#304 Loop de Loop

Like a Melody in my Head

Melody and Scott talk about DIY Loop and type 1 diabetes. 

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

Scott Benner 0:00
Hello everyone and welcome to Episode 304 of the Juicebox Podcast. Today's show is super sized. And because it is super sized We will also give it a super sponsor, how bout touched by type one.org used to be dancing for diabetes. Same great organization new name, check them out touched by type one.org. And who else should be the sponsor of today's show? That Contour Next One blood glucose meter. If you don't know about ardens meter, the Contour Next One, check them out at Contour Next one.com. You can even click on links in your podcast player, the ones that are available at Juicebox podcast.com. We're at your next endocrinologist appointment, just ask your doctor to switch you to the Contour Next One.

So far, I've done two episodes dedicated to looping. If you don't know what looping is, you should go back to Episode 227. And listen to that one called diabetes concierge. And then jump to Episode 252. A loopy few months. Diabetes concierge will explain to you what looping is in detail with Katy de Simone. And then in 252, it's a 14 week follow up to Arden's time looping. Today's episode is me trying in vain to figure out looping. By having a conversation with a mom, who is also looping, I want you to keep in mind that as I speak these words, it is six months past when this episode was recorded. My goal here is for you to be able to take this journey with me as I learned algorithm based pumping. But for me to be far enough ahead in real life, that when you get through listening to it, I'm able to already start talking about it. So this is going to be the last episode of me being like looping, I don't understand. And the ones that will come in the future will be a little more about what worked and what continues to work. Because I believe that algorithms are a future, treat them well and let them lead the way. Please remember this. Very, very important in this episode. 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 or becoming bold with insulin. Remember the algorithm that we are talking about here today is do it yourself. It is not from a company. It was downloaded from the interweb it's not even FDA approved. If this all sounds confusing, Do you seriously, go back to Episode 227. Then listen to 252 then come back to this one.

Unknown Speaker 2:36
Hi, I'm Melody.

Melody 2:43
Melody. Would you like me to introduce you? Sure.

Scott Benner 2:48
Okay, a lot of pressure, saying who you are. Then the rest of this should go

Unknown Speaker 2:55
really early.

Scott Benner 2:57
So melody is someone I asked to come on the show because she is the overseer of people's looping. And she understands it in different ways. So who do I reach out to that I reach out to Pete? Yeah, okay. And Pete works at tide pool and your husband works with, with Pete that tide pool, and then pizza to your husband.

Unknown Speaker 3:19
Pete sent an email and said, Hey, would you be interested in doing this? And Matt said, Melody would

Scott Benner 3:25
see how easy this was to say who you are.

Unknown Speaker 3:28
So many people passing the buck in that situation. So

Scott Benner 3:32
melody is Matt's wife or the way melody prefers to think of it Matt is Melody's husband. And Matt works with Pete and Pete works at tide pool and tide pool is taking the DIY loop app and trying to get it through the FDA. Did I say all that right? Yes. All right, look at me. Now. My goal was I've had two looping episodes so far right? At first I had Katie on and Katie really explained looping to me and brought me in from the ground up, because I really did not know what it was or what I was talking about. I was pressed by a listener to find out more about it. And I was completely happy with my daughter's care. And I didn't want to loop I was waiting for Omni pod to come out with whatever horizon is gonna be and I was gonna try that. So I got pressed into it by a listener and I thought, you know what, True enough. This is going to be the future. And I should understand it so I'll jump in sooner and try to wrap my head around it. So Katie came on she explained it to me Katie was really cool. She sent me her Riley link. an extra one we trot got set up and tried it. I hated loop. In the first three days, I almost quit. In the second three days. I really almost quit. I've almost using it a million times two weeks ago, I almost stopped using it. But nevertheless, I persist, which I believe I believe is a famous quote that I'm taking out of context and one yeah, so I had another episode on looper Jenny Smith came on. And she and I just went over what I thought of Luca. Here's the funny thing when it was over, I thought, Oh, I'm gonna hear back from a lot of angry loopers who are like, Oh, you, you know, don't understand or Let's all instead, all I got back was a lot of people going, yo man right on, like, that's exactly what happened. Oh geez. So my next goal was to have someone on who's doing it with success and has been doing it much longer than me. So that we can really just interview you about what it's like to use it, taking my experience out of it. So that's what I'm hoping to do today. Does that make no pressure at all? No, I mean, you're just gonna screw up the entire movement. If you get this wrong melody. That's all

Unknown Speaker 5:40
right. Like,

Scott Benner 5:42
your husband doesn't need that job, does he?

Unknown Speaker 5:45
We're fine.

Unknown Speaker 5:47
We don't need insurance or anything.

Scott Benner 5:49
Exactly. So let's get a little background on your first how many kids do you have? How many of them have diabetes? Who else has diabetes? What's the deal?

Unknown Speaker 5:57
We have three daughters. And our youngest, Hazel is the only one with diabetes. She's the only person we we knew no one with type one when she was diagnosed. It's not a family thing. totally out of the blue. kind of situation. And she was 18 months old when she was diagnosed. I was the person who diagnosed or our pediatrician kept brushing or brushing us off. And eventually, I just took her to urgent care and said, okay, pediatrician, we'll just do this urgent care thing. Um, and urgent care sent us to the ER. And while we're waiting for room in the ER, Matt started Googling, like type one things. Like we're both doing, like, we're both talking to family and like keeping people informed and all this kind of thing. But he started Googling and came across the we're not waiting movement, the like less than four hours into diagnosis. And so he was like, This is great. And I was like, I'm not in a place to hear this right now. Talk to me later.

Scott Benner 7:10
18 month old has diabetes, you found some well meaning idiots on the internet and you want us to hand their care over. I'm not really

Unknown Speaker 7:18
wasn't quite there yet. It was just, it was just here's something that gives me hope that this won't be as terrible as we thought. And so that got a back burner. And over the next couple of weeks while we were trying to figure out what we were doing. Yeah. And before we left the hospital, I asked the doctor for a CGM and a pump. And he was like, sure, what pump do you want? I was like, I don't know, you know more about these things than I do. And so we started out with an animus Ping. Um, that's what the, it was a teaching hospital and, and the fellows and the residents, they conferred quickly on the round and was like, probably the NSP? Yeah, yeah, enemas. And so about six weeks after diagnosis, because insurance is slow. We started her on both the Dexcom and the Animus. And once we kind of got settled into those, it took about a month. Um, Matt started reading more about the, the looping and the open APS, which they're two slightly different systems.

Unknown Speaker 8:33
And

Unknown Speaker 8:36
it, we had an HMO at the time. And I know a lot of people struggle with insurance, but it's so hard to get supplies sometimes. Like I was doing the primary, I had the primary role of like fighting with the insurance company and saying, Do you really need another prior authorization? kind of thing?

Scott Benner 8:58
You need me to send you another piece of paper that says she has diabetes? Because I've done this already? Yeah. Could you could we all just agree, you're trying to put me off for a couple of wait a couple of months, then you can send this stuff over without even

Unknown Speaker 9:10
Yeah. And so. So Matt started saying, I think we should do this looping thing, but we need to do, but it has to be an old Medtronic pump. And I was like, Okay, I'm spending all my energy getting the supplies that we need for this pump. If you get the pump and you figure out how to get the supplies for it, I'm on board,

Scott Benner 9:27
leave me out otherwise.

Unknown Speaker 9:30
But I can't handle trying to secure supplies for two different pumps from two different supply chains. And, and so he did, he posted a link on a post on Facebook with a cute picture of Hazel and said, Hey, anybody have old pumps that they're not using anymore, and we got two or three. One of them worked for looping with the old Medtronic pumps and so about six months after we We started her on the Animus Ping. We started looping.

Scott Benner 10:03
How long ago was this? Like? What year was it?

Unknown Speaker 10:06
It'll be two years next month.

Unknown Speaker 10:08
Wow. So we're,

Unknown Speaker 10:10
we're about, we're about to hit our loop. aversary.

Scott Benner 10:14
Okay, so so that your daughter Hazel's had diabetes for two years. And in that time, yeah, yeah. You've just sped completely through all of this process to the point where your husband now works that type of what did he do before? Please don't tell me he was like a butcher before? What did he do prior?

Unknown Speaker 10:31
No, no, he was an auto mechanic. Just kidding.

Unknown Speaker 10:35
Um, he was developing mobile apps for higher ed. Okay.

Scott Benner 10:42
Okay, so is he right now as best as you're allowed to say? Is he helping to refine the loop app for typo or what?

Unknown Speaker 10:50
He's a product designer? So he's not doing any of the technical stuff. He's doing the make it look pretty pretty and be usable?

Scott Benner 10:58
I gotcha. All right. Well, that's simple. That's more, it's not more important than how well it works. But, but it's it. But it's incredibly important. Because if it's not intuitive, then then people will be put off very quickly, and then maybe never come back to it. So

Unknown Speaker 11:11
that's exactly what we have way too many conversations about. So does this make sense to the user does this?

Scott Benner 11:19
So melody? Are you good at answering those questions, honestly? Or is the DIY loop from tide pool just going to be exactly the way you want it?

Unknown Speaker 11:29
Well, Matt is not the only product designer, so he's one of a team.

Scott Benner 11:33
They have wives, too. I think he right now, there are four ladies who have children with Type One Diabetes, who are gonna be different, not just joking, but

Unknown Speaker 11:41
well, and some of them have husbands.

Scott Benner 11:44
Or vice versa. Of course, I'm a sexist, I didn't understand. Trying to get through the conversation quickly, but I appreciate that. No, no, I'm okay. But good.

Unknown Speaker 11:52
And, um, they The cool thing about tide pool is almost everyone who's working on this project has either has type one themselves, or is the parent or married to someone with type one. So it's very much I'm close to everyone working on the project, a personal connection? Yeah. Okay. So all right. Let's dig in. So so let's assume I'm going to make some assumptions here, that mat set the loop up originally, like you weren't digging around in the code. And he did that. That's our division of labor. He did all of the build, and technical support. And I'm the one who generally does setting changes and such.

