#597 Does Jenny Burnout?

December 20, 2021Scott Benner

Scott and Jenny Smith, CDE discuss burnout, restarting T1 management, the past year of the podcast and whats to come.

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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 597 of the Juicebox Podcast.

We're just gonna have a few more episodes in 2021. And I thought we'd go out on a high note with Jenny Smith from the defining diabetes and diabetes pro tip episodes. You love Jenny, you know, Jenny, and today you're going to talk to Jenny. Like she's just a regular guest. Yeah, sort of. I'm going to ask Jenny, a question about diabetes burnout. And then we're gonna chat about what we've done this year and things we have planned for next year, etc, etc. So on and so forth. Please remember, while you're listening that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, please always, also consult a physician before making any changes to your healthcare plan, or becoming bold with insulin. If you find yourself with a few minutes, and you're on your sofa with your phone, go to T one D exchange.org. Forward slash juicebox. They're looking for US residents who have type one diabetes, or who are the caregiver of someone with type one to answer a few questions and a quick survey that benefits people living with type one diabetes, and the Juicebox Podcast, T one D exchange.org. Forward slash juicebox. This episode of The Juicebox Podcast is sponsored by Omni pod, head over to Omni pod.com Ford slash juice box to get started, learn more or find out if you're eligible for a free 30 day trial of the Omni pod dash. This episode is also sponsored by touched by type one, to learn more about them go to touched by type one.org or find them on Facebook and Instagram. All right. So here's the good news. It's the end of the year. I'm not gonna ask you anything, you're not gonna need to know anything technical. I'm just, we're just gonna talk again, because we haven't talked for a while like people on on the podcast. So yay, I do have a little bit of a, an angle. So okay, we'll see how it goes.

Jennifer Smith, CDE 2:23
There's always an angle there's got to be.

Scott Benner 2:27
So it's got to be about something. But before we start on that, I just wanted to ask you. I wanted I guess I kind of wanted to get your opinion about how all this is going like you and I have been at this for a while now. Like I think we started making the protests in 2019. Maybe that sound right? Yeah, that

Jennifer Smith, CDE 2:46
sounds about right, I think Yeah.

Scott Benner 2:48
And, you know, for people who, like, are just jumping in and listening. I think it's about time that I explained again, that just so people understand like, Jenny doesn't work for me. Like she's not. So So I want to give people the background for a second because there are a lot of new listeners since 2019. I don't know how long ago now maybe in the first year of the podcast in 2015. Jenny just came on as a guest. And I remember talking to her and having a really good time. And I left the the podcast episode feeling like Wow, I like that person. And I really agree on a lot of stuff. Stuff that I don't normally hear people talking about around diabetes,

Jennifer Smith, CDE 3:33
right, I believe it was it was about a one C, if I remember correctly. It was about a one C and the grander picture of a one C and the other things to consider. And even things like what's now known well, but things like time and range and standard deviation and all of those kinds of things. Right. So yeah, that was a long time ago, gosh, trying

Scott Benner 3:58
to see when it was see if I can pull it up. But I always do this, I always searched the wrong. There's such an easier way for me to do this. And I always do it the hard way for some reason. And the other thing about that episode is that while we were talking, I was saying things, you know, that I talked about and you weren't treating me like I was a lunatic. You were like, No, that makes sense. And you know, even though I was speaking about it probably differently than other people do. And we're kind of like, I don't know, blue collar simple terms or stuff like that. Like, I never got this feeling back from you. Like you were like, Oh God, what is he doing? You know, like you were like, No, yeah, right. It was all about a one see with Jenny Smith CDE it was actually April 6 2017. Okay, was that maybe yes.

Jennifer Smith, CDE 4:43
That would have been right because it if I remember, even remember the office, like I remember sitting in that office space, which it was a different house than we have now. And our little boy Who is he'll be five in January this year was just he had just been born.

Scott Benner 5:06
Well, both of our memories are failing us, because that was the second time you were on. Really? Episode 105. That episode in 2017 was the second time you're on the time I'm talking about with episode 37. November 10 2015. She really just a guest on the show the first time. And then I asked you back to like it two years later, because

Jennifer Smith, CDE 5:32
that was so memorable. Oh, no,

Scott Benner 5:34
no, no, you are you stuck in my head the whole time. But I kept like thinking like, I can't have the same people on over and over again. But it just seems so important that when I had an angle, I was like, let me bring Johnny back to talk about a one C, then after that, that's when apparently it takes me two years to do everything. Because for that entire like, next two years, I kept thinking, Where does Jenny fit? How can I get her to come back on it, you know, and keeping in mind too, that it's not your job, and I'm not paying you to do it. And so you can't just you don't want to intrude on people's lives. And then I sent you a note. And I said that I thought there was a collection of ideas within the podcast. And I want to talk about them singularly. And I think I sent over like the seven like, like broad topics that I wanted to cover. And I knew that you were the right person. Because you when you email me back, you're like, actually, there's 10. And I was like, oh.

