#538 Hypo O' No

September 7, 2021Scott Benner

Kelsey experienced a bad low that she had trouble forgetting.

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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 friends, and welcome to Episode 538 of the Juicebox Podcast.

Kelsey is here everybody. Kelsey has had Type One Diabetes for quite some time, almost two decades. When this was recorded, she was 28 years old. And she came in to talk about the last three years of her life where she's been significantly impacted by a traumatically low blood sugar event. While you're listening, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise. Please always consult a physician before making any changes to your healthcare plan or becoming bold with insulin. I want to thank everyone who has supported the show through buy me a coffee.com forward slash Juicebox Podcast. Some new members include Susan, someone who calls themselves someone Yoli, Alexis, Kristin, Jeanette, Sarah, Amy, Steven, and Dell. I'd like to thank them all of you and all the other supporters of the Juicebox Podcast. This show is sponsored today by the glucagon that my daughter carries g vo hypo Penn. Find out more at G Vogue glucagon.com forward slash Juicebox. Podcast is also sponsored by touched by type one, learn more about them on their Facebook page on Instagram, or touched by type one.org.

Kelsey 1:55
My name is Kelsey, I'm a type one diabetic. 28 years old, I was diagnosed when I was 10 years old. So I've had diabetes for a little over 18 years now. through that experience, I actually had a pretty bad event in my mid 20s, where I almost died from a significant load that I could not get back up. And that has caused me to have like very severe anxiety about going low, which of course in turn has made my blood sugar's high. And so I was able to seek out counseling and discover the reason of why my anxiety had become increasingly bad and how I was able to get my bloods back under control.

Scott Benner 2:41
Gotcha. Hey, are you fidgeting?

Unknown Speaker 2:45
Yeah, okay. Yeah,

Scott Benner 2:46
sorry. I was just posing. No. Oh, is that that's fine. Well, we're always okay. My buttons are very loud. That's okay. No, but sometimes people get nervous. And they, they tap their fingers in between words. They don't realize it or anything. But that's just different. So you were literally telling us about your life with diabetes while giving yourself insulin. That's excellent. Are you is your blood sugar higher than you want to be right now? Or are you? Did you just eat? Yeah,

Kelsey 3:08
yeah, it is higher than I want it to be right now. I did a Pre-Bolus. And it didn't do what I wanted it to do. So I just took another little Bolus to see if I can get my numbers to go back down because I'm an arrow up right now to 10.

Scott Benner 3:22
Gotcha. All right. So let's figure this out. First of all, just background, how long have you been listening to the podcast?

Kelsey 3:29
So I've been listening to podcast. And really, actually, since I started going to therapy for it, it was one of my counselors advices to try and reach out to the diabetic community, because I was feeling very alone in my problems that I was having. And so I found your podcast, and it has just helped me so much just to be able to hear other people's stories and the issues that they had. It gave me so much more confidence going forward, like okay, yeah, I can I can handle this.

Scott Benner 4:01
It's excellent. Okay, good. I just wanted a little context for if you have been listening for a while or anything like that. So I guess I want to start with when you were diagnosed, how old were you again? I was 1010 1018 years ago. 2003 ish. about right. It's just right. That's fine. And so technology existed. Was it something that your parents said, Hey, well, you have diabetes now Good luck with that, or were they real involved? What was that diner? My

Kelsey 4:29
parents were amazing. They were incredibly involved. My dad is a firefighter. He's retired now but so he already had a pretty good grasp on what type one diabetes was. And they were so in tune with me. I remember my mom not leaving my my bedside. Like I feel like if you can go home now she's like, Nope, I am going to be here. I'm going to watch what you do. Like I need to know everything. And and so growing up, they were coming Constantly, you know, I've heard you talk about art and having check her blood the middle of the night. parents did that for me. And then I was able to get a pump. And from there, my parents wanted me to learn how to be more independent and not have to rely on them so much.

Scott Benner 5:19
That's kind of a classic story for that time period. really like the idea of like, Oh, you have a pump now. Now you do it. And the idea of just like, but you didn't have a glucose monitor like I continuous glucose monitor.

Unknown Speaker 5:30
No, no. Do you now?

Kelsey 5:33
Yes, I do. I have the Dexcom. And I also have the CGM that matches with my insulin pump.

Scott Benner 5:40
Gotcha. Okay, so it's just that it's interesting that the rest of it gets, I guess, the curtain pulled back on it. As the CGM comes like, I can see how the conversation prior to CGM would be alright, now you know, you know how to use the insulin, you know how to count your carbs, you know, when to put in your in that, go ahead and go do it for yourself? And then what did you do? You waited a few hours and test it again, we're not even.

Kelsey 6:06
Yeah, no. So that was my, my go to test before, I don't know, sometimes tests an hour. And then like another hour, I was my endo told me that I was testing more frequently than most people would. Because I wanted to be in such control at that time, even when I was 13, and 14.

Scott Benner 6:28
So you would, so I used to do this as well. So I would test Arden before a meal. And then I like to know, like 45 minutes in where she was like an hour and a half ago, I had these times where I wanted to know what her blood sugar was. And I would always look before the glucose monitors I always thought of it is I knew something was going on behind the scenes that I just like, I knew there was a lot more information than was available to me. And I was trying to figure it out. But the truth is to try to grab it. Like one snapshot at a time without any real perspective. Like I didn't know how to use insulin back then or anything like that. It was just, it was maddening. I'd be like, oh, now it's high. Now it's low now, you know, like it just right. Yeah. And it was always just wait till she felt low and then do something about it afterwards. That's a young, a young age for you to be doing that at for certain. But you were okay with that. Is that right?

Kelsey 7:18
Yeah, I was okay with it. I just I had accepted it. And like I said, My parents were amazing. And they're like, yep, it's just, it's what you have to do going forward. And so that's what I did. I was very active playing sports. You know, I remember having little glucose tab baby socks pinned to the inside of my soccer shorts in case I went low when I was running on the field. And that's just how it was. I just learned to to take care of myself and not have to rely on my parents so much since I was such an active kid.

Scott Benner 7:50
This is normally not something I would stop the conversation for. But I heard what you said. I wonder if everybody else heard it. You had babies socks? Safety pinned inside of your shorts and inside of the baby socks. Bear with us, Alex.

Kelsey 8:02
Yeah, that's what my endo suggested. Because I would go low constantly during my soccer matches, and I have to run off the field, go grab some juice run back on it was kind of a hassle. And so when my end does was like, well, this is what other people have done you safety pin a little baby sock on the inside your shorts and filled up with glucose tablets and just pop them as you go. Here.

