#1485 Cookie Mom

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Tiffany recounts her misdiagnosis, a life-saving low blood sugar emergency rescue, and exploring GLP-1 treatment options with her endocrinologist.

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Scott Benner 0:00
Welcome back, friends to another episode of The Juicebox Podcast.

Tiffany 0:15
Hi, my name is Tiffany. I have had some form of diabetes for the last 11 years, and recently found out within the last two years that I'm actually type one

Scott Benner 0:27
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. Don't forget to save 40% off of your entire order at cozy earth.com All you have to do is use the offer code Juicebox at checkout. That's Juicebox at checkout to save 40% at cozy earth.com AG, one is offering my listeners a free $76 gift. When you sign up, you'll get a welcome kit, a bottle of d3, k2, and five, free travel packs in your first box. So make sure you check out drink AG, one.com/juice, box. To get this offer. Are you an adult living with type one or the caregiver of someone who is and a US resident? If you are, I'd love it if you would go to T 1d, exchange.org/juice, box. And take the survey. When you complete that survey, your answers are used to move type one diabetes research of all kinds. So if you'd like to help with type one research, but don't have time to go to a doctor or an investigation and you want to do something right there from your sofa, this is the way t 1d exchange.org/juice, box. It should not take you more than about 10 minutes. The episode you're about to listen to was sponsored by touched by type one. Go check them out right now on Facebook, Instagram, and of course, at touched by type one.org, check out that Programs tab when you get to the website to see all the great things that they're doing for people living with type one diabetes touched by type one.org the show you're about to listen to is sponsored by the ever since 365 the ever since 365 has exceptional accuracy over one year, and is the most accurate CGM in The low range that you can get ever since cgm.com/juice cgm.com/juicebox, this episode of The Juicebox Podcast is sponsored by Medtronic diabetes and their mini med 780 G system designed to help ease the burden of diabetes management, imagine fewer worries about mis Bolus or miscalculated carbs thanks to meal detection technology and automatic correction doses. Learn more and get started today at Medtronic diabetes.com/juicebox.

Tiffany 2:49
Hi. My name is Tiffany. I will be 42 in three weeks. I have had some form of diabetes for the last 11 years, and recently found out, within the last two years that I'm actually type one last

Scott Benner 3:03
two years, two years. Yes, okay, let's go through that. But first I want to tease people out a little bit. Sure you have a great story, but you're on the podcast most specifically because you saved yourself with G, VO, hypo, pen recently. Is that right? I did. Okay, all right, we'll get back to that. Sorry. I just, you know, want to make sure people hang on, because it's going to be a good story. Let's see 42 now, just about your birthday. Happy birthday. Thank you. Maybe we share a very similar birthday on the 12th.

Tiffany 3:36
That's my daughter's birthday on the 21st Oh, congratulations.

Scott Benner 3:39
Arden's is the 22nd that's so cool. Yes, please don't send cards. Let's see you've had what does it mean you've had diabetes for 11 years? How were you diagnosed?

Tiffany 3:49
Oddly enough, I was diagnosed with pre diabetic. We were trying to have our first daughter, and we were having trouble conceiving. So the OB did a whole bunch of the fun little blood work that they do, came back as pre diabetic. Changed the way I was eating, cut out all of the extra fruit I was eating, and was able to get pregnant within like three weeks. So they immediately put me on insulin, sent me to a diabetic educator. But again, no one told me how to actually use the insulin, or that my insulin needs would vary greatly while I was pregnant. Hey,

Scott Benner 4:32
wait a minute. So did they see you as pre diabetes type two? Yes. Okay, and so somebody, Oh, that's interesting. So you got your blood sugar down a little bit, that got you pregnant, and then you don't have any direction, even through the pregnancy, about how to manage,

Tiffany 4:52
um, just a whole lot of threats from my OB that if I can't get my blood sugars under control, my baby is going to be in the NICU. Too overweight, I would cry leaving every OB appointment. And I'm not the type of person to cry regularly, so I would be so upset, probably because of the hormones as well, but I would be so upset leaving those appointments because they were threatening me about my blood sugars, and I was doing everything I could to keep them in the range that they wanted them in, but nobody that there was no education really offered on exactly how to do that.

Scott Benner 5:28
The OB sent you to an endo. No, no. Who gave you the insulin? They

Tiffany 5:33
did give me a referral for an endo, but the OB actually first sent me to nutritionist,

Scott Benner 5:38
okay, yeah, well, yeah, I'm in the very beginning. That's what got you going. But once you're on insulin, who's managing the insulin, who's prescribing

Tiffany 5:45
it, I would see an endo once every three months,

Scott Benner 5:49
okay? And that was just for the did you think that was just for the pregnancy, or did you know that was forever? I thought it was just for the pregnancy. Okay? There's always a lot of confusion here in these stories. Okay, so you believe yourself? Do you think then that you're type two, or do you think that you're experiencing gestational once you're pregnant? I'm thinking

Tiffany 6:11
I'm type two at that point. Okay, my insulin needs obviously dropped off to next to nothing right after. I had to be like, in the hospital. While we were still in the hospital, they were like, Okay, well, we're gonna give you like one unit of insulin. I'm like, wait a second, I just had like 80 units of insulin with breakfast yesterday. And then they put me so out of the hospital. They put me on Metformin, which was a roller coaster, because I had crazy gi effects with metformin. Yeah, I don't find out until a few years later that the one that they finally put me on that was that I could tolerate, was the osmotic, extended release version, which I find out later when I drive myself to the hospital with a high blood sugar because I stopped taking it cold turkey, which was a very bad thing, but I couldn't handle taking it because my my insurance changed and would no longer cover the osmotic release or extended release, so They just gave me the different version without telling me. My pharmacy changed the prescription without telling me.

Scott Benner 7:26
And you were like, once you started having the GI issues again, you're like, No, thank you. Yes, I see. And you are, well, let me, let me get a tiny bit more background. How many kids do you have? Sure, two, two. But that first one's about 10 years old, yep, okay. And then How old's the second? Two and a half? Oh, both girls, right? Yep. And okay, so you are using a ton of insulin during the pregnancy. You experience a drop in a need as soon as the pregnancy is over. Is that right? Yep, okay, and then they put you on Metformin, because now they're treating you interesting. Okay, so then they put you on Metformin. Is the Metformin keeping your a 1c down, or is it not really helping?

Tiffany 8:13
I'm kind of riding in the mid sixes. Okay,

Scott Benner 8:16
mid sixes for years. How many? Probably

Tiffany 8:20
about, well, they start experimenting with other things because the mid six is just that wasn't a good enough target, right? Um, so I'm like, Okay, I'm eating good, like decent. I'm not eating terribly. My portions are good. I'm not eating like cake every day. I'm exercising regularly, and I just can't lose weight. I'm doing every everything that I'm doing should suggest that I should be losing weight. I can't lose weight. So we start experimenting. Okay,

Scott Benner 8:50
before, before you tell me about the experiment, the weight. Did you have it before the pregnancy? Or did it come with the pregnancy? I

Tiffany 8:57
had it before the pregnancy. I started having issues with my weight around 2007 because that's when we actually found out I was diagnosed with Hashimotos. Oh,

Scott Benner 9:09
okay, okay. Oh, and so nobody, all right, well, we'll get to that. So, so you had Hashimotos 2007 is it well regulated? Is your TSH under two or no. Today's episode is sponsored by Medtronic diabetes, who is making life with diabetes easier with the mini med 780 G system. The mini med 780 G automated insulin delivery system anticipates, adjusts and corrects every five minutes. Real world results show people achieving up to 80% time and range with recommended settings, without increasing lows. But of course, Individual results may vary. The 780 G works around the clock, so you can focus on what matters. Have you heard about Medtronic extended infusion set? It's the first and only infusion set. Enabled for up to a seven day wear. This feature is repeatedly asked for, and Medtronic has delivered. 97% of people using the 780 G reported that they could manage their diabetes without major disruptions of sleep. They felt more free to eat what they wanted, and they felt less stress with fewer alarms and alerts you can't beat that. Learn more about how you can spend less time and effort managing your diabetes by visiting Medtronic diabetes.com/juicebox Today's episode is sponsored by Medtronic diabetes, who is making life with diabetes easier with the mini med 780 G system. The mini med 780 G automated insulin delivery system anticipates, adjusts and corrects every five minutes. Real world results show people achieving up to 80% time and range with recommended settings, without increasing lows. But of course, Individual results may vary. The 780 G works around the clock, so you can focus on what matters. Have you heard about Medtronic, extended infusion set? It's the first and only infusion set labeled for up to a seven day wear. This feature is repeatedly asked for, and Medtronic has delivered. 97% of people using the 780 G reported that they could manage their diabetes without major disruptions of sleep. They felt more free to eat what they wanted, and they felt less stress with fewer alarms and alerts. You can't beat that. Learn more about how you can spend less time and effort managing your diabetes by visiting Medtronic diabetes.com/juicebox.

