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Scott Benner 0:00
Everyone welcome. This is Episode 172 of the Juicebox Podcast. Today's episode is sponsored by dexcom, makers of the G six continuous glucose monitor, and Omni pod, the tubeless insulin pump that Arden has been using for a decade. In today's episode, we're going to be speaking with john, john was diagnosed with Type One Diabetes as an adult when he was an airline pilot. This, of course, meant that he lost his job and had to find different work. We're going to talk to john about living with Type One Diabetes, about losing his job, but moreover, about what he's trying to do to get that job back. When you finish listening to today's episode, if you're moved to try to get a Omnipod demo, you can go to my omnipod.com Ford slash juicebox. Or click on the links in your show notes or at Juicebox podcast.com. where maybe you'll be interested in finding out more about the Dexcom gs six continuous glucose monitor. In that case, you want to go to dexcom.com forward slash Juicebox Podcast again, the links in the show notes, or Juicebox podcast.com. Hey, it's a little bonus special treat today, I'm going to put a link in the show notes or you can go to art and stay calm to my blog to see this. But there's a koala bear named Quincy at the San Diego Zoo and he's wearing a Dexcom g six continuous glucose monitor. It's pretty amazing. I have a video on my blog of Quincy having his blood sugar check, having his dexcom put on, and him getting insulin, which all was really very interesting. It's a short little three minute video produced by the San Diego Zoo. It's incredibly interesting. So look for the links for that. Please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise. And always consult a physician before making changes to your health care plan.

I really appreciate you doing this. And I'm glad we were able to slide the time to make it a little better for you. So thanks so much.

John 2:20
Oh, yeah, yeah, I appreciate you moving that time I my work schedule I, you know, have various shifts out the training department, I just happen to get assigned one that starts at 7pm and goes until 2:30am last night, so that was enjoyable.

Unknown Speaker 2:36
Do you always work overnight?

John 2:38
Um, no. Basically, the way our training department works, that's where I work for an airline, um, and I'm in our flight training department, we have flight simulators that basically run 20 hours a day. And so the instructors, you know, have to basically work around four hour shifts in there. So long story short, they just kind of cycle through, you know, sometimes I'll get the night shifts that are like eight to noon. And, you know, other times I'll get the really late night ones, because we have so many pilots that have to go through either new training or recurrent training, that they just have to run those things nonstop. So when I do that particular type of instruction, you just have to go with what they assign you.

Scott Benner 3:25
You know, just, I get I made me wonder like, do you ever see anything in those simulations that make you think, Well, I'm not getting on a plane,

John 3:33
you know, occurred occasionally. And, you know, before, of course, the subject that we're gonna be talking about to today, when I was on the other side of it, I the student or the pilot that was in there for recurrent training. You know, it was a little bit different perspective, but now I'm the one causing the problems instead of having to deal with them. So it's a little bit more entertaining from my point of view now.

Scott Benner 3:57
Excellent. So listen, every once in a while I'm getting like a thumping or something is your Are you wanting a laptop or a phone? Which,

Unknown Speaker 4:04
um,

John 4:05
let's see, you know, I'm, I'm going through my computer right now. So let me see if I can make sure there's not anything weird going on outside the door here.

Scott Benner 4:13
Also use your cell phone. If you if you have a cell phone with you move it away from the computer, that that definitely helps you.

Unknown Speaker 4:19
Yes, I

John 4:21
can absolutely do that. So I'll set that on the other side of the room and maybe that'll help.

Scott Benner 4:29
All right, my brother works shift work because he does something where they're running basically 24 hours a day to Okay, it just, you know, it's funny, he's he doesn't mind it once he's doing it but he says that the switching back and forth from different shifts is is really hard. You know, he's like, he's like once you're in it for a day or two. It's not such a big deal but he's like this the swap from like a day to a night or something like that. He finds difficult but

John 4:59
yeah, Definitely Well, yeah, it's one of those deals where I try and stay away from that really late one, because I'm a little bit more of a morning person, I guess. So, you know, given the opportunity, I let our schedulers know that I'd rather have the one because we do have it one that starts at 4am. And then goes until, like noon. Okay, so I actually prefer that one over there really late night one, because, you know, like, for example, you know, even when I have multiple night shifts, you know, I'm one of those people that, you know, I'll wake up at eight o'clock in the morning without an alarm clock, just because that's why I'm

Scott Benner 5:34
getting older and have your day when you're done. That's pretty cool. Yeah,

John 5:37
yeah. So,

Scott Benner 5:39
john, we don't really start in a real formal way or anything, just you know, introduce yourself Anyway, you want to be known. And we'll start talking and it'll find its path that you'll say.

John 5:49
Right, and john Ross was diagnosed with Type One Diabetes fairly late in life, age 36. So I'm just coming up on having it for three full years now. And very active person do a lot of outdoor activities and mountain bike racing, and so on. So basically, this diagnosis came as a pretty big shock to me. Also the ramifications on my chosen career. So I'm, Currently I work for an airline as a instructor. However, prior to that, I was a full time airline pilot, and I've had to make some pretty significant life changes as a result of the Type One Diabetes diagnosis. Wow. So

Scott Benner 6:37
you what, how long have you been flying your whole life or

John 6:40
on? Yes, so basically, I started flying. When I was 16. I just started off. Basically, in the summer, I had an interest in flying. Prior to that, you know, it's kind of into remote control airplanes and that type of stuff when I was when I was a kid. And over the summer, my dad kind of said, Well, you know, might as well give it a shot and try the real thing and see if there's anything to this and start flying small private airplanes when I was 16. And then actually had to wait until I was 17. To take my first I guess, level of pilot certification. And then I've been flying since then. And right after I got done with high school, I went to Ohio State University through their collegian flight program, and continued my training there and then kind of progressed after college. So yeah, so I've been in it in it for a little over 20 years.

Scott Benner 7:44
I really believe that has to be something you just love. Like, it just has to make sense to you when you look at it. Because there are, you know, there are people like me who if you said to me, hey, there's a possibility you could get in this mechanical thing and go up in the air and you'd be in control of it. I'd be like, I, there doesn't seem to be any good reason for me to do that. And that sounds exactly a horrible idea. And and yet, there are certain people, you know, I guess we're lucky there are who look at that and think I can do that. That's amazing. And, and to have that feeling when you're so young is is kind of special because I don't know, you just you know, at 16 How often do you find something you love at 16? You can still love when you're 40? You know like that,

Unknown Speaker 8:24
right? Yes,

Scott Benner 8:25
that's that's that's definitely special. When I think of an airline pilot, you were an airline pilot before your diabetes, you were flying like passenger jets and all kinds of things like that.