Scott Benner 12:33
So let's go back in time to when you strapped it on the first time. What What was your Do you remember your initial experiences and what the first roadblocks were and how you got over them?

Unknown Speaker 12:44
Oh, I remember, we started out in open loop. Which means that, excuse me, we weren't letting the system make any, any bazel change decisions. It was running just her schedule. bazel. And we were both listening through the phone though. Um, and we were trying, we actually we ran it for a day without it connected to her. I don't remember how we got the CGM data, but like ran it for a day watching what it would do just with the pump, tubing hanging off the end of the couch.

Scott Benner 13:19
That's interesting. So So were you genuinely afraid at that point to just hook it to your kid and be like, Oh, I hope this works.

Unknown Speaker 13:26
I don't think we were afraid. I think we were cautious because she had just turned two. And she was 25 pounds. And this is a DIY thing. Right. And so I think being cautious is warranted.

Scott Benner 13:42
100% Listen, you you you got a you got a used insulin pump off the internet that downloaded some code from some nice people. And I think I think it would have been reasonable if you would have looked into a pig first. But I get what you're saying.

Unknown Speaker 13:54
pata pigs and maybe our older daughters were not willing to be guinea pigs

Scott Benner 13:59
for money.

Unknown Speaker 14:02
Although one of them probably would have done it for LEGO sets. But we didn't go there.

Scott Benner 14:06
Well, that's really, first of all, that's smart. So you basically just watched how this thing administered. And so just to make sure it worked.

Unknown Speaker 14:13
Yeah, and just to see if we can understand the decisions it was making, if there was going to be like any glaringly obvious things that we needed to change in the settings or things like that. Um, and then I remember, we put it on her and the Medtronic pump use the same infusion set as the Animus. So it was really easy to just switch it over. We put it on her and we were running in an open loop. And we went to do pony rides that day, we were watching this open loop and like pushing the button every five minutes because it will give you a base of recommendation and you can push this button say yes, I agree with that. And I got tired of pushing the button and I was like, Man Can we just close the loop is it makes sense what it's doing? And he was like, are you sure we're ready to do that? And so like that this was your idea.

Scott Benner 15:07
You said, you're not sure.

Unknown Speaker 15:11
If he was going with the cautious approach, which I appreciate, and

Scott Benner 15:14
he's being a guy, I do this stuff to my wife all the time, I push us to the brink of like something that I'm like, are you sure we should be doing this? She's like you said to? Yeah, that I see what you say he's trying to take away anyway, go ahead. I know.

Unknown Speaker 15:29
Eventually, it was, she had just gone to bed. And her blood glucose was pretty stable. And we decided to close the loop. Because closing the loop meant it would automatically suspend Basal if she started to go low. And I remember very clearly, we had nightscout setup, which is another monitoring to third party monitoring. app. Yeah. So we had that set up. And we literally sat on our bed and watched the night Scout, every five minutes, like her bazel would slightly change, or, and there were tears involved, because we're like, this system is doing all the work that we've been doing for the last six months, which isn't as long as some people have been doing all this work, I realize, but it was just this gratitude and happiness that there was finally something that was helping us keep our kids safer.

Scott Benner 16:24
Can you looking back now Do you know how many people approximately were using it when you started using it?

Unknown Speaker 16:30
Um, I think it was less than 1000. I

Unknown Speaker 16:37
remember, I have the number 400 in my head. And I don't know if it was 1400 or 400. ish.

Scott Benner 16:43
Yeah. Well, one way or the other, not a lot of people. And these aren't even people you can quantify are using it. Right? They're just they had downloaded the bottle. Right? Right. Right. So first of all, you're really great parents. And I'm not joking. I'm not joking, you should be lauded. It's really amazing when I put the loop on art, and she said, Is this thing going to kill me? And I? I responded? Probably not. So then she looked at me like, Are you serious? I'm like, it'll be fine. And then we walked away from each other. So

Unknown Speaker 17:15
the risk aren't the risk are not inherently in the loop system, the risk are in diabetes, right? If something's going to kill them, it's going to be diabetes, right?

Scott Benner 17:23
Because the loop does not say the loop doesn't go, Oh, I'm gonna give you 10 more units of insulin. It's you can you can make your settings so that stuff like that can't happen. And, and I was mostly joking with her. There was part of me it was like, I mean, I don't know maybe, but it doesn't seem like just a lot of people using it. They haven't died. Let's give it a try. Which I think is the pioneering spirit if you ask me. But she laughed and and we went along our way. And and it was terrific. How soon into the process. Did you first want to quit looping? Or was your experience before looping so much worse than looping? And not that looping is bad? I'm just trying to set up an idea in your head. Because let me give you my thought. We were doing incredibly well without looping. My daughter's a one c 5226245 years. no appreciable lows, no highs, anything over 140 was a little unheard of in our house, and eating whatever she wanted. Yeah, then I go to looping. And I'm gonna be honest with you. It's still not that good. In the loop still can't do what I was doing prior. Now. It does do things that I couldn't do. Here's one of them. It you alluded to it a second ago. It can do things while I'm sleeping. And I can't so last night. Perfect example. didn't feel well. When I was going to sleep. I was like, Huh, little tickle in my throat. Gonna really need some sleep tonight. Right? I don't want to get sick. Arden's blood sugar was a little low. This is around 11 o'clock. She's up studying really late. we bumped her blood sugar back up. I closed my eyes never thought of it. And she woke up this morning. She was 106 Beautiful. That is what the loop does that I can't do it can it can it can make decisions in the wee hours of the morning without dropping dead. I can't I can't do that.

Unknown Speaker 19:07
We call it our robot nanny.

Scott Benner 19:09
Yeah, yeah. It's fantastic. So So every time I hit a roadblock about loop, I just think I can figure this out. And and I'm doing something and I hope people don't think of it as hard headed. It really is about me and how I learned and about the podcast too, because I want to be able to explain loop to people in the future. And these algorithms in general, I do not go to other people to ask about the loop. I help I let people help me set it up. And since then, I do not ask anyone's help I look at what that thing does. And I try to imagine how to get the result I want and I'll give you an example. Right now. I'm doing what I consider to be an extended bolus with loop right so if Arden's meal is 70 carbs out, tell it I don't know 30 carbs at a two hour absorption rate, and then 30 carbs at a three hour absorption rate and 10 carbs at a four hour absorption. Right? And that way I trick it into leaving the bazelon. Right, I'm so thrilled with myself when I have no idea.

Unknown Speaker 20:18
I think that we came into it a little bit differently because we didn't have a really long traditional pump therapy experience. And, and so, instead of learning all the tricks on a regular pump, we were learning them in loop. And so I think that changed our experience. I don't think I ever thought about quitting. And when, when the Omnipod caught code was released, we switched Hazel to Omni pod. Um, that was May I think,

Scott Benner 21:00
you just recently that's got to be you. And I have probably been doing it about the same amount of time. Is it on Wi Fi?

Unknown Speaker 21:05
Yeah. And the Omni pod Kenya's going into different angle than the steel ones we were using. And it was a really hard transition. And I don't think I ever felt like quitting. But I felt like a failure a lot. I was like, Why can I not get this right?

Scott Benner 21:25
And how right was it going for you prior to that, like so, if I might, if I may, and if you're willing to. I saw I shared with you. We didn't see anything over 140 frequently I never Arden's blood sugar never languishes in the 160s or the 170s prior to loot, but now it does. Right, right. And yesterday, she had a big after school snack that we totally missed on and it might have taken us four hours to get her blood sugar breaking come Wow. Right so and I'm talking about going outside like opening the loop up injecting insulin like doing like doing all of this stuff. And when I finally broke that's why she was a little low before bed because yeah, we had to put so much into make it go like, I don't those things did not happen to me before. But so what what do you Well, first of all, I guess the question is, is your is your child? Is she eating like a normal? Not like reasonably carb meals? Like it's not a little existence? That's

Unknown Speaker 22:25
her favorite meal of spaghetti and meatballs?

Scott Benner 22:27
Not low carb. Okay, then, and, and what goal? What's your goal for her blood sugar range?

Unknown Speaker 22:34
Um, my goal is for it not to affect how she feels.

Scott Benner 22:39
Okay, so what number do you attach to that idea?

Unknown Speaker 22:42
Um, bought the range I have set is in between 70 and 140. And because she's she's four now, and she commonly doesn't let us Pre-Bolus Okay, because she's four and impatient. We do see spikes when she first starts to eat regularly, depending on what it is and how we like, for example, one day we went to the playground and I packed a lunch for us thinking that we she would play for a while and then we would eat and I would just Bolus or a few minutes before it went out. We were going to eat. Um, but she had other ideas. We got to the playground, and she pulled out a container of grapes and said I'm ready for this now. And it was great. And

Scott Benner 23:32
look over there is that Elvis? Elvis Presley, Peppa Pig would be a little bit more that would get her more than they think probably. Yeah, I mean, Elvis is supposed to be dead. You don't think she'd find that? shocking?

Unknown Speaker 23:45
Yeah, I don't know. I don't think she knows who Elvis is.

Scott Benner 23:51
So So what is that? So what happens then? Right. she's she's throwing you off your schedule. Here's the grapes, Mommy, I want these grapes. You're a nice person. I'm going to give you the grapes. What do you do? Do you do Bolus more than the carbs for the grapes? Or how do you control the spike then,

Unknown Speaker 24:04
um, I

Unknown Speaker 24:07
sometimes that sometimes I do the what they call a super bolus where you give it like, I knew that the grapes were 15 grams of carbs and I might enter like 18 and know that if she needed a little bit more I had a whole bag of food because I never go anywhere without without a whole bag of food.

Unknown Speaker 24:25
And

Unknown Speaker 24:27
and then we is when I talk a lot about um insulin and glucose being the tortoise and the hare in like the old fable. And so as she starts to eat the grapes and like I say, it's I'm giving you the insulin for these but you remember insolent is a tortoise and those grapes are a hair so try to eat them slowly so that they don't win the race. Yeah, because she's for how she learned to give you the finger yet or

Scott Benner 24:57
that not yet.