Scott Benner 8:22
We're here the Major League Baseball player, Sam fold on here. And he said that if you see me in the outfield, and I'm chewing gum, I felt low. Oh, no, I haven't heard that. I thought that was I was really interesting to me when he said that. He says like, if you see me chewing gum, I'm below. And if I have seeds in my mouth, I'm probably not. I was like, Oh, wow. But yeah, lots of little tricks around that. So you feel low, you'd reach into your baby sock and grab a thing and keep playing. Yep, exactly. Excellent. And of course, baby socks strong contender for the name of your episode. So, but were early on, things could change. Kelsey, they really could. Now, how many years? Do you go on like this before you have what you described in your email to me as a trauma? Yeah. How long? Was that? Okay, was everything okay?

Kelsey 9:10
Everything was good. Honestly, probably. I think I experienced that trauma when I was 24. So it went on for what? 12 years and 1213 years being totally fine. Um, and then yeah, and then I had that trauma. And that kind of flipped everything around for me.

Scott Benner 9:29
Gotcha. So that's only about six years ago. You're with me, you're out of college at that point, or just,

Kelsey 9:36
I'm still in college. I'm actually still in college. Right now. I'm getting my master's for counseling. Sorry.

Scott Benner 9:42
I was like you should take more than one class this semester. No, no, I understand. So you're taking longer you're taking a longer course. So you were still in college when this happened? Were you at college when this occurred?

Kelsey 9:53
No, I was actually at work when this occurred and and then it led throughout The night and into the next morning.

Scott Benner 10:02
Can you tell me? Does it bother you to talk about? Can you tell me about it?

Kelsey 10:06
Oh, yeah, no, I'm fine. Talking about it now. Okay. But basically what had happened was at that time, I was actually on shots. And so what essentially my endo thought had happened was I was exercising a lot. And then I took a larger dose of the overnight insulin. And so the next day, my blood, I could not get it to stay up for the life of me. And I think I had over 500 carbs by like, noon. And I just could not get it to stick up. And then by the time I went to bed, I had, I couldn't sleep and I had a very bad low or I thought, like, Oh my gosh, that I'm not going to be able to even dial 911 right now. Um, and I was living alone at the time. So that was scary for me as well. But luckily, I forgot I had a juice box in my side drawer that I was able to break open and feed myself before I had passed out. And so after that, point, it the low, still continued, I was able to kind of regain, I don't wanna say regain consciousness, but get a good grasp again, and continue to feed myself until I was normal The next day, and the lamp has had officially worn off. But what had happened, really where my brain went at that point was I had I was like, Oh, my gosh, you know, I'm living alone. Nobody, nobody knew I was having the slow, what would have happened to me, if I passed out, I, that would have been it. And so it led me into that, that anxiety kind of started to develop, every time I would start to go low, I would start to feel that most PTSD in a way, as my counselor described, it was a very, very small amount of PTSD. And I just freaked out and I wanted my bloods to be high, because that was like, my safety zone.

Scott Benner 12:15
Right? So just so I can try to pick it apart a little bit to understand, do you think that you mistakenly gave yourself much more lantis than you meant to?

Kelsey 12:24
You know, what, honestly, they still don't know. I gave myself my normal dosage. And I did my normal things that day. And that's why I was so scared going forward, because I was like, this was my normal routine. You know, of course, diabetes never is the same, right? And so I told my No, she's like, honestly, sometimes, you know, you could have eaten something two days before, or you could have exercised really, really hard two days before, and it's still with you, and you don't realize it. And so, not really having a direct answer, like, Oh, yeah, I, you know, it took 15 or 25. And was part of that anxiety because I had done everything normal.

Scott Benner 13:06
No, it seems like if you can't, if you can't narrow down what happened and feels like it was random, then it could feel like it could be random and ever again, just anytime, you could pop up again, that had this ever happened prior or since

Kelsey 13:20
now, hasn't happened prior since I got back on the pump. And so that has significantly helped me. Because it's just, you know, the continuous background in Flint. I'm not taking one single large dose at night, right? So that's helped a lot. But since then, No, I haven't had any event like that.

Scott Benner 13:39
So after this half, not after this happens after you give yourself that insulin and that it's you spend the day, just constantly low and you can't feed the insulin enough to get to get up over a certain number. Where was where was your blood sugar sitting?

Kelsey 13:54
I probably remained I fluctuated between 70 and 50. I would say, I would you know, go down to 50 each, and then it would bump, you know, start to go back up to like 7075. And I was like, Okay, I'm coming up. And then I'll check again, not even 30 minutes later and back down to 60.

Scott Benner 14:16
Yeah. Wow, that's crazy. So you just how you see Did you have the feeling while you were doing it? Like this will be the time where it'll go up and stay up? Like did How long did you play that game? Like Yeah, like, it feels like a horror movie to me. Where, where you feel like you're trapped in a room that like just get this puzzle, right? We won't cut your head off and you can leave and get the puzzle, right? And then there's another door and you're like, wait a minute.

Kelsey 14:39
That's exactly it's like you know, Okay, I get it this time. I have this hope. And then each time it was like, that's why I feel like it was just so defeating like, Oh my gosh, what can I do? Like, just that loss of? Yeah, defeated,

Scott Benner 14:55
right? Yeah, just the idea of like, I got it. No, I don't I got it. No, I got an answer. I would imagine I'm imagining after hours turn into a half a day turns into a full day and then you've got to go to bed. You're probably just like, oh my god, like, this isn't gonna stop Did it ever? Were you ever in a position where you had the ability to contact the person to like, come sit with you, but you thought no, it'll be all right. Or did you not live in that situation?

Kelsey 15:21
Um, so being 20 what I how 23 at that time and being moved out, I didn't want to worry my parents that I was having this problem. Yeah. So I didn't contact them. And looking back I absolutely should have but I didn't want to worry them. Think like, Oh my gosh, she she can't live on her own like it was happening.

Scott Benner 15:42
It feels like it would have bigger ramifications. If you if you if you said and I'm not judging you. I'm just interested in the thought process that goes through the whole day.

Kelsey 15:50
Yeah, so that was it. It was just I don't want to worry my parents, I want to prove to them that I can live by myself with Type One Diabetes and not have any real consequences.

Scott Benner 16:01
But there was no way to know that after this experience you were going to suffer. But like the PTSD of the situation that it was going to come like you just thought you were getting through a moment it sucked. And it would be over eventually. And even though the physical part was over, you got visited by a different aspect of it that obviously you didn't expect. Yeah, exactly. Hey, Kelsey, that sucks. really sucks. And so how long do you I'm assuming then you start leaving your blood sugar's higher than you'd like. And let's give that a little bit of context prior to the event. Let's call it The Happening prior to the happening. Where was your agency? And then where did you let it rise to to feel comfortable?