Tiffany 11:35
Yes, currently at point 740, good for you, but that was a roller coaster as well. Getting that

Scott Benner 11:42
straight was hard too. Yes, yeah, there's a lot of things that doctors aren't sometimes very good at helping with, and thyroid can definitely be one of them. Nope,

Tiffany 11:52
as soon as they would get me within the acceptable range, I was basically accused as being fat and lazy. Oh,

Scott Benner 12:00
so as soon as the TSH dropped, they were like, see, you haven't lost weight. Magically. You haven't lost weight magically. So you're not doing anything. You're eating poorly, correct? Yeah, it's tough. Oh, I lost my train of thought. What were you gonna tell me? Experimenting,

Tiffany 12:12
experimenting with different type two drugs. Thank you. I think I've tried, like, Invokana, that was, like, one massive yeast infection, like, for a month straight.

Scott Benner 12:24
Wait, I'm sorry, are you using yeast infection as a euphemism, or you actually had a yeast infection.

Tiffany 12:29
Actually had one. See, I never had one previously in my life, like ever, until I went on in O'Connor. Because

Scott Benner 12:36
the reason I asked is because I've heard people say, like, dumpster fire show stuff like that. But I was like, is yeast infection a euphemism? I don't know.

Tiffany 12:44
Now shows basically my favorite one to use. Sorry,

Scott Benner 12:49
you have a month long yeast infection sounds like a party. Do you know why? What about invocana? May or may not have had to do with that. I

Tiffany 12:56
don't know. But when I would Google, I would find that that was a common side effect for diabetics on

Scott Benner 13:03
that drug, or just on that drug really, okay, yep,

Tiffany 13:09
we tried glomiparine, and I would drop really, really low. I would have lows.

Scott Benner 13:13
Okay. So how long did you try that? For? Probably about a month or two. So how long is this, this whole experimenting going on for? I want to

Tiffany 13:24
say straight through to about 2018, so, like, four or five years. Okay? I tried Victoza, could again, GI issues. I really tried to stick it out. And I just, I couldn't. I was like, running to the bathroom at work, I would get sick and nauseous. It was terrible. And I was like this, I just can't an honest to God show. You're saying an honest to god actual show.

Scott Benner 13:51
Hey, I want to tell you I have a little bit of information here before we move forward. Invokana could the mechanism of Invokana, while effective in controlling blood sugar also leads to increased the risk of yeast infection. And diabetics, for several reasons, increased glucose in the urine, moist environment. I don't want to read this, but I'm going to the presence of glucose in the urine can contribute to a warm and moist environment in the general area which is conducive to yeast growth. Sorry about for that. One diabetic vulnerability are people with diabetes are already at a higher risk for infections altered microbiome. The altered glucose levels can disrupt the balance of the normal microbiome in the general area, allowing yeast to proliferate. Well, live with that thought, everybody Wait. Does that mean there's little bugs in your now, let's not talk about that. Okay, sorry, um. Omar, yeah, all right, okay, sorry. You know it's so funny, like, I reached out to you. I'm like, you want to tell your story about glucagon. You're like, yes, but then you sent me this list. You're like, I'm a episode on my own. I was like, oh, okay, well, like

Tiffany 14:52
a recurring guest, seriously, because I actually did a full, like, write up, because I was just trying to, like, write down my whole history. And it was like five pages. As long. So you got a very shortened list of what truly is my show journey you're gonna be. You're

Scott Benner 15:05
gonna be like, somebody who just comes on every six months and like, Okay, where were we and this, alright. So then you go to, what was the next thing you

Tiffany 15:13
tried? I think we were just back on, back on Metformin at that point, because that was the so we, we did the experimenting, and then we had the Metformin, and then I had the episodes before, where I stopped taking the Metformin when they switched the dose. And I was actually at an amusement park one day and ended up in their like medical area, first aid area. I was testing my because I only had a meter at that point testing my blood sugar, and it was just reading high. So I think that meant, like, my blood sugar was over 500 the person in the first aid area just told me to drink a lot of water well. And I'm like, okay, so I did that, and it gradually came to a walking around in the amusement park. With the exercise eventually brought me down, I guess. But I'm actually questioning whether or not that may have been like DKA. Not sure.

Scott Benner 16:07
I mean, it's, you know, it depends on how long DKA can come on, very quickly. It could, actually can happen without enough insulin, even with a an in range blood sugar. So, right, which

Tiffany 16:18
I've learned from the podcast. Oh,

Scott Benner 16:20
sorry. I just, I just drop in these little things as we're talking. Do you think sometimes people are like, I've heard him say that before, and I was like, Yeah, but everybody hasn't heard me say it, so I'll slip that stuff in. Okay, so you're wandering around this park on just Metformin.

Tiffany 16:35
That's when I stopped taking there's like, a weak stretch of where I stopped taking

Scott Benner 16:40
it. You're like, I'm stopping this, and I'm riding a roller coaster. Roller coaster,

Tiffany 16:43
pretty much roller coaster. Indeed, me

Scott Benner 16:47
and my moist, gentle area are gonna go to the Six Flags. Jesus Christ. Do you feel crazy at this point? Like it's a number of years into it now, and this is just like, like, people really have to step back when they listen to this and recognize that the span of time and days in your life that go by with all this inconsistent information and unknown like outcomes that are happening all the time, like, does it just eventually get to you? Do you just think I'm just a sick person? I

Tiffany 17:14
never really felt that way. My husband was like, Okay, you suck. Like like you're always sick, and I'm like, You're just generalizing, I'm not always sick when you're in it you don't realize how long it truly is. But when we finally get to the end, and I look back like I'm feeling all the feels, because I am just pissed off at this point that people have literally twist my life for the last 10 years?

Scott Benner 17:43
Yeah, okay, it's a decade. It's into your husband's point. Like, it feels like you go to the store and there's like 50 boxes there, and you somehow grab the one that's missing apart, like there were so many girls like, how to get this one. But no, seriously, they, they. It's important to bring up, because I believe that while you're going through all this, sometimes the person going through it is the last one to really see it, and it does impact the people around you. And then, you know, finally, you have this reckoning where you understand fully what's happened to you. And I don't see I mean, you gotta have a really good attitude, not to feel like somebody stole something from you. You know, well,

Tiffany 18:24
you go through the range, like the stages of grief, almost for the years that you've lost rage, you know, you're sad, you're depressed, you're whatever, but then I am way too much of a take charge person. And obviously, you know my kids, they put everything into perspective and give you something to like. Well, I may have lost this time with you before, but we're going to make the best of everything now,

Scott Benner 18:49
I try to remember too, that all the things that I figure out about my health could likely help my kids one day, and then they won't have to waste that time. That makes me feel better about it. Sometimes, absolutely, yeah, yeah.

Tiffany 19:01
Or, and then any stories that we can share like this, part of the reason why I wanted to come on and share is that somebody listening somewhere, hopefully will think a little bit more about advocating for themselves to get what they need to get. Yeah, we're going

Scott Benner 19:15
to reduce moist genitals everywhere with this conversation today. Also, I think we're going to save some people's assets when you talk about your what happened with your glucagon. But okay, so anyway, we get through all this, this time and and you continue to live the way it goes. What gets you to the somebody saying, Hey, you have type one diabetes real quick.

Tiffany 19:37
I want to back up for a very quick story, because we we're not there yet. Oh, okay, we get to a point of where trulicity. So I start trulicity. That actually was very helpful. I was all. I also get to a point of where I'm like, Okay, I'm done with this. I felt like I had better control blood sugars while I was pregnant using a. Actual injectable insulin. So I basically bully my endo to give me insulin so I can just do it on my own. I do get much better control there, but I still end up having crazy lows again, still not fully understanding how insulin works. The big one for me, I think, was fat and protein and how that really affects insulin, because I would do all of my dosing up front and be like, What the hell just happened? Yeah, um, you'd crash. I would crash. I was like, Okay, so my husband sees the Dexcom Super Bowl commercial for the g6 really, with Joe Jonas. And he was like, You need to get one of those. And I said, Oh my gosh, that is exactly what I need, so that I can prove to my doctor that she has me on too much freaking insulin.