Jennifer Smith, CDE 6:36
And I put them in order. Like we have to start here and then go here and then go here. And

Scott Benner 6:41
then you reordered them, which is something that I think we all know from listening to this podcast that I never would have done, I would have been like, look, pick through them, like don't bother. Which doesn't make a lot of sense. And then we kind of set off on making those pro tips. And I mean, I guess we both thought they were gonna be 10 long. And I we got them done pretty quickly. Jenny was a trooper like we recorded a number of hours a lot over in a short amount of time. But and I mentioned this all the time. We never spoke about it prior. So every pro tip episode you hear is just me going like Hey, Jenny, let's talk about Pre-Bolus thing today. And this is our topic, kind of just focusing for a second and then doing it. Literally no first sentence, no bigger idea about what we were going to do. And I'm very happy with them. I think they turned out really well. I also have to say that at this point. There are way more than 10.

Jennifer Smith, CDE 7:43
Because just in the pro tips. Yeah, I'm going

Scott Benner 7:45
to look to see how many. Well, you've just done. We just recorded two more that the people two more will hear pretty soon after this comes out. But 210 is newly diagnosed or starting over 211 is all about MDI 212 is all about insulin 217 Pre-Bolus 218 Basal 219 pumping. Oh my gosh. 1234567. All right, hold on J 123456. All right, I'm up to six when I do pumping, you count on your fingers the next seven okay. 220 fours mastering CGM to 25 is bumping nudge to 26 is perfect Bolus to 2231 is variables. To 37 is setting Basal insulin to 56 is exercise. 263 is fat and protein 287 is illness injury and surgery 301 is glucagon and low Beegees. Now this isn't a 2020. So that's 15 Okay. 307 is emergency room polar protocols. 311 is long term health. 350 is bumping nudge to 364 is pregnancy 371 is explaining type one. 391 is glycemic index and load 449 is postpartum and 470. is weight loss. How many is that? 23. Okay, and that took us into April of 2021. That's the last time we put up a pro tip was in April this year. Okay.

Jennifer Smith, CDE 9:22
I know we talk and do things all the time. So we must have been doing a variable since then. Yes.

Scott Benner 9:28
Yeah, we smoke all the time with the variables this year. And then what did we just record?

Jennifer Smith, CDE 9:33
We just did? Hormones, hormones. And we did. Did we do we did alcohol to

Scott Benner 9:40
menopause? No, wait. Menopause wasn't a protip alcohol. Maybe alcohol was

Jennifer Smith, CDE 9:45
a longer variable. I know we did alcohol as a separate longer, but I don't know if it was a variable or if it was a pro tip. I think it was a variable.

Scott Benner 9:54
So this should show everyone that you and I talk a lot more than they. So we don't speak Every day, we speak in like bunches, like an hour to hear an hour or two there. But you guys hear Jenny almost every week on the show. But Jenny and I don't speak every week. So I don't know why that's important. I just think people should understand that. Cool. Yeah. So anyway, those pro tip episodes are, I mean, I'm super proud of them, I think you could take them and listen and really change the way you're managing your diabetes pretty easily. I think they're cool, because you can listen to them at your own pace. It's not a class, you don't have to pay for them. You know,

Jennifer Smith, CDE 10:36
I think the other thing that's different about them, and I think it goes along with, whether it's a pro tip episode, or any other of the kind of episodes that we've put together together, is that it's not a cut and dry rip off sheet that just says, Here are all of the numbered steps to do something. Right. It's also we bring in, in a conversation way we bring in how did we do this ourselves? How, what kind of example Do we have to how this actually works in real life? And from the standpoint of just personal life with diabetes? You know, if I was somebody who I wasn't today, with the education piece that I have, I would listen to that in a much easier learning way. Then reading something that, you know, I've gotten as like a rip off document of, well, these are all the testing steps just go through them. And, you know, so personality, I think, brings a lot to people's ability to apply. Because the casual nature of discussion kind of makes it easier to make sense. Yeah.

Scott Benner 11:59
I think in a weird way, we've kind of combined storytelling with diabetes management. And yeah, that is how people's minds tend to work. So I'm super proud of them. I just looked the other one that we recorded recently. That's not up yet. his honeymoon. Honeymoon. That's

Jennifer Smith, CDE 12:13
right. I knew there was another one. And the

Scott Benner 12:15
reason that they pro tip episodes can keep growing, is because the Facebook page for the podcast is so big at this point, that it is a legitimate sample size of what people go through or think about. And so I kind of get to stand back a little bit and watch and when you see things happening over and over again, you say okay, this is a real need for people. Like it's not just it's not just a an outlying concern that a few people have, like, there needs to be a pro tip about honeymoon. It's, you know, you know, it feels super simple sometimes to Jenny and I but you know, like, sometimes we'll start I'll be like honeymooning. Yeah, just stay flexible. And eventually, the pancreas will stop working. And then you'll find level and you're done. But that's not really very helpful. Yeah, so we have these bigger conversations. And, but we never get to, we very infrequently talk to you like you're a person, like I think we did at the end of last year, right? Where we just one person I promise, Jenny's like a real person. So I wanted to ask you a question. And we're gonna get a little technical for a second, but a little personal. And then I'd like to kind of, well, you'll see where I'm going. So here's my question. You've had diabetes for Let me test myself. 33 years. Yeah, good job. Thank you. I don't know when you were diagnosed, but I feel like in my heart, you were like, eight 911? Like in that range?