Kelsey 16:46
So my agency was what last time I checked, actually just checked the name for coming on. It was at 6.5. Okay. And then after this event happened, it went up to 10.

Scott Benner 16:58
Wow, that's a significant impact on you. Oh, no kidding. Yeah. How long? Did you live like that? before? You thought I have to address this like, Well, let me ask you first, did you just imagine that the anxiety would dissipate at some point, it just never did?

Kelsey 17:12
Yeah, that's exactly what I thought, you know, once again, thinking, Oh, I can handle this. I got this. And I gave it about a year. And at some point, I just kind of gave up on myself, honestly. And I was like, You know what, it just I'm tired. I'm burnt out on this. I don't, I don't want to deal with this anymore. And so not that played into it as well. Yeah. Um, and it wasn't really actually until I got together with my now fiance, who's a paramedic, and he was like, What are you doing? I treat, you know, 10 diabetics a day. Like, if you pass out, I'm just gonna give you some glucagon. Like, you'll be good. And so it was once I started being with him that I was like, holy crap, you're right. Like I, I need to, I need to get this under control to live a long and healthy life. And that's when I started really seeking out that counseling. And I had that desire finally, to want to get myself better.

Scott Benner 18:08
It's just really telling how impactful anxiety can be on on the on the people who are afflicted by it. Because you know, what's up? I mean, you've lived day after day after day after that, you haven't gotten low again, like that. So you, you know if common sense, was the only thing you need in this situation, you'd be like, well, it was a one off thing. It doesn't look like it's gonna happen again. And I'll be fine. But that anxiety just stops you in your tracks. It's fascinating monster really, really is crippling for the people that have decides to attack. Wow, 10s a one sees Yeah, this guy likes you. He's not looking for you to have a 10 a one. See? That's for sure. Okay, so. So you recognize? How do you recognize the steps to take next, like, how do you decide where to begin trying to break free of this.

Kelsey 18:57
So the first thing I did actually sought out counseling on my own. And I just found a local psychiatrist who specialized and anxiety. And so I started seeing him and he did is called CBT cognitive behavioral therapy. And that is to try and essentially get you to readjust your brain is the best way I could say it. I'm trying to like do almost exposure therapy where you're like, Okay, I'm going to get down to 200. I'm going to let it sit there. And I'm just going to it's going to scare me, because that's not it's outside of my comfort zone. And finally, after about I would say three months of seeing him, I just, I was like, Okay, this is not working. And just his method wasn't working for me. So I actually reached out to my endocrinologist and was like, Look, this is what's going on. This is where I'm I want to get better. I'm really determined right now. What do I need to do and so she set me up with it. a psychologist who worked for my doctors and knew about diabetes. And she was the one who actually got me on Prozac. And when she got me on Prozac, I'm like, I'm not sad. I'm not depressed, like, I'm just scared. And she goes, Yes, I know. But here's the problem is that your anxiety is starting to cripple you to the point where you're willing to have these significant possible, you know, lose a foot in the future, just to stay safe in the moment, and we can't have that. And so I started taking that, and that significantly helped me and it helps ease your anxiety, which I had no idea that that does. Prozac was meant for anxiety as well, because it works with your brain chemicals to go Okay, like, yeah, you're panicking right now. But look, this is going to help to relax you. So when I had started having, you know, the triple arrows down, I wasn't going into like this automatic panic mode of Oh, my gosh, I need to stop this blood. I'm dropping what's going to happen? I was just like, Okay, well let it ride and see where it goes. Right. So that's been the pattern I've been doing. And it's, it's just has made such a huge difference. That's

Scott Benner 21:16
excellent. Wasn't whatever helps is the right answer. And I wonder, too, so which is the second doctor says you should reach out and find like, some people who have diabetes to find a community?

Kelsey 21:30
Yeah, she was one because I told her I was like, Look, I, you know, I don't I personally know any other type one diabetics, I feel very kind of alone in this. And that's obviously not helping my fears, because I don't have anybody who I can talk to who can truly relate to what it's like to go low, other than a diabetic. And so she was like, hear, reach out on Instagram, listen to podcasts, here's books. And so I started doing all those things, and joining the diabetic communities through Instagram. And that's actually how I found you your podcast. And I was like, Oh my gosh, like, being able to listen to other people see, they're physically see their graphs on their CGM of them going down to 40 with two arrows down, made me go Oh, my gosh, like, it's not just me, like, these people are scared of that, too. Yeah. And having that kind of outreach really, really has helped.

Scott Benner 22:22
Right? Well, that's my finding is that the feeling of community, I've seen it pay people back over and over and over again. You know, I don't need to study on it to tell me how great it works. So that part is absolutely fantastic. The it's great even that the Prozac work, I looked it up while you're talking and says Prozac, people using Prozac can see improvement in symptoms of anxiety, one or two weeks could usually take between four to six to feel full benefits. That's, that's just that's magical, you know, because it wasn't going to let go of you. I don't think how long have you had a glucose monitor a continuous glucose monitor?

Kelsey 23:03
Let's see, since I got my pump, I have the Medtronic 670 G. So I've had that for about three years now. Maybe a little over three? And how

Scott Benner 23:14
long has it been since you met that this second doctor that you talked about? Just two years years? So one year with a continuous glucose monitor didn't make a dent in this Can I guess? Did it almost make it worse?

Kelsey 23:26
Oh my gosh, I was gonna exactly say that. That's what she said. She's like, because you're able to see your numbers doing the scary, scary drop. It makes it worse for you versus kind of being able to go an hour without knowing Yeah. And I actually she said, I actually developed a little bit of OCD with it too, because I was continuously like, every five or 10 minutes, like okay, Where's it at? Now? Where is it at now. And that's as soon as it updates is five or 10 minutes. And so she was like you have this very interesting dynamic because a when you go low, you feel it. But also when your anxiety kicks in, it almost feels the same as going low. So you kind of are having this crazy double whammy of mentally feeling it and physically having to feel it where most people who have anxiety don't really experience that. I have

Scott Benner 24:17
to tell you that when continuous glucose monitors became popular, like when they they were available in the world and people started using them. There was so much talk from people who had lived with type one for a while prior to continuous glucose monitors, saying how much continuous glucose monitors made them feel anxious. But you don't hear those conversations nearly as much if at all, from people who are born in the moment of continuous glucose monitors who excuse me diagnosed in the moment of them. People who have them from from go. Don't have that like that same. That same impact. Doesn't seem to occur. As for me, this is anecdotally me looking at people, obviously. But I think there's something about like, people who are diagnosed now or have continuous glucose monitors might not recognize the people that lives with diabetes prior to that, like they were, they're alive and doing the way they're doing. But they didn't really know why. They just, they're following the rules, right? Like, do this, count that shoot this, eat that. And you wake up every day? And you go, huh, well, that must work. Because here I am standing here. And then all of a sudden, that glucose monitor comes up and you look and you go, wow, there's a lot of things I could be doing differently here. That's how it hits some people. Some people are then given a picture to what's going on inside of their bodies. And they're like, Well, wait, that's been happening the whole time. Like, that's scary. Yeah. Yeah, no kidding that trend. So can you tell? So I guess I want to ask a question before I asked this one. You've been listening to podcast for a little bit now. Does your blood sugar still fall drastically like that?