Scott Benner 20:50
Can I say something before you go on? Sure. When Dexcom put Joe, Jonas, no, Nick, Jonas, Nick, right. Nick, yeah, sorry, sorry, sorry. Everyone's like, you don't know it's Nick. I'm like, I don't really when they put Nick Jonas in that, in that Super Bowl commercial, I heard so many people bitching, right? Spending all that money. That's why these things are so expensive. You don't have to do that. Blah, blah, blah. And this also came very much from the, I don't want to just say the Instagram crowd, but like, there's that age range. You know what I mean? When you're like, 26 you think you understand everything. Sorry for 26 year olds like you, you have big ideas about things, and sometimes you don't recognize there's other things you still haven't learned about life. And you make these big pronouncements. I saw a lot of these big pronouncements from people of a certain age. This is a waste of money. Blah, blah, blah. Like, first of all, a million dollars is a lot of money for a commercial. I don't actually know what Dexcom spent on it, but let me just say this, like, in the grand scheme of things, it's not that much money. So, like, you know, like, if they gave back, if they took the million and split it up amongst all of you, you'd all get about 46 cents to just calm down. It wouldn't make everything you know, 50% cheaper, nevertheless, that goddamn commercial saved Tiffany, you know, and how many other people who are like, you know? Just because you know about it doesn't mean everybody knows about it. And so you got to get out there in the public and show people, and that was, you know, a bold thing to do. It's so funny because, like, we complain and complain that diabetes companies don't do enough. They don't do enough. They don't do enough. And then one company is like, you know what? Let's reach down deep in our pocket and buy a Super Bowl ad. And they do it, and then people complain about that. I just love watching people complain nevertheless.

Tiffany 22:31
Well, I feel it's the human condition, right? People are not like content with life unless they're bitching about something, apparently,

Scott Benner 22:37
also a little bit of your Philly accent came out a minute ago. I appreciated that. Oh, yeah. Are you from here originally, or just Pennsylvania in general,

Tiffany 22:48
Pennsylvania in general? But it's funny because my older daughter, when she was in daycare, they're like, Do you have family in New Jersey? Your daughter has this accent, which is a perfect blend of like, Pennsylvania Dutch and New Jersey.

Scott Benner 23:02
Yeah, no kidding. My grandmother was Pennsylvania Dutch and she she spoke out of order. And I've never, yeah, I've never. I The best way I can never explain it to people is that if there was a cow on the other side of a fence, and she was on this side of the fence, and she had to throw hay to the cow. She'd say, throw the cow over the fence some hay.

Tiffany 23:24
Yeah, I think it's the, well, it's just like the bastardized German, because that's basically what Pennsylvania Dutch is, yeah. And it's just the order of their, like, adjectives and verbs, yeah. Anyway,

Scott Benner 23:33
I just heard a little bit of like you almost sounded like an actress who was told they were going to be in a movie that was set in eastern Pennsylvania. It was fantastic, nice. I'm so sorry. Anyway, the Super Bowl commercial, let's assume it's the year that the Eagles killed the New England Patriots and embarrassed Tom Brady, and then move on. So you saw that commercial, and then what happened?

Tiffany 23:55
So I reach out to my doctor, who has to do this like huge justification for my insurance company, because I'm type two, but we get that taken care of. And I'm like, Yes, finally, things are coming together. I have my insulin. I can micromanage the hell out of my diabetes now, because I'm a data junkie too. So now I'm like, I'm going to have all of this data. It's going to be great. Two months later I get pregnant. Well,

Scott Benner 24:23
so you were really managing your a 1c and your body loves being pregnant when your blood sugar is not high, apparently. So

Tiffany 24:28
apparently, but that kind of it like, I'm like, yay. This is super happy. And we it was planned, and we loved it, and it was fabulous, but it was going to basically with me proving my doctor wrong? Oh,

Scott Benner 24:42
you're like, but I, I really, I need this insulin. I wonder, insulin like, I need

Tiffany 24:47
to prove her wrong. I need to prove her wrong. So now we're, you know, riding the pregnancy wave yet again, crazy, crazy amounts of insulin. I do okay. For the most part, I do. It's total. Different ball game wearing a Dexcom when you're pregnant, versus just testing your blood sugar. And I'm like, wow, you go low. Like, a lot, like, especially when your older daughter's favorite meal is Fettuccine Alfredo.

Scott Benner 25:14
Yeah, it teaches you a lot being able to see your blood sugar like that in real time. I think, honestly, everybody would benefit from seeing their blood sugar a couple of times.

Tiffany 25:22
I think, like anybody who is diagnosed as diabetes should have a CGM, like, I just

Scott Benner 25:28
at no point did anyone say you have Hashimotos. That's an autoimmune issue. I wonder if you're type one. Not

Tiffany 25:34
a doctor, okay? And now I've seen, I've seen at least three different end those at the same practice. Now I

Scott Benner 25:40
just want to brag for a second if I talked to you, then I would have figured out you were type one in eight minutes. That's that in the beginning of the episode, I would have been like, wait, no, you probably have type one. Yeah. Okay, so

Tiffany 25:51
fast forward through the whole pregnancy again. Go off. Well, not that insulin needs reduce after my second daughter is born. She does almost try to kill me on the way out. So that was that was fun to grab onto something. What happened? Well, maybe because I was hemorrhaging. Oh,

Scott Benner 26:12
Mom, we should bring this kidney with

Tiffany 26:13
us. Yeah, like we need extra parts on the outside.

Scott Benner 26:18
I, by the way, don't know how the body works, if I just assume you can grab everything while you're in there, but go ahead. Who knows? I'm sure someone knows. I almost

Tiffany 26:25
pass out, you know, because they always try to give you the baby, like, right away, when, when they're first born, yeah? And yeah, it's all fun and great. And then you kind of have this superpower of where you don't feel pain. Yeah, not me. They put her on my chest, and I was like, yeah, no, not yet. No, no, I can't. I can't. Why felt myself flipping Okay, and this is valid, because it would later when we talk about Chivo, I was as close to feeling like I was gonna die when I was having her as I ever did. And I just heard a voice in my in my head, say, you can't give up. If you give up, you'll die,

Scott Benner 27:02
really, jeez, from the hemorrhaging so

Tiffany 27:05
well from the so my epidural didn't work. Oh, and I had, you know, the contractions for they they induced her, she wouldn't come out. They tried absolutely everything I was going through during COVID. So the only person there with me was my husband. So no, like, real, like, support. I mean, I love my husband, but like,

Scott Benner 27:27
Tiffany's like, he was done, yeah, right after he got me pregnant, I didn't really hear from him again. Didn't have a lot to do.

Tiffany 27:35
So I do love him dearly. They were to the point of where they were going to give me laughing gas, and then they're like, well, we can do this. But then I was like, I tell him. I was like, You need to get that doctor. Like, I'm ready. I'm ready to push. And he is like, no, no, you're not. She just said you're not ready. And I'm like, I'm telling you I'm ready because, like, unless you've physically had a child before, there's just your body just knows right when it's time. And she came back over, and I think I dilated from like seven to 10 inches in like five minutes. So that was real fun. But anyway, so. But that feeling, that feeling the voice in your head of like you cannot give up, you will die if you give up, was again, the first, the closest I ever felt like I to coming that I was gonna die. Second would have been the G, VO, guess. But anyway, after I have her, my blood sugars, believe it or not, are terrible. I was riding in like the 250 to 300 Oh, I don't know, for probably about three months. It pushed my a 1c to a 9.4 and there was no like, I would ask. I'd be like, what is happening? Like, why is this so high I also had crazy, terrible inflammation in my hands, to the point of where I was even having trouble picking my baby up. The answer for that was steroid injections. People are

Scott Benner 28:56
like, you seem like you're hard on doctors on I'm like, well, have someone come on and tell a story that doesn't make it sound like nobody's doing it. Nobody's doing anything. What I wonder is, I see this happen sometimes in complex medical situations, what yours is because, like, the timing around the pregnancy confuses people. You know, the the oral medication seems to help, which confuses people. I get all that, but sometimes I think it's because they know the whole story that they're confused. Like, if you just went to a new person on that day and said, You know, I was needed insulin. I got pregnant, the pregnancy ended, and I just need, like, my blood sugars are 250 constantly. By the way, I have Hashimotos. A new set of eyes would have went, Well, yeah, it sounds like you sounds like you have type one diabetes.