Jennifer Smith, CDE 13:39
Yeah, I was I had just turned 13.

Scott Benner 13:42
Okay. And I as I started saying, eight or nine, I started adding that the 33 And I'm like, Jenny's not over 40 I was like, so that's not right. Like, like, how old are you?

Jennifer Smith, CDE 13:51
I'm over 40

Scott Benner 13:53
My heart Jenny or not?

Jennifer Smith, CDE 13:57
Not in my brain. I'm not either. It's it. I know. It's kind of like, I was looking at my number and think I just, I, I guess I have this eternal feeling of being like 32 I don't know why that number. But like, I I have a visual now being you know, over 40 that, like the 20s are a lot of growing and changing and learning and finding like, your place, right? And then I feel like the 30s are like growing in that like, you feel a lot more stable or many people do I did. You found like kind of this like, friend group. You're on this path kind of thing. And then like bolder than that, you just keep developing. On top of that. You might make some major changes, but you have a lot more. You've got a lot more hindsight to make better decisions in those changes than you did when you were like 26

Scott Benner 14:58
I don't think if the internet was only full of people in their 40s There'd be much less arguing, like, for some reason, because you just be like, Oh, no, I see where this is going like this. We don't need to talk about like this, we can be kind over here, you know, or whatever.

Jennifer Smith, CDE 15:12
As long as they're not politician, yeah.

Scott Benner 15:15
I so I agree with you, I, I felt the very same way about like you're kind of building on yourself through life. But the reason I asked the one to give context to how old you are, and how long you've had diabetes, because you started out, you know, as a child, you know, taking regular an MPH, right? So and yeah, I

Jennifer Smith, CDE 15:34
didn't I did regular and then the same as NPH. It used to be called L or lenti. And it was made by Lilly, of which it Yeah, it's now enter MPH is the only what was called an intermediate acting insulin on the market. You cloudy had to roll it and mix it.

Scott Benner 15:51
I can remember my friend Mike rolling his insulin. Yes, yeah. But But you've lived through pretty much every modern change. Yeah, variation of diabetes management. Mm hmm. And I guess I'm wondering because, you know, well, because of the, of what we do here together, it could be easy for people listening to see us kind of two dimensionally, right. Like, you know, I think people think my daughter's blood sugar doesn't go over 85. And that's not true. And you have to tell people that but but the one thing I want to know is, is it Have you ever experienced what people classically call burnout?

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Jennifer Smith, CDE 18:59
It's a good question. And I've it's not that I haven't thought about that myself. I mean, I've seen the burnout books. You know, there's a lot of there's a lot of resource in terms of burnout, but I don't I don't honestly know, I don't feel like I've gotten to the point of burnout. And I don't I've asked myself I'm like I don't I don't know why. I don't know why I just don't do some of the things that are typical for burnout habit or burnout tendency. I had a friend that I met in a diabetes training camp as an adult and I think her sort of acronym was PMA positive mental attitude. And when she brought it up at Camp I never thought about like applying a term to kind of how I think about things. But even before diabetes, and I have memory of that, because I was certainly not young, young, right? I am typically a pretty happy person. And I don't know if that has something to do with it. I don't know. But I, I also was the person who went to college knowing what they wanted to do. I had a defined path, I knew that it was gonna probably take some turns and angles and wasn't going to get there directly after graduating from college. Right. But I think some of my positivity goes into how I talk to people and teach people. And I felt long term like I had a really good diabetes educator to begin with. I had a really awesome dietician. I don't know if I hadn't had them as good bass. Would I have even decided to go into this as a career. Because at that point, when I was diagnosed, I actually wanted to be a veterinarian. Okay. I had done stuff with our local veterinarian, I had done some, like volunteering in the office, and then loved my dietician loved her, and transitioned in high school to thinking, Well, gosh, I really like nutrition. I really like where this can put me. And I felt even at that point that I wanted to give back. I wanted to be able to teach people like, why I could do what I did. So I don't

