#397 The Lost Julia Tapes

Dr. Julia Blanchette, PhD

Scott interviews Julia, a CDCES who has been living with Type 1 diabetic for over 20 years and whose education has been focused on psychological factors of self-managing T1D. They discuss how COVID-19 has brought changes that have shifted lifestyles and diet and increased stress and anxiety—and how that can and does affect mindsets and especially approaches to glucose management.

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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 0:09
Hey, everybody, welcome to Episode 397 of the Juicebox Podcast. Today we're gonna get to see what a difference six months can make. And I have a short story here before we get going about the difference 24 hours can make. Before I get to all that, I want you to remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, please always consult a physician before making changes to your health care plan. We're becoming bold with insulin. Today's guest is a return guest it's Julia. And Julia is a I would tell you she's a CD but just call herself something different now. There's been a change, you know, I don't understand the whole thing. But there's some group of people who tells people what things are. CD E's are now googling it. Certified diabetes educators credentials are changing to the certified Diabetes Care and Education Specialist, the CDC s credential, right check this out.

This episode of The Juicebox Podcast is sponsored by the Dexcom g six continuous glucose monitor. The show is also sponsored today, by the Omni pod tubeless insulin pump, you can find out more about that g six@dexcom.com. forward slash juice box. And they get a free no obligation demo of the Omni pod sent directly to you. All you have to do is go to my Omni pod.com forward slash juice box now short story about 24 hours ago, the computer that I use to make this show just crashed. I mean, it took a you know what I mean? It was gone. At the time it crashed there were 63 unproduced already recorded episodes of this podcast living on it. But don't worry, they were also living on multiple backups online and physically here in my home. Anyway, it's been a stressful day, everything's working again, we're back up and running. But I almost threw up when I had to erase the computer to reinstall the backup because I knew I was functionally erasing 63 episodes of the show when I did it. And I was insanely scared that my backups weren't going to work. But gratefully they did. And here we are. Now. That's the difference 24 hours can make. Julia came on the show to talk about stress and anxiety, things like that, around COVID back in April, and I never got the episode out. So this is going to be interesting for you, especially in the very beginning, it's very heavy with conversation about living with COVID-19, just as it began to happen. So you're really getting an insight into how I felt about it and how Julia felt about it, how it was impacting people. It's a little time capsule episode that I think might be timely, because

Unknown Speaker 3:34
well, you know, I mean,

Scott Benner 3:36
hopefully things are getting better, but seeing a rise in infection a lot in a lot of the country. And so I thought maybe now's a good time to run this one as a reminder about how things seem in the moment, but maybe really aren't. Anyways, a little perspective here plus Julia and I talk a ton about living with Type One Diabetes, so really great conversation, but it's a little front loaded with COVID stuff. That's a real look into how people's minds worked in the first few weeks. It was even very eye opening for me when I edited to this when I edited this Why can't I say edited when I edited this. And I heard myself talking about certain ideas. You know, we back then we were very worried about transferring virus by touching things. And not so much about breathing at that point. Although masks were sort of a thing, but they they weren't really at the time. We were in that kind of flux moment. I want to be clear because I don't want to trigger anybody. I wear a mask in public all of the time now and I have since actually just you know not too long after a story you're going to hear me tell in the beginning. Anyway, I don't usually end up explaining myself in this podcast, but this is a very specific and touchy situation. So anyway, wants you to listen to it and you'll hear it for yourself.

Unknown Speaker 4:55
Alright, so I am Juliet. I've been on this podcast Previously, I think a few episodes ago or maybe longer based on when Scott decides to put this out, but I am a Diabetes Care and Education Specialist. I live in Ohio, and I have my PhD in nursing. And my PhD work is pretty focused on the psychological factors related to diabetes, self management.

Unknown Speaker 5:24
And I Oh, sorry.

Unknown Speaker 5:27
I was gonna say, and I've lived with type one for over 20 years,

Scott Benner 5:30
people say I've lived with type one for 20 years and my my first like, subconscious thought is always I wonder where they met, like, in high school or at a dance.

Unknown Speaker 5:40
You know, we met before a dance class in elementary school.

Scott Benner 5:46
Just out there in the parking lot hanging out. Yeah, see, that's exactly

Unknown Speaker 5:49
that's your story. I was on my way to dance class. And well, I thought and my mom brought me to the pediatrician said,

Scott Benner 5:57
was that that was at a smoke and mirrors, ducking cover situation. Was she telling you it was dance class? She did she make a in game decision, and change.

Unknown Speaker 6:06
She got me in the car. And then like, typically, we would have gone to dance class from the bus stop. And she was like, Hey, we're going to the pediatrician. And I flipped out. I was like, but dance class, but my friends. And she was like, we can go to dance class after but that never happened. Yeah.

Scott Benner 6:23
Your dance partner? Isn't dancing anymore. your pancreas? No, no,

Unknown Speaker 6:27
no.

Scott Benner 6:28
Well, okay, so Julia, I thought after interviewing you last time, there are forever questions rolling into the podcast about like psychological ramifications around diabetes. And I sometimes bring it up to Jenny privately. And I was like, you want to talk about this? I'm like, here's a question about you know, and I read the question, she goes, we can talk about it. She's like, but it's just gonna be my opinion. And I was like, right. She's like, I don't have any, like, you know, learning behind it. And I was like, gotcha. So one day when we were talking, I thought Julius, maybe we should try this with Julia. So you're, you're totally getting the gig here.

Unknown Speaker 7:06
All right. So we'll see how it goes.

Scott Benner 7:08
But if you're bad, you'll know you'll never be back on the podcast again. Don't take it personally. I Oh, hey, I can't feed these peoples rebel, they've come to expect something. Okay. But you know, where it's weird. I never timestamp the episodes. But for the for this. It's April 21 2020. And I don't know about you. But I have been pretty much in my home since March 13. So 2345 weeks. Yeah. So that's a while. And I've noticed a couple of things about the world. And I've noticed a couple of things about our life. And I've noticed some things about diabetes. So before we get into the diabetes thing, would you like to hear a story from me picking up takeout food?

Unknown Speaker 7:59
I'd love to

Scott Benner 8:00
it's a Corona Bay story. So first, I want to be clear, I've only been out of my house and gone somewhere public four times since this has happened. And each time has been to bring food back, usually from a grocery store. But this last weekend, we were like, Should we order something like we can order out. And that worked out really well. You know, like the pizza guy came and just abandoned the food on the, you know, on the front step. We sent out a strike team with Lysol, hit the boxes. The strike team then backed off, and then the movement team brought in the boxes, set it on a predetermined area, remove the food from the boxes, dispose of the boxes, wash their hands, cleanse the area presented the food. By the by the time you're all done, the food's cold. But hey, we shouldn't have to cook. Right? So so that went really well. And we're like, Huh, we could probably do that a little more frequently. So then another opportunity came up. And my son's like, hey, let's get that seafood from there's a seafood place in town that people it's funny we like but don't love. It's like one of those things where you're like, Who wants deep fried seafood that's going to take six months off our life. And when we all agree, like once every two years, we go to this place, no lie. So it's a little it's not shady. I don't want to say it's a shady place. But it's a place it's been there for a long time. Like you can see how it would have been quaint in the 60s. Okay,

Unknown Speaker 9:31
like a hole in the wall place

Scott Benner 9:32
a little bit. And you go up these steps and through these doors and you know, there's a little you know, you go through another door and now you're standing in a place a space that I'm going to call probably 20 feet wide but only about six feet deep. And and that's you know, we're in front of the counter.

Unknown Speaker 9:51
But no,

Scott Benner 9:52
no matter though, Julia because on the website, there's clear instructions about how to pick up the food. You call you pay in advance, you show up you tell them you know, when you pay what kind of car you have, and they, you know, bring it out to you. So it's like Oh, hell, all right. Like, you know, I'm gonna flip open the back of my car somebody's gonna set it in I'll push another button it'll go down. I won't even have to touch the food like we'll be able to eliminate an entire strike team from this you know, scenario. Well, I call an order the food and I said, you know, I'll pay you now and my car she was gonna just come in. And I said, What and she was Yeah, you can just come in. So my like before Coronavirus brain just thought, yeah, I mean, cuz nobody's ordering greasy. Seafood takeout I'm going to be the only one we're not going to go through this whole song and dance. I'm just going to show up and get my credit card. And I'll you know, I'll put the the schmutz on my credit card. When I'm done. It'll be nice and clean. And I'll be all set. So I roll in. And the important part of this is that Arden bolus, some insulin. So I roll in not a lot, just enough to get her moving. We've changed a pod recently. So I roll in and there are I don't want to over exaggerate. 123456 710 there are around 11 cars in the parking lot. So I'm just like, obviously, 11 people work here. Well, no. All right. So now I'm looking around better there are people sitting in cars that have just picked up food, there are people sitting in cars that that are like, you know, going through the whole thing you have you had this experience where you pull up somewhere and it's like you're gonna rob a bank in a Navy movie, you're like, you know, pulling on gloves and putting on a mask and everything. This is all you know, so everyone's doing that in the car. Yeah, well, Julia, here I am. I didn't bring a mask on. Because just the entire lead up to this whole thing was, you know, I'm just gonna, they're gonna bring it out to my car. So my whole planning was off. And then she kind of caught me by surprise. And the last thing that caught me by surprise is when I hung up the phone, she said, it'll be ready in 15 minutes. Well, it's a 10 minute ride. So I rushed out of the house. I didn't take this mask. So I get there. And my common sense tells me screw this food, go home, forget this. But my diabetes brain tells me Arden gave herself some insulin, you need this food. Alright, and so now Mike. Alright. So I removed my credit card from my wallet so that I'm only carrying my credit card. And I put my phone somewhere where I won't touch it. You know, while I'm in there. Like I've thought this through. And I've got my little I really should think of the right word for it. It's the aloe stuff with the alcohol and hand sanitizer. So I've got my got my hands on I've been calling it schmutz for so long that I don't really know what it is. So I got my hand sanitizer and I go in. Well, there are five other people in there. Now they are