Kelsey 26:02
It does. But I don't get us freaked out. I don't suspend my insulin, I don't try to correct it right away. I just let it be and let it ride. And just like from listening to the podcast, it's like, oh, yeah, you know, people you trend down for and downtrend down, and then boom, you level out. And so I now have been doing that and trying to wait for the arrows to stop trending and start leveling. Okay.

Scott Benner 26:31
So can I talk to you like about just like insulin for a minute? So I can, I want to orientate around some context here. So would you say that your basil rates are really good? Or do they need work?

Kelsey 26:42
I would say that my basil rates are very good. And I still have some anxiety issues. So when I see that there sounds silly to say, but when they are, where my levels are, where they need to be, I'm 100, straight line, it still triggers some anxiety, because I'm like, Oh, my gosh, at any second, you know, I could I could start to go down because I have three units on board. And so it's a little more complicated for me to still be able to see, like, I know, my Basal rates are where they're at, because I am where I'm at where I need to be. But yet, in that back of your mind, that anxiety is like, Oh my gosh, but what if but what if? Yeah, and so it's kind of a still kind of a funky battle?

Scott Benner 27:32
What about overnight? Where do you sit? stable overnight

Kelsey 27:34
at? Yep, overnight, my line is perfectly straight.

Scott Benner 27:38
What number is still around that? 100?

Kelsey 27:41
No, I overnight, I'm still reading around 150 to 170? Because that's still kind of my safety net? Sure has, yeah, with that, just with the anxiety of it being asleep, and not being able to see exactly what is happening all the time like I can when I'm awake, right? And it's still a jump I need to overcome.

Scott Benner 28:01
Yeah, and please keep in mind, I'm not trying to talk you out anything I'm trying to figure out. Structurally, why are you Why is your blood sugar falling during the day, so so so, you know, the way I think of it is, if you're higher overnight, like that, then when you come into the day, and you hit that, you know, feet on the floor, like life anxiety thing, and your blood sugar wants to start going up. Now you're going to be bolusing more aggressively at numbers and leaving the the meal insulin or the corrected insulin, whichever it is you're doing or maybe both at a position where at some point, it's going to become counterbalanced or out of balance with the number than or the carbs or the need. So you start at a higher number. It makes you Bolus more food, eventually, the food leaves your system, the insulin remains behind, and then you come crashing down. And as I realized that this is a specific scenario, we're talking about anxiety, so but if you came, if you and I were having this conversation, and it was just about management, and there was no anxiety in it, what I would say is that if you can keep your blood sugar stable and lower overnight, and even a little lower during the day, then you wouldn't be making up for your basil deficit with Bolus insulin. And the likelihood of having a low after a meal would be significantly less because you'd be using far less meal and so on. Does that make sense?

Kelsey 29:32
No, that's what makes that's a really good point. And I actually honestly haven't thought about it like that. Because I'm so used to, you know, for the past three years, just when I get high, just continuously taking little micro doses. Yep.

Scott Benner 29:47
So you end up stacking insulin up because of that, which is weird because I don't usually say stacking because what I'll tell you is, if your settings are right, and you need insulin, like I say if it's it's not stacking if you need it, but You can't, you can't stack to make up for a basil deficit. So one of the most interesting things that happens, Kelsey when I'm talking to people, and they're just like, look at my graph, I don't know what to do. I have this peak here, and this peak here. And the peaks are always, you know, after meals, and then I get really low and the really lows always like two and a half, three hours after meals. And you know, and when I'm, you know, when I look when they're away from food completely, their blood sugars are super stable around 140 or 150. And then I'll look at that. And I'll say, well, your basil, I think your basil needs to be higher. Because first of all, when you're super stable away from food, or, or Bolus insulin, you know, if your basil was where it needed to be perfectly, your blood sugar would be super stable, but it would be super stable at 85, not at 150. So there's what 65 points higher, that you can eat out of your blood sugar with basil insulin, and that ends up being a lot of insulin. And so now you're counting carbs later, you know, your blood sugars are stable at 150. you're counting carbs later. And you're like, well, this is 30 carbs, that's three units, or whatever your ratio is, and you put it in, but you're, you have a deficit of basil every hour, it could be half a unit depends on your size, right? It could be any amount, but whatever amount it is, that you've been missing all night long and all day long. like think about it, if it was in there, it would be in there but it's not. So you're just sort of bolusing but your Bolus is just going towards the basil instead of going towards the carbs. Right and then you keep you keep you keep both now your Bolus thing the number, the number, the number, the number and then eventually the food digests out of your system stops impacting your blood sugar and then straight down.

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Right? Have I described your life?

Kelsey 33:25
Yeah, pretty. Yeah, that's exactly what I've been doing off to try to try increasing my Basal rate that

Scott Benner 33:34
that makes a big you increase your basil and get yourself where you're super stable. And I'm saying whatever number you're comfortable with, obviously. But the lower you go with that comfortable number, the less insulin you're going to need at meals and the less insulin, you're going to need for corrections. And then you can start, you can start setting your alarms on your on your CGM to actually help you so like, you know, you set it at 130 as you drift above 130. And I say this a lot, but the amount of insulin it would take you to bring a 130 diagonal up back to 90 is a pretty small amount of insulin. But the amount of insulin that would take you to bring a 250 back down is a lot and again, it's going to get out of balance with the with the insulin need at some point. And then you've find the low so it seems counter intuitive. But those people who show me the peak and then the low and then the peak and the low they're like oh it peaks up after I eat then it gets low and then I eat something that jumps back up again this keeps happening. And then you say to them well I think if you turn up your basil this might not happen here are the reasons why a lot of people here but no, I get low a lot more insolence not the not the answer. And what I'm saying is it may actually end up being less insulin. You're just shifting where it is and the job it's doing.

Kelsey 34:52
Yeah, and that which totally makes sense because I know that with one of the things with the anxiety is that having A large amount of insulin on board because you know, when you have that large amount that you're more likely to go low. Yeah. So that absolutely makes sense to raise your basil to only have to do those little micro boluses to get you to where you need to be.