Unknown Speaker 25:00
He has to learn to roll her eyes because he has a 14 year old sister. But, um, she has not learned much profanity or gestures.

Scott Benner 25:12
Well, she'll get to school in a year or so. And that'll all just show me one terrible little kid. And that'll be the end of it. But no, no, but so does she listen, then does she does she slow walk the grapes when you tell her that?

Unknown Speaker 25:22
Sometimes, but usually not. But we're also at the playground that day. So she ate them and then started running and playing. And so I think she might have spiked up to maybe 180 and then come right back down. So it wasn't terrible.

Scott Benner 25:37
Gotcha. By now you know that dancing for diabetes has changed their name to touch by type one. Here's why they did it.

Unknown Speaker 25:44
For nearly two decades, dancing for diabetes has been spreading awareness about type one, raising funds to find a cure and inspiring those with Type One Diabetes to thrive. Our organizations incredible growth over the last 10 years has pushed us to challenge ourselves and reflect on how we can impact more people to better identify with our community. To properly explain who we are and increase our reach. We are rebranding and becoming touch by type one. rebranding will allow us to continue all of our career programs, as well as expanding grows, then we can reach more people and change more lives. We are ecstatic for this new journey for rediscovering who we are and what we can accomplish for our global community. Together, we enter our 20th year as who we've always been, and who will continue to be touched by type one, check us out a touched by type one.org,

Scott Benner 26:44
check out touched by type one.org. Now type it into your browser, use the links at Juicebox Podcast comm or look right there. In your podcast player. There's show notes. There's a link. All right back to melody. And this thing is just going to start going I am gonna like lose my mind at some point. While I'm talking to melody. Here's a good time to tell you, I found this conversation that I had with melody, incredibly therapeutic. And I have an aha moment. At the end, I know this one's a lot longer than most of them. But this episode ended up being like a therapy conversation for me about looping. So you're really listening to me, kind of hammering my way through it. melody is very generous with how she uh, let's say puts up with me. Alright, let's get back to it. spiked to 180 came back down how long between giving her the first insulin and back down?

Unknown Speaker 27:47
I'm less than an hour, less than an hour. Okay. Yeah, so it's like,

Unknown Speaker 27:53
if she influenced us in this right, then a lot of times, she doesn't spend too high. If she's like, she doesn't spend too high. But that's if the insulin dosing is right. And being a tiny person, getting that right is difficult. So I also learned not to be a perfectionist with a toddler with diabetes, because it was making me crazy.

Unknown Speaker 28:21
And

Unknown Speaker 28:24
the, we have fairly flatlines at night. Because she's not eating, she's not running around. growth hormones always mess that up. And that she sold her other hormones will mess that up too. But, um, but for the most part we have good night. And then in the day, she's she's in range around 60 to 80% of the time most days. And, and on the 60% there's usually something going on we watch for patterns, and then we figure out what it is correct and move on. Yeah.

Scott Benner 29:00
Well, first of all, I agree with you. I am not despite I guess the podcasts that I do. I am not a person who gets upset if a blood sugars not in a flatline and it's 85 I don't feel that way. And I don't I don't try for that. Also in our house when my wife says this is making me crazy, one of a stop one of a stop, sir. And we qualify and go crazier.

But but but interestingly, I also think you're in it. You're I mean, you're obviously I mean she's four, right, four years old, right? So, and it's great that you see it too, because I do also see people online who have pre pubescent kids were like, look at these lines. They go on for days and I'm like, yeah, there's no real hormones like you know, like there's, they have variables but they don't even know yet that the variables that are going to hit them when their kids get older, or the ones that adults have to put up with. You know what I mean? Like they're, you don't realize your kids pretty much an amoeba still Just sort of just floating through life going, Oh, this is great grapes swings. This lady comes with me. You know, that's sort of the deal, right? I don't mind that, like if Arden's blood sugar. If Arden's lunch today would have popped the 140 and come back, I wouldn't have thought anything of it. But here's what happened with Arden's long shot. And it's a bit of a blend of yesterday and today. So yesterday, with a very similar lunch, we had a little spike that happened, and it kind of leveled off around 150. And it came back. So later I was like, Oh, my God loop. We know what we're doing great. Yay. Then I am pack your lunch bag later, the half a sandwich I sent with her she didn't touch. So so 30 of the carbs of her meal she didn't need and it's still missed. So now I'm thinking, Oh, god, what if I would have like, What if she would have eaten that sandwich? Right? Yeah. So today, I when we text about her lunch, she's like, hey, it's lunchtime. I'm going to Pre-Bolus down on the cool. Are you hungry? And she goes, not really. And I was like, Ah, okay, so then we did a slightly smaller bolus. So instead, I think we did something like ended up being about eight and a half units, which I think it was like 30 carbs at two hours and 30 carbs at three hours, something like that, right. And her blood sugar was 106. Wow. Oh, starting out. Starting out. Starting out at 106. We put in this insulin, probably 15 or 20 minutes later, she's eating lunch. And for the next half an hour, 45 minutes, her blood sugar is just it's just bopping along, like 103 95. And we're winners. And then. And then suddenly, it just went 128 diagonal up. And there's a bend in the Dexcom line. Anybody listen to podcasts knows what that band looks like, this is me, I type right into the text message. It's trying to run. And so that's that's our code, right? Like it's trying to run. She says, What should I do? And I'm like, open the loop and Bolus three and a half minutes. And then and then I was like, Did you eat everything she was? Yeah, you know, I ended up being much hungrier than I thought it was. That's great. So So the three and a half probably still wasn't enough. But I was just like, open the loop Bolus three and a half units. That's my new code for smack in the face. And so she's 128 diagonal up after almost an hour of the insulin being in and I am just like, there's a, I see it now. And I'm like, I now know what to do. If I over if I can bolus enough insulin to crush the number and keep it and bring it back. Now I'm learning how to stare at that like not stare. But I know when the graph tells me to turn the loop back on, like yeah, right so that I can catch a low later because I'm putting way too much insulated in this moment. And then if I put the loop back on a little cuddalore away that is something I've taught myself through all this though, keep in mind please while your daughter's that delightful small child buying around with some grapes aren't had half of a peanut butter and jelly sandwich, like those little Oreo flats, that you can spread the cream on yourself a small grab bag of potato chips, a large bag of grapes, ask me how many grapes I have no idea because I would never count a grape and a yogurt.

Unknown Speaker 33:09
So we don't want to count every grape that goes into your teenage daughter's lunch. I

Scott Benner 33:13
have never counted food in my life. That's why this podcast mainly exists. I didn't want to count carbs, it's like I have to figure out how to do this without counting carbs, because I'm not going to do that. And they end up killing her. So what would have happened prior to lube is that I would have made this kind of crazy, bigger bolus, that I also would have included in a large Temp Basal increase along with and then that way when I could tell on the line where we were and and take away the Temp Basal increase if it was necessary, leave it on if it was and I sort of create these two different blankets of insolent with the Bolus bazel where a loop makes me want to curse, spit and and burn something to the ground is it I get this bolus, right? It's perfect. And the loop goes, Hey, you know what we should do here? Let's shut off the bazel. And

Unknown Speaker 34:05
it's all the information you're feeding into the system. And so

Unknown Speaker 34:08
Luke said too much.

Unknown Speaker 34:11
We've only had the information you give it and so Lupe said she's had enough insulin for this for the amount of carbs. So we're going to shut off the insulin because we don't want her to go low. But Luke doesn't actually think because it's a machine. It's an algorithm.

Unknown Speaker 34:29
And, and there is no

Unknown Speaker 34:32
machine learning involved in this. Just clarifying that.

Scott Benner 34:34
Yep, I bring sure to bring that up every time like because you know, people think this thing's gonna see it three times and fix it. It's Yeah, it's not Skynet. So yeah. Oh, God, please. Oh,

Unknown Speaker 34:46
yeah, you know that she needed more insulin. You saw from her graph that she needed more insulin. What I generally do when I see that the insulin that I gave Hazel for male is not enough. I'll go back and retro Add carbs to the meal. Yeah. And then it will continue to it will give more insulin and then add bazel. And

Scott Benner 35:11
so when you do that it gives more insulin but in the form of bazel.

Unknown Speaker 35:15
Um, a lot of times if you enter more carbs into a previous meal, then it'll recommend the Bolus to

Scott Benner 35:21
Yes. Now here's where. And please, I always want to be careful whenever I'm talking about loot because I genuinely mean what I'm about to say. It's amazing. Any any person who put any effort into getting it to this point in the world is amazing. I am not disparaging it in any way whatsoever. But here's where it sucks, because I hear what you're saying. Because like, it's like, oh, pending insulin, but like you got to go into a screen to see that it's not like it pops up and it goes yellow man bolus. It's not It's not like that, right? You have to go figure it out and

Unknown Speaker 35:52
you add carbs. Like if you add carbs retroactively, even then it will pop up. recommendable.

Scott Benner 35:58
It doesn't do that for me, like I know It must be because and as I'm sitting here talking about it with you Arden's some of ardens meals are incredibly carb heavy, right? So even when you're like, Okay, well, let's call it 20 more, I still, it's like, dude, that's not enough for me. And I think I need to be telling it more. But what do I want to say here about that? I it, huh? I'm lost a little bit because this is what this is what Luke does to me. It makes me it makes me lose my thoughts. I want to be able to tell it more. And I do and a lot of times I'll bolus pending insulin because that's a trick that Jenny Smith taught me. She's like, if it's, if it's saying pending insulin, she's like, just Bolus it. And I was like, okay, because it can only steal it away with bazel later that I love. But it's the it's the heavier carb stuff. What I wanted to say was that everything I do for a meal that's not particularly carb heavy, you know, like the like, the night before Arden had a big like sort of just house salad that I made for her. And she ate I think a cheeseburger with it and maybe a couple of other things. She's very interesting the way she she has a an interesting collection of food when she eats us like

Unknown Speaker 37:11
I have a 14 year old

Scott Benner 37:13
you know what I'm saying? Like I should have with this burger a salad I'm like, Yeah, absolutely. Here you go. Why not? And no lie the loop handle that meal perfectly. Now I think had I had it gotten more karbi then it that's when it just I don't know. Like it can't. The bazel can't get ahead of it enough. It tries and and I've and you know I've tried. I know that people warn against like not having your max bazel up too high because you don't want them to be making too many decisions. The bezel? I'm telling you that away from food right now we have the loop working. It's not It's not like my settings are way off. It is a bit of a pain because as soon as she becomes premenstrual then the settings aren't right. And then you have to go in and kind of bump sensitivity.