Unknown Speaker 12:51
course

Scott Benner 12:52
they are as far away from each other as they could be in like, you know, corners of this space. But I opened the door. Julia, I have to believe this. I opened the door and people look at me, like my kids hanging out. That's just my you're not wearing them because I'm not wearing a mask. Right? They looked at me like, Oh my god, what is this insane person doing? And I had to fight off that feeling too. Because I was like, Yeah, like, be cool brother. You know, like, so I walked in and the guy looks at me goes yeah, what's your name? I go, Scott. And he goes, Oh, yeah, not done yet. So now I'm like, Oh, good thing I rushed, like, you know, right away. So now I find a place to stand. Now I want to be clear next. I don't touch a damn thing. Okay, I don't lean on a wall. I don't lean on a table. There are chairs to sit on. I don't sit on a chair. I am an island unto itself, not touching anything. Right. Now the four people that are in there, two of them are seated on chairs with armrests and their hands are on the armrest. They've got their masks on, but they're holding the sides of the chair. The third guy's leaning on the door. The thing, everyone who's been in there touches. And now I'm in this interesting social situation. And I think psychological experiment. These people have no trouble pulling a credit card from their wallet, handing it to a man who's wearing gloves and a mask. But he's not washing or cleansing his hands in between transactions, hands it back to them. They finger the card up, jam it back in their wallet, jam it back in their pants. They're touching their shirts again, all this is going on that I start really paying attention. They get their food. One guy goes out to his car. I swear to god reaches up with his hand, takes his mask off, runs his hand through his hair and begins to eat out of the package. He hasn't put anything on his hands he isn't cleaned himself off. Still the woman on the chair now people are coming in and out. They're all acting like if they don't get near each other. They're fine because they're Superman. They have this mask on Right. Meanwhile, most of them are just paper masks. There's nothing medical about them. I still am standing like the Statue of Liberty. Well, this goes on for quite some time. And eventually he, the gentleman at the counter turns to the woman off in the corner sitting in the chair who's you know, just just molesting this chair with her hands, probably, you know, out of anxiety. I'm really watching her. And she says, ma'am, let's have you pay now. And then you'll be ready when the food comes out. And she looks at me and she goes, I'm not coming over there until he leaves. He's not wearing a mask. And I was like, Oh, no. Okay, how do I handle this? So I turned to her and gave her a little wry smile, and a thumbs up.

Unknown Speaker 15:46
Kind of like going

Scott Benner 15:48
like, Hey, yo, you know, you're right, baby. Stay over there. Yeah, if your scalps get cold, it's on me. I don't know what to say. I'm apologize, right. So anyway, no lie. Four or five were five people come in and out. They do the same, the same rigmarole they leave, they touch their door handle, and they open their car door that now here's me. I hand the guy my credit card, he hands it back to me, the credit card goes right in the front pocket of my sweatshirt, right. And I take the food I go out to the car, the food goes on the floor of the car on a rubber mat where it is not going to touch anything else in the back. Now, I haven't touched the car yet. I've only touched the fob, right? Because I've opened it with a button. Now. I got the hand sanitizer, hand sanitizer myself a hand sanitizer my credit card, I hand sanitize the fopp. I'm now clean, as clean as I can be in the situation I get in my car, I drive home. I go through the process, I talked about the thing. It is my contention that I was the only safe person in that space. Privately safe. Now people will say Oh, yeah, but you're not protecting other people. And right on I hope you heard the lead up to the story. Like I was bamboozled into being there without a mask on. But I have worn a mask everywhere else I've gone. And I plan to as long as that's the law of the land. I'm happy to do it. But what really struck me was just how all of these other people were ignoring every bit of common sense that went around transmission. And I felt like and maybe I'm wrong, but I felt like it was because they were wearing a mask and they felt safe.

Unknown Speaker 17:24
Say that was a really interesting observation or insight that you have. And I'll tell you why when you're done.

Scott Benner 17:31
Oh, no, I'm done,

Unknown Speaker 17:32
please. It's really interesting. So I think these masks are giving people this like false sense of being invincible. So they think I'm wearing a mask, I'm safe. And then you still have to stand six feet apart, you still have to be cautious of surfaces. And I think I got I think we just think of it a different way. Because you know, I'm living with diabetes, and you have a kid who's living with diabetes. And I think our brains are kind of just wired differently when we're thinking about transmission. I don't think the general person understands everything that you went through in your head, like, and it's really interesting, because I've kind of had to get myself out of how you were thinking, because it was making me too anxious going to work every day.

Scott Benner 18:19
So and that's the next step is that it didn't bother me so much, because I did it one time. But I did begin to wonder, right? What if I was out every day, because you know, even little things like that prior to talking to you a package arrived, you know. And so with package, it gets Lysol, which is not something we would normally do, you know, pick it up, bring it in the house, and then I go to wash my hands. So I'm in a hurry to talk to you. So I soaked my hands, I'm washing my hands here I go and wash and Wash, wash, Wash, wash and I get done water all over my hands. common thing to do I flick my fingers towards the sink. Right? And I happen to notice when I did that, yeah, just where and everywhere What are ended up in my kitchen, it was eight feet to my left on the countertop. Now it was over here. And so if if I have something I forget anything, if I have something on my hands, the flu, the common cold, the blah, blah, blah, I don't wash my hands properly. I do this now eight feet to my left on the countertop. People are like, Oh, your kitchens eight feet wide fancy. And I'm just kidding, it was far away on the left is what I'm saying that water hits there. If someone else comes along and lays their cup on it and five minutes laters you know, resting their cup in their palm. That's it, whatever was on my hand is on their hand now too. And you can't think like that, because it would be debilitating. It really would like you know, we talked about it around diabetes too, right? That whole idea of like, if you really thought about what insulin was, if you really thought about it, it'd be hard to give it to yourself, you know, again, and some people really fall into that scenario. So anyway, this whole process and situation just opened me up to thinking about what's going to happen to people's anxiety, people who were paying attention to it, because I'll be able to ignore it again, I don't get sick that often, like, at some point, it's gonna roll out of my head. I'm, I'm too, you know, I'm too empty headed not to not to hold on to it forever. But in that moment, what does that anxiety do? And then how does that anxiety affect people's blood sugar's? And then we see that cascading effect where you know the norm whatever their norm used to be 100 150 whatever people are keeping their blood sugars that suddenly creeps up 20 and 30 points, they don't notice it because so much else is going on. And before you know it, it's gotten away from them. And for people who it's already away from Yeah, I imagine it becomes a hailstorm. So what have you been doing to sort of pay attention to your diabetes while you're in this new situation?

Unknown Speaker 20:58
Yeah, so I think what happened to me personally, I'll share my personal story, because I think it'll help others. Yeah. So you know, I'm an essential worker, so I have to go into work every day. And I would say for the first week, where, you know, the Coronavirus cases were really exploding here in the United States, I was so tense going into work like I, I wouldn't get in the elevator, I was taking the stairs, which when you park on, like the fifth floor of the parking garage, that's not my norm, like I will take the elevator typically, um, I am supposed to be advocating for using stairs, but whatever. So, so that was a thing. And then I was scared to touch everything. So I was trying to let other people go in front of me and like, open the door. Um, I was putting my hands or washing my hands. But every single time I even slightly touched a surface. So going into work, I have to open a door. First, I have to slide my ID badge, open a door, then I was sanitizing my ID badge. And then I was washing my hands. And then I was going to the clock to clock in. And then I was swiping my badge again, and putting my finger on the finger it to clock myself in. And then I was sanitizing my ID badge and sanitizing my hands. And then I was touching a doorknob, and then I was sanitizing my hands again. And then I was walking down the hallway. And if I touch anything in the hallway, I was sanitizing whatever part of me touched it. And then I was going up a staircase and through a door and then I was sanitizing again. And then Monday I dropped my iced coffee while I was doing all this. And I was like, wait, I was like, This is too much. It's like I

Unknown Speaker 22:45
I found myself drop my coffee

Unknown Speaker 22:47
sassing recently.

Unknown Speaker 22:51
I need to sanitize everything when I'm done with everything. Right? Right. Like when I get into my office, that's when I need to sanitize my badge, wash my hands. So I think all of the hype was getting to me like I do have generalized anxiety. But it's like I don't get panic attacks. I don't have OCD. So typically I'm pretty stable. Like I I'll get more about certain things, but this like exploded it for me. Yeah. Well, so yeah, I think I kind of just had to take a step back and look at everything I was doing and think about it, realistically. Um, so for essential workers, it's a much more difficult situation. But I kind of got to the point where I'm like, it is what it is. And I can only I know I'm following the guidelines and I can do my best. But if I, if I get it, it's kind of out of my control at this point. So I kind of had to get to a place where I accepted I can only do what I can do. And that took a few weeks like I was not in a good place a couple weeks ago.