Scott Benner 21:43
know. I wonder if you know about yourself that if you were very angry, because I've spoken to you privately when you've been upset about things are sure pissed off, if you were very angry, and I shut the audio off and could only see you, I would have no way of knowing you're angry. Like you smile through anger. Like I don't even know if you're aware of that or not. Like you don't you never look unhappy, which I think is also why I think of you as younger. Oh, well. That's a good thing. Yeah. And, and I take your point. And, you know, from my perspective of talking to, I mean, at this point, there are probably 60 episodes that have been recorded that aren't out yet. So I've probably spoken to like 700 people who have diabetes or love somebody who has diabetes. And recently and I've talked about it in smatterings on the podcast. But recently we found out kind of out of nowhere that my mom had cancer, that she had just been healthy. And then she didn't. And then she wasn't, and she's had surgery since then she did really well through the surgery. And she's got chemo coming up in a couple of weeks. And, and so she's doing very well for her situation. astoundingly well, she's 79 years old. But as I was taking your home one day, from a doctor's appointment, like in the car, I felt like I was talking to my kids was very strange. You know, you get your kids in the car, and you're like, let me explain something to them why they can't get away. And I said to my mom, I said, Mom, I've spoken to a lot of people who have lifelong illnesses. And if you ask me what the biggest differences between success and not being successful, I said, I can't believe I'm saying this. I think it's attitude. I just think it's desire to fight an attitude, and not falling down a well of despair. And now, there are some people who are predisposed to that, right? Like some people are more predisposed to depression or anxiety and a lot of things that make diabetes more difficult, right? Correct. And as I asked you the question, have you ever burned out? In my mind, I thought, There's no way she has like, you just, it's not. It doesn't seem like how you work. But but that's not to say that a person that it happens to, is doing something wrong, I just, I just think that outside influences hit you. And the chemical makeup in your brain responds the way it responds. You can't tell you can't tell a depressed person not to be depressed. Right? Right. No, right. And you cannot and you and I don't think you can tell a person who has no inclination towards depression. Go ahead and get depressed because I grew up as broke and kind of destitute at times, as you can imagine. And I've never felt depressed in my life. Really? You know what I mean? Like, and I've had some pretty bad things happen to me. And I've rebounded from them pretty quickly, not effortlessly. They were difficult, like personal like things to write. But I think people just get they can't help it. Just pull out a dream, you know?

Jennifer Smith, CDE 24:44
Yeah, I mean, I can think back honestly. And I've read I mean, I remember my diagnosis very well. I remember being in the hospital at that point. They kept me in the hospital for an entire week. And even even in the house As my friends came to visit, and I had a room full of balloons, and you know, all of that kind of stuff, I never even at that point, I don't remember, maybe I was, but I don't remember being angry about being diagnosed with something that now is going to be a daily thing to manage. That means like being handed like a newborn baby and be like, Here you go. Figure it out, because it's all brand new. And it's all up to you. You know? I mean, I did I have really good support from the beginning, did that make a difference? I have to say that that was at least a good piece of why I started out managing the way that I did. And even at that point, management was very simple, right. And I was diagnosed at a point in which glucose monitors, home based glucose monitors had only been on the market for a couple of years. It was hadn't been a long time. But I never remember being angry about it. I can remember situations that made me angry. At more like a person, like my mom, for example, in high school, I so wanted our, our, our boys, varsity team made it to state. And it was in a city that was about an hour and a half away from where we were, and all my friends, they had all like put in and like gotten a hotel room to stay over. It was one night, and then the next day as well. Everybody was going to go right, I thought everybody was going clearly that only meat was staying home. But my mom was like, Absolutely not, you're not going you know, all these things. And I know a piece of it, that she'd never said, I'm worried about your management. There are all of the other things that were brought up. But in the back of my mind, I had a sense that a lot of it was her worry that nobody else would know what to do to help me which wasn't really the case. I mean, I'd really good friends who knew signs and symptoms of low blood sugar, they knew I had like, raisins in my pocket and stuff, right? As well as parents, you know, their parents who I had slept over at houses, and they knew how to help me and what to do, but I was not allowed to go. And I remember being irritated. Not that I had diabetes, but that I think that I thought that my mom thought that was enough of a reason to be like, you can't go

Scott Benner 27:39
it's not safe. You know, hold your

Jennifer Smith, CDE 27:42
I was a senior and it would have been I was probably eight teen because it was my senior year in high school. Okay.

Scott Benner 27:51
So you know, I have to name this something specific. But if I didn't, it would just be called Jenny has raisins in our pocket. You don't get I don't get to be on the episodes where people name their own stuff by saying crazy things out loud. But you said you feel like that's as close as you came to being upset?