Unknown Speaker 38:02
I know people who use overrides for periods and pre periods.

Scott Benner 38:07
I have the override setup and I have to tell you, I can't make positive overrides help me I can make negative overrides helped me but not positive. I don't know why I'm still figuring it all out. It's a freeze. Really. It's like I'm in a snowstorm without glasses on I just I look around. I'm like so much swirling whiteness. I don't know which way to walk.

Unknown Speaker 38:28
So many Dexcom dot.

Scott Benner 38:30
Yeah, like what's happening. So So can we pick through the settings a little bit? I would love. I would love your opinion, because I don't know. So when variables kick up, and let's just say that insulin needs are more do I? Do I need to move the bazel the Max bazel the bazel rate and the insulin sensitivity? Do they all need to become more powerful?

Unknown Speaker 38:55
Um, it depends on why like, if you're saying she's great without food, then your Basal is good. Okay. Then

Unknown Speaker 39:07
if she's eating and steady for an hour, and then going up, she needs more insulin for that meal.

Scott Benner 39:14
Yeah, right, right. Right. But what setting is that

Unknown Speaker 39:19
high ratio.

Scott Benner 39:21
That can't possibly be right though, because Arden's carb ratio is like six carbs to a unit. If I make her carb ratio any higher, she's gonna like that won't that that doesn't make any sense to me, because we're

Unknown Speaker 39:31
getting on what what the food is like, there's Hazel, and I go to Starbucks once a week, and we have breakfast there and there's the sandwich that she loves. And it's taken me about the amount of time that we've been going to Starbucks, like two years to figure out how to dose the sandwich and on the menu or on the nutritional information that says it's 28 grams of carbs in this bacon cheese

Unknown Speaker 40:01
egg sandwich thing. Um, I've learned that I have to almost double that,

Scott Benner 40:07
probably because of the bacon and the cheese.

Unknown Speaker 40:09
And, and because it's processed, like, the more processed the food is, the more infinite takes, I don't understand why there may be like some food chemist or something, you can help me figure that out. But like the carb count for fruit is going to always be like, I can give Hazel 50 grams of strawberries, and that's four grams of 50 grams of strawberries and weight, which is four grams of carbs, and give her the infinite loop says it will be fine. I can give her the same amount of like

Unknown Speaker 40:46
something that's been processed, like I'm assuming something. And, and she needs more insulin, yeah. Then the carb count says,

Scott Benner 40:55
I'm assuming you probably have imagined this too, but that your body just can't break it down as well, when it's been processed as it can when it's just an organic sort of singular food that yeah, it's in there. And so it stays in it. Yeah, probably stays in their stomach longer takes longer to break down, gives off its carbs slower over a longer period of time plus the fat and the from the bacon in the morning. I'll spread it out. But that's cool. So you figured it out. But now, but do you say to 28 grams, and you did say 28 grams for 28 grams sandwich? You've doubled it to 56? Don't I paused in there for you to be impressed by math. But you'd have 256 But that can't be all right. You don't just put 56 in and let her eat you spread it out somehow did did you change

Unknown Speaker 41:38
I put it over four hours generally. Like in the him. I pushed the hamburger icon. Okay. And I commonly, I commonly it'll recommend, so Hazel's on diluted and fluentu, which is another fun factor. Um, so the way I think of units, when I say that, I give her five units for this. It's not it would four per units is one regular unit. So

Scott Benner 42:04
right. So if you gave her five real units of that insulin, she would just follow like that. Yeah, gotcha. So how long? How long have you been doing it? obviously been doing that the whole time. But have you? Like, are you gonna Is there a moment when you'll be able to get away from it or waiting for some,

Unknown Speaker 42:21
I hate diluting the insulin, we do it ourselves. And it's a tedious process that if you get wrong, it has major consequences. And so I would love to stop. But, um, we just get better control with the diluted insulin because you can give smaller doses basically.

Scott Benner 42:41
Right? Good for you. I think whatever works is, is the right thing.

Unknown Speaker 42:45
And it's standard is the center of care in our clinic. Like I'm all small children start out on diluted influence. And I don't know why it's not everywhere, but it's not.

Scott Benner 42:56
No, yeah, I don't meet many people at all who use it, honestly. And I talk to a lot of people and, and so it's not something that commonly comes up actually, I'm gonna say to harden right now, to close the loop. See how long it takes me to see that? Wow. Okay, so all right. So you're so how do you think about it? Like, I'm gonna break down some of these settings and tell me how your brain thinks about them. Okay, let's go with let's start with I think insulin sensitivity. I'll start with where do you see what is that setting, say to you? Let's see what happens when I type in the phrase Contour. Next one.com into my browser. Now? I don't think it should be any surprise. I'm on the webpage for the Contour. Next One blood glucose meter, the same exact blood glucose meter who's sponsoring this episode? Are you surprised you probably shouldn't be top of the page, yellow button to get a free Contour. Next One meter. I click on it. It does explain that not everybody's eligible. But it's pretty easy to find out who is email address, your name, birthdate, phone number, address, city state. I mean, it's pretty much that do you have diabetes? What type of diabetes do you have? It's that kind of Zynga. You don't mean and then you click Finish. Boom. Come on. You don't want to go find out if you can get a free Contour. Next One blood glucose meter. You don't want to know if you can have the blood glucose meter that Arden is using that I have been telling you about for a while now that Arden has been using for quite some time. That is in fact, the most accurate blood glucose meter I have ever used with my daughter. Ever. Not only that, the thing is, um, it's handy. You know what I mean? Not too big, not too small. Got a little you get that little light on it. There you click click at night. You can see where you're shooting. And of course, second tried test trips. So if you hit it once, don't get it right, you go back into that blood drop one more time without wasting a test trip. All these are great reasons for you to go to Contour Next one.com honestly, it's even a better reason for you to click on my link in the show notes or Juicebox podcast.com. Cuz that way they'll know you came from the podcast, check it out. I think insulin sensitivity I'll start with where do you see what does that setting say to you?

Unknown Speaker 45:30
That's the golf score. Because like golf scores are, the lower it is, the better it is or stronger. So I always think of it in terms of golf.

Scott Benner 45:43
Strange. So the lower the number, the lower the number is, the more powerful it is.

Unknown Speaker 45:47
Right? And so, I SF, if you're seeing a lot of roller coastering when there's like your, your Dexcom line looks like I'm doing the hand motion, but you can't see that it looks like a sharp waves or peaks, and then you probably need to change your ISF. Um, the ISF is tricky because if it's too strong, like too low of a number, you can get the if it's too strong of a number, you generally get the ups and downs. If it's too weak of a number, then loop has a hard time bringing it back down. But a lot of people compensate for a weak ISF with something else, like higher bezels.

Scott Benner 46:38
So sometimes people make their their ISF too weak, but they jacked their bazel up, which is not the really the correct way for the algorithm to be doing what it's trying to do. What's the telltale of that? Do you see the bezels open and close a lot when you have that wrong?

Unknown Speaker 46:51
Um,

Unknown Speaker 46:56
the telltale would be if

Unknown Speaker 47:00
if so,

Unknown Speaker 47:03
if you have a two week ISF, I'm gonna get this wrong and people are gonna yell at me. No one's impressed. They can't find you. They don't know. You're fine. Don't worry, you told them where my husband works.

Scott Benner 47:14
Oh, please, they figured that out. By the way. In the time you've been talking, I've now written closed loop or you will die. Hey, close the loop. And I finally got an Okay, so we're all good. Now.

Unknown Speaker 47:24
I love waiting for teams to text back. My favorite thing

Scott Benner 47:26
fairness, she's in class but, and she got back to me within a couple of minutes. It's just I like so I'm looking at nightscout off to the side. While you and I are talking. Right? I saw the flatten out. I saw the drop. And then I saw the the arrows stay the same, but the number change and that's when I was like, ooh, close the loop. Because it's gonna start falling. And then she jumped like from like, she jumped like 10 points in five minutes. I was like, hey, just let's close the loop now. Only because she's not in danger. I just don't want her to drink a juice. I'm trying to keep her low later. So anyway, alright, so don't say anything you're not comfortable with. I'm really looking for like your, like what do you do when you see those scenarios?

Unknown Speaker 48:09
So when I see the up in the quick up and down um, I haven't changed my stuff in a while, but I'm making the ISF a bigger number. makes it less roller coaster.

Scott Benner 48:24
Okay, so a weaker sensitivity factor or a higher number and God bless whoever said like that. And so what takes away so if your roller coaster and just those gentle kind of like ups and downs and ups and downs, that's because probably your ISF is too powerful. And, and and you're and so it's pushing you down, and then the basal is cutting back and then it's popping back up, and then it pushes back down again. Okay, see, that's, that's really valuable. I appreciate that. And what about Max bazel? So where do you see it set like are ardens in bazel and sounds really interesting on loop. So she's like 2.6 during waking hours, 2.6 units an hour during waking hours. For perspective, even though it doesn't matter. Anybody she's 15 she weighs about 130 pounds, she's like five, seven? overnight, she's 1.1 or 1.2. But her bazel is very that much overnight to being awake but her sensitivity factor overnight isn't that much different were weaker than it is during the day and I don't know off the top my head it's only it's a few points off. Yeah, and and when she sleeps in and everything kicks in for like waking hours. That's when I I have a lot of luck with an override I do a minus 30% override and that keeps her stable. So my assumption is is that her nighttime ISF is about 30% lower than her daytime, but that also, but but that doesn't but 30. But but it's more than 50% lower during the night for bazel than it is during the day. So even that 30% doesn't work. I just somehow I've randomly. I've literally lucked into an override that lets her sleep in.