Scott Benner 23:51
Okay. Um, all right. I want to talk about that first though. Are you in a room with the door closed? I think your Wi Fi is a little weak. It my doors open the doors open. No, no, I just I was I you're you're kind of fading a little bit and I don't think you're moving away from the microphone. And I think it's, it sounds like it. How does the signal look strong on your Wi Fi meter?

Unknown Speaker 24:20
Um

Scott Benner 24:23
Do you not know where that is? Julia?

Unknown Speaker 24:25
Let me know. Can we can we pause for a second?

Unknown Speaker 24:27
Yeah, hundred percent. I'll connect to my

Unknown Speaker 24:29
I'll connect to a hotspot back here because I think I'm too far away from the router.

Scott Benner 24:32
Alright, cool to get to the surface. So hold on. If I lose you, that's fine. All right, well, Julia is moving to a better location closer to her router. I'll tell you about the Dexcom g six continuous glucose monitor. The dexcom g six is going to allow you to see your blood sugar in real time or a loved one's blood sugar in real time. Here's how it will do that. This little sensor with a little transmitter in it, and the transmitter sends a signal to a receiver or to your Android or iPhone. Mm hmm. That's right. You can see your blood sugar on an app. Not just your blood sugar, not just my blood sugar is 146. Not like that. It's 146. And what direction it's moving, if it's moving in a direction. And if it's moving in a direction, how fast is it moving in that direction? I know what you're thinking, holy, Anna. That's some good stuff, Scott. And you're 100%. Right? All of you who struggled to get your basal insulin set correctly. Imagine if you could see your blood sugar completely overnight, to try to imagine a eight hour period of seeing exactly what your blood sugar's doing. You'd be able to say to yourself, I think I need more bazel at 2am. I see myself getting high around six. Oh, look at this. It's my daughter's blood sugar right now. That's how it works. You get a little beep on yourself. But her blood sugar's just gone over the alarm that we've set of 120. Did you know you can set alarms to tell you when your blood sugar leaves the range that you desire? Well, now you know, Arden has just gotten an alarm on her phone at beep beep. She knows now she probably needs some insulin. So she's going to look into it. And if she forgets or doesn't or, you know, get stuck, you know, in English class, I can send her a little text and a reminder, hey, probably half the bolus here is the tiniest little bit of what the Dexcom g six says you should definitely find out more about it. dexcom.com forward slash juice box the links in your show notes. Were the ones that are available at Juicebox podcast.com. You know, when you're looking for those links for Dexcom, you might also see a link for the Omni pod tubeless insulin pump. This is clicky clicky time for you if you're on MDI and you've thought about pumping, or if you're already pumping, and you wish your pump didn't have any tubing all over it because the Omni pod is tube less. That is less the tube, meaning a new tubing. The greatest thing that Omni pod does, perhaps perhaps although making a tubeless insulin pump pretty great. One of the great things I guess I should say is that they will send you a free and no obligation pump for you to wear and try. It's a non functioning pump. Don't get me wrong, but it's still the entire of device. You can put it on and wear it. You can go for a walk, you can go for a run, you can go for a swim, because yeah, on the pod. You can take that thing in the pool, you could take it in your shower, you could take it in your bathtub, you could take it on a trip to Illinois if you wanted to. And every place you take it, it won't have any tubing to get stuck in your bra or down your pants. And when you don't have tubing, it can't get caught on a doorknob and rip out your infusion set. You're gonna love it. And my daughter has been using the Omni pod since she was four years old. It's over 12 years now. Everyday she's had an omni pod on and it's always been a friend in this journey. My Omni pod.com forward slash juicebox decks Podcast comm.com forward slash juicebox. Links in your show notes. Links at Juicebox podcast.com. Click on the links support the sponsors support the show. Back to Julia. Let's see if she got any closer to that router.

Unknown Speaker 28:47
whacked my glasses with my headphones. Okay.

Scott Benner 28:50
Let me just trying to hold what you said my head because I have I want to say afterwards.

Unknown Speaker 28:57
Did you hear me well enough?

Scott Benner 28:58
Yeah, yeah. No, it was fine. I just wanted to I don't want it to happen again. Moreover, they'll be able to hear it. Okay. It'll be better this way. But it distracts me. I start I stopped listening to you and I start thinking about how it sounds not. Is this better? Because I'm connecting to my hotspot now so I shouldn't have loss of snap. Hmm, that was worse. You went out. That was worse. You try again say the rain in Spain falls mainly on the point. Okay, the rain in Spain falls mainly on the plains got

Unknown Speaker 29:29
the rain in Spain falls mainly on the plains

Scott Benner 29:31
if you've never heard that before.

Unknown Speaker 29:34
Now, oh my god,

Scott Benner 29:36
like four years old. Okay. Well, that either is no break in that so good. So okay, so you just explained you just explained walking into a building. And I want to play devil's advocate on both sides of this. I could easily say you don't need to do all that. And I can make a real real argument for what you just said. So here it is. As your card that you're swiping to get into a building, and a doorknob or a door handle or about the dirtiest places on the planet, right? And so it doesn't not make sense. You can clean your card before you leave the house. It doesn't mean I clean mine. Right? And you really start thinking about the history of my card, right? Like I took my card home Monday night, and I laid it on a table where everyone else in my house lays their keys. Now everyone in my house and everything they've touched is in a central location near my card, and I pick it back up, and I do what I do. I put it back in my wallet, I stick it in my pocket. I put it next to my phone, my phone, which they say is filthy, filthy dirty, right? And so dirty, dirty, dirty, dirty. So, you know, now I've done that dirty thing, right? I stopped I've stopped it at the drive thru at you know, I don't know Dunkin Donuts, they get a coffee on the way I handed them my dirty, filthy credit card. they hand it back to me that guy's touch 90,000 people's credit cards this morning for coffee. He's not washing his hands, blah, blah, blah. Yeah, that's the truth, then you get to the door. Now you've touched the door. Isn't it great? When you can push a door, you're like, ooh, a push door. I don't have to put my thumb on it excitement. But you know, when you turn a knob or grab a handle, I find myself reaching inside of my sweatshirt and grabbing with my sweatshirt. And then I think well, now it's just on my sweatshirt.

Unknown Speaker 31:35
Right? At least your sweater you can take off when you get home.

Unknown Speaker 31:38
But you don't have to

Unknown Speaker 31:40
keep wearing it. I know there's so many thoughts that go through my head with with that. And I think it did make me really start thinking like I was walking six feet away from everyone going into work. But not everyone was staying six feet away from me. Right. And that was one of the big moments where I realized Wait, so not everyone's thinking like I am right now. But I mean, so Moral of the story, though, is that it is still important to make sure that you're following the guidelines. But if you're not getting from one place to another, as long as you're not touching your face in between everything, or dirtying another surface that will stay with you, right? Don't sanitize between every single action or try to wash between every single action because it'll make you go crazy. And it made me it I was like not in a good place for a couple weeks because I was so hyper focused on not getting it but all these small actions. Yeah, the truth.

Scott Benner 32:37
The truth is in that scenario, what you really need to be focused on was not touching your face, and keeping track of things that you had touched until you had an ability to watch. That really is the game. It's alright, I like my keys, my my faab you know this that like, these are the things I've handled since I've been here. I get here, I'll do my hands. But at the same time, it's hard to just remember common courtesy, like I spoke to someone yesterday who was at a job interview. And they got there just thinking it was going to be a distance to interview with and they're like, no, come on into this room. Now she's in a room and talking to a person, right. And she's, you know, trying to be cool about it. But then a second person came in the room and just out of, you know, sheer repetition. And you know, geniality being a human being the person walked in and offered their handout. Oh, no. Right. And so now, now this person did a job interview and they're like, wow, do I shake their head in a split second, I don't want to offend them out of love. She just said maybe we shouldn't shake hands. And then the the person who tried to shake him was like, Oh my gosh, I'm so sorry. Like, clearly just forgotten, you know, in the course of whatever they were doing. I just think that we're gonna be we're all going to be in a different situation. No, listen, here's the other side of it. Right? There are I forget what the number is. But there are like a bazillion viruses in the world. And you know, it, you have not thought like this prior to six weeks ago. And if you had, maybe you wouldn't get one or two colds that you get a year. But it's still not going to avoid everything. And and so the answer has to be how do you keep your your sanity? Right? And, and take care of yourself and do the best you can, you know, it really is going to be what's gonna be and then hopefully from there, you know, inoculations may be our thing. You know, obviously, that's going to be some time from now. But I just think the most important thing is that the hospitals aren't overwhelmed so that if you do get sick, and it progresses to a serious place that somebody can, you know, thoughtfully take care of you.

Unknown Speaker 34:44
That's so important right now. And that's why social distancing so important.