John 8:37
Yes, yes. Yeah, I currently work for a what's called a regional airline. So we fly for our aircraft are painted for the various air carriers that we work for. And we fly everything from 50 seat jets up to our largest one is 76 passengers. Okay. And we fly for basically all the major airlines now as far as United Delta, American and Alaska Airlines. So, yeah,

Scott Benner 9:09
so when you diagnose that 36 That's it. You know, listen, I think being diagnosed at any age is a real shock. But I think that living, I don't know how other people think about it, but I used to, I used to have this feeling like when I was younger, I thought, like, if I could just make it out of high school, like I made it out of high school, you know, and then you're like, in your 20s you're like, Okay, well, if I don't get hit by a car, right, like, maybe that's cool. And then in your 30s you start thinking, well, if I don't kick cancer, then you know, when you get to 40 you're like, I did it like I know that's an unreasonable feeling. But you're like I've been alive for a while and I'm nothing really terrible has happened. I've won some sort of a, you know, again, that's not really existing. Like, I know, that's ridiculous. But I used to think like that, like, I saw, I saw my life in stages, like if I get past this, this won't happen anymore. If I get past this, this won't happen anymore. Every time somebody I know gets divorced, I think Ooh, that that makes my odds better for not kidding. Because we all can't get the worst, and I have those unreasonable thoughts pretty constantly. So I'm at 36, you have to in your, like, you described yourself as healthy, outgoing, you know, active that that kind of thing? How does it hit you to be diagnosed with something so life altering at that age? And how much of that of your age do you think had to do with how you felt about it?

Unknown Speaker 10:22
Um, you know, I

John 10:23
definitely think that, you know, that, yeah, the age probably gave me a little bit more ability to, I guess, appreciate all the things I still had are still had going for me, you know, it was one of those things where, you know, because I, you know, enjoy an active lifestyle, and, and, you know, have a great wife and, you know, have, you know, like, things to be thankful for in my life, I could at least look at those and say, Well, I still have all of that, you know, and how is this diagnosis going to affect those things, and the big ticket items, if you want to think of it that way, you know, in life that, you know, Type One Diabetes hasn't, you know, I guess significantly, you know, adversely affected those things. You know, however, it just so happens that I'm in one of probably a very, very few selected, you know, professional careers that is directly affected by the disease, you know, so, it was like, okay, you know, I'm sitting there, and, you know, I kind of tell people a story, when I went in for my, or when I went in, when I was finally diagnosed, you know, I'm sitting there in a, you know, bed in the ICU, you know, looking at the FAA website, you know, at, you know, this particular factor of, you know, how it's going to power, how it would affect my medical certificate certification to fly. And it's like, right there, they boldface letters, you know, insulin dependent diabetes is a disqualifying event for all medical certification.

Scott Benner 12:00
So how long could you been flying professionally at that point?

John 12:05
So let's see, at that point, I had been flying 10 years with commercial airlines. So passenger service, and then before that, I flew two years as an air cargo pilot.

Scott Benner 12:17
So it's not only something you love, but it's the way you make your living. And oh, yeah, yeah. Just like that, like a snap of the fingers. You just couldn't fly a plane anymore.

John 12:26
Exactly. Yeah. So you know, 20 years of effort. And, you know, a sidebar to that, at this airline. I just received notification that, you know, the next week, I was I literally had my bags packed to go to upgrade class as a captain. So yeah,

Scott Benner 12:45
so again, all that work, and you're about ready to kind of take that final step that you've been working at your whole life, and then this happens. Correct. Any diabetes in your family? Was it shocking? or weird? When you look back now, do you think oh, wow, this guy's has it? My uncle has it? It's not that crazy.

John 13:03
Um, no, I, you know, I, of course, after, you know, all this happen, and you know, when you're in the hospital, of course, they ask, you know, that same question, and, you know, no one, well, no one that I know, for, that my parents know, of, and our family has type one, my mother or my grandmother on my mother's side, I should say, had type two. But other than that, there was very little prevalence of type one, there were a few other folks that did have some, you know, various, um, you know, coronary artery disease, there's a bit of that. And then there's also a few folks that did have some other you know, immune type diseases, but nothing, nothing of great significance. Yeah, gotcha, odd.

Scott Benner 13:59
Well, you know, sucks, it really does a B. I know it doesn't, it's sort of meaningless whether you had a background in it or not, but there's, you know, maybe you'd been living your whole life thinking Oh, it might happen to me or something to soften the blow a little bit, but, but But no, so So tell me something when that immediately happens. Does the company look for other ways to keep you employed? Or are you just are you scampering for a job or what what happened to you after? As far as your work goes?

Unknown Speaker 14:28
Right? So,

John 14:29
um, you know, at the time, I do feel fortunate, that's one of the reasons why I actually transitioned to the company that I currently work for is because you know, they have a really good reputation as as far as you know, supporting their employees which is unfortunately becoming more and more of a rarity. And, you know, basically the what happened there initially is that you know, we do you know, as I said before, I have a lot of things to be thankful for, you know, I had short term ability. So at that point, he's basically just have to call and, you know, like, you know, the immediate upline person, for me would be our chief pilot and let him know that I'm currently out on a medical leave. So they put you on a medical leave. And then after that, you know, when it became apparent that, you know, there was, in fact, you know, no way for me to return to flying currently. You know, they then said, Okay, well, you're on, you know, disability right now, you know, we'll, of course keep you on as a employee, until that runs its course, well, you have time to try and figure out this medical issue. And then, in that timeframe, you know, I then, you know, once I got out of the hospital and had, you know, at least a few weeks, I'm not the type of person who likes to sit around. So, you know, I had a few weeks to try and start understanding more about the disease, I then started to look at the company for other, I guess, positions that I could take. And that's kind of what led me to the, the training department because I of course, I knew a lot of people at the company, and they say, you know, we do have this position open, you should go and interview with these folks. And, and try and go through that process, because, you know, they felt like I would be a good instructor pilot based upon my experience.