Unknown Speaker 50:17
Oh, that's the first thing in the morning. It's one of the hardest times for me because

Unknown Speaker 50:24
Hazel doesn't go to school yet. And she doesn't always wake up at the same time. And so

Unknown Speaker 50:33
like, as soon as she wakes up her blood glucose is going to start to rise. But not until the minute she wakes up. And so getting the basal set right there is so hard. I'm hoping that will be one thing that's easier when she starts school and in a very routinized

Scott Benner 50:54
I what we do on school days, Arden wakes up. She's usually like this morning, she was one of six but a lot of times she's around 85 or 90 when she wakes up. And I could see if it wasn't for loop. I could just bolus right then I would without compunction bullets a year and a half of insulin when she woke up, just blind Bolus, I would do it. But I can't because if I do that in the loop takes away all the Basal. Like you messed up, buddy. And I'm here. And I don't want to and I don't want to like I try not to like hard like fake carb lie because that messes things up too, right? So I have to wait for a blood sugar to start drifting off. Then when she gets the 128 depending on pops on. It's like, yo, you should be bolusing. And I always want to look at it. Yeah, I know. And then. And so she does that usually on the ride to school. And it'll catch her around 135 or so and bring her back.

Unknown Speaker 51:46
So if she used, you know that she needs like a unit unit a half somewhere like that, something like that.

Scott Benner 51:52
Is that what you said? Yes, absolutely. So should I jacker bazel for an hour right before she wakes up? Probably Yeah, right. Except I always like I'm not killing your kid you make. I'm not giving clinical advice here. Melody, listen at the beginning of the podcast in a very deep voice. I will remind everybody that you and I are not giving anybody advice. I mean, honestly, they're hearing us talk there's no way they would take advice from us anyway. So you were outsmarted by a kid with grapes earlier this Congress.

Unknown Speaker 52:25
It's one of my kids regularly.

Scott Benner 52:29
So So okay, so I think about that, but then I get to the idea of well, then Saturday I'll come and then that's going to be way too much. And what if I don't wake up that early? I'll tell you, I said this with Jenny the other day, on one of the episodes and I'll say it with you. Pump companies or if you know tide pools listening or whoever. You have to give people weekday and weekend. Can Trump Yeah, don't make me remember to get up at six in the morning to stop something that works Monday through Friday.

Unknown Speaker 52:59
Um, what I've heard other people doing is Friday night before they go to bed. They just changed the time on the bazel

Scott Benner 53:07
hundred percent that's still bullish. Yeah, I don't want to have to do that. Like, like, this is such a simple thing. There should be I should be able to set something up for weekdays that started, you know, Sunday night at midnight or something like that. And that, you know, and

Unknown Speaker 53:22
I should be able to read the alarm on the clock that set and then just start kicking the bazel in like an hour prior to that when the alarm goes off. That's

Scott Benner 53:30
genius. I know. Yeah. They really,

Unknown Speaker 53:33
I should be the one designing these things.

Scott Benner 53:35
Yeah. What's what this guy did that he was just making Apps for Education stuff. He doesn't know what he's doing. How did he get this job? Just kidding. I'm sure he knows what he said typo was obviously, you know, doing that stuff. And you and I are having you're having an amazing idea right now, which obviously we can't really implement. But in a perfect world. Imagine that. Imagine if the app said Oh, her alarm set for seven today we should start pushing her but to her bazel insulin up at 630 or six o'clock. I mean, obviously there's that's fraught with pitfalls, but it's in a perfect world scenario. What a genius idea.

Unknown Speaker 54:12
Your phone already has all this information.

Scott Benner 54:14
It knows when you start moving. It knows when you start breaking REM sleep and everything. And you know, it's it definitely knows what you're doing on Facebook.

Unknown Speaker 54:22
That's the whole the whole concept behind the we're not waiting movement. They're like they they were like we have the CGM. We have this pump. Why can't they talk to each other? Yeah. So now we have this phone. And we have and it has all this personal information about it. Why can't it inform the decisions of our insulin delivery?

Scott Benner 54:40
Even a little bit? Yeah, just even just even cuz it's funny as you say that even if ardens bazel rate would move up by 30% an hour before she woke up in the morning. That would be enough to stop that. That initial rise that life rise. You know what I mean? When you open your eyes, you're like I'm awake I through school and everything starts hitting you and you're rushing around and irritated that you're feel tired and it starts pushing your blood sugar up? And yeah, I mean, listen, Something's got to give because, you know, parents, parents are the ones who do it. Normally, I know so many people who set an alarm and get up an hour before their kids to get their kids blood sugar's ready for when they wake up in the morning. And then poor adults don't have that luxury of their mom still sitting behind, you know, at the foot of their bed, trying to wake them up helping them with their health. And so they're putting a completely different problem. So when it's a kid, even if you outsmart it, and there are a million ways to outsmart this stuff, those ways still entail effort and time. And I know it's hard to think of in the moment mount, you know, melody, but that effort that you and I are and other people are putting into things. It beats you up over time, you know what I mean? Like, I am not the same fresh faced, young man, I was before my daughter got diabetes, and there is part of me who wonders what I would look like if diabetes didn't exist, you know, they mean, like, would I go for a walk once in a while? Like, what kind of energy and and you know, like, what would life be without that stress? And that extra stuff to do? And what don't you get accomplished in your life? Because you're thinking about it? And you know, and how can these things help you with that? I listen, I like to, you know, I can play in while I'm talking. That's part of my, my charm. But I love loop. And I think it's stunning. I can't wait for tide pool to get their thing through the FDA. I can't wait for, you know, horizon to come out from Omnipod. I can't wait to see it all. You know, I'm super excited.

Unknown Speaker 56:33
So when, when we were looking at loop for Hazel way, two years ago, there were no other systems on the market. I think the 630 g was available for adults at that time, maybe. But there was nothing. I talked to the Medtronic people in detail. And they're like, there is no way we're going to put a two year old on our pump. At this point, it is not approved.

Unknown Speaker 56:58
Yeah. Yeah. Like, right, it's gonna happen. Our system that's not approved.

Unknown Speaker 57:05
But it's exciting that there's like, tandem and Omni pod and there's so many more that are coming out and and loop works well for us. Different things work for different people. And different things make more sense and in different lifestyles and such, right?

Scott Benner 57:26
Oh, absolutely. Yeah, you got to find what works for you. You can't just I mean, Arden uses a Piedra nobody uses a feature. it you know, as its own. It works so perfectly for her. You know, and so I didn't get to that we use no blog. Just go doctor gave us no log. I was like, yeah, sure, whatever. This is insulin. And then one day someone's like, you know, the problems you're describing. Have you ever considered trying a pager? And I was like, I don't even know what you're talking about? You know, and I tried it. I was like, Oh, this is way better for her. So and I know people have tried it, and it hasn't worked for them.

Unknown Speaker 58:01
Yeah, um, But to answer your question of, like, 10 minutes ago,

Unknown Speaker 58:07
we have our max bazel set at three times what her?

Unknown Speaker 58:13
Normal, highest bazel is okay.

Scott Benner 58:17
And so what is your highest? bazel?

Unknown Speaker 58:20
Um, remember, she's on your 25 deleted in fun. Price. bazel I think is point eight.

Unknown Speaker 58:29
Which would be point two,

Scott Benner 58:33
if it's not, right. So

Unknown Speaker 58:36
her highest basal hurt the periods where she has the highest basal is right when she goes to sleep, and right when she wakes up.

Scott Benner 58:47
Okay, so if you have it because of the because delidded you have it at point eight. So so your max is?

Unknown Speaker 58:56
I think it was right around three, three. Okay. We,

Unknown Speaker 59:00
when when we first started Omni pod, we upped our bezels considerably because like, this isn't working. She needs more insulin with this system. And then I think part of it was the craziness of our summer. And then and so her Max bazel at one point, the her the highest bazel setting she had at one point, I think was one and that's when I moved it up to three and I just haven't lowered it again.

Scott Benner 59:28
Gotcha. And and by not and by not lowering it, lowering it It hasn't hasn't had bad effects on anything. So actually, your Mac your max bazel rate is significantly higher than three times higher than her normal base. Right?

Unknown Speaker 59:41
Like half a unit.

Scott Benner 59:43
Okay, okay. Gotcha. Well, yeah, but it point to a half seems like a lot to me appointed.

Unknown Speaker 59:48
Yeah. But good, but it's diluted half unit,

Scott Benner 59:53
which is really more like hardly anything.

Unknown Speaker 59:56
Yeah, like 1.5 or something. I don't know. Nothing. Hard.

Scott Benner 1:00:00
Kidding, please. That's another reason why I have this podcast because I'm not I don't like the math, and why the loop makes me upset. Because it all it all seems like math.

Unknown Speaker 1:00:11
It is. And

Unknown Speaker 1:00:14
I love that. Diabetes has made me have a slightly different relationship with math than I did before. Like I remember shortly after she was diagnosed, I wanted to write a letter to my high school math teacher and say, and say, remember, when we all ask you when we would need this in life? Now I use it to keep my kid alive. So I guess thanks.

Scott Benner 1:00:36
Appreciate it. Really glad you understood everything. And you taught it to us so well. I still so you know the way I do it before loop. The way I would handle all this had no math in it whatsoever. It was all just vibe and feel and it works. So well. I mentioned it when I talked to Jenny about loop. But Arden said to me earnestly she's like, I don't understand why we're using this loop. You and I are so much better at this. And I was like No, I know. But we need to figure it out. And ironically her Awan sees not changing. You know, even though she's seeing higher blood sugars we're not seeing but that's because we're like purposefully like smashing them. I think if being honest, if I would not readdress spikes, I think Arden's agency would have gone from where it was, which I think was 5.5. When we started, I think it would be seven by now. Well, and now what I'm trying to say is, is that I also think that there are scads of human beings on the planet, who would be incredibly happy with a 781 say, and not just happy, but it would be an incredible improvement for their health.