Scott Benner 35:14
Yeah, definitely helpful. Can I? I'm sorry, I know you didn't think this was gonna happen. But what are your What are your Basal rates at? Hold on, let me pull up here. And then get ready for the part where I ask you how much you weigh. Sorry about that. So

do you have like one singular rate? Or do you have a bunch of different rates? I have a bunch of I was gonna guess that? Yep. Yeah, a

Kelsey 35:42
bunch of different rates. Okay, so let's see here. Okay, so from midnight to 330, my if that 1.1 3:30am to 8am, point eight to five 8am to 12 1.2 12 to 3.953 to 7pm, point 375. And then seven to midnight, one unit?

Scott Benner 36:17
Well, so you're basically you've set up a bunch of different basil programs trying to outsmart problems that you have. Is that about, right? Yeah, that's pretty good, right? Especially with the weird hours I work. I work 5am to 5pm. And so I set that because I know in the morning time, I'm not going to be eating for three hours. So I know that my bloods naturally going to drop during that time. Do you work in a hospital? No, I actually actually work in a jail. Oh, that's more fun. That's a much it's a much more different answer than I expected. So I'm not saying that there aren't times a day when your basil needs need to change drastically when you're in your pot when you're on a pump. Arden uses frequently less insulin overnight for basil then during the day, but it's not that significant. So like 12 to 3.95 going into three to 7.375. That to me sounds like you're like incredibly active at work and not eating at a certain time. Is that about my guess? Right?

Kelsey 37:21
Yeah, that's right. So during that time frame, I've noticed that as when my bloods will just crash, because it's after eating, and I'm not going to eat again until seven. Right? And yeah, running around at work. It just drops during that time period. Yeah. Okay.

Scott Benner 37:37
So I'll bleep this out if you want me to, but how much do you weigh? So right now? Yeah, bleep it out. I'm at one, now, okay. All right. So I would say if your blood sugar's are consistently overnight, in the 150 range, and consistently during the day at the 100 range, when you're not, when you're not using insulin at the moment, and there's no active food or insulin in you, then I think there's a lot of space in your basil. Like it really is. So and I'll bleep this out, too. And I'm sorry for the people listening. I'll give you some generic answer later, but we're talking to calcium protecting the parts of our life she wants to keep to herself. I would say that I frequently, when I start guessing about people's Basal rates, I usually guess point one per 10 pounds. Now, that's it, that there's nothing mathematical about that. And there's nothing there's nothing medical about that. It's just something I've noticed, and some people don't fall into it all. But like a kid that weighs like 35 pounds, sometimes they're like point two 5.3 in that space, you know, somebody 100 pounds around a unit, like that kind of thing. Like Don't get me wrong, 100 pound person might only need point eight, they might need 1.2. They also there and there's always outliers, who, you know, you see people's graphs, they're absolutely amazing. And their Basal is like half unit an hour, and they weigh 120 pounds. And I'm just like, that falls outside of my thing. But what I'm saying is, if you just tried to bring everything up a little bit, I wonder what would happen and I would start on a day when you're not at work. Like a day off from work, and just I don't know, like 10% of the time, just move it up and see what happens. Now I'm going to do that. Yeah, because if you could create because I'm listening to what you're saying about the anxiety, right? You're you're afraid of falling quickly, and that fear is precipitated by having a lot of insulin on board. Because insulin on board feels like falling. I'm going to tell you that. If you're there's a wolf in your house. I'm going to tell you that if your basil is rock solid You do a good job of counting your carbs. And your ratio is pretty close. Right? And I'd say you need to understand the difference between carbon packs, meaning that, you know, white rice or big potato is going to impact differently than maybe, you know, I don't know, watermelon, or grapes or something like that. If you can keep that stuff straight in your head, I've, I don't want to, I definitely don't want to flip you out. But my daughter's eating Chinese food right now. Her insulin on board is like 18 units or something like that, oh, my goodness, that would freak me out. But her blood sugar is also not going to get high. And it isn't going to get low later. Because these 18 units are active, while the food is also trying to impact her. And so that becomes the last bit of it is that you have to understand where the insulin, you have to you have to understand how to get the insulin working while the carbs are working. So if you've never heard the Pre-Bolus there's a defining diabetes, no way. I don't know my own podcast, diabetes pro tip Pre-Bolus. That episode talks about how to line up the insulin, the you know, the impact of the carbs with the action of the insulin and keep them sort of working at the same time so that they're working against each other. And then as the food digests, the insulin wears off, and then there's no high or low afterwards. It's not that it's Listen, it isn't like, don't get me wrong, like you're not gonna, like get off the thing and be like, Oh, I got it. But it's, but that's to me the information that gets you to a place where you won't see a bunch of falling. And you won't have to be putting in a bunch of extra insulin all the time. And then hopefully, one day you can roll out for a pizza and not feel weird about it.

Kelsey 41:52
Yeah, that's I'll definitely have to listen to that episode. And try again, if we're going to try that going forward. because like you said, eating how Arden's eating Chinese food right now i i am very limited in my diet, because I don't want to eat higher carb things, because I know that that's gonna mean I have to take more.

Scott Benner 42:10
Yeah. Yeah, listen, for most for people who have not had the problem you've had, you know, the the trauma that you've had. It's still a and for me as well, like, it's still a great leap to get over. You know, like, I'll never forget when Arden was growing, and the first time you're just like, you know, I mean, you just got to remember like, I remember setting basil rates like point two, five an hour. And when I got to a unit, I was like, Oh, my God felt insane, you know, but now now there are times around her period where I'm like jacking her basil up to like three units an hour.

Kelsey 42:42
Oh, yeah. The hormones behind it. Oh, my goodness. Yeah. Yeah. It's a lot to try and remember and taken,

Scott Benner 42:50
it certainly is. I mean, listen, there's there's just no doubt, but I also hear in your voice, that you're, you're really do want to find the other side of this. It sounds like to me. Oh, yeah, absolutely. Yeah. That it just it didn't seem like I'm scared. And I'm okay. Staying here. Like, it seems to me like you're like, Okay, that's enough of this. I gotta, I gotta move forward. Plus, I take advantage of this time you're dating this paramedic. So right.

Kelsey 43:18
Exactly. Yeah. And so yeah, especially with, you know, weddings coming up. And we want to have kids like, my numbers have to be prime. So I'm not so scared anymore. As much as determined. I'm trying to be with it.

Scott Benner 43:34
Good for you. Yeah. No, I mean, can you imagine if trying to have a baby? And having this is still like, afflicting you, you know, like the I can't do what I can't bring? I can't give myself more because there are parts of pregnancy. I've had a number of pregnant women on the show, there are parts of pregnancy where your your insulin needs just skyrocket?