Tiffany 29:43
But okay, so now, now you'll find out how I got there. Okay, daughter number one decides that, like, hey, let's, let's, let's be a Girl Scout. So we sign up and I am again, super type A I become. The cookie mom, so that means I'm going to be in charge of all of the ordering of the Girl Scout cookies for our entire troupe. So through this, I run into another girl scout mom who essentially has the cookie cupboard at her house. So every week my troop says, Hey, this is how many more cookies we need. I go to the cookie cupboard to get the cookies for our troop. It's funny because just in normal, like 15 minute conversation picking up cookies each week, we get into a conversation about thyroid, and she tells me that her daughter was recently diagnosed as type one. So this conversation is happening in April of 2022 so her daughter was diagnosed in October, and she's like, Oh, I listened to this podcast while I walk. It's great. So she starts telling me about the podcast, and then the next week, she's walking by dropping off some cookies for me, and she says, Hey, I'm going to send you a link. There's this article about Lada, so the latent auto immune, diabetes and adults. And she's like, I think, I think that you may actually be type one. I read the article. And she's like, these are the two blood tests that you need to ask your daughter for or your doctor for? Yeah, so I send a message in the portal to my doctor, and at this point, I'm like, I need a new I know that I need a new doctor, but I like, I also need my prescriptions at this point. So I was just like, whatever. She can still send in my prescriptions, and I try to message through the portal, because their office just sucks. I mean, you can call they lose messages. It's a complete show. So I message to the portal and say, Hey, I'm wondering if I might not have Lata, can we run these two blood tests for my next appointment? And she says, Yeah, sure. So she sends them. We're on vacation in July. I look at the blood test, because I do my blood work right before we go on vacation, I'm looking at the results in the portal, and I immediately Google, right? Because I'm going to Google diagnosed myself to see, like, what the ranges were. And I'm like, Oh, holy, I have type one, yeah. And it was kind of like, it was almost like a relief, in a way, sure, um, little did I know what I was getting myself into, but I was like, at least I might have some sort of an answer. Now,

Scott Benner 32:29
you know, there's a there's a hint in your story, when the trulicity helps, that you might be type one as well, because you're seeing now, a lot of type ones on glps need significantly less insulin, and if you were at the beginning of a lot of diagnosis and GLP suddenly brought your needs down, that doesn't surprise me at all. I did you hear Jim's episode like last week?

Tiffany 32:51
I didn't hear his yet, but I did listen to the first Dr Blevins episode. Yeah,

Scott Benner 32:56
Jim is a 58 year old type one who most likely has either a really slow onset, or moody or something like that. But nevertheless, he was on insulin for six years. Like, heavy use of insulin for six years, he started using Manjaro, and he's, like, completely off of insulin right now. And like, that's insane. But that's when, when you said the trulicity was helpful. I thought, Oh, that makes sense to me. Okay, so you dr, Google yourself up. By the way, you've definitely called this episode, probably the cookie mom, or cookie mom. Cookie mom would have really helped if you would have said the cookies were moist. But I don't want to pin you down on the details, because then we would have had some double entendre going, which would have really been lovely, but nevertheless, but, but so you figure this out for yourself. Does the doctor bite or does she push back? So

Tiffany 33:44
she argued with me. I have my my doctor's appointment, interestingly enough, the same day I have an ablation done because your heart so no, my uterus. Oh,

Scott Benner 33:57
uterine. Okay, sorry that I think my father in law just had to have an ablation, which made me think harder. You got the lady parts lasered?

Tiffany 34:04
I did get the lady parts lasered after my cycles started up. After my my second daughter, I had a crazy, crazy periods with super crazy bleeding that I was like, I thought I was dying at one point. I was like, I'm like, there is no possible way this much blood should be coming out of me.

Scott Benner 34:28
So is there anybody who wants to be a girl after they hear stuff like this?

Tiffany 34:32
No, no, just turn away. So I'm like, still hopped up on some of the drugs that they give you for the ablation process. I have a video appointment with my endo at this point, and she gets through the entire appointment and she's like, okay. And I was like, Well, hold on a second. What about those, like, blood tests that we did? And she's like, stuttering, you know, at this point, you know, she just didn't even look at the the results and forgot that she added them to my. Blood work. And then she's like, she actually got an attitude with me. And she's like, Well, what do you want? Do you want to go on an insulin

Scott Benner 35:05
pump? I would like you to just like, be reasonably competent, if you don't mind, do your damn job. That's what I would like. Oh, how much of college did you drink your way through? Lady? My

Tiffany 35:21
gosh, we'll see you get degrees, right? Oh my god. There are people that suck in every profession, sure. So I get off the phone and I am, like, livid, and My poor husband is getting an earful because I'm just venting, like I don't even know what to do with the rage that is currently inside me. 20 minutes later, I get a phone call. The doctors calling me back, apologizing to me, Oh, finally, stuttering, like, stammer like, I just don't know. Yeah, I didn't, I didn't realize you had all of this blood work done at the same time. I'm like, Oh, really, because I can see it in the portal, and it's time stamps, they're all the same day. Like, seriously,

Scott Benner 36:00
I forgot to do my job, but I just did it. Now, when I hear up the phone and we gotta get you some insulin,

Tiffany 36:07
right? And I'm still on, I'm on injectable insulin

Scott Benner 36:11
at this point. So anyway,

Tiffany 36:15
she's like, Oh, well, do you do you want to go on a pump? She goes, Do you have any idea what pump you want? And of course, you know, because I diagnosed myself two weeks ago, I see all about Omnipod five that's coming out. And I'm like, Yeah, I want this one because my my toddler. I love her, but she is basically trying to kill me every other day. The last thing I need is tubes for her to yank one and pull. So I'm like, Yes, I would like a tubeless pump. And I was lucky enough to kind of beat the rush and got my starter kit, like, right as it hit mass market. Oh,

Scott Benner 36:55
wow, you hit that kind of sweet spot in there. That's interesting. Good. Yeah, well, I mean, the kid grabbed onto your fallopian tube. She was definitely gonna pull out tubing. So pull

Tiffany 37:02
up tubing. She was definitely gonna pull off I gotcha. So obviously I get with an educator who, like, is all excited about me. I was only like the second person she was gonna be training on Omnipod five. But the problem is, is that my settings that the doctor was going to put in there were based on crap to begin with. So the educator actually sat down with me to help me try to figure out a starting point for settings to put in that were way different than what the doctor was going to suggest. So but it's still a roller coaster, because, like, anytime you start that it's like, it's just a starting point, and then you have to basically correct like the hell out of it, so that it learns. Okay, we need, we need to be better. So basically, at that point, right? So I was at a 9.4 a, 1c, once I get the insulin pump, the Omnipod five and obsessively listen to the podcast, I'm like cooking dinner, like driving anywhere, like not listening to my family when they're talking to me, just like trying to ingest as much as I possibly can of the podcast. I By October, have my a 1c down to a 6.00 my gosh.

Scott Benner 38:14
Oh, I wish you wouldn't have gotten the ablation, because I think the next kid could have been named after me, but that's okay. I want you to be happy, I guess, Wow, good for you. Hey, that's wonderful. Must have felt like such an accomplishment, too, after all that time.

Tiffany 38:27
Well, it was. And then I'm like, I'm her star patient. But I go through some other hurdles, right? Because at this point, like, I am just starting an insulin pump, so and I have to switch the vials. I don't have enough of a supply. So when one starts to go sideways, I'm kind of screwed. So I ended up on more than one phone call with the office manager at my office or at my practice, yelling at them, basically saying I because nobody told me how to what do I do when I don't have a pump or in the event of an equipment failure? Because why would we have sick day protocol? Why would we teach people what to do if their pump doesn't work or if they run out of supplies? Why would we do any of that? It would like put them out of business? I guess I don't know, but

Scott Benner 39:18
we don't want to let you know how to take care of yourself, because then you wouldn't have to call here and then, oh, call here, and then we couldn't give you no help. Then you come in and give us $40 this is really the goal. We need the $40 and we need

Tiffany 39:29
the $40 Yes, yeah. So, oh, and I also yelled at a pharmacist too, because they were short staffed, and because it was during, like all the COVID injections and everything. And they're making the pharmacists, which I do get, they are making pharmacists do way more than what they had the capacity to do, sure, um, but somebody screwed up my insulin vial, like prescription, and they gave me a partial at one point, and when I went back in for more, they were like, no, no, we already, we already gave that to you. And I'm like, Well, no, no, you didn't. And I need insulin. And I think I well, I made the pharmacist cry when I was like, it's not like, this is in Viagra, and I'm trying to get a hard on. I need it to live. Needless to say, I walked out of the pharmacy with my insulin, and that pharmacy is no longer in business. I'd like to think that I had a little bit to do with that. Maybe I did, maybe I did a pharmacy

Scott Benner 40:26
went out of business. Yes, oh, when all their employees had to go get, like, long term therapy because of you, is that what they were like, we have to, we're admitting a lot of our staff for psychiatric care, so we can't keep going. Was it just bad? They just didn't do a good job? Do a good job? Well, no,

Tiffany 40:44
and they didn't, and then they were so rude. I mean, it was you would have to wait almost an hour in line just to pick up your prescription, and you couldn't call because they wouldn't pick up the damn phone. And, like, I guarantee you, they had this, like, security cam footage, like photo of me hanging up behind the counter that was just like, give this woman whatever she needs. You're probably

Scott Benner 41:04
serious. You're probably on a t shirt that they handed out at the Christmas party. Well, listen, you're frustrated, right? And then there's all that, I mean, the COVID anxiety on top of everything else. And you're just figuring this thing out. Also, I would listen, if we're going to be realistic, you spent almost a decade trying to get an answer for yourself, and now you have it, and you look up and the next person in line is giving you a problem. Yes, it feels like it's never going

Tiffany 41:30
to stop, and I'm done at this point, because I'm like, I am not going to mess with anybody getting in my way anymore.