Scott Benner 16:17
The Omni pod is a two part insulin management system. The first part, the pot, the pot is a small device that you fill with insulin and were directly on your body. It includes a small flexible candle, it inserts automatically with just the push of a button. And then the pod communicates wirelessly with the personal diabetes manager. And that's how you program your insulin, you tell it, hey, give me a unit, I'm eating 20 carbs, that kind of stuff. Now the second part of the system is the PDM is a personal diabetes manager that wirelessly manages your insulin delivery based on your settings. So try to imagine you have this tiny little thing that you where it has your insulin. And there's this thing you hold to it every once in a while, you have to pick up and tell it, Hey, I just ate something or turn up my basal rate or something like that. Now, in this moment, in June of 2018, the PDM is the same PDM, the company has been using for a while, but insulates a company that makes all the pot they just received clearance from the FDA to start marketing their new PDF, which is really cool. It's sleek and touchscreen, exactly what you expect in a cell phone age. So it's going to look like a little android phone almost, but do all the same things. incredibly cool. It's actually the first time in the history of on the positive the PDM matches the futuristic nature of the pump itself. It used to be sort of this thing, a little rubber buttons on it and stuff like that, like you imagine a medical device. But no more. Now we're living in the future, maybe I want you to go to my omnipod.com Ford slash juice box or click on the links in your show notes or Juicebox podcast.com. When you do that, you're going to be able to get a free, no obligation demo pod sent right to your house, you'll be able to wear it to see what I'm talking about. And then decide if it's something you want to move forward with. When it is you tell on the pod, hey, I want to get this and they'll help you the rest of the way. It's really very simple. Miami pod.com forward slash juicebox.

Do you find it satisfying? And I mean, I'm assuming you missed the flying but do do it at least find the new work satisfying?

John 18:53
I do. It's definitely something that, you know, I enjoy. Um, and you know, as we kind of touched upon before, you know, it's sort of one of those things where you get to this point in life and because I enjoy flying, you know so much that it would be hard for me to kind of imagine a, I guess a career track that would just completely not or, you know, go away from aviation. So this does still keep me into things. And, you know, the, even though the flight simulators that I instruct me are called level D simulators. So they're basically one notch below actually being in the airplane. So I definitely do find it satisfying and as I was gaining flight experience going up through the ranks, so to speak, when I was in college and so on. I was a flight instructor for a while before getting into commercial flying and you know, I do enjoy the construction side side of it, but it's, you know, one of those things where, you know, when I go up and do observation flights or you know, check flights or things like that, you know, I tell people You know, I don't look up and in the sky and see an airplane fly over that, you know, I wouldn't prefer to be there, you know? Yeah,

Scott Benner 20:06
I definitely think I understand that for sure. Okay. Um, so it's funny because in when the when the disability first kicks in, they use all the language they usually use when you're talking to people, like, you know why you get this figured out. You're like, figured out I'm not getting rid of diabetes. So there's, there's no figure, there's no figuring it out. But what what did so you're three years into 2000? We diagnosed about 2014.

John 20:32
Yeah, so this coming January will be three years. Okay. so

Scott Benner 20:36
and so. In that moment, when you're diagnosed, and you have insurance and all this stuff's going on? Do they start talking to you about insulin pumps? Do you look into insulin pumps? Do you not have an insulin pump? Like what what is the technology that you're using right now?

John 20:50
Right, so I'm, you know, listening to your show, and others, you know, I have, you know, it's kind of,

Unknown Speaker 20:56
I don't know,

John 20:57
I think it's probably a bad thing. But there is some comedy to be found out, basically, how similar people's experiences at the hospital, you know, although the hospital has the best of intentions, they literally, you know, get you stabilized in the ICU, and then kind of kick you out the door with a couple vials of, you know, lantis and, you know, novolog, and some syringes and say, all right, you know, we'll see you in a week with the CD. And, you know, hopefully you don't kill yourself with this stuff in the meantime. I mean, you know, that's, you know, being sort of facetious, but

Scott Benner 21:30
it's really it is, it's, it's a little bit of like, hey, this does this is this. Here's this mathematical formula, which we all know, if you have diabetes for a while, it's pretty useless. And then they're either like, right, good luck. Yeah, yeah. Yeah, it's

John 21:42
completely preposterous. You're like, Are you kidding me? Yeah.

Scott Benner 21:45
So no more explanation, right. I'm just leaving now.

John 21:49
Yeah, but oh, well, yeah. So as far as you know, when I did leave the hospital, um, you know, very, you know, little, I guess, explanation, or rather mentioned of additional product products or technology, or what have you, you know, it was literally like, you know, hey, you know, stop by Walgreens on your way home and get one of those blood glucose monitors things. I'm like, Okay. And, but as far as that goes, um, yeah. And that's kind of what led me to send you that initial email, you know, I'm still utilizing MDI, for my, for my control. And, and I'm still continuing to use that. So I use, you know, pens, currently use you know, lantis and analog. And then I actually use metal one R, for a lot of times for mealtime bolus. Okay.

Scott Benner 22:45
And you're happy with how things are going? Because you're a once he's pretty great, right?

John 22:49
Yeah. I mean, for the last, basically two years consistently, I think my highest day once he was 5.8. I'm currently at 5.1.

Scott Benner 22:59
So So how do you do that? This is, do you have a glucose monitor?

John 23:05
Yeah. Oh, yeah. Um, luckily, that was something that I was See, I believe it was my second visit with the endocrinologist where she had mentioned the dexcom on at that time, they were still on the g4 system. And she mentioned that to me, and, you know, being have kind of a technical background, and someone who, you know, is, you know, assesses data and likes to mitigate, I guess, as we call the industry mitigate threat. And I saw that, and I'm like, Yes, I want that right now. Yeah.

Scott Benner 23:40
It's interesting, because I think your mind must work a certain way to be a pilot, because you know, when a lot of people reach out to me on the podcast, usually what I'll tell them privately is, hey, look, it's just gonna be a conversation, it'll find its own way. You know, I'm not going to give you topics or anything, but you asked me two separate times while we were emailing, but what are we going to be talking about? I could tell I was like, oh, because he really is uncomfortable, not knowing what he's getting into before he gets into it. I'm sorry, I left you in that space. Knowing No, but but but at the same time, it makes sense that you have an A one see that is that low, because your your brain must just think about these numbers in the right way, like in a way that you can make sense of and make adjustments to but that's still very impressive. With shots are you do you have like crazy lows? Or are you pretty steady? Because I've been in a one to five one has got to be what an average, I'm guessing. But that's got to be an average blood sugar in the mid 80s.

Unknown Speaker 24:36
Maybe?