Kelsey 43:55
Oh, yeah. I've listened to those episodes. And I'm like, Oh, my God, you have to literally double your insulin. So knowing that going forward, I I know this is something that I really need to conquer and get a lot more control of.

Scott Benner 44:10
It's really admirable that what you're doing, I know, it's probably to you feels like you're lost in this like slog trying to figure this whole thing out. But you I mean, I hope you know how many people are listening who are in the exact same situation you're in and have not found a way to even try to address it. It's very common, what you're talking about.

Kelsey 44:33
Yeah, and that's part of the reason why I reached out to you because I'm listening through your stuff. I noticed that there wasn't too too many expressions of people who have anxiety and have had to get counseling and like me have had to get on Prozac or whatever you need to do. Because there's some shame behind it. Like when I first started I was I was a little bit shameful myself because I knew I wasn't doing good and it's kind of getting over that. That hurdle. And being like, you know what I write, I'm not alone. And I want to be able to make myself better so I can make my life better for everyone else who's in it

Scott Benner 45:11
is overcoming that shame. Like one of the first steps,

Kelsey 45:15
I would say, so, for me, originally, when I was having this problem, and people asked me how my diabetes was going, I would sometimes I would just break down, it'd be like, as soon as I started talking about my diabetes, I would just start crying because I was like, Oh my gosh, like, I don't have anybody else to share this with like, this is, you know, it's so scary. I know, I'm doing bad. And so I think once you kind of start, for me, it was admitting step a was admitting like, yeah, I have a problem. And then seeking the help to try and fix that problem helps you to overcome that shame, or at least it did for me to help overcome it by just simply admitting it and having people be like, okay, you know, like, we're not mad at you. We're not like, oh, how dare you have high numbers of everybody has been so helpful. And, you know, open arms about like, yeah, let let me know what you need. Yeah. And I think that was a really big, important step.

Scott Benner 46:18
Does this shame feel like something you end up putting on yourself? Like, you think it's going to come from disapproval, but it's the fear of disapproval? I don't know. Like, do you understand the mechanism of that?

Kelsey 46:29
Yeah. So for for me personally, um, my shame was within myself, because I knew how good I had been doing previously Of course, and then now to go to my endo and However, she literally the first time I went in, she gasped, she goes, Oh my gosh, what happened? And I know that a lot of people have that fear of going into your endo because it's like, oh my gosh, this is it like you're on trial to see how good or bad you're doing. And so a lot of it was put on me. And because I wanted people to be proud of me and my numbers, because again, in my very small town I live and I'm like one the only diabetic so when people ask me how you're doing I'm like I'm great. And not be like oh gosh, it's so bad.

Scott Benner 47:21
As the person who's standing up for all of us at this longitude and latitude let me just say I'm doing terrific because I'm you felt like you were the correspondent for diabetes for your for your songs. I mean, the whole thing is because I I'm trying to imagine you have this episode The you know this terrible low and this traumatic thing and you go back to your doctor next time you're a one sees hire like what if she would have just said or he would have just said hey, well this is really out of character instead this in her head You know, this is really our character Something must be up let me find out what's going on let you tell the story of the the load day and the impact it's had on you and help you out of it and then you don't get stuck for the last six years in this you know, it maybe or maybe not maybe maybe your brains wired in a way where like any trauma would have would have been something that stuck with it. I don't know like do you think if you ever had a car accident you'd be afraid to drive or I guess there's no way Oh right. No,

Kelsey 48:18
I mean, I guess there's no way to really truly know that if you haven't been in a car accident and I think that I you know I've been in a fender bender right I was basically a little cautious after that but now I'm like okay, you know you're back to I continue my life yeah, I'm back to normal and so I think that if people if my endo maybe had not reacted so strongly it wouldn't have instantly put that that oh my gosh, okay, I need to not tell her anything Yeah. How it's really been

Scott Benner 48:52
you do live in a small town I just heard the steam engine go by it's probably gonna pick up at the bank and then take cattle into Kansas right? Yeah, forget that. Seriously, it felt like it was in a Western for a second. I was like I can't help the train No, no, no, I it's been one of my favorite things has happened so far today. Don't worry about it. I was like this is great. I'm waiting for for guys with masks to to ride out of the dust now would they be wearing masks because of COVID? Or because they were going to rob the train? I have no way to know probably. Yeah, could it be I don't you keep I hate to be the one to say this out loud. But don't you keep waiting for there to be a ton of bank robberies because we're all wearing like, Am I the only one who's been like sitting around going we're all the bank robber. He's gonna have oh my gosh, yes. Especially when someone walks in with sunglasses. I just I just keep thinking like some industrious robbers gonna be like, Huh, you know, but I guess not. I guess there's more to robbing a bank than wearing a mask. I don't know. I've never I've never looked into it. But anyway, I just I there's an 11 year old inside of me that just keeps waiting for there to be 9 million bank Rob. That's the silliest thing. I've ever thought as an adult, but it really does happen. When's it gonna happen? Well, so listen, I think it's interesting because I never know, like, so you're listening to the show more for community, not as much from management. So I'm gonna say this to you. If I'm you, I go to Episode 210. It's called diabetes pro tip newly diagnosed are starting over. And it's the beginning of the diabetes pro tip episodes. And they're very management. Rich, and not, they're not boring. I don't think it's me and my friend, Jenny Smith, who's a CD, she's had diabetes for, like 32 years now. And she she was really nice enough, this is going back a couple years. Now, I said to Jenny, I have these tenants like, I realize I'm saying the same things over and over again, the podcast, I'd like to drill down deeper on specific ones that I think lead to stable management, right. And so she was nice enough to come on and have these conversations with me. And I'll tell you, that the feedback I get about them is stunning to me. Like, I can't believe that people find them as helpful as they do. I meant for them to be helpful. I thought they were, but I can't believe the feedback. So if you have, you know, 20 hours to listen through a handful of episodes, I would think that the things we kind of chatted about today loosely would come into focus for you. And I would love to see you not be I would love to see everyone not feel that anxiety. Because, I mean, again, being the parent of someone with diabetes, it does give you this the this passionate feeling where like, you're like, well, if I make someone low, it's not making me low. And I'll still be here to fix it if it happens. You know what I mean? So like, there's

Kelsey 51:44
no, I 1,000% Get it? Because that's, that's how my fiance is, you know, he's like, as soon as I got the Dexcom He's like, share that with me. Yeah, I you know, cuz he knew I, you know, I have this fear. He's like, I, if he works nights, or whatever, that actually really helps when I got it, because I was like, Okay, I'm sharing this with somebody else. So if I go low, it's not going to be just me home alone, I'm going to be able to alert somebody that like, hey, something's going on

Scott Benner 52:11
this. You know, I've never done this before. And as I'm saying it, I don't know why I've never done it before. But would you be willing, while we're talking right now, would you take a screen grab of your 24 hour Dexcom graph and texted me real quick? Yeah, grab my phone. I'm gonna tell you it's not pretty. But no, no, it doesn't matter. It just needs to be what it is. I can see it. You know how to turn it sideways and choose 24 hours? Yeah. There we go. And I'll definitely remember to bleep out your weight now because I'm not the Bleep out my cell phone number. is important. Keep my weight and I know you said, I stick with what you said. Don't worry. All right. Okay, go ahead with your numbers. I should bleep out the bleeps with curses. But I really

Okay, there we go. I got it. All right. Yeah. You don't have enough basil.