Scott Benner 34:48
Hundred percent. I know it's weird because they always make up a marketing term like, you know, like flatten the curve. Like we're gonna flatten the curve, you know, because saying to people, look, we can't overwhelm the healthcare system, but and get that long. explanation doesn't fit, you know, in a tweet, so we're gonna flatten the curve. And it's important, like, it's, it's the, it's the crux of the entire thing. It really is why less people have suffered than the projections thought, and you know, so that's amazing. But we're gonna get out into that scenario later, everybody needs to be ready for it where the one I mean, that woman had no trouble looking me in the face and saying, I'm not walking over there across the room with people in it. He is not wearing a mask, and she was just a kind looking woman in her 60s, I don't feel like that's who she is at her core. Did you know they mean? Like I bet two months ago, she would have just walked over there and done it not fun, I think about it, but her brains in a different place now.

Unknown Speaker 35:47
I mean, everyone I'm noticing even with some of my patients, and then even some of my friends and family members, people are just in a much different place. And it about COVID. And I think people from what I've observed are adjusting to it. Since this has been going on for like five plus weeks now. But the first few weeks, I think were extremely rough for a lot of people. And I'm sure there's still some people that are still in a rough place. And I do think this whole situation with the masks like the master giving people a sense of power over COVID. But when you take everything else into account, like that woman touching all those surfaces, they're not really giving you power, unless you're unless you're actually following the rest of the guidelines

Scott Benner 36:33
as well. So now let's devil's advocate the other side of it. Okay. Everyone coming into that place is ultra paranoid. Right? The woman is touching the chair. But I don't know how many other people touch the chair. And if maybe it was just a bunch of other really like, you know, you know, prepper hand sanitizers who got there in their car, put their mask on sanitize their hands and went in that chair might be the cleanest thing on the planet right now. I don't I don't know. But if the mask is helping her not to have the anxiety about the virus, that's great, except her anxiety just shifted from thinking about the virus, to thinking about other people who aren't thinking about the virus like there's no way for people who are anxious to be free of it, because it's just going to shift perspective. Does that bring true with you

Unknown Speaker 37:24
know, that's really that's really insightful. And I agree with that. I think what I'm also hearing is a lot of people are being almost like bullied or judge for how they are responding to Coronavirus. And in a situation situation like yours, okay, you weren't wearing a mask, but you were in your head, you're following all the other guidelines, you're not doing anything. To put yourself at higher risk of it. Like you're not having people over, you're not having parties, right? Nothing so and you're being really cautious of everything. So I think you just don't know what someone else is doing. So I think just trying to focus on your what you can control in your own situation. Yeah, um, what you can't control what you can't control.

Scott Benner 38:08
We, you know, if if 25 year old me was in that scenario, I probably would have spoken back to her, I probably would have said, Hey, listen, I showed up here because these people said they were going to bring the food out of the car, and I didn't think I would need a mask. I just need you to know I haven't been out of the house more than four times in the last you know, five weeks. I'm probably the cleanest person in here. I'm not sick. I know you can't trust that blah, blah, blah. But all those that thought went through my head and I just thought How is she gonna believe that and I'm gonna sound like a lunatic explaining it to her. So I just smiled and gave her the thumbs up, like, you keep doing you, lady, keep on truckin. You know, you're doing great. But But imagine, imagine if I was like, you know, a hothead kid or I was, you know, somebody whose anxiety had boiled over around this, made an honest mistake not brought their mask, and now felt attacked. Like there was a real opportunity for that to go wrong there. And it didn't, obviously, but

Unknown Speaker 39:02
yeah, I mean, I have a colleague who she went to the grocery store yesterday, and she was texting me or maybe it was a couple days ago. And she was like, This is great. They're distancing everyone. But people are glaring at me and looking at me like I'm a criminal, because I don't have a mask on. But

Scott Benner 39:18
yeah, now it's gonna be a

Unknown Speaker 39:19
minus. For now. No swear mustard.

Scott Benner 39:24
You broke up. I'm sorry. You're what?

Unknown Speaker 39:26
Oh. So we're not in a state where they're mandating that we wear masks and is recommending it. Gotcha. Gotcha. Oh,

Scott Benner 39:33
no, I it's going to be a whole. Arden said they were talking about sending them back to school and having them wear masks. And she goes, those kids can't remember their lanyard. They're gonna remember their mask.

Unknown Speaker 39:44
Like, surgically I

Scott Benner 39:45
know. Right. And, you know, what about is that anybody been out in public and seeing somebody wearing their mask, but not over their nose? And

Unknown Speaker 39:53
I've seen that I mean, I've seen that in that in the hospital setting. And that's, to me as a health care provider. I'm like, oh, You're not really doing anything, you're not protecting anything,

Scott Benner 40:03
right? No 1,000,000% here's the other side of it. I've, I just posted on Facebook to share with the world so that I would probably shame myself into eating less. I'm now I now know that bank robber is not a reasonable job for me. Because I can't push a cart in Costco with my face covered without thinking like, Oh my God, is this the end? It's just there's something about breathing through the fabric. And like, I was like, I gotta I gotta go for a run or something.

Unknown Speaker 40:32
Yeah, it's not very pleasant to wear the mask the right way.

Scott Benner 40:35
No, it is what it is. There's no way I'm gonna have a bag of money in one hand, and I got in the other hand to be able to run away from the cops. It just isn't gonna happen with my face covered. So

Unknown Speaker 40:44
to focus on how your face feels.

Scott Benner 40:47
not breathing is what I'll be focused on.

Unknown Speaker 40:49
Yeah. Yeah.

Scott Benner 40:53
Just start dropping the money. You'll be like, Why even bother doing this? I knew I couldn't do it because of my experience at Costco. And yet, I didn't listen. So I just figured learn the lesson ahead of time, Julia, don't rob a bank until I'm at least in better shape? Because Oh, man, you know, it's so if anyone sees me, like when a real regimen of, you know, like cardio, I'm thinking Robin back.

Unknown Speaker 41:17
Because there's no other reason I can think of to run anyway.

Scott Benner 41:23
Well, so here's what I've been seeing with people that I interact with, virtually, I guess I got to make sure I say that. And with my daughter around diabetes. So I do think that all the extra things to think about for some people, give them an excuse. And I don't mean excuse, like, they were looking for an excuse. But I mean, there's now a reason why they're letting their blood sugars get away from them, and not being kind of as vigilant. And there's a lot of there. A lot of they're impacting stressors around diabetes are changing. And I don't think they realize it, I think it looks like I think it looks like I'm sitting in my house, or, you know, my very active job became a desk job, or whatever it ends up being. So there's a lot there. And I and I want to, I really do want to talk about that I am having fun and talking about other stuff. But I really do want to talk about that. And, and I think the first thing is that we talked about all the time on the podcast, but I don't think people who don't listen, no. And maybe even some people who do listen to miss the idea. stress and anxiety can and will raise your blood sugar. Yes. And and how do you handle that have you had to change anything about your management during this time.

Unknown Speaker 42:43
So I think for me, it was just finding ways to cope with the anxiety I was facing. So I do a lot of mindfulness, there's a lot of mindfulness apps that I um, that you can get for low cost or for free, and kind of just refocusing. But for others, it could be, you know, upping therapy sessions, which are available, virtually and online, a lot of therapists are offering that service. There's even like I have a service at work I can use which is like therapy sessions that are free for the employers. So like I've been doing that as well. So I think just figuring out ways to cope with my anxiety and stress so that it didn't impact my blood sugar any of my patients as well. So like, hearing out, first identifying that stress or anxiety that you're facing and recognizing it, and then figuring out how to kind of tackle it so that it doesn't continue impacting your blood sugars.

Scott Benner 43:40
So it's interesting, right? I thought immediately of your blood sugar goes up, how do you address it with insulin and you thought your blood sugar goes up, figure out why your blood sugar is going up and stop that from happening. Both very valid, I guess. Yeah. So I like that idea. Now, how do you how do you know you're stressed when you're a person who feels like so I don't know if this is, you know, overwhelmingly, abundantly. I don't know what the word is I'm looking for. I don't know how many people understand this. But truth is, the better you think you handle stress. Probably the worse you are at it. So those people who were like I'm unflappable, I those people just internalize their stress. Do you know what I mean? For the most part you were and the people who kind of freak out or are letting you out? So

Unknown Speaker 44:31
yeah, yeah. And I think everyone has different coping mechanisms up. I get worried Personally, I always ask my patients when I'm meeting with them, we have a question or we have to fill out when we're going through our Diabetes Education meetings. And one of the questions is, what are your stressors and then what do you do to handle stress? And whenever I have a patient that tells me I don't have stress, but like, based on the answers to the rest of their psychosocial questions, And I can tell they probably do have stress, right? That's like a, that's a red flag to me that, you know, they're not recognizing it. And, you know, everyone's at a different place. Um, if you're not recognizing it, it's going to be a lot harder to address it. Right? Yeah. So that's definitely the first step. If your coping mechanism, I also get concerned when

Scott Benner 45:23
I'm sorry, I was just gonna say if your coping mechanism is saying there's no stress when there's definitely stress,

Unknown Speaker 45:29
big, big red flag,

Unknown Speaker 45:31
huge red flag. And I mean, I used to have people, I think this is an answer, I get a lot, oh, I just don't get stressed. And I think, Wow, tell me your magic trick. Because I'd like to share them with everyone. Um, but yeah, and I think maybe some people do get stressed that they just don't even recognize it. So I think that's a big barrier there. But another thing that's concerning is when people do tell me all of the stressors they have, and then I asked them, How they cope with it. And they say, I just don't, like that's also concerning. Um, so I think figuring out ways, especially right now, with the current situation, you know, we're kind of limited, like, you can't go to the gym, necessarily, or you can't sign up for a yoga class in a yoga studio, right. Um, or you might be more prone to kind of binge eating when you're stuck in the house right now. And that can be something that's common for a lot of people with diabetes. Um, so I think just kind of figuring out what you can do is really important. So I've been a huge proponent of recommending going on walks, I think getting outside, and, you know, getting fresh air and then getting a little bit of exercise is a great thing that we can do right now. And then another thing I've been recommending is using the mindfulness apps that you can get on your phone, or your mobile device. And then I've also been recommending doing exercise classes online, because a lot of them are free now.