John 24:41
I think on average, I ride right around between 80 and 100. Because, you know, as I started do more, I guess research and learning more about you know, just the disease and not just the disease but what what is normal. You know, I'm kind of one of those people where Do you find out clinically, normal blood glucose is kind of defined between 77 to 99, you know, for fasting blood glucose. And so, you know, I looked at that and said, well, that's normal. And that's what is going to give you your best opportunity to, you know, again, avoid or mitigate the risk of having long term diabetic complications. So I'm not satisfied making 140 my goal, I want to make normal my goal because that gives you your best chance at long term health. And

Scott Benner 25:32
what would you say is the main focus of how you can accomplish that, if you restrict diet? Or do you just think you have a really good grasp of how the insulin works? Or is it a mixture? Well, I

John 25:42
think it's a combination of both and, you know, folks that I that I have talked to, and, you know, I have, you know, met with a few other folks that have, you know, type one and even type two, you know, it's a combination of, you know, understanding the insulin, just like, you know, you are very, very adamant about and understanding what it does for you, you know, because, as you said, a lot of those calculations that you get, initially from even a best intending, you know, endocrinologist or CDE, are, I guess, starting points, and you have to figure out, how does this affect me, and becoming comfortable with that, so that you can just like you say, you know, be aggressive with insulin, and, you know, correct when you need to answer and the other facet of that, that I've found that I'm a firm believer in is that, you know, making dietary changes that are going to, I guess, set you up for success, so to speak,

Scott Benner 26:44
either things you cut out, or were you always eating like the like this, are there things that you looked at one day, and we're just like this, I can't make this work. So it's gone, or?

John 26:55
Yeah, yeah, absolutely. So prior to my diagnosis, you know, being a pretty active person, and, you know, a mountain bike racer, and, you know, someone who does a lot of activities, you know, I, I had, I were my wife, and I, you know, I've always eaten healthy because I also have a background in sports physiology and in nutrition. And so, at the time, you know, we were eating, you know, you know, fairly healthy and, you know, well balanced diet, and stayed away a lot away from a lot of processed foods, but, you know, we still a, you know, more sugary type stuff, particularly when we're exercising and, you know, because of the level of exercise, we could get away with a lot more because we were burning so many calories. But, um, you know, with the diagnosis, I then had to start looking at, okay, well, what causes a blood glucose, you know, Spike or insulin, you know, requirement. So you start looking at, you know, of course, sugar and carbohydrates. And so, the process of that was basically, you know, I started off with kind of removing all of those really simple sugars, and, you know, um, you know, trees, if you want to think of it that way, I was kind of notorious on, you know, around my friends for having, you know, updates, you know, hankering for muddy buddies, I don't know if you know what those are. They're like, their Chex Mix that are covered in like, you know, powdered sugar and chocolate, you know, those anymore. Now those have to go right out the window, those are gone immediately. So you

Scott Benner 28:32
find yourself thinking, hmm, money buddies.

John 28:35
I mean, it's more like I have that thought, but it's, it's more of a comedic sense, like, holy crap, I used to, you know, take down a bag of those things and not even think twice about it. Which, of course, would be preposterous now, you know? Yeah. I don't even know what that would do to me. Now.

Scott Benner 28:54
If you put insulin over your head, you'd probably be okay. Exactly. Yeah, I know. It's funny when you you think about like health and the way people look versus how they how healthy they actually are, I used as an example, sometimes when I was growing up, my parents had these friends and the husband of the of the of the other couple was just this very tall, in shape lean guy. And he died before any of them, you know, just because because he'd be like, he'd be like, one of those guys, like you'd order pizza, he's a whole pizza himself, he wouldn't gain a pound and somehow, you know, in 1979, that translated into He must be the lucky guy who's just healthy. You know, no one thought about a past that. So. Anyway, he's, he's long gone now, because he had a heart attack before he was 50 years old.

John 29:39
And what that I mean, that's a really interesting, you know, thing to the story rather to bring up because, you know, that sort of getting back to the dietary and health changes, you know, it's, as I started to, you know, I guess use some of the studying techniques and kind of looking back at, you know, things I learned in college, you know, That idea where, you know, and I kind of consult folks now with, you know, non die bikes as well, as far as, you know, attaining a healthy lifestyle, you know, mainly through nutrition. You know, there is that idea where I think, in today's society, and this has been kind of propagated, you know, from probably the 80s, and so on, and has been probably increased or made more of an issue with media that a lot of people equate, I guess, body weight or body composition with health, you know, they think, Oh, well, they're thin and fit, and yeah, they do all this stuff. But from a health standpoint, that doesn't necessarily mean that they're a healthy person, you know, like, they could just like that guy, you know, and I have some other examples of similar type stuff where they look very healthy, but you pull their blood work, and it's just, it's a train wreck.

Scott Benner 30:52
Yeah, it's, it's funny how, how you just sometimes doesn't correlate at all. And, you know, and you would, but it is our it is kind of the way we're built, like, our brains are built, like, you just look if you don't look. And it's such an odd thing, right, because, quote, unquote, if you don't look unhealthy, you must not be unhealthy, and vice versa. And so it is really interesting. I just thought that because I what you're describing eating that Chex Mix covered in chocolate, like I know, for my body, if I had even a reasonable amount of that I'd wake up the next day, three pounds heavier, like I just I wouldn't be able to avoid it. So it's just it's, it's just, you know, different people. But but so you just completely cut these things away. So did you always think of yourself as somebody with a good constitution for things like that? Or is that something you developed for diabetes? So I'm supposed to be telling you about the dexcom g six continuous glucose monitor. But all I can think about is the video I saw this morning of Quincy, the koala bear at the San Diego Zoo, wearing a Dexcom g six continuous glucose monitor the videos really cool, you can see Quincy getting his blood sugar checked wearing the dexcom g six, getting insulin, it's really kind of captivating to watch, I hope you go back to the blog later and check it out. But that's not really what this time is, for this time, which now is less than when I started is to talk about the Dexcom g six continuous glucose monitor. You hear us talking every day on this podcast about the great things that come from wearing a continuous glucose monitor, being able to see your blood sugar rise and fall to know how fast that's happening, to be able to make great decisions about Temp Basal rates and Pre-Bolus saying all the things that you hear me talking about here, that information that I get from the Dexcom allows all that to happen. If you're someone who needs to know what someone else's blood sugar is the Dexcom features a share and follow app. So one person as the share app, the person who has diabetes and one person as the follow up, the person who's following along, you can do this with an Apple or Android phone. It's really spectacular. It's how I learned to let go and allow my daughter to do all kinds of things in the world that I couldn't previously imagine her doing really is a life changing device. So between the really cute koala bear, and everything else, I really hope you go to dexcom.com Ford slash juice box to learn more about the dexcom continuous glucose monitor. I genuinely think you'll be happy that you did. Did you always think of yourself as somebody with a good constitution for things like that? Or is that something you developed for diabetes? Yeah, I