Unknown Speaker 1:01:45
Yeah, I'm happy with the seven, like six months in. Yeah. And that sounded really condescending. Like, I remember being happy about a seven. Because it our doctor, our endo said with a condition we want her below 8.5. And so the seven was great. Yeah, you're like, I'm one

Scott Benner 1:02:03
and a half under the best, you know, yeah, I see that. I listened. And I don't think people take that as kind of I think people with a nine wish they had a seven I think people who were told eight and a half would be thrilled with a seven. And now you're lower than that. You think I remember a time when I was thrilled with seven? Don't you know? Yeah, I hear what you're saying. You're not hurt anybody's feelings story. People listen to the show are tough. They can take it, they listen to me. So they got a really thick skin. I don't know what we've done here. Naughty. I really don't like what I you know, what I really realized as we were talking. So if I may summarize or pull this together for a second, just to kind of make a bigger point. Your kid is little, and you're doing a terrific job Hurry, when C is great. Her variability is really amazing. All this stuff is going really well. And yet, when I said to you, hey, in this scenario, what would you do to that setting? You were still like, um, well, it right?

Unknown Speaker 1:03:01
I need a little bit more information than right. What we do, what I do is, I look at patterns. If she if she goes slow once at a certain time, then then it could be because I just feel wrong or because she was wearing her sparkly shoes. And she thinks that her sparkly shoes mean that she needs to run more or any other variable, but if she goes low in the same place two or three times, then I'm changing a setting. And so I look for patterns.

Scott Benner 1:03:34
And so the interesting thing to me is that you're charting a course right like you, you're thinking about loop and and your settings, like you're standing on the shore of New York, and you're trying to get to Europe. And so you're plotting and charting and making everything, like decisions ahead of time what I was doing before loop was I got in the boat, and I and I started rowing, okay, and then if there was a storm up front, I would just go around the storm. And then if a pirate ship came, I'd hide. And then like, you know, like I just went and I got over there. The same way you got over there. Like we're both standing in Europe now going, huh? Your Way worked and my way work. My way was more like fluid and kind of flexible and blue. Can't do that loop needs to know. settings it needs to understand. These are the numbers I'm working with. And those numbers need to be right. And if those numbers are wrong, it doesn't just stand up like Oh, no worries. We'll hide from the pirate ship. Now it does. Yeah, yeah.

Unknown Speaker 1:04:34
It's a system that needs the correct information to go forward. Whereas you're human and you're able to bob and

Scott Benner 1:04:42
weave. Yeah, yeah. So do you know anybody that closed loops at night and open loops all day?

Unknown Speaker 1:04:49
I'm sure there are people. I've heard of parents doing that with school. Some

Unknown Speaker 1:04:56
I don't know anyone particular who does that regularly.

Scott Benner 1:05:00
I'll tell you I, in my mind, that would be the best answer for us with the exception of the fact of that when you put loop, when you re close the loop after a day of it being open, it immediately looks and goes, Oh, you've used way more insulin than we need, and then shut your base forever. And it's just like you mother, then. So he, so everything I tried to trick it with.

Unknown Speaker 1:05:24
I'm hearing that live causes you to curse.

Scott Benner 1:05:27
I curse aside of loop. But a loop makes me want to curse more than than normal. It just because every time I feel like I have it outsmarted

Unknown Speaker 1:05:37
it, I'm wrong. Yeah. And I think that, that trying to outsmart it is is maybe counterintuitive. Where you're going wrong? Yeah, but because. But you have to figure out how to work with it. But you've been doing this other system for so long. Yeah. And working so well, that it's kind of like trying to learn to ride a unicycle after you've been riding a bicycle or something. I don't know if that's a bad analogy. But

Scott Benner 1:06:07
all analogies are fun. I think that what I would love to do is put you and that kid in a time machine and send you forward 10 years. And then let you live a week with loop and ask you these questions again. I feel like you'd be like, Oh my god, Scott. Right, huh? Yeah, because with hormones, you mean hormones, and big, bigger appetites? Like like that, like that kind of thing? Because right now, like, I mean, like, honestly, like in carbs, what's the biggest meal? She might eat?

Unknown Speaker 1:06:41
Um, we were at a pool party the other night, and there was pizza and corn on the cob and cookies. And it gave me a slight anxiety attack. And I think it was over 100 grams.

Unknown Speaker 1:06:54
Wow, how did that go? Um,

Unknown Speaker 1:06:59
it. So she ended up having a second cookie, because I wasn't familiar with the kind of pizza that was. Um, yeah. And so I ended up giving too much up front. And then she went low, and ate a second cookie, and then eventually stabilized and was okay through the night. But it was it was rough.

Scott Benner 1:07:22
Yeah. Can I add context? what's, what number is low in your mind?

Unknown Speaker 1:07:26
Um,

Unknown Speaker 1:07:29
well, we needed to drive home and I don't like to put her in the car if she's, if she's below 70. Okay, because I don't like to drive and try to, like, throw candy back at four year old,

Scott Benner 1:07:42
open your mouth stop moving.

Unknown Speaker 1:07:45
And we live in in the Los Angeles area. And so it's not just like, you can pull over on a side street. It's like, one time I was navigating a difficult like going from the five to the 210. I don't know, some numbers. And and I hear the Dexcom alarm. And I'm like, Why is she low? She shouldn't be low right now. And then I look back and she's asleep. And kids fall asleep in the car all the time. And I'm like, Is she asleep? Because she's low? Is she asleep? Because she's didn't take a nap today. And and then I'm like, trying to navigate this highway transition and yelling at her trying to make sure she she will wake up.

Scott Benner 1:08:26
By the way, anyone who's listening who is not imagining melody, whipping candy at her daughter's face trying to hit her open mouth is not allowed to listen anymore. Just shut off. You're not allowed to listen. Because you have to be picturing that right now. She's just got these like little gummy bears. And she loved them. What

Unknown Speaker 1:08:42
is it? dum dums are it's my candy of choice for the car because I can hold the stick and hand it back and mostly reach her

Scott Benner 1:08:50
cuz the lollipop makes it longer. Exactly. Oh my god. Now you all have to be considering this. Also, if none of you have ever driven in Los Angeles don't it's a terrible, awful. Yeah. But Oh, wow. You have painted a picture that I will live with for the rest of my life. Molly, thank you so much. It's you trying to negotiate five lanes of traffic

Unknown Speaker 1:09:11
and can't

Scott Benner 1:09:13
afford four year old in the face with a lollipop. It's great. Anyway, so she got lowered. And then yeah, how high did she end up at that picnic ever?

Unknown Speaker 1:09:27
Um, well, it was time to go and she was in the 60s and so I didn't want to get in the car again. She had a ton of insulin on board because of all the corn on the cob and the pizza. And the pizza was thicker crust than we usually eat and so I think it was hitting slower. So with another cookie, I got her up above 70 and we got home and I don't remember. I'm I think she probably went high later in the night. Then I went back and entered the grant. Like I didn't enter the cookie initially because I didn't want it. I didn't want if she went up high enough, I didn't want loot pushing her back down while we were in the car. And so I went back into the cookie, and got it all leveled out eventually. But it was, this was a birthday party. It was just a pool party in the summer

Scott Benner 1:10:20
party. Is it a good time? It was great. There was a party that was just like, we should have stayed home. I we could have splashed water on the kids, it would have been so much like, Look, guys enter the year. Yay, I go back in your room.

Unknown Speaker 1:10:33
birthday parties are the hardest, especially when there's a pool involved. And pizza. There's always pizza. There's always sweet things. And it's always things that are unfamiliar to me. And so, like, there's so many things. Like we go to blaze all the time, because there's one right beside our house. And I know how to do that pizza.

Scott Benner 1:10:56
blazes a pizza place because when you said California Blaze, I just thought that's where you guys go to smoke weed. Is that not right?

Unknown Speaker 1:11:02
That is legal here. But no.

Unknown Speaker 1:11:06
Blaze is a pizza place. It's like super thin crust. And so it's really easy. Yeah, and, um, but we haven't had enough experience with all the foods of the world for me to know how to dose everything. And even with bloop it's a learning experience worse

Scott Benner 1:11:22
not lesson it's all a learning, I'm not gonna lie to you, I get some meals so incredibly right? With loop that I'm just like, if she would just eat this all the time. I I'd be golden. You know, it's, and I'll tell you what messes me up more than anything right now. It's the, it's the bolusing process and loop. So you know, I told I told you earlier we did like 30 carbs to our start. So she does 30 carbs two hours then doesn't deliver anything. Right? And then bangs back in says 30 carbs, you know, three hours and then it it gives the it gives the suggestion for the entirety of 30 carbs, two hours and 30 carbs throughout? The problem is right in that moment. I want to be able to say to her, how much is it suggesting to you? But we don't have that kind of time. And we're texting, right? Think prior to that, I would say hey, I think we're going to use this much insulin, then I would know what goes in. And so I don't know how much is in her. Because had like today is an example. She would have said to me it once like eight and a half units. And I would have said that's not nearly enough. Right? We should use more. But I can't see that. And because of the way the process. Can you

Unknown Speaker 1:12:28
see it on nightscout when she enters it, like when the Bolus goes through?

Scott Benner 1:12:31
Yes. But it's it's there's a lag. Right, right. And then by the time it pops up, you're like, Alright, well, I here's what I do. I am that might not to the people listening, you might not believe this. I'm an incredibly optimistic person. I seriously Am I believe, and I trust and I really am a hopeful person. And so when I do it, I think well, these carbs are right. And this thing says it, I'm going to let it go and see what happens. And then when 45 minutes later, her blood sugar is like 96. I'm like, you know what? See, I'm being rewarded here for being optimistic and hopeful. And then her blood sugar shoots up and I'm like, why don't I trust that stupid. And so that's sort of my roller coaster ride for my own personal thing. But I really am. You know, when it's working so well for all these hours in a row and it gets a meal. Great. When the next meal comes up, you want to be able to say, All right, let me see what it does here. But I still have that unreasonable expectation in the back of my mind that it's going to fight with bazel. It just doesn't that like you said, the minute it thinks she's got the right amount of insulin for a meal, it takes the bazel completely away. Every time I look, I think if it would just leave that bazel then this would be okay. I've tried temp basals from nightscout.