Scott Benner 47:03
Yeah, I think the, the, I'm gonna say the problem, but from the from the everyday man position, I think the problem is, is that I didn't get more time suddenly, because I'm working from home. And there are plenty of people who aren't working from home too. But also the little things that we think of is bad. That may be bad, macro, but we're good for the person. Like, what about the road rage people, like it sucks that they have road rage, but that's how they were letting out their stress. They were screaming and yelling and being angry at everybody on the road for you know, driving wrong. And and that was a way for them, it was an outlet for them. Now they're not now they're not in their cars, right? Like, now that whole outlet is gone. And it's super, it seems to me. I don't know how to say this, it seems to me, like something. I can't say what I want to say. But it seems to me like something that you a well educated, thoughtful person who has a reasonably nice life. And me a person who, you know, records podcasts for, you know, a living and then goes off is a stay at home dad the rest of the time. For people with lives like ours, it's easy to say, you know what I ought to do I would probably just pop onto YouTube and do like one of those 20 minute fitness challenges, except cracked. That's not everyone's life. And and, and so like, what, what do average people do, you know, average people. By that I mean, get up in the morning, go to a job, it's probably not a job that they just love the hell out of you. You know, they mean, and, and they've still got the anxiety that they've got money, and they've got all the other problems. And on top of that their kids are at home. You know, they're like that kids smoking weed. He's not going to science class on zoom. Like they're worried about things. You know, and then the and then all the other things like, Oh, I hear people all the time talking about like, my kid didn't get to go to prom. They're not getting to go on there. This like there's their little but they're not like I have an incredible amount of stress. Over my and off its stress. But it's I don't know what to call it, but that my son's baseball season got canceled. Like it and that seems to anyone else that would seem like, Dude, it's just baseball. But it's not like, you know, when he was nine, he started telling me he wanted to play baseball in college. Do you know what I mean? And yeah, it's now it's gone.

Unknown Speaker 49:31
There's another side of that too. I think so you're upset because you're thinking this. This was his dream. This was his aspiration. I was so proud of him for achieving this and for being able to do it. But I think something that I'm hearing a lot about too is, you know, getting rid of, or inability to do these sports and extracurriculars that really kept kids engaged and focused and in a good place and not having them anymore is also a problem. Um, And then from, you know, from my standpoint, like I don't get to walk in my doctoral magalia. Like my PhD graduation was completely canceled, and I'm bummed about it. But I think my parents are more bummed than me, right? Because I'm like, Well, I already achieved everything. It is what it is. But I think there's other people that were looking forward to kind of seeing that moment. So I think sometimes parents, you know, feel even more upset because they're proud of their kids.

Scott Benner 50:29
Oh, Julia. Julia, not sometimes. All the time. Yeah. It's, it's all I was leaning on the counter last night. And Kelly was leaning on the other side of it. And I said to her, Hey, this having kids thing was a huge mistake. Hmm. She, oh, and she goes, Yeah, no kidding. Right. And but not for the reasons you think, you know, right? Like that. People might joke about something like that. It's because you can't stop being concerned. For every aspect of what it is is happening to them. Your does, my wife will say to me, does this call seem okay to you? And I'm like, you know, yeah, but he's not. He's as upset about what happened to him and losing his he lost half of his sophomore year of college. You know, during the season, we went out and hit the other day, we found a nice open field where nobody was. And I'm not the greatest soft tosser, which might be a word you don't know, but I'm not great at it. I'm inconsistent, at best. Yeah. And normally, he just looks at me, he's like, Dude, what are you doing, but it frustrated them. And I realized he was as frustrated as me as he was the fact that we were out there soft pissing in a field, you know, in his hometown. When that weekend he was supposed to be in Baltimore playing baseball. And so you know, it there's a lot going on for everybody. Yeah, Arden stress is definitely up. Even though, even though she appears to be just banging through it, like she gets up, you know, gets herself together. She goes down, does her work. She's diligent about her schoolwork, getting it all done. She told me yesterday, she had a 94 and a French test and 97 and a math algebra test. I think it was, I tried to congratulate her said, Ah, algebra is easy. And I was like, Oh, okay. Okay. I was like, whatever she goes, why do you see my geometry test scores? That isn't gonna be as good. And I was like, all right. And she's double like, she's taking a double math. Yeah. And, you know, and but that there's tension, she gets her shoulders when she's, like, stressed out. that hadn't been there for months. And now it's back. Yeah. And, and so that's how it hits her, she just hurt her shoulders get really tight.

Unknown Speaker 52:42
And that's actually a big sign of stress for me too.

Scott Benner 52:45
And so massaging and it doesn't matter, you massage it out, it comes right back again, you know, get a massage your brain, not your shoulder,

Unknown Speaker 52:53
because you're just in a tense state with everything going on, it's hard to release it.

Scott Benner 52:57
So what's the what's the. So it's nice to say? All the things that you said, they're all reasonable things, you know, you can work out online for free, you can you know, blah, blah, blah. But the real things that people get their stress out with are not, you know, are not available to them right now, you starting to hear a little more about, you know, casual drinking is picking up, because there's just nothing to do you know, the time, the time feels endless. Have you lost track of what day it is like I have

Unknown Speaker 53:28
all your work because I have a work schedule. But otherwise, I definitely would have by now

Scott Benner 53:33
I don't even the weekends meaningless at this point.

Unknown Speaker 53:36
Yeah. And I can, I can totally see that. So I do have some tips. Um, I think one thing I've been telling a lot of my patients, I actually learned this from my boyfriend, he is really good. Because he's working from home right now. And he's working kind of on his own schedule. He sets himself on a schedule every day. And he follows that schedule. So he's in a routine. And I've seen how well he's done with it. And so I've actually used that as a suggestion to give my patients I'm like, you know, you have to adjust to your new normal, but part of that I think, is trying to set a routine and figuring out what your new routine is. And following it because I think that in itself help.

Scott Benner 54:18
I'm sorry, that in itself, what

Unknown Speaker 54:20
helps a lot of people having that routine to kind of keep you organized.

Scott Benner 54:24
Do you think that a pitfall that people fall into is the idea that this isn't going to be forever? And and and so I'll just ride this out like a long summer vacation and then I'll bounce back to it. I actually it's one of the reasons that that that feeling is one of the reasons that you don't hear me talk about cure cure science around type one diabetes, because I don't I don't think it's valuable for people to sit around thinking Oh, it's almost over. You know, because then there are things you're supposed to be doing in the moment for your health. That you start slacking on, because you think, please, you know, an algorithm will run my insulin pump in a year. So I don't have to worry about these next couple months, or they're gonna cure it in five years. So I mean, it's not gonna kill me just have high blood sugar for five years. Some people feel that way. And I wonder that around this too, if like, somebody's like, Look, this isn't gonna last forever, they're gonna let us go back to work. Everything's gonna go back to normal. So if I gain What are people calling it the COVID-19? Have you heard that?

Unknown Speaker 55:28
Yeah,

Unknown Speaker 55:29
so awful. Yeah,

Scott Benner 55:30
how'd it go? I gained the COVID-19. I mean, really, not even funny. People are dying. And at the same time, people are so creative online, is

Unknown Speaker 55:41
so creative with these new terms.

Scott Benner 55:44
But I don't want that, like I'm 50. If I gain 19 pounds, I'm getting rid of it. You know,

Unknown Speaker 55:51
right. Well, I think so. You know, I've had a lot of family members and friends asked me like, when do you think this is gonna end? And I just keep saying, like, you, you know, we don't know, like, and that's the truth, you don't really know how long this is going to go on. And the other part of the truth is that, even if this ends, what if we have another pandemic in the future? So I think, you know, kind of letting yourself go like, that definitely isn't a healthy coping mechanism, or one that'll help you long term. And I think it's helping a lot of my patients that I've been meeting with on the telephone or virtually to actually check in with me, and review all of their data, or their blood glucose readings, if they don't have a CGM, okay, and kind of just check back in with their new schedule. And think about different things that are now influencing their blood sugar's that might have been different before isolating, so I think I'm even meeting with your health care provider. Like we're all here, we're all doing virtual visits, like it is still so important to meet with us and to check in and to not just say, Well, I'm not doing right now, because of COVID. Like being honest with yourself and kind of reflecting on what is happening is such an important self management tool,

Scott Benner 57:10
how much of our checks, right, our quarterly no checks, or however we do it? How much of it is just about accountability? Do you think?

