you can and and trust what you've seen the last time like if it happened Tuesday night, and Wednesday night you get woken up with the same sort of rise. I would be as aggressive I would think back to the night before and how much insulin did this take and I would I would get involved in getting as much of that insulin as I could. also keeping in mind how long has your pumping on if you're pumping, you know you might have a first day of the pump might might be better than the third day of the pump when the site starts to get a little old. Yeah, Rachel, um, I don't know where you have the high threshold. But I was just telling everybody, I have mine at 130. So it may be if you give yourself the ability to react sooner, it won't get as high, you can be a little more aggressive a little sooner. And stop the stop the spike a little bit. This is all Rachel, go back and listen to this when it's over. But this is all about just insulin and timing. It's not really I wish I could say the diabetes was really complicated. But once you understand how the insulin works, and that most of this is about the amount and timing of the insulin, it is at least easier to diagnose things because a lot of the variables here's something I didn't say before. People spend way too much time wondering why things are happening. Oh my God, my kids blood sugar went up. I don't know what to do. Why is it because of food is because who cares? Why more insulin?
Unknown Speaker 1:05:53
Right?
Scott Benner 1:05:55
What Why do you care? Figure it out later. So that next time maybe you can get ahead of it. But I see too many people online spending hours putting up graphs going What could this be? What could this be? I know what it definitely is? It's a high blood sugar. So insulin, right? And so I think similar to that, he says how palsy gonna be Oh my god, you'll be dead. By the time he gets done growing, Rachel. I mean, at least exhausted like a zombie, right? I'm sorry. It sucks. It'll be Spitz in spurts. It'll, he'll stop again. It won't last that long. I know. It sucks. I mean, I know better than anybody with these dark circles under my eyes like literally like they're tattooed on at this point, I can't get them to go. Is novolog works quicker than others does. novolog work where I think insulin works for different people in different ways. Arden doesn't use novolog she uses a pager. We used to use no alive. But we see a lot of double arrows up dalaras down with no vlog. I don't ever see a double arrow ever with a pager. And I find it to be a little smoother acting. It definitely works better for artists than anything we've tried so far. Which is the only thing I would say there is is that insulin is not the same for everybody. And you may have to try a couple different. A couple different brands to figure out which one works best for you. All right, guys. Say goodbye. So I can hang up, say like Merry Christmas or Happy New Year. And then I'll know everybody's like on target. Now if you guys listen to the podcast, please subscribe. So when the new ones go up, and then tell people about it. Because that's how it grows. And it has grown really well. And hey, Terry, how are you? Oh, Tyree. You're I'll pull something up to tell you real quick. I don't usually talk about it quite like this. So the podcast will be three years old in a couple more weeks, just 353,000 downloads. That is pretty cool. So I at this point receive an email almost every day that talks about I learned to be bold, I've gotten rid of my fear. And my agency is going down and my my blood sugar is less valuable. I promise you go back, listen to the podcast. Take your time to listen to these conversations. Eventually this information builds up and it becomes a repository for you. And then when you're having these experiences you don't sit around wondering what to do you just instinctively know and that really is what we're talking about. Like how do you know how do you know because eventually the experiences build up. So Alright guys, I love you guys. I love that you guys are being so bold, Merry Christmas to everybody. Happy New Year Happy Hanukkah, if you were doing doing the Hanukkah thing, which I think is over or almost over. But thanks so much. Bye guys. The Juicebox Podcast is going to be sponsored again in 2018 by Dexcom and Omni pod these are the tools that we use here to help Arden's Awan see stay what has now been between 5.6 and 6.2 for four years, I vouch for these companies like no other go to my omnipod.com forward slash Juicebox Podcast dexcom.com forward slash juicebox if you want to learn more, we're please use the links in your show notes because that sort of helps us a little bit. I've been getting a lot of great reviews on iTunes from you guys. Thank you very much. That is really fantastic means a lot to me. I really love getting all your notes over the holiday season talking about all the success that you guys have having really just really helped me have a great holiday season. I appreciate it. All the interviews are coming. We got a whole bunch of them lined up episodes are going to come every week in 2018 and all I ask from you all I asked from you in return he's to share the podcast with someone else and listen all the way through and subscribe and don't say anything mean about me online. And I mean that's pretty much all I'm asking unless you want to bold with insulin t shirt then you should go to Juicebox Podcast comm where I will actually ask you for money for the T shirt.
Unknown Speaker 1:09:48
I'll see you next week.
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