Unknown Speaker 1:13:49
But the targets are template override.

Scott Benner 1:13:53
Let me pull it out. So I say the right thing. It is type Temp Basal start. And then I try to pick a duration. Right that I want it to go on for, say 30 minutes and I want a jacket way up and I jacket way up. And I do that because I think well if I only do it for 30 minutes, and I double or bazel she's only getting like these 30 minutes, bah bah, bah. And I do all that. And then at some point, it seems like the sometimes the loop just decides, you know what, no, we shouldn't be doing that. And it just shuts. I'm like, Wait, what? Why did I Why can I override it? If you can override me, this feels like being married. Like I feel like I'm an adult I should get to make a decision. But then there's this other thing in my life that's allowed to tell me no, you're stupid, you're wrong. And it's over. And then I don't get to say anything in return. So it won't let me outsmart it. And so opening the loop is the only thing that comes close. But then like I said, when you re close the loop, a lot of times you get high after that. So there's no winning. I have to stop I have to stop using this thing. I've got

Unknown Speaker 1:14:59
yeah or

Unknown Speaker 1:15:01
You, it takes a lot of experimentation to figure out.

Scott Benner 1:15:05
Okay, so good question. How long do I have to be at this before I feel better about this?

Unknown Speaker 1:15:10
Um

Unknown Speaker 1:15:14
How long did it take you to feel good about regular pump therapy?

Scott Benner 1:15:17
Oh, like six years?

Unknown Speaker 1:15:20
About six years? No, I

Scott Benner 1:15:27
think so. So so I am I'm obviously I'm a bit of a different breed in this scenario, right. So I can describe to you that when Arden was first on a pump, like Arden got a pump first, her a one seemed like eight and a half, and I was like, oh, we're gonna get an insulin pump. Everything's gonna be great. So, so her blood sugar went from like her, her he wants he's much like eight and a half like 7.9. I was like, Well, that was not the decrease. I was thinking. decrease. Yeah, so good, whatever.

Unknown Speaker 1:15:57
How old was he when she got a pump?

Scott Benner 1:15:59
Just four and a half. Okay, right. And so then Okay, so then we get to CGM a couple years later. Excuse me while I get a drink. We get to CGM a couple of years later. And I like go from like, languishing in the high sevens to like, all of a sudden, like, you know, lower sevens. And I was like, Oh, look at six point, you know, 7.2, like, really fancy. And at that time, the ideas that I've been blogging about started to kind of coalesce for me, I was like, Oh, my God, all these things are like, in line, like, there was a moment I was like, I have a system. You know what I mean? Like, so I started putting the system into practice a little more, so paying more attention to it. And that was it. Once I put those ideas, the ones I talked about on the podcast into play, 72686765646 boom, just kept falling. Like I couldn't stop her agency from going down. Without without loads, like I was just like, Oh, my God, I figured it out. And so I just sort of started turning up the power on my ideas until I got our agency to where I wanted it to be. I was like, Okay, these steps at this power equal 5.5. Just that that's it. I know what to do. And I went on to describe it to people on the podcast, and then it started working for them. Yeah, and then I'm gonna tell you like, no lie. I started talking to a family last Saturday, so not just this past couple days. So it's been about eight or nine days. And their son's teenage sons graph was a disaster. And at this point, now, it's amazing. It's really stunning. It just from talking to them, she helped me with something. So I helped her with this. Right. So we traded we traded it was like the barter system in the in the Old West. She She got me a water from her well, and I brought over my my cows for milk. And so we traded. And I, I fixed our kids blood sugar and eight days. Well, it's it's amazing, you should say. And so I know that thing so well. That this is just very infuriating. It just it really is. But I see the reason to understand it. Like I know I need to understand this. And so I'm not going to give up. But everyone I talked to, it's like I'm in a bad movie. That's a road. It's like a road trip movie. Like I meet Katie on the Hey, Katie Hill. Now Katie is like the queen of this. And then Katie tells me stuff like, that didn't really help me that much. And then I sit down with Jenny and Jenny tells me some stuff and I go back a little better. And then I was talking to him, like melody is gonna have the ends. No one has the I'm just walking through this road show movie and people I got Yeah, it's over that way. Like what? Yeah, just walked towards that, then.

Unknown Speaker 1:18:41
I think it's a more of a movie of self discovery, where you have to figure out the answers for yourself and no one's gonna hand them to you.

Scott Benner 1:18:46
Yeah, no, I don't. Yeah, I know. But you don't expect them to be handed. But I guess, I guess where my confusion comes in, or irritation? I don't know what you want to call it is that I was able to hand what I was doing to someone else. Right. And I want to meet the person who can hand loop to something. Right, and I haven't found that person yet. Ah.

Unknown Speaker 1:19:11
Um, so your lunch problem where you entered? You knew that she needed more insulin. Right. Right. So in the same way that you learn to, to bolus meals before loop you can learn to bolus meals with loop were like okay, last time we did this, and we put it in as 32 hours 33 hours and the insulin ran out before the carbs did so she needs more insulin. And so you entered is more carbs. Like I learned with the Starbucks sandwich that's it has to be a lot more carbs than I thought it was going to be.

Scott Benner 1:19:55
So I need so I should have lied to this thing about her meal today. And just lied to it about the amount of carbs until I was comfortable with how much insulin she got.

Unknown Speaker 1:20:05
I wouldn't call it line as much as

Unknown Speaker 1:20:09
like there's the face value carbs, and then the how the what the carbs actually do to her blood glucose.

Scott Benner 1:20:19
So I have to consider glycemic load and glycemic index. Yeah, I can't do that.

Unknown Speaker 1:20:25
Yeah.

Scott Benner 1:20:26
Why can't it do that? I'm just kidding. I know why.

Unknown Speaker 1:20:31
elimination technology.

Scott Benner 1:20:34
I understand why I can't. I yeah. So I guess here's, you know, what, maybe now that you, as you say it like that. And I am be trying to be a little introspective. I think the problem is, is that the idea of loop infers the idea of less effort, which I know it doesn't, yeah, like, but it does. It doesn't it doesn't.

Unknown Speaker 1:20:54
Right,

Scott Benner 1:20:55
right. Yeah. Like, how is it? Right, right. You know what it's like, it's like, if it's like, if 12 hours of the day, I had a really great spouse who loved me. And we had this great relationship, and then the other 12 hours a day,

Unknown Speaker 1:21:08
Jen, when the sun came up, yeah.

Scott Benner 1:21:10
Like she was just running around having sex for money. It makes sense, because, because in my 12 hours, whether she's, I think that's it like I think it lulls me into a sense of comfort, overnight, that doesn't exist during the day. And then I have trouble switching gears and going from, I don't have to pay much attention to diabetes to I do have to pay more attention to diabetes. You should be a therapist.

Unknown Speaker 1:21:40
Um, that is an interesting career choice I might consider.

Scott Benner 1:21:45
But no, seriously, you really helped me just now because I that that really is what happens is like, you just keep getting lulled into like, Oh, it's gonna be okay. I don't need to do this anymore. It works. I figured out my settings, like everybody tells me it's about the settings and settings, right? Look how good everything it's like your brain. It's you know what it is? It really is my hopeful nature. It's screwing me. Right? Because I see it work for 610, eight, you know, 12 hours in a row. And I'm like, Oh, yeah, loop works. It's great. I have my settings, right. Trust the settings, do the thing. And then I and then I don't realize that this is this is Jekyll and Hyde. Like it's one thing overnight, it's another thing during the day.

Unknown Speaker 1:22:26
Yeah, the the food is difficult. And yeah. And when it's working, it works so well. And when the food is not entered correctly, or I mean, it's in there correctly, but it doesn't react the same way, then.

Unknown Speaker 1:22:47
It's hard.

Scott Benner 1:22:49
Yeah. lupus, like if Dr. Jekyll was a hooker, I think that's what we figured out today. That I don't want to be.

Unknown Speaker 1:22:55
I don't want to be involved in figuring that out. I don't want my name attached to that.

Scott Benner 1:23:00
Well, I'm putting out the tide pool right now. You need Dr. Jekyll in a skirt. Standing on a street corner. That should be the new logo. I'll reach out to the right people. No, seriously, I really. I seriously think you just helped me. Because I and I and I can see the the confluence of events that lead me to like this roadblock. Because I was involved before. And when I wasn't involved, I didn't need to be involved. Right. Like, I know, I know, some people when they hear about the podcast initially, like Oh, that sounds like a lot of work. And it isn't the beginning. But the real like cool truth of it is, is that after a little while, it stops being any effort whatsoever. Yeah, like, it just works.

Unknown Speaker 1:23:45
I think that's the same.

Unknown Speaker 1:23:48
With loop. It's just another system you have to learn. And, and it sounds like the language you use about it. Like you're tricking it. You're outsmarting it. It sounds like you're fighting with loop.

Scott Benner 1:24:01
I am

Unknown Speaker 1:24:02
and yes. And it's you.

Scott Benner 1:24:08
I need I need no rules. No, I need new rules. Like Like, like when I sit here and I think about this stuff. I tell people on the podcast like you know, you'd rather be high than low. Don't you know, don't accept blood sugars above like I'd say these things like t shirt slogans at this point, right? And but they work like if you keep these things in your mind, it works and you can kind of overpower diabetes. For the most part. I think that I need to step back from what I'm doing from loop and look at my troubled moments and figure out if I were to do this in this moment, this would stop this and then give it a give it a slogan that makes me remember that moment. I know that really is easy, but I think that's what I need. I need to stop at lunchtime and say, Okay, this is like a high carb scenario. We're going to, we're going to like you know, decide that this meals on the other side of the glycemic index, it's on the higher And we're just going to put, you know, attacks on it. And, and add more, you know? Yeah. Melody. How's it feel to save a life? Because you've just done?