Jennifer Smith, CDE 28:12
I do. I really do. I mean, even through like another point that's is since I work with a lot of women through pregnancy with type one, right? I think that I could have been irritated about it during my pregnancies. Had I not had a good MFM team that really outraged outright told me they were like I you know, outside of your diagnosis, I wouldn't have you coming to a high risk clinic because you're doing a really good job of managing, like, you know, your visits here are not really as necessary, because of everything that you're doing. Could it have been different though, if I had a team that really didn't respect what I knew how to do? Sure, but I think I don't, I don't think that I've been angry about the diabetes, I would have been more angry about their interaction with me, it's

Scott Benner 29:11
interesting to me because there's so much about us that it's out of our control. Like you're also like, you know, you're generally speaking a lean, athletic person to like if you had a different body style, it could be different for you just as sure theme as if the chemical makeup in your brain drug geared more towards being sad about it. Like it's, you know, one size doesn't fit all for everybody, obviously, but I just wanted to ask you if it ever happened, and now that we say that it hasn't. How do you help people with it when it does happen? Because now you're more clinical and less like it's not your personal experiences come through other people now instead of through yourself, right? Because you speak to a lot of people I imagine this Yes.

Jennifer Smith, CDE 29:50
Right. A lot of people.

Scott Benner 29:52
Yeah. It is interesting for people to know that like, like my personal experiences that come through my life. are one thing, but now I have personal experiences by talking to other people to like I keep opening up my perspective by meeting more and more people, right? I had a person asked me kind of privately the other day, they were surprised that there was a afterdark episode about heroin use. And I was like, I was like, I don't know why you'd be surprised by that. I, you know, I was like, this is a person, this happens to people, it happens to people who have diabetes, like, don't you want to hear what it's like, so that you can expand your knowledge of things? So I just think of that as well, like, how do you deal with burnout? I guess a it depends on who you are. And, you know, like, and what your scenario is, do you have support from other people? Do you have good tools about there's part of me that thinks that a lot of burnout is avoidable? Just by understanding how to use insulin? I think that you know what I mean, like, it's almost like, right, it's almost like being tortured. When you don't know how to use your insulin, right? Because your blood sugar goes high, you have all those cloudy problems in your head, you end up you know, doing something about it, some people just leave their blood sugar high and give up. Some people Bolus like crazy, make themselves low get caught on that, you know, that bouncing up and down. There's so many different aspects that start to feed into it as it as it happens to you that if you can just avoid it. I think that's a big piece of it. Now, you might burn out on the on the necessity of what you have to do to avoid it,

Jennifer Smith, CDE 31:24
to avoid it. Right? Well, and that's where I think taking into consideration understanding of, you know, we have a huge list of variables, right things that we discussed things that people wanted to address, because they thought that they were variables and whatnot. But I think when you understand the variables that are in your life, like, I am not a mountain climber. Is that could that be a variable? Things like altitude and whatnot? Yes, absolutely. But in my day to day life, that is not a variable I have to consider. So I think some of the burnout comes from maybe not knowing enough of the variables that are your consistent things. And it takes time, you you have to learn to manage around those that are yours on a day to day or week to week kind of basis. But I think burnout comes more from, as you said, the up and down swings that look like there's nothing different that you can do that you've tried this, you've tried that and a big one that I see it happening is definitely parents. And I think a big piece in that picture. And it kind of goes along with adults to is overnight, when you're supposed to be sleeping. That major shift in glucose that has you up every couple of hours or the worry that Well, I adjusted. And now is it actually going to work the right way I have to get up again, I have to get up again, are alarms, nuisance alarms that are you know, they become a nuisance. Really, it's not that they're not necessary and beneficial. It's that they're they become a nuisance. They think the overnight time period is, is a place that burnout is most likely to come from, because not only are you managing something that looks really erratic at one point or another, but you're losing sleep. Yeah. So you're not getting this like revival overnight, which is what your body is supposed to be doing to get you ready to take care of the things the next day. I think many people can deal with the ups and downs in the daytime. Because you're supposed to be awake. Yeah.

Scott Benner 33:42
They it's so it's heartbreaking. I mean, I'm not. I'm obviously not bragging but I was away from Arden all day yesterday, we my mom is moving out of her of her apartment and going to an assisted place to stay while she's getting chemo. She just lives alone still, and we didn't want her to be by herself if the chemo might make her sick. Safety. Yes. And so I was gone yesterday for I mean, nine or 10 hours, like out of the house. And Arden went and got she got her prom dress yesterday. So there was some adrenaline that they handled pretty well. I think I sent one text and I was like here do this just because I don't think either of them thought that it was going to be super exciting to go get a dress but I had in the back of my head, there's a variable. And then they went to a meal later which my wife and daughter did a great job of bolusing for and a couple of hours after the meal. I started seeing a rise that I knew was fat. And I sent a text and I said you know have you done anything about this rise? And my wife said yeah, we added 10 carbs to the meal because she's looping and I said that's not gonna work because the the fats gonna act like its own separate meal. And I was like so just I just picked a number out of my head based on. I mean,

Jennifer Smith, CDE 35:02
just based what she had probably, I don't know what an experience I have