Scott Benner 41:39
How long ago was this? So this

Tiffany 41:42
was probably the end of 2023

Scott Benner 41:48
okay, so pretty recently. Hey, listen before, before we move on, because we're going to jump ahead to your to your low blood sugar and something. But I just want to let you know that at the end of my notes here about when you asked about, when we were talking about the other drugs, it says, one of the tips it gives to avoid, to avoid a yeast infection, is to avoid tight fitting underwear and to opt for breathable fabrics, like cotton. So I understand the breathable fabrics part, but between you and me, I've never worn underwear as a lady. What is loose fitting underwear if

Tiffany 42:19
you're a woman? I guess I'm supposed to identify as a guy and wear boxers. I mean,

Scott Benner 42:23
because, like, I get guys wear boxers sometimes. And so when you say loose fitting to a guy, it means that it's, like, not hammocking your your business, right? Like, but when you got lady business, isn't it all sort of pretty, like, streamline, yeah.

Tiffany 42:37
Like, there really is only one kind. I mean, even the boy shorts for women are, they're

Scott Benner 42:43
still tugging the junk.

Yes, but, like, yeah, like, everywhere that women's underwear is touching you, everywhere that women's underwear has fabric is touching you, right? Yes. What the hell would loose fitting women's underwear be? I don't know. That's all I got here for you on that one. I just wanted to break up the story so that we could go to something else and let everybody and let everybody think for a minute. What does it mean? Loose fitting women's underwear? I don't understand at all, because it just sounds like, like baggy in the crotch, right? Yeah, well, that's what it would have to be,

Tiffany 43:15
all right, maybe, maybe I should Google that later. Maybe that's another Google.

Scott Benner 43:20
I have to tell you, I thought for a minute when you were coming on today, like I was like, maybe I'll ask chief oak if they want to sponsor this episode, because it's going to be how I realize. I'm not going to be answering. I'm not going to be asking them that at all. They won't be using this episode on their website. That's for certain.

Tiffany 43:37
I warned you. I do believe I warned you. That's fine. Don't worry about it. So super tight control right at this point, I'm basically just using my my doctor as a drug mule for the prescriptions. It's great. I'm using the podcast. I've listened to the Pro Tip series defining diabetes holy variables was like a goddamn life changer. Like, who knew that your insulin needs can increase, like, three times the actual amount that you need usually use, you know, during your period, like we

Scott Benner 44:06
just talked about adding to that series recently, to the variable series. So you're out there in Pennsylvania, middle of Pennsylvania, I'm your doctor. Through a podcast, me and Jenny, is that basically how you're managing this?

Tiffany 44:20
Yes, a Girl Scout, cookie. Mom diagnosed me, and you're my doctor.

Scott Benner 44:25
Yeah, there you go. Life's fair,

Tiffany 44:29
and, oh, you're a nice little disclaimer. Hey, don't try any of this stuff. I'm not actually a medical professional. I was like, Well, I'm obviously he knows what he's talking about, so we'll give it a try.

Scott Benner 44:39
Obviously, it happened. How could this go wrong? He seems very worried about what loose underwear means, but I'm gonna listen to him about this Pre Bolus IDs. God, that's ridiculous. I'm never gonna stop being bowled over that this podcast is popular because it. Didn't need to be. You

Tiffany 45:02
know what I mean? It shouldn't need right? It's this should all be stuff that is given. This should be basic information, yeah, given to patients when they're diagnosed. But it's not. And that's the problem. Like there are good doctors, but most of them suck. Maybe in another episode, we talk about how a rabbit in my backyard led me to a new end though, who I absolutely love and she, she loves me, and we're great. We have a wonderful relationship.

Scott Benner 45:28
Hey, rabbit in your backyard. That's not a euphemism, is it? No, okay, there was actually a rabbit in your story.

Tiffany 45:34
Okay? Yes, it's a rabbit. Dogs are involved. There's three er trips. Yeah, it's fun. I

Scott Benner 45:41
once heard a lady go, whoo. I got a rabbit in my backyard, and I didn't know if it meant the same thing.

Tiffany 45:47
That's like, wow. So anyway, I learn through the podcast basically everything I know variables, the timing and effective insulin, the fact that I should be walking around with a rescue pen wherever I go, because, you know, even if you are super well controlled, still can happen, yeah, um, leads me to my Gmail story that we've been chatting for an hour.

Scott Benner 46:15
So let me just say this up front. I want to be I want to all of this credit to fall right on me. You are. You are carrying je vo KIPO pen because of the Juicebox Podcast, 1,000% okay. What happened? So I get to work,

Tiffany 46:32
normal day at work, right? I sit down, I'm turning on my monitors, and, like, everything kind of looks a little bit dark in my office, which I'm like, Oh well, the sun's shining in so, you know how you get, like, that sun blindness, of where it kind of messes with your vision for a little bit. And I'm like, oh, we'll just, you know, chit chat on the phone here a little bit as I start my day, until the sun goes down enough for me to be able to see my monitors, because I was too lazy to get up and pull down the shades, having a little bit of trouble concentrating because I'm on the phone, talking to somebody, but at the same time working, which I, you know, I multitask, but I'm I'm having trouble doing even one of those things. And I'm like, What the heck is going on? And then I start to see the, like, the bigger spots floating around in my vision. And I'm like, Oh no, that can't be right. What's going on? Look down at my Dexcom at this point. I'm like, it's 104 double arrow down. The 104 is kind of irrelevant, because I would expect to be right around that amount. But I'm like, the double arrow down makes zero sense. I have only dosed for my coffee at this point, which I usually throw an extra five carbs because the coffee hits me, even if it's black. So I'm like, but I didn't. It's not like I ran up a flight of steps or, you know, did anything. I literally sat down in my chair at work few minutes later, drinking my coffee, going on about my day

Scott Benner 47:57
as you would have any other day, as I would have any

Tiffany 48:01
other day. Okay? And then I really start to just like, the vision is just going more and more. And I'm like, holy crap. I look back again, not even like, I don't know, 510, minutes later, now I'm at 64

Scott Benner 48:17
straight arrow down, and

Tiffany 48:19
I'm like, Uh oh. So I text my husband, and I'm like, because he follows me on Dexcom. And I was like, there's some crazy going on with my blood sugar. Just wanted to give you a heads up. I'm working on it. So this is just in a text, right? Yeah. So I'm still on, like, the phone with my friend at the point at this time, who knows I'm type one, and she's forever been my like, don't die, buddy, right? She knows she could tell by the color of my cheeks if my blood sugar is low. So I test my blood sugar. Because I was like, Is my is my Dexcom really that off? Like, I don't think it's off. I mean, the arrows, right, but the number seems off for the symptoms that I'm having, because I am also hypo one aware.

Scott Benner 48:57
Oh, okay, you don't feel lows at all. I don't feel lows, okay.

Tiffany 49:03
Spots usually are what I see, and by the time I see those spots, I'm in the 50s.

Scott Benner 49:09
Okay, the two arrows didn't scare you, or were you already kind of out of it, but

Tiffany 49:15
it all happened so quick because it was rapidly falling. So I pull out my Contour Next One, which I also

Scott Benner 49:24
got through the juice box contour, next com, slash juice box. Go ahead. So

Tiffany 49:28
then I test, and I'm 36

Scott Benner 49:31
Oh, and did you and are you out of it at that point, or are you cognizant enough to go I'm in trouble?