Unknown Speaker 57:21
From my standpoint, it's all about accountability, because you can show up right? and get your a one c checked. But what's happening in between? Okay,

Scott Benner 57:32
yeah, yeah, but I'm, what I'm saying too, is like, like, I don't know how I mean this for the patient coming in, like, I know that it's there, you're going to always hear from people who are pressured by it. And that seems like oh, my visits are so much pressure, I feel so much anxiety. But what about those people who just need to have to report to somebody to keep them honest, I guess is the is the is the phrase I'm looking for. And then if you start skipping that appointment, all those people get lost. See, I think the interesting, the interesting thing about having a conversation around this is it's easy to say, you know, everyone's different. But we all fall into reasonable buckets, right? Like, there are people who feel anxiety. And they, you know, they don't want to go to this appointment, they dread going to their endocrinologist plan, because they don't want to get that report back. But, you know, they still do it over and over and over again, it's somehow it's part of their, their thing now that their their pattern, you're hoping at some point, they figure some stuff out about management, and then those visits don't seem like that anymore, which I think does happen for a lot of people, eventually they get things figured out. And I heard somebody the other day, tell me that, um, they're missing their annual appointment, because they did a lot of good work to get their agency and their variability down. And they wanted to go tell something like they wanted a pat on the back. You know what I mean? They're like, I want my pat on the back. I worked hard for this.

Unknown Speaker 58:57
Yeah, so I think something that, um, that I didn't hear you bring up in that not everyone realizes if you do have a diabetes educator, or sorry, Diabetes Care and Education specialists available to you, we can meet with you in between your endo visits, and like I have patients who I'm meeting with every other week. And, like, I'll share a story about one in particular who I met with recently, and this patient told me, I like meeting with you because things are different right now. And it's helping me kind of keep myself in check. So that is part of what I do as a Diabetes Care and Education Specialist is I'm here to support you and help you reflect on your goals and if you're meeting them or not, and then kind of give you that support you need so that when you do go to your endo appointment, you don't feel guilty if you weren't able to meet your goals. Yeah.

Scott Benner 59:50
Hey, you you've heard Jenny on the podcast say look, I'm a CD. I'm calling myself a CD. I'm not changing but I know you're right. What do you call it? What it What did they change? too, is it CES?

Unknown Speaker 1:00:02
No, it's even more complicated. CDC, so certified Diabetes Care and Education specialists. So I am changing on. And part of that is because I have not been in this field for so long. So I became a certified diabetes educator in 2017. So I'm kind of new, right, so I'm not so established and calling myself a certified diabetes educator, I hear you. Um, I also believe that the name was chosen based, like the certified diabetes, current education specialist name was chosen based on what our profession has, um, does in real life. So we don't just provide education, but we also are specialists in diabetes care. So I think that name was chosen based on feedback from our profession. And I respect that.

Scott Benner 1:00:55
That was very nice of you to say my wife has, my wife has had titles in the past that are completely made up words. So

Unknown Speaker 1:01:02
I know it sounds like a made up word is it so long now. But if there was a lot of thought put into it, you know, I'm involved with I'm a DC s, which used to be a D. So the Association of Diabetes Care and Education specialists, which is formerly the American Association of diabetes educators, and I really saw what they put into, I'm deciding to change the name and why. So I thought I found meaning.

Scott Benner 1:01:30
I'm not taking it from me. I'm just saying I hope everyone's ready to be called my diabetes person, because the CDC s does not roll off the tee. You

Unknown Speaker 1:01:39
UMG or something? Right? Yeah. How do you spell tongue is what I'm getting? Yeah.

Scott Benner 1:01:44
It's just a, it's a little bit of a twister. But never. Listen, not in my lifetime. But

Unknown Speaker 1:01:50
yeah. And it's okay, that Jenny still wants to be called CDE. So like, that's the other thing. They're not forcing us to change our names yet. Um, and I think, if that's how Jenny identifies, and that's who she's been for her career, like, I have nothing against that. I wasn't trying to say no,

Scott Benner 1:02:06
no, apologize.

Unknown Speaker 1:02:10
I'm just sharing my reactions on why I choose to identify as CDC, Yes,

Scott Benner 1:02:15
I heard you don't back up, use this stand on your principal. Listen, I know a lot of doctors, I've never once looked at them and thought, there's my friend, Adam Edelman, MD. So you know, doesn't really, it doesn't really matter. But I was just as you were saying it, it struck me. So we have people who have different levels of anxiety, they're going to handle it in different ways. Some of them are going to yoga, on YouTube, some of them are going to go for walks, some of them are going to yell at their dog, I don't think you should do that. I'm just saying somebody's going to, you know, like, everyone's going to try to get their anxiety and their stress out there are people who are going to drink too much, they're going to be plenty, I'm assuming there are a lot of you out there smoking a massive amount of weed. You know, I think there's a lot of stuff going on. But you have to use, in my opinion, the information that's coming in. So if you're seeing your blood sugar, doing things that it doesn't normally do, you have to save yourself, whether it feels like it or not, my situation has changed my day to day has changed how my body you know, Acts, you know, I'm not walking around as much at work, or I'm working, I'm walking around more, or whatever it ends up being, and you need to adjust. And when that moment comes. Just remember that everything that we talked about in the diabetes protip episodes, it all just holds true still, like diabetes, diabetes hasn't gotten weird on you, just the little the influencers have changed. So go back to basics, look at your basal insulin, make sure it's right. You know, look at how long your Pre-Bolus saying how much insulin you're using? Are you eating the same amount of foods? Maybe you're like you said, maybe you're eating different foods all of a sudden.

Unknown Speaker 1:03:57
Yeah, and that's happening, I think, to a lot of people who are trying to eat foods that last longer to kind of, you know, they might be eating less vegetables or more of these, like processed foods. I've having a lot of patients tell me that. So that's just

Unknown Speaker 1:04:15
I'm sorry to say that, but I thought it wasn't no joy.

Scott Benner 1:04:17
You're 100% right. We're buying things now. You know, even you know, in bags, stuff that doesn't go bad. Yeah,

Unknown Speaker 1:04:24
you know, less fresh fruits and vegetables. That's what you ate before.

Scott Benner 1:04:27
Yeah, I mean, cuz how because how long can you really keep, you know, a head of lettuce? I had a romaine lettuce like fresh in your refrigerator. I mean, what's it right four days, and then it gets a little weird. And then you're just like, now you're down to like, well cut some of the green stuff off and you know, so you can't go out and buy three packs of lettuce and make it last three weeks. That's not going to happen. And right. There's a real there's a real blockade, both physically and mentally about running out to the store like nobody's

Unknown Speaker 1:04:56
running out really is Yeah. And even people who are trying to Use the like the delivery services, a lot of them are really delayed. Mm hmm.

Scott Benner 1:05:04
My mother used this one. My mom is an old old woman, she lived with Dinosaurs A long time ago. I say that just in case she ever hears this. But anyway, she uses one of those services. And she just told me, it's funny, you brought that up. She just told me two days ago, hey, Scott, I made my order, but only about half of it came. Yeah, Mom, essentially what they had, you know,

Unknown Speaker 1:05:26
yeah, that's a problem, too. So I think that's a huge factor. That's, um, you know, we A lot of us eat a lot of the same things over and over again. And so when you have to change up what you're eating based on the situation, that can be a huge factor. But everything you said about going back to the basics is so important right now, because you know, what things are going to change, our schedules are changing, the factors are all changing. And that means our blood sugars are going to be influenced a lot differently. So it's normal. And it is a really good time to reflect and take a look at everything, your patterns, again, many people may be finding out right now that they're not as good at bolusing for a meal as they thought they were, they've just gotten good at bolusing for the meals they eat all the time.

Scott Benner 1:06:13
Right, right. And that's an interesting thing. And that doesn't mean suddenly, like, you don't know what you're doing. It just means it just means you kind of you got into, you know, you were sort of on autopilot a little but you don't realize it, you know, it was meatloaf night, ate carbs is that 12 that 15 here, that's 11 units here I go. Like, you know, you just knew that and you did it, you probably don't even realize it, which is great. Until all the sudden, you're working from home and you stay on the call a little longer. So now instead of having lunch at noon, you're having it at two, but your basal rate changes at one and you didn't think about that. And you know, and then you get up and decide that a handful of potato chips is really how you're going to roll you're not having whatever you would have done, you know, at the cafeteria at work or what you might have packed for yourself, because you don't even listen. How many times have you packed a meal for yourself at home taking it, opened it up at lunch and thought to yourself? Oh my god, I don't want this. But you eat it? Because you bought it. Yeah, pack that you brought it, you do it right. But now now you're at home. And your brain goes hell, I'll get an apple and I'll have a lovely ham sandwich on some nice rye toast. And about No, you know what, I'm not gonna do that. I'm gonna have a rating.