Unknown Speaker 1:25:11
Oh, I'm

Scott Benner 1:25:13
gonna put this on your resume once saved a man.

Unknown Speaker 1:25:19
Yeah, I'm

Unknown Speaker 1:25:23
still too early for me to have woody come back.

Scott Benner 1:25:25
You're fine. It is early in the morning. You're doing a very nice thing. It's so it's, it's like 889 o'clock here you are 915 I can't I kept you on way longer than I said to. Are you completely unhappy that you did this? Are you okay with this? I think I'm okay.

Unknown Speaker 1:25:42
Um, I will probably spend the next 48 hours thinking back to all the things I said and how I should have said them differently.

Scott Benner 1:25:49
That's no big deal. You're just having the same response that people have after dating me. It's over and you're like, I don't think I should have done that. probably right. And so, but it's too late. Now I have the recording. No, I'm just No, but I appreciate I think this kind of like rambley conversation is going to be one of them that I look back on, I think like this pulled me through because I have seriously because having too much of a like, I've tried having somebody come on and tell me like, this is how it works. But it's their perspective on loop. And why I need to figure out my perspective on it.

Unknown Speaker 1:26:28
You have to figure out how to fit the way your brain works in with figuring out the settings. And I have a good friend who has I'm gonna say it wrong. Just calcula it's like dyslexia, but with math, okay. And she's always saying, I don't know what I would do if my kid had diabetes. There's way too much math. I could never do that.

Unknown Speaker 1:26:54
Like, well, you figure it out. I figure things out.

Scott Benner 1:26:57
I'm looking it up right now. discount, by the way. First of all, he said it 100% right, it looks like this calcula severe difficulty and making arithmetic metathetical that Earth pathetical. What the heck calculations as a result of a brain disorder?

Unknown Speaker 1:27:13
Hmm. It's like dyslexia, generally, except for with numbers instead of numbers.

Scott Benner 1:27:19
Yeah, that that person's kid can't get diabetes. Oh, she'll have to return the kid. If that happens.

Unknown Speaker 1:27:26
You just know you can figure it out. I mean,

Unknown Speaker 1:27:31
I think everybody I think so. I think with accommodations, you can figure things out. It's like,

Scott Benner 1:27:37
yeah, I can tell you, your friend who I you know, I don't wish any bad on her family at all. I think that she is a she is the kind of person who hears my podcast and goes, this makes complete sense to me.

Unknown Speaker 1:27:50
Because it's not about the numbers. Right?

Scott Benner 1:27:52
Right. Yeah, see? She'd be fine. All right, I take it back. She'd be okay. Thank you very much for doing this. I want you to know that it doesn't go up right away. So you can you can, you know,

Unknown Speaker 1:28:05
cried about it for longer

Scott Benner 1:28:06
or no, just let me know that you really feel like you said something stupid. At one point. You're like, I really wish that wasn't in there. But I feel like you did a great job. When I edited I listened very closely to what's going back. You know, don't let anybody make a fool of themselves or anything like that. No, of course, but what am I trying to do? I'm trying to help people with diabetes, not not embarrass you. I'm embarrassing myself. I think that's enough embarrassment for the whole situation. I but I seriously think you really helped me just now. And I hope to be able to report back to you soon that I figured out a way to work more harmoniously with loop.

Unknown Speaker 1:28:40
Oh, I hope so. And

Unknown Speaker 1:28:44
yeah, and for for Arden sake. How does she feel about it? Oh,

Scott Benner 1:28:49
Arden doesn't want to do it. But Arden spoiled. Arden lived the life where she didn't really have diabetes.

Unknown Speaker 1:28:57
When and you were just doing everything? Well, like off camera.

Scott Benner 1:28:59
Yeah, we know we do it together. But that's such a small part of our day. So it really is I do believe true that most of the people who hear the podcast but don't follow along with trying it themselves, probably really don't believe me. But I don't think that prior to loop I thought about diabetes more than about six or eight minutes in total every 24 hours.

Unknown Speaker 1:29:20
Like you're recording a podcast about diabetes.

Scott Benner 1:29:22
Yes, that's a different thing. I take that out. But yeah, but so I really like she and I spent no time thinking about it now. With loop. I've been irritated and thinking about loop for the last two hours. I put more thought into diabetes today than I would have in a week without loop.

Unknown Speaker 1:29:37
Yeah. And so Matt always says that when when you start a new job, there's like six months of feeling like you're completely out of your element because you're learning new system new everything. And I think when learning a new diabetes management system is kind of the same because It makes you feel like all the things you already knew are not working in the situation.

Scott Benner 1:30:09
Yeah, yeah. It's everything I thought was right about the world I'm wrong about now. And that's it. Like, I just everything I thought was right is wrong, but I can learn this. And that is where I feel like that's where I'm at right now. I know I can. I know I can learn it. And I do have a little extra pressure because I feel like I need to learn it in a way where I can explain it. But I know I can learn it. I and I know that my time with it isn't as long as it probably feels. Although it's, you know, May, June, July, August, September. I'm getting there at six months now. But But the truth is, I'm way better at it today than I was three months ago. So it's coming. It just, it just is really a it's frustrating. To feel like it's fighting with you.

Unknown Speaker 1:30:51
Yeah, you know?

Unknown Speaker 1:30:54
Yeah, there are many moments where, where I'm, I'm not going to curse, but I do. And I'm like, What are you doing, Lou? And then I look and say, Oh, I didn't introduce carbs correctly, right? Or, Oh, I forgot to include the sugar in that car. pout, gotcha.

Scott Benner 1:31:14
I'm still very bad at the, you know, when you when you you know, tell it Hey, it's this is 20 carbs. And then later, it doesn't agree. Yeah, like, I still don't completely have that. I can't wrap that around. Like whatever it is, I need to wrap it around so I can understand it. Like if I tell it 20 and it says no. 17. Does that mean that at some point, it had to cut away more insulin because it didn't hit like 20 carbs? Or? Like you don't mean like we're What about when I tell it? 20 it says no, it was 30? Like I just I don't know. I don't know why it seems simple yet. When I look at it, I can't make sense of it. Um,

Unknown Speaker 1:31:55
yeah, then

Unknown Speaker 1:31:59
I

Unknown Speaker 1:32:02
I got a text in the middle of that from our nanny with Hazel.

Unknown Speaker 1:32:08
I'm good. But I missed the last half of your Senate.

Scott Benner 1:32:11
What I was gonna say what I'm saying is, is that when you tell some tell the loop Hey, this is 20 carbs. And later it tells you Oh, yeah, what was really 15? Right? Oh, my God, what does it mean when it says that?

Unknown Speaker 1:32:23
But the way your body absorbed it and the amount of insulin that was needed, matched 15 as opposed to 20?

Scott Benner 1:32:31
And what about the opposite? What if it says no 25?

Unknown Speaker 1:32:35
Then

Unknown Speaker 1:32:38
it's like saying, we used enough that your blood glucose data shows that you needed 25 grams worth of insulin.

Scott Benner 1:32:46
But you said 20

Unknown Speaker 1:32:47
Yeah, so it absorbs and, and so that's a really good thing to look at when you're when you're retrospectively looking at meals to see, okay, we just this is this, but it says, I don't this is 30. But it says that it absorbed like 45. So the next time she has this meal, he should do that. Do 45 gotcha. And, and it tells how long like the amount of time to. So that's honestly how we figured out our favorite pizza. Yeah. And now we eat pizza probably too often, partially because it's delicious. And partially because we know exactly how to Bolus and I know, I'm not going to be correcting this if we pizza. Nice.

Scott Benner 1:33:30
No, I mean, I would think I as you were saying that I thought I should be using that as a way to like measure load, like the load of the glycine, because I'm getting the Listen, I don't count carbs, but I can I can swag carbs pretty well. So I'm not like 30 carbs off when I make a decision, but that there is the impact that I'm off on sometimes. So I have to come up with a scenario where I understand what, how much extra carbs, covers impact of more carb, heavy food, or more dense food with more of a load. Okay. All right. I'm gonna let you off the hook. Now. You've done a lot for me today. I appreciate it. I don't know if anybody listening will get anything out of it. But I've gotten a lot out of it. So thank you very much. I really appreciate you walk away. It's kind of fun. Hey, you had fun. That's great. I can't tell because you're so West Coast and I'm east coast. I can't tell if you hate me or you were having a good

Unknown Speaker 1:34:25
Oh, mostly a good time.

Scott Benner 1:34:28
Ironically. I don't care. I just I can't tell. I'm just kidding. You were really terrific. Thank you so much for doing this.

Unknown Speaker 1:34:34
Thank you Have a good day. That's a

Scott Benner 1:34:37
huge thanks to melody for coming on the show and sharing what she's learned about the loop algorithm right. She helped me immensely as you heard. Today, I am much more adept at using loop. And it is very important to say that when this conversation was recorded, there was a difference. version of loop available. It has been updated since then. And the update has been a piece of how I've gotten to where you're going to hear next. You know, the next time I talk about looping, when I'm all like, yeah, I'm so good at this. It'll be because of what melody helped me with all the things I learned before all the people who helped me the time that we put into figuring it out, and of course, the hard work of the people who work on the algorithm. I want to thank very much the Contour Next One blood glucose meter, please go to Contour Next one.com click on the links in the show notes, click on the links at Juicebox podcast.com. And go get yourself a Contour. Next One blood glucose meter the thing just flat out rocks, and of course, touched by type one.org. Check them out today. Take a minute touched by type one.org go look at what they're doing. I don't usually give a heads up about future episodes. But later this week, another after dark episode is coming up. It's lovely. It is just really amazing. I am stunned by the open and honest nature of some of the people who come on this podcast. So there'll be another after dark episode coming up this week. And it's about trauma and addiction. You really should not miss it.

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