Tiffany 49:37
No, I knew I was in trouble, but it still didn't really register, because I'm stubborn, and I like to not it was in denial, basically. So I tell my friend, I was like, Okay, I need to call my husband quick. Like, I

Scott Benner 49:51
this is, this is bad. Do you know why? Why did you think to call somebody? Like, why not eat something? Because

Tiffany 49:57
I was too nauseous. So. Okay, there were like 9 million thoughts going through my head at the same time. Yeah? Because my brain was still fully functional, I just didn't have my faculties. Yeah, that's what I'm

Scott Benner 50:08
trying to I want to make sure you get that across to people, like, it's not like you were you're altered. You just kind of half don't realize it. So you're just, you're following whatever your common sense at that moment is telling you, is that

Tiffany 50:20
right? So the very first thing I do when I see I'm 36 is I pick up my omnipot controller and I'm like, Oh, I have four units on board. And I was super nauseous by that point, because I had dropped so quickly that I knew, like, juice is like, my go to I knew there was no way I was keeping that juice down. So at this point, I know that I have to use my G VO, which obviously I've never used before. And I'm like, I really hope this works.

Scott Benner 50:51
This guy on the podcast talk me into getting this and let's, let's see what happens.

Tiffany 50:55
Yep, now my life is literally in his hands. I

Scott Benner 50:59
only live if a boy named Scott who knew how to buy a microphone was right about something called glucagon, let's go,

Tiffany 51:07
dude. I'm not even kidding, because it kind of gets worse, because so I hang up with my friend to call my husband quick, which seemed like it took me 30 minutes to do, because I am focusing every ounce of my being like I've had an iPhone for years, right? And I'm like, and they're both in my favorites, and I'm like, Okay, hang up for us. I had two buttons to push, and it was all I could do to push those two buttons. And what finally kind of snaps me into action is my husband yells to somebody that he works with, like, Dude, you just gotta hold on a minute. My wife's on the phone. She's crying, which I like never do. She's having a diabetic emergency, and then, for whatever reason, that is what snaps me into like, Oh, this is really happening. So you

Scott Benner 51:57
contacted him without really even knowing, you push the buttons, and then you kind of like, come to to him, yelling, is that the idea?

Tiffany 52:03
Well, no, no, he's, he's, I'm still conscious at this point, yeah. But

Scott Benner 52:08
I mean, like, I know you're conscious, but like, your focus, your understanding, does it, is it fading in and out? Or do you not even remember? Yes, it is. Yeah,

Tiffany 52:16
because, and I didn't even realize to me it wasn't at the time. But like my friend told me, after the fact, she goes, you were, I was asking you if you had juice, and you were never even answering me, because I don't ever remember hearing her, because I am, while I never pass out, I am, like, essentially in and out of consciousness. Yeah, I managed to call her back. But while I was on the phone with my husband, she had called somebody that I work with who is physically in the building, because we're working a hybrid work schedule, so that building is very like, sparsely populated on any given day. So luckily, she has somebody come to my office and she's like, What do you need now? Jivo, I mean, it has picture instructions on the actual package, right? I have told people how to use this thing, no fewer than 100 times. Because, like, anytime we're out or doing something active, like, I will actually show people, like, if it's a different, you know, group of people be like, hey, you know, if I drop over, like, here's this thing super easy to do, like, an EpiPen. Like, just, like, follow the instructions. But for the love of God, just don't take my pants

Scott Benner 53:21
off. And if you want to yell clear for fun, you can, but it's not necessary. Well,

Tiffany 53:25
because the package has like the little dude, like he's naked, you do not need to strip all of my clothes off.

Scott Benner 53:32
Just find a little skin. Please. Doesn't need to be all of it. I have to stop you and apologize. When your friend said I was asking you to drink juice and you weren't responding. I started to cry, because made me think of when this happened to Arden, and I was on the phone with her, and I there was this moment when she stopped responding, and I knew what was happening, and it's the, maybe the worst feeling I've ever had in my life. So it just rushed over me, sorry

Tiffany 53:58
from from a parent's perspective, because that is one thing, like, out of anybody, like, I am so glad that this was me and not my kids, because I do not know that I would be able to handle my kids right having a diagnosis, because it's just, it's a different world. It

Scott Benner 54:13
sounds like you'd be okay. You've been through enough stuff, but I'm sorry, go ahead. Probably

Tiffany 54:19
it's okay. So then, so, so I have a friend on the phone. I have a friend in my office. I am able to tear the package open and pull the pen out, but then I look at the friend who's physically with me, and I say, now what? Because I was, I was stopping. I was I, I had to be, like, literal single digit minutes away from passing out. Yeah. So we do the injection. It burns a little, not terrible. But then then we're sitting there, because now I'm like, so other friend on the phone is googling the out of this, which is like, how long is this gonna take to work? What do we need? What do we need? To do, and at this point, like, because I also need to replace my pod at some point. But I'm just like, No, no, I have to leave the pod on because, like, I don't know how high I might shoot up after I take this. Like, all unknowns, right? But I would say within 15 minutes, I think I was up from now, and my Dexcom never alarmed, never alerted. I didn't get the the fall rate alarm, because it just, I think it just happened so quickly that it didn't even, like, give the alerts. So I think maybe within like, 15 minutes, I might have been around, like, 70, okay? And then I was like, once I hit 70, I was like, Okay, we're we're turning around. This is good, right? But then, like, after the fact, I'm on the phone with my friend, and she's like, how do we do this? Like, better next time, what do we do? What do I need to react faster? You need to do this. So we were just doing this whole, like, debrief of what just happened. Because I will also say, until I listened to the podcast, I look back, like, over the years of using insulin, and I actually realized how many times I was very close to a seizure and or dying, you just didn't know about it, and I just didn't even know. And this time, it wasn't quite as bad as when I was in the hospital with my daughter, but this was a very close second to if somebody would not like if I wouldn't have had G, VO, and people there with me to help me with that, I pass out. Nobody even comes looking for me for at least 30 minutes, and I die. Yeah, on the floor in my office. Nobody wants to die at work, that's for sure. So the biggest message in like all of this, that I would have for people is it does not matter how much you think you have your together, how good your a 1c is, how good your control is. It can happen to anybody.

Scott Benner 57:00
No, it just, and it doesn't have to be a lot of insulin. It doesn't have you could just, you can just have these random confluence of events, and the next thing you know, you're in a situation that you have to act in. And, you know, it's funny, because I would bet that if this happened to you again, exactly this way spots in your eyes too nauseous to eat, you'd go right to the gluco next time I imagine, Yep, yeah, yeah,

Tiffany 57:28
because that was my I was kind of not seeing what was happening. But yeah, from the second I get those spots, like, because that's the scary part of being, you know, hypo and aware, not knowing or feeling those lows, is the second that you have one that you do notice you need to act immediately. You're farther

Scott Benner 57:47
gone than you think you are at that point. Yes,

Tiffany 57:49
yeah. And depending on how quickly, like, I've had that happen in the past, but I've been able to, you know, juice or, you know, fast fasting carbs my way out of it. It's

Scott Benner 57:58
interesting too to watch you go to, like, the steps, like, like, I'll call my husband so he doesn't worry which you look back on now, and you're like, that wasn't important to do. And, you know, just, I think it was

Tiffany 58:10
because it's like, him having the reaction that he did is what kind of snaps me, yeah? Like, back awake.

Scott Benner 58:15
Oh yeah. That definitely got you lucky, having, yeah, yeah. Boy, isn't it crazy? Like, you can like Monday morning quarterback this stuff to death, if you want, but it's just, it's going to be different for everybody. The situations are going to be different. You know, if you would have decided on that coffee 20 minutes before you got into work, you could have been in the parking lot, in your car while this was happening,

Tiffany 58:36
or driving, yeah, on the road, right on my way to work, yeah. So over a large body of water,

Scott Benner 58:41
Lake Erie, not quite No, not that big. Wait, Erie, Pennsylvania is not where Lake Erie is, is it? Yeah, it would make sense, though. Erie,

Tiffany 58:51
Erie is like borders, Lake Erie and that, but that's in the north, no, western part of the state. That's

Scott Benner 58:59
neither here nor there. Okay, so then I have a question the next day. Well, first of all, do you go back to work or do you go home

Tiffany 59:07
now I stay there and finish my day, because if I'm gonna take off work, I want it to be for something fun. That's

Scott Benner 59:14
how you know you got a good employee, right there. You're like, yeah, I almost died, but things are good. Now, let's get back to it. Jeez. I hope my boss listens to this podcast. Well, yeah, no kidding, it's worth a raise, I think, or at least a shout out at an event or something. The rest of you were hiding in the bathroom. I know you're hiding in there. This lady just almost had a seizure and she's still working. Next Day is the next day of work day. Uh,

Tiffany 59:41
next day is a work day. Did you bullish for your coffee? I do Bolus for my coffee. And why? Tell people why you did? Because my sugar is going to go high if I don't. Okay, good. But do

Scott Benner 59:51
you have any idea what happened that day for that, that low blood sugar incident? Do you have any idea? Like, in hindsight, I

Tiffany 59:57
think it's a combination. Um. It was iced coffee and not hot coffee, which I tend to sip, like, slower, or like the hot coffee, you know, you got to drink it before it gets cold, so you you tend to drink it faster. And my pump was on the last day, like, like, already expired. So I'm in the eight hour bonus window at this point. And they're from swimming and everything over the weekend, I think there was some condensation in the window, and just kind of like pod placement of where my cannula may or may not have bounced out a few times. I think there was a little bit of extra insulin in the window, and when I Bolus for my coffee, it leaked in.