Scott Benner 35:06
no, I gotta be honest with you have no idea what she ate. I looked at the angle of the Dexcom graph and the number and how long it had been since she ate. And I said, Why don't you put a I think I said, 20 carb Bolus here like it's a new meal. And then by the time I got home Martin's budget was like, 84. Mm. Right. And

Jennifer Smith, CDE 35:24
but that's also hindsight. It's not like you've never seen graph happen like that. So you're, you know, even not really consciously acknowledging it. You're kind of going into the recesses of your brain thinking, this is more, it's about this more from previous experience of what I've had to do at this point of the day. Yeah,

Scott Benner 35:46
yeah, I basically said 20 carbs, she's like four and a half to one. So I was like, I actually was in my car. I was like, four 812 1620. You know, like, I just kind of I wanted to have about five units is what I thought, which is why Yeah, 20 carbs. And it's just the I've also seen the fat from these things kind of rest in the 20 to 30. Like, grams of fat. But that's not my bigger point on second. Excuse me, this is this could be it. I doubt it. He imagined. But anyway, it it. My point is, is that there are plenty of people who see that rise and stare at it and don't know what to do. Don't understand about fat impacts, like, you know, because you go to a restaurant, there's like, you know, don't think about how salty restaurant food is that dehydrates you. Like there's all kinds of things, right. But I've seen it so many times. Now. I just know what to do. And I think other people could get into that position as well. And I know you're in the rest of the time that we're talking. I just I'm thinking it's the end of the year, beginning of the year here. I was wondering, if, if someone's listening to this, and they either want to figure something out, start over, put an end to whatever madness is going on in their life. I just thought we could spend a couple of minutes here at the end just telling them maybe, you know, I'm not into like New Year's resolutions, but, you know, like, where to start to start over again.

Jennifer Smith, CDE 37:19
Yeah, I mean, well, I think a, an easy one, quite honestly, if they're gonna stay with information from a podcast, they could easily just do the very first pro tips, honestly, which is like newly diagnosed or starting over, right? It's a what, what do I really need to look at? I mean, you're motivated enough to say, I have done I'm so burned out on this up down that I can't figure out and nothing looks like day to day is ever the same. Then starting over by saying okay, well, maybe you need to simplify things a bit, right? Maybe you just need to go to K I am just going to eat like three meals today. And I'm going to see what happens after the meals whether you're injecting insulin or pumping insulin or you got some algorithm driven kind of you know, management if those are your big pieces that the roller coaster starts after address where that starts right for many people it's definitely meal times. If it's not, you feel pretty good about the daytime but it's the overnight that you're like, I have got to get sleep please let the you know Sandman dust calm and let me sleep tonight. But then, you know, maybe that overnight is oh gosh, I don't know what's wrong. So maybe I have to do a Basal test. So if you simplify down to a point of time, versus the vast like whole 24 hour for many people that it makes it more doable Yeah. I think

Scott Benner 38:56
that and I wonder if you agree but for all the graphs that I've seen, and I used to just see them when people sent them to me but now the Facebook page is like people post a lot of graphs This is crazy. I've been drinking water the Hold on What I would say is without seeing your graph or knowing your life if you're struggling like this, Jenny's right on like your either your Basal is bad and it just could be better or you're bad at meals like like just bare bones like I know we don't usually talk like bad but like, like just just to kind of shock you into place. You're either not Bolus in your meals correctly with timing or amount, maybe both. And if your Basal is wrong, those meals are going to be more difficult it's super easy overnight to find stability because there's no food in there. Now there's sometimes there can be growth hormones and but but you're looking for long stretches without meal insulin or food where there's real stability like stable blood sugars, you're not fighting lows, you're not fighting highs you're sitting, and you have to decide what that means for yourself, I can tell you in my life, I think my daughter's Basal is perfect when her blood sugar sits in the, like 8090 range, like right in there. I'm pretty good with that. And then from there, if you're eating and blood sugar shooting straight up, well, you didn't Bolus, right, you know, like so learn about and some

Jennifer Smith, CDE 40:22
of that might be from ratios that you've been given that aren't absolutely correct at all right, it might just be recognizing Well, I've put into action, I've heard all this about Pre-Bolus, I've put that into action, and my blood sugar doesn't even move when I Pre-Bolus 45 minutes, and it's just sitting there. And then I can eat and it still rises Well, you know, there are a couple things to look at there. So your settings