John 33:35
think I'm a I've always been one of those people that once I see, I guess really positive either information or, you know, undeniable, I guess science, if you want to think of it that way to show that it's a positive thing. And I kind of set my mind to it, I'm able to, I guess, either make those changes or to kind of follow that track, you know, and, and stick with it. And so, you know, I guess as that applied to diabetes, you know, once I start to figure out, well, here's what causes the most amount of, I guess, stress or frustration for particularly type one diabetics, well, if I can work on, and, you know, it's a process, it wasn't like, you know, one day, it's just all gone. But it was a, you know, process over probably a year to kind of get where I'm at now. dietarily. You know, I, I was able to say, Well, you know, those are the things that seem to cause the most amount of issues. So if I can remove those things, you know, that will give me again, you know, better control of the disease and therefore, you know, give me the best potential for long term health and that was my big goal to say, you know, all the research and, you know, folks that have to have diabetes for long periods of time type ones. You know, the I guess fear, I think that a lot of people have is, you know, not so much diabetes, but the long term consequence of uncontrolled diabetes. And, you know, just talking with physicians and folks that have been involved with it for long periods of time. And they know, a couple in particular said, you know, these are not,

Unknown Speaker 35:22
you know, a,

Unknown Speaker 35:25
you know, a

John 35:27
definitive thing that's going to happen, you know, it's, it's preventable, provided, you know, you can get good control of the disease, because I think a common phrase is that diabetes never killed anybody. It's usually the complications from poorly controlled diabetes that causes the problems.

Scott Benner 35:45
You think of, you know, DK, for example, is something that does happen to people and it's you just, it's something you can see in the moment, like you can, you can see, like cause and effect like, I did not take enough insulin, my insulin pump got knocked off, something happened, my blood sugar rose, I went to DK this happened. Like, I got out of it, I got better, I died, like, you know that, but you don't often think I had chex mix on Thursday in November in 2017. And in 2034, this happens to me, you don't think, you know, think about that way. And, but but you do, because it hit you that way. And you were able to, like make that decision, but you're probably at the right spot in your life, right? 36, you'd had a lot of that you'd had a lot of that check specs by now. Right? There's, because there's things now. I'm 46. And there are things now that I know, I'm like, oh, that would be good. But yeah, like he kind of like, you know, what's not worth it. Or I know, that'll make my stomach hurt or you know, blah, blah, whatever it ends up, you start feeling you just you're able to pass it by? Maybe that's just because you've had it so many times. It's or maybe Yeah, I've got the time, you know, you got the time into life, where you really understand things a little a little firmer, and no, it's not, it's not like, um, it's not like, You're, you're seven, and I've got to explain to you how you can't have this or, you know, it would be better if you didn't have this or whatever. Right. I know that the one time Arden stopped eating something, and it was her idea. And and it you know, I talked about it a couple times here, but she just she heard the doctor talking about a one C and we were discussing how to maybe get it to move and she just, we went out to the car and she's like, how what could I do to make my agency go down. And I remember telling her back then I was like, you could stop eating cereal for breakfast. I was like, that would make things so much easier for me to know the huge. Yeah. And it wasn't it's funny, because I couldn't figure it out. Now I can Bolus for a bowl of cereal like it's nothing. But back then back then I just could not figure it out. And so I just figured if you could just remove that from the the larger equation, maybe I could focus on some of this other stuff and figure out some of this other stuff. And it's right, but you really seem to have so So tell me a little bit about like, in the course of a day. Do you eat? Like how? How many carbs Do you think you take in the day? How in do or is it?

John 38:05
Sure? Yeah. Um, yeah. So you know, I'd say it definitely in the last year and a half, I became more focused on you know, transitioning my body over to becoming more Well, yeah, I guess, well, the term is fat adapted, so that it, it processes fat more efficiently, both, you know, as you know, body fat and then dietary fat. So, I would say in a given day, you know, depending on my activity level, and, you know, big day at work, where I'm doing double shifts, I'm just going to be, you know, at work for 14 hours, you know, I probably only take in about 30 grams of carbohydrates the entire day. And then other times when I'm out doing, you know, big mountain bike races arrived, so where I'm burning two or 3000 calories at a shot, you know, I might take in 80 grams of carbohydrates. Okay, so they're very low carb,

Scott Benner 39:05
what do you eat besides carbs? And like, what do you take in to keep you going?

John 39:09
Well, yeah, so um, you know, moderate protein, you know, probably, I mean, you know, from a sidebar on that, you know, approximately one gram of protein per kilogram. So, you know, 170 pounds, so, probably about 70 grams of protein and the rest of it is, you know, healthy, excuse me, dietary fats. So, you know, because fat has very little necessity for you know, coverage by by insulin. Regardless of whether or not you're a diabetic or not. It just requires very little insulin to process, provided your body has become adapted to being able to tantalize it, you know, efficiently, particularly for activities, you know, if you're not, you know, overly active of person,

Unknown Speaker 40:00
it's

John 40:01
not quite as challenging, but, you know, if you're highly active, you kind of have to work up to that, or, you know, kind of retrain your body to be efficient with that.

Scott Benner 40:10
But as you were, you would experience a bunch of lows. And sure, yeah,

John 40:15
yeah. So, you know, like, with the inbox with a desk, calm, you know, on their, on their dashboard, you know, it shows your time within range, you know, and, you know, I only have, you know, like a 1.2% of the time that I've gone low out of range, you know, in my, my ranges between, you know, I modify it, you know, put the low alert, you know, and of course, that's another big, you know, huge advantage of having our rather, understanding the technology is to say, well, when I'm out exercising, I put my low alert at 85. Whereas when I'm just, you know, doing normal daily things, I set it at, you know, 75 or 70. So that way, when I'm exercising, it gives me that alert, earlier, so I can just correct it, and it's, you know, done with and then same thing with the high range, you know, like, I have my high range on the desk, comm set to, you know, 135. And so I correct immediately if it even starts creeping up on that, on that level.

Scott Benner 41:14
Yeah, we, we correct at 130? Yeah, any kind of diagonal up or, or up arrows, I just assume I've messed something up and, you know, more or more insulin. So you're not afraid to inject though. So you're an adult who has made that decision, like, if you make a bolus for a meal, and then you know, 45 minutes out of your 130, diagonal up, you're not, you'll just pull your pen out again, and give yourself more?