Scott Benner 1:00:38
That seems less likely, but I like the other thing about the drinking pace, because you may definitely the pace, yeah, because you have it worked out. I put the insulin in. I drink the coffee like this. The coffee hits me hard. It battles with the insulin. I stay nice and stable, and then you put the insulin in. Basically didn't consume the coffee the same way. The insulin got ahead of you. Because I do think it's possible that 1042 down, that goes to the 64 one down, but it's not reading fast enough, like maybe that is a little bit of the coffee trying to help but being overwhelmed by the Bolus, if that makes sense, Yep, yeah. Otherwise, man, that's scary. Wow. And then, then, how do I end up knowing about this? So

Tiffany 1:01:23
I immediately want to go out to the Facebook page, because that's like, these are my people, right? Anytime I'm panicked or I have something that, like, I don't know, like, I don't know how to do something in this in this area, or if I have a question, it's like, you go to the group, you search other posts, or you just do a post and say, Hey, has anybody had experience with this? Because doctors at this point can doctor you. To a point, the people who live with this disease in and out every day are going to be a better resource than anybody. So I'm like, dude, like, this is crazy, but I feel this need to post this story for people, because I believe that anyone who's using insulin should have a G, VO or or another equivalent to rescue them in a situation like this. So I just want to share, get the word out. You seen my post and then said, Hey, do you want to share your story? And I'm like, Sure, let's do it. Cool.

Scott Benner 1:02:23
Yeah. Well, I really appreciate you sharing in there, because over and over again, I'm stunned by how few people understand about the reality of a very low blood sugar that they don't understand about glucagon. They don't know that they should be carrying it with them, that they should be telling people around them how to use it, like all of that stuff is just super important. I know people don't want to be bummed out. They don't want to worry about things, but this is just being ready in case. And so worst thing that happens is you never use the information

Tiffany 1:02:54
right? And it's better to have the tool that you need and not need it than to need it and not have it, because the alternative is not bright and sunny.

Scott Benner 1:03:04
I think the happiest moment of any time you know, quarterly, probably around here, is when you throw away an unused Jibo type event, when you go

Tiffany 1:03:16
about to do because luckily that one didn't expire, but it's set to very soon. Yeah,

Scott Benner 1:03:23
when I look at them, well, all right, this is expired. Now we have a new one that came in. I and you take that old one and you throw it away, and you think, like, Wow, great. Glad to have had it. Even happier I didn't use it, glad I didn't need it, yeah, yeah, yeah. Best thing you'll throw in the trash ever. I do. Also sometimes mess with them and test on on things, so I can, like, see how it works and stuff. But

Tiffany 1:03:44
well, we were definitely, we were gearing up to it. We were even talking about it. It's like, I would have one that my friend, my don't die, buddy, was going to be able to she's like, I just want to, I want to play with a stabby pen when it expires.

Scott Benner 1:03:56
Let me see it. Yeah. Well, it's a great idea. You inject it into a banana or something like that. So you can see how it works, and it'll it takes away a lot of the fear for somebody who, I mean, even you right, like, yeah, it comes in this package. You never opened the package before. It's in the package. So you open it up and you're like, oh, is this what? This is? Okay. Here we go. How

Tiffany 1:04:16
do I do it? Okay? And knowing that it's not going to, like, shoot me through the roof right after too, like, because that was a fear too. But, I mean, obviously the low was more of a concern than the high at the time. Yeah,

Scott Benner 1:04:27
it's actually interesting. I wonder how low you were going to get, because, I mean, it's a real indication that you were probably going to have a significant problem if the glucagon never made you higher than 70 after that. Well,

Tiffany 1:04:39
I did go higher after that. So I think, I think I capped out around 150

Scott Benner 1:04:42
that's still very reasonable. I think, you know, wow, yeah, did you at any point yell, please don't pull my pants off. I'm wearing loose underwear. I don't

Tiffany 1:04:53
I No, because we still don't know what loose underwear is. No

Scott Benner 1:04:57
lady in the history of the world wearing loose underwear on purpose. I just want to say that now this is my opinion. I'm not a woman, but I'm jumping to this conclusion very quickly. I would assume, if your underwear was loose, as a lady, you'd think to yourself, I need to replace my underwear.

Tiffany 1:05:11
Well, I would imagine, yeah, like, holy cow, I lost some weight.

Scott Benner 1:05:15
What happened? My god, I'm swimming in these things. Or, Oh, my

Tiffany 1:05:19
God, I've had the same underwear for 17 years. It's time for a new pair. Is

Scott Benner 1:05:24
there anything better, Tiffany, than throwing out old underwear? It's one of my favorite things. I don't know it's one of my favorite things. Yeah, I love it.

Tiffany 1:05:31
I do enjoy throwing out holy socks. Do you

Scott Benner 1:05:35
Yeah? Underwear? Like, every once in a while I have such a poor person's attitude because I grew up like, so broke, like, my wife will be like, what? What's going on? Why are you so happy? I said I bought three new packs of underwear, and I act like I've like, like, I'm Rockefeller, yeah, I mean, like, I'm like, I've bought three new packs of underwear, and I'm gonna throw away the equivalent amount of old underwear today. I'm living like, Wow, you

Tiffany 1:05:58
are. And it wasn't even a birthday present. No Christmas present,

Scott Benner 1:06:01
no, no, no. Just treat myself. Just treating myself. I swear to God, I don't know what's wrong with me. I never feel more accomplished than when I

Tiffany 1:06:09
do that. You're like, I saved a life. Today, I'm gonna go buy some new underwear and get myself

Scott Benner 1:06:13
a new one. My God, so, um, yeah, go ahead and say that out loud for people one time. Go ahead. Did I save your life?

Tiffany 1:06:19
You that You saved my life, absolutely

Scott Benner 1:06:22
with a podcast, a podcast ridiculous, saved my life, yeah, how about that? I'll be damn well. And you came on here and told the story very well. I appreciate it. You're very good at this. Actually. You ever been on a podcast before? Never? No, you did a good job. Awesome. Yeah. And tell me something now, if I had you back on one day, we could talk for another hour about something completely different. No problem. Well, absolutely, your note was, like, fantastic. Like, every once in a while I get an email and it basically starts Four score and seven years ago.

Tiffany 1:06:58
No, well, I can't I give you highlights. I can't give you all of the it's like a preview, right?

Scott Benner 1:07:04
Yeah, yeah, no, no, yeah, that's really wonderful. So I was

Tiffany 1:07:07
at my endo yesterday, and we actually are discussing trying to get me approved for either man Giro or zbound, so I may have more to discuss. Okay,

Scott Benner 1:07:20
excellent. So based on how did your doctor ask for it? Well, I asked for it, okay, because

Tiffany 1:07:29
I still have weight to lose because I start the insulin pump, and I'm probably going through a pod every other day for the massive amounts of insulin I'm using. I do lose weight over time. We actually tried, I tried ozembic. Got terribly, terribly sick on ozempic as another means to, like, try to lose this extra weight that insulin has so wonderfully helped me gain. We tried phentermine pills and that, I think, I lost close to 40 pounds since,

Scott Benner 1:08:03
since October. That's half of fentan, right?

Tiffany 1:08:08
Really, sure, is that right? Meeting. Isn't that a young Yeah, is it like a dietary supplement? It's an

Scott Benner 1:08:13
appetite suppressant. But how does it work? But it's not

Tiffany 1:08:16
that part of it. I don't believe, because I because when she it's, it's usually prescribed with an appetite suppressant. But I didn't need the appetite suppressant problem because, if anything, I have like, an anti food problem. Because of having to go through years of feeding insulin, the last thing I want to do is eat like I'm I do not have the like the food voice.