Unknown Speaker 53:17
Okay.

Scott Benner 53:20
Most days like this.

Kelsey 53:22
Okay, yeah, it's that that roller coaster of high then like, as you can see super high overnight because again, with that anxiety of not being able to sleep, it's something I really need to like,

Scott Benner 53:38
don't you don't apologize. This is very, very fixable. Call me with the low line of setup, though. Where's the low alarm at a low alarms at 7070? Where's the high one at one at 180? Is that right? 170? Yeah. All right. Yeah, you could easily or you could easily be doing 1.3 units an hour for basil. You think that's where I'd start. And as crazy as it sounds, I'd write down all your settings. Right? So you have them. And I would just go to what 24 hour Basal rate? That's how I would start. So I would I start, I'd start. How would I start? What's your overnight 1.1 overnight and 3/8 is point nine five. Okay, so we got to enlist the boyfriend. We got to do we got to do it on a Friday night. Right? And you just 6pm on a Friday night that you're not working? You go to listen, let's try we'll try 1.3 right. And if it's 1.2 it's 1.2 if it's 1.4 is 1.4 whatever. And you just you want to get down low and stable like meaning get to wherever level is for that Basal rate. Get this table, and then just let it roll for a while and see what happens. So let's say it gets you to 110. And you're, you know, it's six o'clock, because he changed it at 6pm, it's not really gonna start taking effect till 7pm, maybe by nine or so you'll see about what what's up right now at 1011. If you start drifting lower, fair enough, right, like if you if you get lower than you mean to then take a little bit of the Basal away, make it you know, 1.2 instead, until you come stay stable where you want to be. But just keep in mind, you are going to go stable somewhere and at 1.3. At from what I'm seeing from this, I'm guessing you'll be stable around 100, maybe. And then if you don't have any active insulin in you overnight, okay, so you don't make a big Bolus at nine o'clock or 10 o'clock or 11 o'clock, something like that. I'm not a doctor, and you certainly shouldn't listen to me because my wife says I'm an idiot, okay. But you're not going to have a drop. If your Basal rate is where it belongs overnight, you shouldn't see a significant drop. And if you do like it one o'clock, you start drifting down, and you get to, you know, 90, and you're not comfortable with that, well, then maybe, maybe from 6pm till midnight, then it's 1.3. And at midnight, it's 1.1. Like, I don't know, but well, definitely, that's something we're gonna do that and I'm pleased so that, you know, he'll say I'm making up numbers right now. You have to you have to figure the numbers out for yourself. But this, this graph can handle a lot more basil throughout the day. And when it and when you have it, because I see your I see your meals, like you're shooting up immediately. And staying up after a meal, which is an indication that you're not using enough insulin for the meal and your basil is, is low to me. And I'm getting that from the angle of the pitch that your blood sugar goes up at after you eat. So and I can even see here, you make corrections that are pretty aggressive. And it takes some a couple of hours just to get back to 200. And then it just bounces again. So yeah, so it's you. So in order, get your basil, right, figure out your Pre-Bolus time, what's a fair amount of Pre-Bolus time for you learn the glycemic load and glycemic index of foods meaning that 10 carbs of potato might need, like say you were 10 units, let's say you were one unit per 10 carbs, right. And so if you were one year for 10 carbs and 10 carbs of potatoes might need a unit and a half were 10 carbs of you know, strawberries might just use the unit. So So meaning you're gonna have to learn that there are some foods that punch above their weight, they need more insulin than your ratio indicates, just as there are some foods that need less insulin than your your ratio would indicate. So then you got your Basal, right, you understand Pre-Bolus Singh, meaning you want to get the timing of the insulin, you know, lined up with the impact of the food. And then you know, have a reasonable understanding of what foods need what kind of like strength. And from there, the rest of stay flexible, which might in possible might be the hardest part for you in the beginning. And meaning that you know, you know, if you if it tries to get higher, you might have to correct it. If it tries to get lower, you might have to bump it back. And I swear and try those protip episodes. If you're not living a different life in a month, I'd be surprised.

All right, I'll definitely do that. I'm excited. I'm excited to do that going forward, actually. Cool. Kelsey, I'm telling you now Now you've interested me now I want to stay involved if you want me to. I want to hear how things are going after you try this. Now. There's no pressure whenever you do it, do it. But I would. I would love to know your graph looks a lot like a newly diagnosed kids graph. Yeah, it's a hot mess. Listen, it all right. You know what? Why am I disagreeing with you? You're an adult. It's a beautiful. It's a bit of a mess. But at the same time, but at the same time, the fix isn't difficult. It's just it's basil than Pre-Bolus than understanding foods. And if you do those three things, listen, you're back to your six, five. I mean, you do those things, you're back to your six five pretty quickly. But that's not the important part. The numbers aren't what we're talking about. What's important for you is is cut being comfortable.

Kelsey 59:40
Exactly. Yeah. Being being able to be at 90 continuously and not being like oh my gosh, I'm 20 points away from being at 70

Unknown Speaker 59:47
Oh my goodness.

Scott Benner 59:48
I don't know if this makes you feel any better. This will just be worse. But the way it makes me comfortable to think about it as this is that I don't have type one diabetes and For most of the day, my blood sugar's 85. That there's a large group of people who don't have type one who they throw in glucose monitors on, who will experience blood sugars of 64, sometimes hours at a time during the day. And really, yeah, and that you're not going I know this is like, I don't usually say this out loud. But your blood sugar's got to be pretty low for you to have an actual seizure. And if you're going to be with your man and trying this thing, you know, I don't you know, it's going to be different for you in the beginning, because your I think your body is going to be accustomed to higher blood sugar's so you might have to do this in segments, because you might get the 150 or 140 stable and feel low for a while. I don't My gosh,

Kelsey 1:00:46
yeah, that's so funny. You say that. That's exactly what my, my endo, in my, in my psychiatrist said, She's like, you will feel low, because you're so used to running so high.