John 41:38
Oh, yeah, yeah. And, you know, again, the education level, you know, and I guess, you know, from doing, you know, podcasts, you know, again, just a huge fan of, on my own accord, and I really admire what you're doing with the community is just to encourage folks to, you know, educate themselves, because, you know, it's a kind of a cliche phrase, but, you know, knowledge is power. So, and it removes a lot of that fear. So, just like you said, If I, you know, maybe went over to, you know, a friend's house or, you know, ate out and there was something in there that I didn't know about, and you know, Hi Bolus, what I thought was correct. And then now it's like you said, Diane Valero up and it's at 121 25 and rising. Yeah, I don't hesitate to say, you know what, here, here's another half unit of homologue. And let's see a knock that down, because I know exactly what that insulin is going to do, or at least relatively close, as best as you can with absorption and all that stuff. But I know that that's not going to harm me, you know, like by taking a half an extra half unit, even if it's an intramuscular injection to really cut it down. I know that that's not going to put me at a dangerous low. Because, you know, I know how my body responds to that. And I know, be uncomfortable with my insulin dosing. And that's very powerful, you know, and that gives you a lot of control over the disease. You just

Scott Benner 43:04
said something I'm not sure everybody would understand. But so if you put the insulin in the way you're supposed to just in, you know, the fat layer, it absorbs in one wire, but you can press a little harder go into a muscle with it, and you get more quicker or more harsh reaction from the insolent. Gabe, describe that a little bit.

Unknown Speaker 43:21
Yes.

John 43:22
So yeah, as you said, usually, either through an insulin pump or normal insulin injection, you kind of do it subcutaneously. So you're injecting the insulin into that little layer, you know, again, body specific, but that layer of fat between the surface of the skin and the muscle, whereas if you inject it's called Im or intramuscular, you're actually injecting the insulin into a muscle, which has a much higher blood flow to it, so that you're removing some of the media that the insulin has to go through. So you're putting it nearly directly into the bloodstream so that it acts more quickly. And you have, you know, a more, I guess, deliberate response. So it you know, instead of maybe taking, you know, for like, myself, you know, homologue like instead of taking 15 minutes to start working like by doing I am literally within five or 10 minutes, I start seeing a change in that in that era on the Dexcom

Scott Benner 44:21
interesting yeah, it's a little things I don't think we think about too much so. So jumping in though, in the last kind of 20 minutes we have here what I want to talk to you about is is your flying so you know this is taken from you, obviously, not something you want as you look back now, because you still run your fly the same has you have you ever flown a simulation and had something happen because you're diabetes and thought, Oh, well, I guess it's good. I don't have a license to fly planes anymore. Or have you thought I think I could do this with type one. No, I've

John 44:54
never had an instance at work. You know, even you know, I teach classroom stuff anyway. Do I'm in the simulator, I do all the emergency scenarios, and I can honestly say that I've never had an instance where I thought, you know, I would be either unsafe or incapable of performing the, you know, those duties. So, um, and that's kind of been the big direction I currently holding in the airline, or rather, those who, of course, are familiar with how pilot certifications work as a private pilot, so if you're just going to go up and fly around on your own, you have your own airplane, or you rent one, you know, small airplanes. That's, that requires what's called a third class medical, and I actually had been able to regain that little level certification, so I can still fly private airplanes. But the airline world requires a first class medical, and that's where the disqualifying event is for insulin dependent diabetes. And, you know, it's one of those things, when you look at the regulations, those regulations, were kind of put on the books back in 1967. And, you know, at that time, of course, it was a, you know, profoundly different landscape for diabetes, you know, it was, it was nowhere near the same and it just hasn't really been looked at, or advocated for, until recently. And, you know, I firmly believe that if you know, a person, it hat is well controlled, and understands the disease, you know, whether through insulin pump and CGM use Anatolian or MDI, um, you know, that you can safely perform those duties and, you know, operate safely. Now, with that, you know, you know, again, this isn't meant to be, I guess, offensive, but I also believe that if it's someone who maybe doesn't have as much understanding, or is kind of still figuring out the control of the disease, I don't believe they should be in the flight deck, because you know, someone who potentially has, or is not understanding maybe why they went up to 350, and then had to take a large amount of insulin, and then, you know, an hour later, they're at 50, and are taking those huge blood glucose swings. I don't think that that would be safe in the flight deck. And the FAA actually has defined parameters for private pilot's that say, you have to keep your blood sugar within 100 and 300. While you're flying. And those same recommendations that were actually derived from work with the ADA, American Diabetes Association, and a board of endocrinologist with the FAA, along with some other recommendations, you know, have been determined as safe levels. And what we're trying to do now is advocate so that they can then apply those parameters to first and second class medicals. So that would that allow me to start flying again.

Scott Benner 48:03
So you think it's, there's a reasonable way to, to find the difference between a person who can keep their blood sugar and that stable range that range and who can't? Like, how do you make that decision? Who's Who? back?

John 48:17
Well? Yeah, that's a good question. Um, and that's sort of part of the debate. And actually, this particular subject matter has gone all the way up to the US District Court of Appeals. And then it's actually very close to going to the US Supreme Court and ruling on what the FAA should be using as a determining factor. And, you know, that's where the CGM comes in. Because when I first started this advocacy, with the FAA, the Federal Aviation Administration had no idea or I wouldn't say they had no idea, but they were unaware of the usefulness or the not really ability, but the what CGM could provide. And so you know, they're trying to decide, you know, while you're flying, you know, you need to be able to show that you're in this range, and they want to see CGM reports and, you know, utilizing the, you know, a one c value and a official report from your treating endocrinologist to, you know, state that you're, you know, you have good understanding, you're able to monitor your blood glucose, you know, how to use a blue blood glucose meter. And then, you know, part of the parameters for pi private pilot, is that prior to take off, you have to do you know, you have to be able to show a blood glucose reading, you know, above 100. And then you're required every hour to take a finger stick and show that you're within range. And then you have to bend show that records during that flight time to show that you were in compliance while you're flying. Okay. So

Scott Benner 49:59
I mean, it's no joke. There's, it's one of those things you completely understand both sides of the argument like you, I have no doubt you could fly an airplane and you're fine. And at the same time, if I'm flying on the airplane, I don't want to be the guy sitting in row seven, the one time you your blood sugar plummets out of nowhere, and it cut and it sneaks up on you. Right? And so, right, but then I get as I sit here, I think I could also you could have a heart attack while you're flying a plane. I mean, you could there's a lot of things that could happen. Aren't there co pilots? Like, yeah, absolutely. So So what's the point? Listen, john, let me ask another question. I met a guy, maybe a dozen years ago now. And he was flying, like the big heavy, you know, planes for major airlines to be moving, moving hundreds of people across the country. And he said that the secret is, he could push a button, that plane would take off, and it would land on its own, and he could sit there and sleep through the whole thing if he wanted to. Is that? Is that true?