Scott Benner 40:47
need to be like all of this is predicated on your settings being right, meaning that your Basal set where your body needs it, meaning that your insulin to carb ratio is at a place where it's going to be effective. And you need to start understanding that all foods aren't created equal. And you might your carb ratio might work great for I don't know, like, you know, some natural food that's, you know, just a, it's just what it looks like on the plate versus, you know, having something processed, that you don't really know what's in there, the impact it's going to have, like, they can tell you how many carbs are in it. But that doesn't mean it's going to impact your blood sugar commiserate to the carb count. Right? But, but Jenny's point is right, like we can sit here and kind of like spit ball around. But the truth is, is that the answers are in the Pro Tip series already, like I could, I could just, it's there, like you have to go listen to it. But that's the part that I wanted to, I wanted to say, because I do see online that people get can get so frustrated or so far into the weeds are so tired that even saying to them look in these, you know, six or 10 hours of listening to a podcast? Or the answers, they'll say I can't do it. Like I'm into that I have to say to you, like I understand, but I think he can't afford not to do it. Because you just you just gonna be lost forever the way you are right? Like, yeah, you have to take a stand somewhere and say, Alright, I'm going to give away some other stuff in my life, I'm going to and I know, you've probably heard a million things about diabetes, you think Well, I'm gonna hear one more thing, it's not going to help, this is really going to help if you listen and understand those pro tips even, I don't know 50% understand them, your ACE earring, once he's gonna come into the high sixes if you really understand them, it's going to come into the lower sixes. And when you really start putting it together, I mean, there'll be a time in your life where you could have a five without trying.

Jennifer Smith, CDE 42:40
And I think the good thing about the pro tips episodes are really two that again, in conversation, we bring in other pieces that could be being considered right things that might be other variables that are hitting just you right, are, are all of your labs, like your thyroid, is that in the right place, because there are a lot of other health related things that despite all your best efforts with your diabetes management, and testing and evaluating may actually be making diabetes management more ragged, it might be making it harder for you. So you know, while type one is typically, you know, the focus is on blood sugar and insulin and everything. Well, if you have type one, and another autoimmune disorder that isn't managed, that could be a piece in the mix, too. And that's leading to your being frustrated with what you thought was right. Yeah. And actually should be right. And it's not. Because of this other thing.

Scott Benner 43:41
I can't say how much compassion I have for that feeling of like, I'm doing everything I was told to do. And nothing's working like I am. I have so much empathy, if that's happening to somebody. Because it's maddening. It really it just it's maddening. Well, in 2022, so Jenny, and I have kind of have, we have a plan, but we're going to do some, like addendums, or add ons to some of the pro tip episodes to kind of like take deeper dives into them. And I think I'm going to try to sneak in a defining series around thyroid terms to because over and over again, I just see people I don't think I don't think that many doctors do a good job of explaining how important thyroid management is to people who need thyroid medication. And you

Jennifer Smith, CDE 44:29
did you you talk to someone right? You talk to a physician,

Scott Benner 44:34
her episode is terrific. But I want to do like just i What do I want to say when people come in to the show? And they're like, where do I start? Like it's easy to say listen to the pro tips. Right? It's but there's some people are so newly diagnosed are so confused, that they need someone to go through and define like, like you can't just hand somebody a toolbox. You have to say to them, this is a hammer. You hold it in your hand like this, and this is how it strikes nails. Now, when you hear that you need to use a hammer, you don't go I don't know what a hammer is. You like the definitions essentially? Yeah. So I think we need definitions around thyroid stuff too. And and then I think towards the end of the year, when that's all done, I think I'm going to reinstate ask Scott and Jenny, if we have time, cool. I like it when people send in questions. And we

Jennifer Smith, CDE 45:23
know the questions are great. I love and as like, as you said before, I mean, I don't work for you like, this is purely because I can't duplicate myself, I can't see enough people. Privately I am, this is a way that I feel like that original feeling when I went to college, to get to this point, I wanted to be able to teach people that there was there was management, there was a sense of being able to feel like you've got some peace in control, right. And I like I don't know, I like doing this because I, I hear back from Scott all the time, about people's comments and things. And I'm glad I'm glad to be able to do something like this. That gives out into the world people I will probably never meet information that I hope is beneficial to helping people live well.

Scott Benner 46:26
So I know that that's how you feel because you've, you've just echoed that to me over and over again over the years. Because there's times that I've said to Jay, like, if I'm taking advantage of you just say no, like, you know what I mean? Like, and she's always like, no, I really like doing this. And you know, this year, if I showed you a chart of the downloads every day, this year, 365 of them in the last half of this year, the show has doubled since the first half of this year. And I was thrilled by how many people listened to it in the first half of the year when not what I was like what is happening. So to your point, like Jenny could say to you like she could come on here and say, this would not be uncommon in in just not the diabetes space. But in the health space, where people jump on to programs like this, where they know they're going to reach people, they say some basic stuff, just enough to whet your whistle and make you think, ooh, that lady knows something I need to know. And then they draw you in and say, Okay, now pay me and I'll tell you the rest of it. And in fairness, Jenny, this is what you do for a living. And yes, yes, but there's a whoever you are inside, whatever makes you smile while you're angry. Jenny just wants to reach as many people as she can. She's not saying I only want to reach the people who are going to pay me and she thinks that this podcast is a valuable way to do it. Is that fair to say? Yes. Yeah.