Scott Benner 1:00:57
Yeah. And that's your body actually trying to you ever, ever hear somebody talk about the idea of like, your body is trying its hardest not to die. So when you start doing something that's killing it, like having blood sugar's high like this, it tries to adapt to it, it tries to live with that longer. And so there's something about the way your blood vessels are blocked, I don't know, again, not a doctor, something about how your blood vessels are helping you to not feel high blood sugars, will then it'll feel it'll feel normal blusher normal blood sugars as lower blood sugars for a little while I've seen I've seen people get through it in a couple of days, I've seen people take a week or so. But you know, I would, I would definitely expect that to happen. But you're gonna have to prepare yourself mentally, like I'm not actually low, I just, this is a feeling I'm having because of this. So maybe you're gonna want to, maybe you're gonna want to titrate this, maybe you're gonna want to start on a Friday and go, you know, just start with a one unit across the board for 24 hours, and live like that for a couple of days. And then push it up a little up a little up a little and just keep bringing it down slowly. I mean, maybe that really is the best idea for you. Again, I'm not a doctor. Just

Kelsey 1:02:09
know. Yeah, that's, that's essentially what they want me to do is they call it exposure therapy is to see that, again, retrain your brain and to be like, okay, Matt 110. And eventually your brain will learn like, okay, like, you're you're not dying. You can be here and you can be fine,

Scott Benner 1:02:30
right? No, I mean, and so I think and if that's what you're going to try, like forget everything else I said, if you want, that's fine. But if that's what you're going to try, I still think a stable basil rate across 24 hours to start with, is a great way to start. Because if you try to start, if you try to start adjusting off of 123456 different basil rates, the variability, they're so great, you're never gonna figure it out. I'd rather see you set it at one, and then come back and say, You know what? One is keeping me super stable at 140. This is terrific. But while I'm at work from three to seven, turns out I needed to be more like point five now or something like that. Like, like, it's so much easier to figure those things out when you're starting from one basil pro one Basal, right? I think

Kelsey 1:03:20
Yeah, no, that totally makes sense. That way, you can see exactly where you look fluctuate and from what time to what time.

Scott Benner 1:03:26
Yep. And when you make that adjustment, just remember that. Just like just like your Bolus insulin doesn't go in and begin to start working immediately. Your basil doesn't either. So if you are consistently getting higher at 3pm, or consistently getting lower at 3pm, you need to change your basil more like at 2pm. So that it has time to either ramp up the stock to high or to start titrating down to get in the way of allow. I'm telling you, I think you might really love the pro tip episodes. Yeah, I'm definitely gonna listen to that. Like, as soon as we're done here. But you already then apologize to the paramedic for me. Is he an EMT, or a paramedic? I forget. He's a paramedic. I apologize to him. Because the very likely days from now you're going to be like, you know, Scott says, and he's gonna be like, please stop doing that. Yeah, yeah. Trust me, I get a lot of notes from people are like my husband's tired of hearing your name. I I'm sorry. I know, I, there's part of me that wanted you just to explain your whole thing and go on. And then like, halfway through, I was like, I wonder if I couldn't help her. get through this. So I shifted my gears a little bit. Is there anything that we didn't talk about that you wanted to?

Kelsey 1:04:40
Um, no, I think we basically hit all the points that that I wanted to talk about.

Scott Benner 1:04:44
Cool. That's amazing. How do you feel after like making like some sort of a, even though it's just a kind of a subconscious decision, like I'm going to I'll try that. Does it make you nervous? Or how do you how do you feel about it? Um,

Kelsey 1:04:57
I feel good. I want to say I feel I guess the best word would be empowered going forward? Because I'm like, Okay, you know what, I have a plan. I'm a planning kind of person. So having some kind of timeframe and a plan of what I'm going to do, what I can do, really actually helps me quite a bit.

Scott Benner 1:05:18
That's excellent. Can I ask you? It's a little off topic, but not really. Are you an anxious person? Aside from the diabetes?

Kelsey 1:05:26
Um, yeah, I would say I'm a little bit more type A, I definitely like to have, you know, a plan and then 15 steps if that plan doesn't work out.

Scott Benner 1:05:41
You got lists of things around the house? Yeah. Yeah, pretty much. Yeah. My wife hands me lists a lot. And I'm like, What do you need for me on this? And what I've learned over years, is she just needs to see me crossing things off the list.

Unknown Speaker 1:05:56
So I'm telling you, that's the key. Yeah.

Scott Benner 1:05:58
Please, if she ever hears this, there are times where I can't get this something off the list. So I'll start a second list of things I need to remember to do and put my line through on her list so she can feel better about it. Turns out it doesn't matter. By the way, if you do the stuff on the list or not. Yeah, yeah. It's meaningless. Different different. Write something on a list. Never get to it. Find the list a year later and go, Oh, I never did that. Oh, yeah. And then realize you're still alive and nothing has changed. Yeah, exactly. Like, oh, I guess it was fine that I didn't do this. Yeah. It once you get mellow in that space, now you're living in my head, where I'm just, I just keep I do actually keep a list of things I need to do. But I keep it very flexible. And something that's at the top of my list today could easily end up at number 10. And something at 10 could add up at one I just stay. I try to stay flexible with what what the needs are around things. And I think of diabetes the same way as a matter of fact. Yeah. I'm super, like, hopeful for you and really interested, I am really serious. Would you keep me in the loop on this? Like you don't have to report in but if this works for you, or doesn't, would you let me know because this episode won't go up for a number of months. And I'd love to be able to put like a, like a follow up email at the back of this and let people know how it went for you. Oh, yeah, absolutely. I'd love to do that. Thank you very much. I really do appreciate that. So as we say, goodbye. What kind of dog Did I make you take out of the room? It sounds like it

Kelsey 1:07:16
sounds like dogs actually. So one is a basset hound, and one is a German Shepherd.

Scott Benner 1:07:22
I thought was the was the shepherd the one that barked. Yep, dammit. I thought that sounds like a German Shepherd. I should have settled I would have seemed like a genius. Now it just feels like I'm making it up afterwards. Damn it. Damn Damn. Well for anybody else who thought it was a German Shepherd. I was with you. Beautiful dogs.

A huge thank you to one of today's sponsors. Je Vogue glucagon, find out more about chivo hypo pen at G Vogue glucagon.com forward slash juicebox you spell that? g VOKEGL Uc ag o n.com. forward slash juicebox. Thanks also to touched by type one. Don't forget to find them at touched by type one.org. And of course those diabetes pro tip episodes can be found at Juicebox podcast.com diabetes pro tip.com. are right there in your podcast player, beginning in Episode 210. Thank you so much for listening. I'll be back very soon with another episode of the Juicebox Podcast.