John 50:57
Um, it's, I guess it's a slight over, we don't quite have the easy button yet. But, you know, um, you know, there are there are a lot of, you know, the the modern airplanes that we fly are very capable, you know, you do have first officers, but you know, it is something that and we train for that all the time, you know, incapacitation, you know, of the other pilot, and, you know, on a sidebar, you know, there's been more instances of flight deck crews having coronary artery events, then, you know, issues with diabetes, because, honestly, On another note, the International Civil avionics Association, or maybe Aviation Administration, I co M, which is all the other countries, including, you know, Air Canada, and European and also Australia. They all allow insulin dependent diabetics in the flight deck, and all those countries. So everyone except the United States, is not one of those countries has had one single report of incapacitation or inability to perform their duties, because of a diabetic event.

Scott Benner 52:09
Yeah, imagine, imagine, if you made every pilot check their, their heart every once an hour to make sure it was functioning, like you're probably safer than than anybody because you're paying such close attend, which is the point we make about people with diabetes all the time, is that they're gonna be healthier than most people, because they're so aware of their health, and right, and to say that there's never been an incident, like, that's what I was, that's what I was trying to get out, which is, what's the difference between your blood sugar and any number of other things that happen to other people? Like, if there's a process in place to put things to fix it? If that happens, then why is your blood sugar different than a heart attack? As far as the you know, the emergency, you know, steps that you have to take? It doesn't doesn't seem like it makes any difference? So let's see, it almost feels arbitrary.

John 52:58
Well, yeah, and that's sort of the, the point, you know, is, you know, the, the way in commercial aviation, you know, there are what they call special issuance medicals, where, you know, if you're not 100%, you know, in the normal range, so to speak, you know, there are certain conditions, some of which are cardiac conditions, and some of them are, you know, even just medications where you have to get what's called a special issuance of medical certificate where you have to show additional compliance to maintain that medical certificate, which is if we can move this forward, for insulin dependent diabetics, that's what I would have to get a special issuance, meaning I would have to provide more documentation and have more frequent checks for compliance than someone who doesn't have this special. And, you know, so And with that, you know, it's just a matter of saying, okay, you know, you have this condition, but as long as it's treatable, and it's safe, you know, that shouldn't preclude or prevent you from this particular, you know, this particular career track, you know, and, you know, as a whole, you know, as a increase to overall aviation safety, you know, the more and more frequent or more prevalence of type two diabetes, you know, when you look at it from a pure statistical standpoint, just the amount of active current airline pilots in the country, you know, well over 100,000 or 200,000 total pilots in our country, from a pure statistical standpoint, the, you know, the ability of even type two diabetes and then them becoming insulin dependent, potentially down the road. You know, you could decimate the pot population, if you just say Terreblanche, you know, you're you're done no more medicals for you and, you know, that creates a whole nother issue.

Scott Benner 54:58
I mean, I assume hearing what you're saying like, you feel like you could do this. And it's not a problem, but I feel like you're willing to if they put other parameters in place, you're willing to follow them. But and I and I hear that, but do you really think they're necessary? Or is this just something you're willing to do to, to get back up in the seat?

John 55:17
You mean, no establishing, you know, parameters and so on, you'll feel that's necessary, the

Scott Benner 55:21
extra testing and the verifications and stuff like Do you really think that's necessary? Or? I mean, is it one of the situations where maybe it's not necessary for a person like you, but it might be necessary if we're going to, generally speaking, if we're going to cover all the population of pilots? Sure,

John 55:37
I think definitely a, an increased amount of I guess, testing or providing things like either CGM data or those blood glucose, you know, finger sticks while you're flying. I think that's reasonable, because it has to be something that the controlling body, you know, can can take to the public and say, here's what we do to make sure that these people are safe. So I have no problem with that, you know, the frustration now lies with the fact that they have these parameters that have been recommended, you know, by a professional or a medical professionals. And right now, there hasn't been any movement on it, simply because they just don't feel like it's, you know, you know, really all that important, but at the same time, yeah. You know, yeah, you know, and at the same time, you know, you're looking at, you know, um, you know, I guess some folks would say, Well, you know, it's it's a form of discrimination. But I don't know, if I go quite that far to say it, it's just a, I guess, lack of need of, of, of action on on their part. So

Scott Benner 56:51
there's not enough people you don't have you're not up to the squeaky turbine getting the grease yet. So you need you need. And so is that something? Is that some so how much it was? we're winding up a little bit, but how much? How involved? Are you in this? And, and and what is it you're trying to accomplish? And at what point I know, I heard you say it's at one level in the courts, and they could go for hire me, do you think it's something that's going to work out in your professional lifetime? Or do you think it's a fight that's going to be fought for a long time?

John 57:21
Well, it's, it's, it's been, I guess, in the background, has, has been worked on for quite some time, you know, the American Diabetes Association, has been heavily involved in and it's, you know, speaking with the various flight surgeons and so on, I definitely think that it's it's going to, it's going to change, it's just the, you know, the trajectory or what what the time frame is, you know, luckily, my current position, you know, being, you know, with the airline that I'm at, gives me the ability to hopefully wait it out. And, you know, hopefully be there when, you know, when it changes, so I am very optimistic about that. And so I think it will change, it's just, you know, with any large organization, you know, and compounded by the fact of being a government organization changes slow.

Scott Benner 58:21
Well, you know, what occurs to me as you're talking is that the understanding that the FDA had of CGM, for example, was not good, until the people at Dexcom really stepped up their efforts to explain it to them. After maybe what your, you know, maybe what your cause needs is a little bit of maybe help from from an entity like that, who already knows how to petition the government about things like that? Like, maybe, maybe that's a bad idea to contact us calm and tell them what you're doing and say, you know, do you have the ability to help me explain to the FAA, the things that we're trying to explain? Can you back it up with that? You know, like, Is there something you could do? Because it really does. Yeah, there are, I think there are a couple of other, like you said in the beginning, there are very few, but there are a couple of other professions, but they don't allow people to type one with insulin dependent diabetes to to perform. And although I can't think of all of them off top my head, yeah. You know, at some point, you know, the next year or two, you're using MDI now, but you could easily switch over to a, an artificial pancreas probably in 2018, that might do a really fantastic job. You don't. So the things are going to change is my point. Right? I don't know, maybe, maybe that's something to consider is to try to loop somebody in who really knows the knows the landscape in DC, you know?