Scott Benner 1:08:41
Oh, interesting people have, but this is a short term use thing is that correct? You're not going to use it for long, okay, correct, okay, because I'm just reading, I allowed my chat GPT overlord to talk to me, says, tells me about the mechanism of action, similar to an amphetamine, actually stimulates the release of neurotransmitters like neuroepferin in the brain and which reduce hunger and help control appetite. But you don't have that problem usage, short term use indicated for a few weeks as part of a comprehensive weight loss plan that includes diet, exercise, behavior modifications, long term effectiveness and safety have not been established. Okay? Yeah,

Tiffany 1:09:19
definitely not long term. So I'm looking to get off of that at this point, right? So that's when I so my husband, who I diagnosed with the help of the podcast as type two diabetes. No kidding, currently on benjaro, so I ask about and knowing about your weight loss journey using zbound, I had inquired with her, like, hey, like, what do we think might happen if I try that? Because my history with GLP ones is usually gastro is just totally outweighs the benefits, because I get terribly sick, but we're going to give it a try if. You can get it approved.

Scott Benner 1:10:01
Oh, good for you. I hope you have, I hope you see a significant reduction in the insulin you need, and that it helps you with how much more weight do you feel like you need to lose?

Tiffany 1:10:09
I'd be probably happy with, I mean, according to a BMI scale, I probably need to lose another 60. I'd be happy with, like another like 30.

Scott Benner 1:10:20
I look at myself now, and I'm like, I'm gonna go with when I look right, like I stopped worrying about the number, almost completely right.

Tiffany 1:10:28
I need to because, and I'm very like, I'm proportionate. I carry my weight very well. People would not think that I weigh what I weigh, yeah, so it's less of that and more of just being healthy, because once I finally got the right diagnosis, once I got my a 1c down,

Speaker 1 1:10:44
I feel 10 years younger, like I feel so

Tiffany 1:10:48
different. So I went from, like, changing a pod every other day to I wear almost every single pod unless it like it's unless I'm sick or something like that. Like through to, like, the death beep right out to the end you it has right out. So my totally, my total daily insulin, went from over 100 to right around somewhere between 40 and 45

Scott Benner 1:11:10
oh, that's so interesting, I have to tell you. Going from 200 units in a day and a half to three days is a big deal already, you know. And then if you see another decrease with the GLP. That's even it's gonna be even more exciting for you. Really cool, and it should help you. It should help you. I mean, listen, I can't say enough good things about the GLP medication experience I'm having, you know, and not, I don't have diabetes, but my health is significantly better. The way I feel, to say is significantly better would be an understatement. I look better. Looking better is almost the least of my concerns, because I used to be burdened with that thing that you talk about, which is, I carry the weight. Well, it's hard for people to tell and that tricks you into believing that you're healthy, because nobody notices.

Tiffany 1:11:58
Well, and I don't give a damn what other people think, either. So that can be dangerous too. Exactly,

Scott Benner 1:12:01
yeah. And then the other side of it is, is that, you know, I've had my, both of my kids come to me at this point, Arden more recently, and she's like, Hey, I was looking at old pictures of us, and I you were fat, I didn't know. And I was like, this is an uplifting conversation. Thank you. But it was, it was interesting to hear from her that, like, you know, you slowly gain weight. Nobody notices, especially the people around you. And then you say things like, Oh, I know I'm way more than I should, but it's probably just 20 pounds. I probably just need to lose 20 pounds. And then you lose 20 for me, at least. And I was like, Oh, my God, well, more than 20, you know. And then I was down like, 30 pounds. I was like, Well, I guess more than 30. And then you start realizing exactly how far you've slid, and you don't, you didn't even know it. So anyway, it's a been a lesson. I actually consciously had the thought this morning that it might take me two years from when I started the GLP to when I actually feel like I'm in a in an optimal health situation, but that I got to let the process pay it out, play out, and just keep doing the things that I know to do, right and I can't care how long it takes. So

Tiffany 1:13:09
I mean, the thing that keeps kind of reverberating in my head is, is when you say, trust that you know what will happen. Will happen. Yeah,

Scott Benner 1:13:18
yeah, it that it's funny, I use that around diabetes, but it's pretty, you know, important in a lot of aspects of your life. Just trust that what you know is going to happen is going to happen, and just kind of just let it play out, ends up being a big deal. And around the weight loss thing for me, especially because, you know, you have it in your I, uh, an acquaintance that went on it, and I was getting the texts a weekend. I'm still hungry. I thought this stuff worked. I haven't lost any weight. You know what I mean? Like, bottom like, hey, been doing it for like, two weeks, you know? Like, chill out, yeah. And then finally, a couple months into it, like, Hey, I've lost 10 pounds. And I was like, good for you, but then, but you gotta, it's all the way you couch it in your head then, because what you could say is, well, just 10 pounds, you know what I mean? Like, everything's kind of interpreted in the way you decide to ingest it, if that makes sense, oh,

Tiffany 1:14:10
it's totally, it's totally, I always said, like, life is what you make it like. You're gonna either view it like, glass half empty, glass half full, right? It's what you like, you have to be your own advocate. You have to take in charge of your own life and make choices. And if you don't like the results that you're getting, then you need to look somewhere else. Yeah, sometimes you

Scott Benner 1:14:33
just got to put your head down and keep going. Too true, because you're not there yet. And you know, just a little impatient, which is

Tiffany 1:14:41
well, may or may not be impatient. But

Scott Benner 1:14:46
listen, that lady you made a cry at the pharmacy, she definitely thinks you're

Tiffany 1:14:50
impatient. I'm sure she does. But disclaimer, I was in line for over an hour and had to call my husband to go pick up my kids because I was going to miss picking up my kids at daycare. Mm. Because I was in line so long. Listen,

Scott Benner 1:15:01
I'm okay with you yelling at her. It's fine. Sounds like you made out okay in the end, walked out of there all trying to fill with your insulin. You're

Speaker 2 1:15:08
like, I did. It got shut down. They're no longer in business. She's still

Scott Benner 1:15:12
telling that story to anybody who will listen. Probably she's like, she really scared

Tiffany 1:15:15
me. Oh, good. That means she learned her lesson. Listen,

Scott Benner 1:15:19
do your job. Everybody. That's, that's my message. Like

Tiffany 1:15:22
that, easy, just do your

Scott Benner 1:15:25
job. Tiffany had a goddamn life threatening emergency at work, and then was working again. Were your parents in the war? Where did you come up with this work ethic? By the way?

Tiffany 1:15:35
You know, middle class, paycheck to paycheck, people who you just had to honestly, you know, work hard for what you have. Yeah, it's

Scott Benner 1:15:42
used to watch my father go to work when he was sick, and I one day asked him, don't you have sick time? And he goes, Yeah, I don't want to use it when I'm not

Tiffany 1:15:51
feeling good, right? Like it's summer, like, I want to use this to go swimming, like, go to the beach.

Scott Benner 1:15:56
I didn't know that that meant, dude, I'm broke. I can't just take off from work. I got to save this for a good day.

Tiffany 1:16:01
Well, there is that too. Plus, I have, you know, the little like spawn of Satan that gets sick and then require me to take off time as well.

Scott Benner 1:16:10
So I thought this went very well. I appreciate you doing it very much. You hold on a second. I'd like to talk to you when I shall Sure. But thank you so much. You were terrific.

Unknown Speaker 1:16:19
Thank you.

Scott Benner 1:16:26
Thanks for tuning in today, and thanks to Medtronic diabetes for sponsoring this episode. We've been talking about Medtronic mini med 780 G system today, an automated insulin delivery system that helps make diabetes management easier day and night, whether it's their meal detection technology for the Medtronic extended infusion set, it all comes together to simplify life with diabetes. Go find out more at my link, Medtronic diabetes.com/juicebox, the podcast episode that you just enjoyed was sponsored by ever since CGM. They make the ever since 365 that thing lasts a whole year. One insertion every year. Come on. You probably feel like I'm messing with you, but I'm not. Ever since cgm.com/juicebox this episode was sponsored by touched by type one. I want you to go find them on Facebook, Instagram, and give them a follow, and then head to touched by type one.org where you're going to learn all about their programs and resources for people with type one diabetes. Hey, thanks for listening all the way to the end. I really appreciate your loyalty and listenership. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast. If you're looking for community around type one diabetes, check out the Juicebox Podcast, private, Facebook group. Juice box podcast, type one diabetes, but everybody is welcome. Type one, type two, gestational loved ones. It doesn't matter to me, if you're impacted by diabetes and you're looking for support, comfort or community. Check out Juicebox Podcast, type one diabetes on Facebook, the episode you just heard was professionally edited by wrong way recording, wrongway recording.com, you.

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