Unknown Speaker 1:07:24
So like, for fun. I can be like, Oh, let me have some breakfast for lunch, like only make some eggs and something else for lunch that I usually wouldn't eat. Right, Joey, I

Scott Benner 1:07:32
appreciate you bringing that up because you got a kid who's now sleeping in, right and getting up at 11. And having french toast? Well, you know how to bolus french toast until 830. And I know that's different, right? But you don't think of it in the moment like, obviously, maybe more insulin resistance in the morning because of coming from a lower basal rate overnight or something like that, or whatever your situation is, four or five hours later, your insulin is different. And right. My point is always, you know, I receive a lot of notes that asked me about in this situation, how would you do this in this, you know, during a soccer game, at a recital when my kids dancing at school, my answers are always the same. The tools work everywhere. Great, you know it and so they work in lockdown, too. They work in quarantine. And and you just have to step back a little bit and see that you've been probably in a little bit like I said in like, you know, auto mode for a while. And you you might have to stand back and get a little manual for a little bit and really think about things again.

Unknown Speaker 1:08:38
Yeah, and it's pretty crazy. I mean, it's frustrating, right? For a lot of people on top of all of the other stress and frustration that's going on right now about being stuck in the house. So it's not fun. But if you kind of reflect and look at everything and break it down, things will get better.

Scott Benner 1:08:57
The other side of it that we're not talking about is that this Listen, I know this is you know firstworldproblems and everything. But yeah, it's starting to feel a little hopeless once in a while. Like not every day like I'm not telling you. I'm not sad. But if you stop and look back and you purge you project out from what you've seen so far, which I think is dangerous, because none of us know Listen, I've said it a million times here worry is a waste of imagination. Anything that I can imagine about the future and worry about very well may not come true. But it's difficult sometimes not the thing. I said this to my neighbor yesterday, just out of like we're yelling across our yards at each other two grown men, you know, like idiots and and I said to him I mean is it really worth living like this? Is this is this it? like am I gonna get up in the morning, hang out in sweat pants. do my work, get cover myself up, run to the store to get food. Bring it back. back. And then what I just sit here until I run out of chicken like is that and then I go back out and I feel like I'm risking my life again for a chicken breast is like like, that can't be it like, I'm a really social person. I love talking to people. I love talking to strangers. I'll talk to anybody. Yeah, and I have none of that now, I'm sure you know, I'm sure the introverts are probably thrilled.

Unknown Speaker 1:10:22
Well, I can tell you I live with an introvert I don't understand them so much, because I'm definitely extroverted like you. But I mean, it's not easy for introverts either, right? Because even though he doesn't get energized from talking to people, like we do see that he likes, it's, he's still stuck in the house, right? And he can't go to the gym anymore, and he can't, you know, he had his routine. And he now had to change everything. And he now has to find new outlets for, um, managing his stress. And I do have to give a PSA about introverts here, just because they're introverted. It doesn't mean they like hiding in holes I've learned, um, he does, like, you know, he doesn't like being stuck in the house all day,

Scott Benner 1:11:03
my what my wife is explained it to me because she's, my wife's introverted, too. And if you know her personally, you wouldn't think that because she seemed really gregarious, but it takes every ounce of energy that she has to be like that around other people. And so the way she describes it is that and you said it a second ago, is that she doesn't get anything back from it. She likes people. She likes talking to them. She likes all that. But she does. She's not charged up by it. Which is 100% true when I start talking to people, like I've never thought of it consciously, but you know, I'm sure there's a little stage with a spotlight on it. And I'm like, Oh, I'm performing people like this dinner to me, like, you say something to someone that they find interesting or amusing. And you get a facial response back from them. And yeah, it's valuable to me, like it charges my battery, even when they disagree with me, I'm like, Oh, they disagree. And then I get to go back into myself and wonder about like, I wonder what I mean, I may I like that person, that's a bright person over there. If they disagree with me, maybe I should be rethinking it all those like little interpersonal mechanisms are gone. You know, and you can say all you want, you can zoom with somebody or FaceTime that is not the same as talking to somebody face to face.

Unknown Speaker 1:12:15
It's not, and I think it, it gives you something right, but it's not the same. Um, and I think, yeah, it's really difficult. Like, I'm thinking about it, I haven't seen a friend outside of zoom for like five or six weeks, which is nuts. It's not really, um, and I honestly think part of the reason why I'm still as energized as I am, is because I am going into work. And I do see my colleagues. So I think that helps.

Scott Benner 1:12:47
Yeah, and I get to record the podcast, which is, is helpful for me, I get to still great people, and edit them and listen to other conversations and, you know, stuff like that. But there, there are moments where, you know, I just am in my house, like, I don't know what to do. Like, I know, I've edited the podcast weeks ahead. I've cleaned everything to within an inch of its life. I you know, I went out my brave the the Costco, I came back with the, you know, I killed the bison, I drove it home. My wife is working, my kids are doing their schoolwork, and I'm just standing there like, it's, it's really, I know, it's gonna sound goofy to a lot of people. But being a stay at home parent, if you really love it. It's a large portion of who you are, is in service to other people. And suddenly when those people don't need you, it's weird. It's very strange. It's like it's, you know, I don't know, it's like, I have no purpose in some moments. And you know, you can listen to that and go oh, Scott, you know, you have interest. Yeah, that's nice. I'm not talking about I don't feel like that for 24 hours. I'm telling you that for 20 minutes or half an hour. I'm standing there, like, Oh my gosh, I have nothing to do like I feel like an outdated tool. Like I just

Unknown Speaker 1:14:04
and I don't mean to like it's like part of your daily challenges aren't there anymore?

Scott Benner 1:14:09
Yeah. And I like that stuff. Like I'm not still a stay at home dad after 20 years, because I hate it. Like I like what it does for my kids and and how it shapes my family and those sorts of things. And obviously, I've supplemented a lot of my time with the podcast, too. It's not just, you know, I'm not doing it. 24 seven the way I used to being a being a stay at home dad, but there's still, there's still plenty of things to do. Even when your kids are in college. You don't realize there's still a lot to do. And just I don't know, like I don't know, what else do I refinanced our house because I was bored and the the rates went down. I was like, you know what I'll do I'll refinance the house.

Unknown Speaker 1:14:46
That's like, well, you were refinancing a house. I bought it. I bought a house. So there's that.

Scott Benner 1:14:51
Hey, by the way, everybody if you have the means good time right now money's cheap. You know what I mean? At the moment? Yeah.

Unknown Speaker 1:14:57
Well, and I mean, I think though, this room Me, um, one of the things that I've done to help myself too is I've kind of done some new hobbies. So for me, it's kind of taking on some, like DIY home projects and doing some home renovation, but I have friends that are doing like more art, like painting and that kind of stuff. Whereas they weren't doing that before as an outlet. So I think just thinking about what you can do, um, like, even trying something new from home, could be helpful, too.

Scott Benner 1:15:27
I almost bought a drone the other day

Unknown Speaker 1:15:29
challenge,

Scott Benner 1:15:30
and let me tell you, I would crash it in eight seconds, if I had a drone, I actually had to sit in front of the screen and say to myself, if you buy this, you're going to bring it home, watch a video about how to fly, it's going to go up into the air slam into the tree, and the money's going to be gone. Don't do this. Don't Don't do this. But that's how bored I was. I sent the Arden the other day. Have you ever wanted the chameleon as a pet? And she's like, what? I was like, I saw YouTube video, I'm sorry.

Unknown Speaker 1:15:58
You need to find a new hobby, too.

Scott Benner 1:16:00
I, I do I need to do something or, you know, it's funny, I there was part of me that thought maybe I'll just sit down and record the podcast every day and put it up daily for a while, like, you know, people who wanted to enjoy it and people who don't can, you know, skip it, except a large portion of the way people listen to podcast is during commuting. And I know now there's a portion of the community that's you know, of the people who just aren't commuting anymore. And I have to say for people listening, you guys are still you're still listening. It's very, it's uplifting, because I I've said this before, but I know other people with podcasts who are their way down, like nobody's listening to them all of a sudden, but you guys still are. But what I'm noticing is I'm missing is the second episode, like, you know, though, there's the one you'll listen to on the way to work and the one you'll listen to on the way home. And now that turns more into one. And you know, it's it's interesting how, how it goes. And there's not as much going back and listening to back catalogue episodes as there normally is. And it's just because and it's because people's lives are changed. So in that moment, you know, it's not gonna last for everybody's gonna get back in their car. I'm not worried about it. But what I'm saying is, in that moment, that's not the right time to start doing like a half an hour like Morning Show, you know, when people already don't have time for the other stuff that they're looking for. Right? You know, it's just very, I don't know, if there's a lot of like this happen. And then that happened. And these two things don't allow each other to work. stuff going on right now. So what do you think? Have you thought about I guess, is my question. Are you going to see problems with patients coming back after this layoff? Do you think do you think you're going to see a one cs go up? Or do you think people are going to take this time to really focus and you're gonna see them go down? Like, overall, generally speaking? And maybe you don't have a guess? But I'd be interested to know, after it's over what ended up happening?

Unknown Speaker 1:18:00
Well, I know I do. If I guess my guess is that we're going to see increase in a one C, just because when you think about the amount of stress everyone's experiencing as a whole, you know, stress increases your blood sugar. And yeah, I have these handful of patients I'm seeing that are kind of like reflecting and taking some time to review everything with me and to kind of reset their goals and refocus, but not everyone's doing that, um, because to begin with, you know, as a Diabetes Care and Education Specialist, I don't see every person with diabetes. So I think that's a huge problem. And then I also think that as a whole, there's a lot of primary care providers that see people with diabetes that I think are not seeing them as frequently right now due to the situation with COVID. So I am worried that um, in general, some patients will get lost to follow up during this time, but I'm also more worried that in general, people are just stressed and not checking in. Yeah, well, they're flat.