John 59:48
Yeah, you know, and it's, it's one of those things where, you know, more, more knowledge and more, you know, I guess, education or you know, folks that are aware of The real I guess the real capabilities of some of the technology and so on there would definitely be beneficial. So, yeah, I mean, the, the organization I'm currently working with is airline pilots Association, which is the largest union in the country for airline pilots. And, and it's something that they've been advocating for, you know, very heavily. And, you know, just for that reason that, you know, they just want the ability to, you know, so that this doesn't automatically become, you know, a career ending event, you know, as long as someone's willing to work at it, you know, and then you extrapolate that even down towards, again, some of the jdrf, and, you know, quote, people I've met with on that regard, you know, kids and so on, you know, I mean, you take a kid that has this dream of being a pilot, and they, they, they want to do it, and it just, it's a terrible thing to sit there and like say, Well, yeah, sorry, kid. Yeah, you gotta type one. So, you know, forget that psychological,

Scott Benner 1:01:00
the psychological implications are bigger than what we're talking about today. But it's, you know, get this incurable disease. And at the same time, it's possible your lifelong dream is, you know, is thrown right in the garbage along with all the other feelings that you're having at the moment. And that's, yeah, you need some, you need something to look forward to, while you're figuring out diabetes and your health and how to manage day to day and stay, you know, stay safe and stay healthy. Like you can't, you can't look up and have no blight. You know it like you said it, yes, it's not a lot of people that it's affecting, but it's more than you think. And if type twos start using more and more insulin, it's going to be more and more people. So now I'm with I think it's a I think it's a great cause. So, you know, I want to wish you a lot of luck, you know, making headway with it, I hope you keep in touch, I'd like to know, I'd like to know where where it leads and what you're able to figure out. But, you know, I know. I was gonna ask you when we're done, but I'm just gonna ask you while we're talking so I so i'm a i'm in Philadelphia, right around, I'm outside of Philadelphia, New Jersey, and I grew up in Philly my whole life, we're baseball fans and everything. And you and I recorded this about a week after boy holidays plane crashed in. And, and I was it's just such a, how, my question is, is How frequently do personal planes go down that we don't know about? Or is it not as frequent,

John 1:02:27
um, it's, you know, a private aircraft, there's quite a few more accidents that you just don't hear about, because it's sort of like a, a car accident. You know, I mean, tons of car accident, there's actually more deaths from car accidents and airplanes, obviously. But, um, you know, you, you know, I drove to work the other day and went by three car accidents when I never made it into the news, because it's, it's a car accident. So, with airplanes, you know, usually the ones you hear about are the ones that end up going into, you know, a neighborhood or, you know, having some other world, you know, involves a celebrity. So, you know, they do crash somewhat frequently, but not nothing, you know, approaching me on car accidents, you know, what, when I was flying air cargo, you know, it was basically just me or me and one other person and, you know, an old airplane with, you know, a bunch of car parts or industrial equipment in the back. And, you know, during those two years, you know, I lost six friends that died in, in accidents because of equipment failure, and, you know, crashed, and those never made it into the news, you know, because it's just one airplane and one guy and crashed out in the mountains someplace in the middle of the night.

Scott Benner 1:03:45
Yes, it is. It's just a it's an aspect of society. We don't think we all understand really, you know, like that the idea that like, you know, six people, you know, in two years crashing planes, and people were just like, oh, okay, because at the same time, if they were driving a truck across country and fell asleep and drove the truck, Alfa cliff, it would be the same really reaction, which is, that's a shame. And sure, you know, it's a personal tragedy. But, you know, in the grand scheme of things, we do expect some people to pass away from our accidents and plane crashes and everything it is really, I don't know, it's interesting. It's a whole part of the world. I don't I don't know that much about other than to say, I've always felt safe during air travel. I've never, you know, like, because it does make sense. Like if you know, if passenger planes were dropping out of the sky, somebody would tell me about it. And so I pray. Yeah, I very infrequently hear about anything like that. I never once I've never once gotten on a plane and thought, like, I hope this goes well. I've never had that.

John 1:04:43
I guess I'm doing my job, right?

Scott Benner 1:04:46
Yeah, well, I appreciate it. I do. I want to thank you for coming on. We had an hour but uh, but thanks so much for sharing, like, you know your story and this whole concept of, you know, what goes on when if you're a pilot or hoping to be a pilot and you get tired One, I hope it raises some awareness for you. And like I said, please keep in touch, let me know how it's going.

John 1:05:06
Yeah, absolutely, I really appreciate you having me on and, you know, getting the chance to talk with you. And I guess just, you know, last parting words, you know, I just want to encourage everyone out there that is dealing with type one or even, you know, type two, just, as you say all the time, you know, knowledge is power, and just, you know, take that initiative to go out there, and educate yourself, because no one else is going to do it for you, you really just have to go out there and get as much knowledge as you can. And that's going to give you the best long term result, either for yourself, or if it's, you know, parents dealing with, you know, kids with diabetes, and so on. Just get that knowledge and apply it. And, you know, I think that's going to be the best thing you can can do and relieve some of that fear and frustration.

Scott Benner 1:05:54
The worst thing that happened to you is you sit back hoping someone's going to tell you, and it's right, and it never happened. So you really do have to be proactive. You know, when something like this happens to your health, you can't just go well, this is what the guy said. So it's what I did, and it didn't work out. But what am I gonna do, he told me and right, you know, and then let it go. You have to go get it. Oh, john, thanks so much. I appreciate you coming on. Absolutely. Have a great day. Okay, thanks. Thank you, john, for coming on and sharing your experience. Thank you. I'm the pod index comm for sponsoring the show, please go to my on the pod.com Ford slash juice box, or dexcom.com forward slash juicebox. To find out more about those great products. You can also find links in your show notes at Juicebox podcast.com. Don't forget to go see the video of Quincy on my blog at ardens de.com I think there's like it's right on the front page. Just scroll down look for the koala bear. And if you don't if this is like two years later, and you still want to say it, you know, go to the blog and then hit the search bar and type koala because I can't imagine there's going to be more than one post about a koala bear on my diabetes blog. Thank you guys so much for the ratings and reviews on iTunes. We're almost up to 100 ratings and almost up to 100 user reviews for the podcast which is really fantastic. Thank you very much. Don't forget this is the last thing don't forget if you're enjoying the show, please share it with somebody else. You are the best chance I have of reaching a new audience member