Scott Benner 1:19:12
Well, this is gonna it you know, listen, it's not promotion, because it's the people who listen already know about the podcast, but I just looked while you were talking, Arden's 90 day average is what it always is, for her agency, time and range. You know, average blood glucose, it's always the same. And I really do attribute that I know it sounds like, but again, you guys all know about it. So I'm not. I'm not trying to get it out there. That those protip episodes if you follow along with those if you live like that with your diabetes, I'm telling you right now, you could be running from a lion in the Serengeti up the side of a volcano while COVID-19 is around your blood sugar is going to stay where it's going to stay. Arden's a one C is estimated at 5.6, or average blood glucose is 115. And it's that's What it always is, like, yeah, I mean, but it's partly because of you guys aren't ignoring no blood sugars in her pattern 100%. But and that's and that's, I mean, listen, that's what it's going to be right? Like, there's the reality that some people are going to, and they're gonna see arise, and then there are going to be plenty of people who don't, you know, who hyper focus on it because they have the time what I'm trying to say is that we're in a rhythm. And that rhythm produces those results. Yeah, like, I'm not running around here wringing my hands thinking about like, Oh, God, everything's stressful Arden sitting more than she used to, what do I do? All those things happened to her. And then we just kind of gracefully adjusted to it as it happened. And there were a couple of days that were wonky. But I moved some settings around and boom, like, right back to it again. And that comes with time, obviously. Yeah.

Unknown Speaker 1:20:56
And I have to say, I mean, I'm kind of it comes with time. But I mean, that's kind of how I manage my own diabetes as well. And so for me, I noticed the anxiety. And that's kind of why before I focused more on the anxiety, the beginning of the episode, when you asked how I focused on making sure that my blood sugar's didn't go all out of whack from this, because for me, it was really more hunkering down on the anxiety because I knew that would impact them, and then just kind of going with the flow and making my adjustments as I typically do on a weekly or as needed basis, huh.

Scott Benner 1:21:31
Yeah. And it's funny because the reason I answered the way I answered was was like, hey, something's happening, use more insulin if you need it. It's because I, for the most part, ignore what the outside stressors are. And I just react to the graph. And and I'm so in the moment, it doesn't matter if it's soccer or stress or what it is. I just know what to do as it's happening. And then when I see that it's happening,

Unknown Speaker 1:21:58
plastic,

Scott Benner 1:21:58
yeah, well, but it's hard for some people don't have CGM, first of all, which makes it very grateful. But it's just I don't know that maybe Arden say once he wouldn't be five, six right now if she didn't have a CGM, but I still think at this point, I be able to see the I don't know what I want to call it, I'd be able to see the pattern behind what's happening. Right, just, you know, from being involved in it for so long.

Unknown Speaker 1:22:30
Right? Or what I might see on my end, too, is like, hold on one second. I need

Scott Benner 1:22:34
God I'm sorry, with you guys. Oh, no, I just I had a problem. on my end, I couldn't hear you. But it was me. I, you, you, whatever you were saying was being recorded, you're fine.

Unknown Speaker 1:22:43
I would say on my end. So if you came to me, and you were like just going with the flow and making the adjustments as needed, I'd be able to see the increase in insulin need. If Arden was feeling a lot of stress and anxiety. Yeah, I would say hey, look at this, you're using more insulin. Which is fine. But I'd say Hey, are you stressed? Hey, it's something going on?

Scott Benner 1:23:04
Yeah. It's a very strange thing. anxiety, stress, depression, that stuff is its own very specific monster that? I don't know. I don't know that there's an answer to it. Like, if you really stop and think about and I'll let you go in a second. But if you really stop and think about it, you know, if if that stuff was as easy as Have you tried yoga, then there'd be no depression? people be like, I'm depressed. And I'd say have you seen how much free yoga there is on YouTube? You know, like, it's their ways of coping. Now, right. And so I think a lot of people are now are seeing with this added anxiety, what other people who have anxiety and stress and, and depression every day, what they live with constantly, and probably a lot of the times at a much higher level than what you're experiencing by, you know, being locked in your house, which let's be honest, if you're lucky enough to have a house, it's not the worst thing that's ever happened to you, you know?

Unknown Speaker 1:24:01
Right. But I mean, being just being refined or restricted and itself is the perfect, you know, it's a perfect setting to be. So it's very anti people struggling right now.

Scott Benner 1:24:17
Yeah, I mean, people are very social, obviously, animals. And this is very anti how everything about you works, whether you're an introvert or an extrovert, or, you know, someone who's living at home or, you know, has to go into work or not. Otherwise, it's just a complete throw off. Like I'm not saying 100 years from now, like as a species, we couldn't adjust to it. I'm just saying that at the moment, the way we've progressed through, you know, evolution. This is not right for us. And it's Yeah, that's how it feels. You know,

Unknown Speaker 1:24:45
it's a really rough time.

Scott Benner 1:24:46
It is. Alright, Julia, I think we've done well here today. I appreciate you being here. Next time. So next time for people. Julia and I are going to get back together and talk about very specific questions that you've sent in. Some people send it asks Scott and Jenni questions that I've earmarked for Julia. So if you're still listening, we're going to hit this question. How about mental health for children diagnosed with chronic conditions when they face denial, depression, anxiety? How do I manage a kid with type one, so they don't also suffer from depression, anxiety, eating disorders specifically? And what else how to handle older kids who sneak food and then lie about it, how to build trust and compliance when kids are really, you know, just tired of being diabetic. Those are a couple of the things that Julie and I are going to talk about the next time we record. So I hope everybody comes back the next time they see Julia's name in the title. Yay. Yeah, cool. All right. You go do your thing. You young energetic CDC s. CDC.

Unknown Speaker 1:25:51
Good job. You got it. You got it done. It'll roll off your tongue eventually. Right,

Scott Benner 1:25:56
Julie? I wrote it down. There's no way I was gonna remember. Plus, by the way, you fooled me. So CDC is Center for Disease Control. So that's what I'm thinking by the time I get to ETS, which I believe was like a Nintendo at some point. So what I see is Center for Disease Control Nintendo. Yes. Which I'm sure was the Yes. What am I gonna do?

Unknown Speaker 1:26:20
I think it was DS not Yes.

Scott Benner 1:26:23
I think you're right. But again, I don't know. So it doesn't matter. CDE I know certified diabetes educator. Anyway, nobody asked me. Um, all right, live your life. Julie's gonna be back pretty soon, answering a bunch of questions from listeners about more kind of psychological things about type one diabetes. Imagine ask Scott. Imagine ask Scott and Jenny. If Jenny was Julia, that's what it'll be like. Thanks so much to Dexcom and Omni pod for sponsoring this episode of the Juicebox Podcast please again, consider getting a free, no obligation demo of the Omni pod tubeless insulin pump by going to my omnipod.com forward slash juice box. And I cannot stress enough the goodness that will come into your life. If you check out the Dexcom g six continuous glucose monitor dexcom.com forward slash juice box.

Let me remind you that if you're enjoying the Juicebox Podcast, the best way to say thank you is to share the show with someone who you think might enjoy it. The biggest thing you can do. How do you do that? That's up to you. But find some people who you think would love the podcast and tell them about it. And they might not know how to use a podcast app so you can show them. You can show them how to open up the app. Search for the podcast and hit subscribe. And my goodness, if you have an app and you are not subscribed, I'm gonna make me cry. Hit that subscribe button people's clicky clicky on this subscription. My son is texting me he's very upset that he is very upset. He's like, why would the Tampa Bay Rays run? They're on that ball? Is this guy stupid? My son does not like base running mistakes. All right. that's neither here nor there. I hope you're enjoying the show. I'll be back soon. If all goes well, meaning if my computer doesn't blow off. I'll have a small episode for you this weekend about how fiasco went for Arden. And then next week, how we eat addition, carnivore diet, and I think I might do an after dark about heroin addiction. I might do that. Might be how I set up next week. Alright, if I do everything I mean to do the next episode will be about it'll be a short episode explaining how fast point followed by how we eat episode on I just let the genie out of the bag here for a second. Wait, the genie is not in a bag right? The genies in a bottle. Well, how can I just let the genie out of the bottle here for the bag? I mean, it's bad enough they're in a bottle, right? But a bag. That didn't make any sense. I feel a little dumb about that right now. Anyway, tomorrow I'm getting up. I feel like I'm rambling like a lunatic. I'm not editing any of this out and I said editing correctly, so definitely not editing it out. Oh dammit. I screwed it up.

From the fundamental health podcast with Paul Saladino, MD. Paul Saladino will be here to talk about eating carnivore. And then I am going to do an after dark. Then I'm going to get you with the after dark episode that I just recorded with a lovely woman In her mid to late 20s, who has been addicted to opiates for a decade and is a has a hell of a story. So yeah, if you're not subscribed, subscribe because if you are subscribed, it'll pop right up on the screen your phone and be like, hey, the podcast just came out then you'll know what's there.

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