Jennifer Smith, CDE 47:44
valuable way to provide again, I mean, the especially reaching more people around the world now, which I know that you are, which is great. I think resources around the world are different country to country. And they're different enough that having worked with people outside of the United States that people really value information that is right, but also information that they can apply. That's not just a standard form of do this, do this. And it should work out or getting the other statement, which I hear often from people, which is Oh, that's just diabetes. No, really. I mean, sometimes there are I call them bad diabetes. Herodias. Were like, I've thrown every magic potion at this. I put all the mousse into it. I don't know what the problem is today. But you know, even those I like I compartmentalize them, right. It's okay. And then tomorrow is another day, right? Yes, I just go forward. I'm like it was done. Today. Looks great. Just gonna go.

Scott Benner 49:02
Yeah, everyday, everyday is not to throw your hands up in the air and give up there, though. It does happen. I mean, I I've had the same thing happen here where I'm like, Look, we changed your pump. We did everything we're supposed to do. i Let's just wait. Drink a bunch of water and try to stare at a wall for an hour. We'll see what happens. Don't think about anything, just let it go. I take I really do take your point. It's I think that the one the thing that gets done on the podcast that I'm most proud of is that, you know, I saw someone recently say to me, Well, I got a note from someone that said, Okay, ready, this person runs a Facebook group about diabetes. And somebody who listens to the podcast was on their Facebook group and someone asked a question and they answered it. They said if I was you, I'd make the Basal stronger here. And they that's not what they do in that group in that group. They would have explained to that person, very simply call your doctor and ask them and that's just I mean, that's fine. There's nothing wrong if that's the kind of support group you want to run. I'm okay with that. But you know, it's not my business. That's just not what we do here. You don't mean like, you're going to get like a concrete answer that you can go as an adult and make a decision about on your own. If you want to call your doctor, you should. But in the middle of you struggling with all the things that we just brought up, that could be going on in your life, to be told, we'll just go call a different person now like, like, Man, I'm here asking you like it. I mean, like you either have an answer you don't? I think the answers are inside of this podcast. And I'm proud of that I can't force feed it to everybody, I can't give you the time to listen, you know, all I can say is that Jenny and I have done our best to like, put out what we know. And hopefully it's valuable to you.

Jennifer Smith, CDE 50:47
And I think the good thing too, is that you don't have to listen to the whole, you know, like library worth of podcast episodes, to get it all working. If you're really struggling with one piece. I would guarantee searching in there for this topic, you will find at least one episode about that topic. And then hey, maybe your questions get answered. Right. And that's great to point

Scott Benner 51:15
of the pro tips was to put ideas in singular places, because the truth is, the podcast works the way my brain works. There were answers but you had to like listen to get them all out. And I used to just say to people, like, Look, if you listen to the podcast, you'll understand. And then at some point, I just thought there are so many episodes, like that's not a reasonable thing to say to people anymore. So that's why this stuff is here. So you have to understand how a podcast is set up, Jenny and I started putting these out in 2019, you're gonna have to go back in the podcast player and find them. I can't I can't just repost the pro tips. So for people who are longtime listeners to understand how a podcast works, I mean, I can I guess, and there's been a part of me who's thought it through? Like, can I just repost them as new so they pop up in the front. But that's very unfair to people who have already heard them. Right. You know what I mean? And I

Jennifer Smith, CDE 52:07
don't because people want new information. If you've been a long enough listener, you want something that's new, right?

Scott Benner 52:14
Yeah. And even on a podcast, like it's impolite to jam old content to people. Like, I don't want to fill your podcast player with something you've heard already. Right? Not that the contents not super valuable. But you got to go find it. And I've done right, you can go to Juicebox Podcast, comm and find it. You can search in your podcast player, you can go to the Facebook page and ask around there's lists in the, you know, on the Facebook page, there's lists. If you want it, it's there, you can find it. And if you absolutely can't find it, send me a note, and I'll tell you how to get started. But don't bother Jenny. I'm just kidding. Oh, Jen, you don't know anything about where to find the podcast?

Jennifer Smith, CDE 52:52
Oh, no, I don't I have to serve some myself. I know this was in here, or somebody will ask me and I'll be like, I'm talking to somebody. But episode was I know you talked about that and be like, I don't know. Let me look for no idea what numbers the episodes are

Scott Benner 53:07
your recollections better than mine? Like sometimes Jenny will be like, we talked about this already. You have to understand from my perspective, like wherever you're listening in real time right now. I'm like six months ahead of you. Like so like I recorded something. I'll record something tomorrow that you'll hear in like July or August of 2022. Great. So when people are like you remember when you said this this lady? I'm like, no, no, I do. He wrote me. I mean, tell me the story. I'll see if it jogs my memory. But it is not easy. Like I live in like two universes almost when it comes to this, like I'm in the present. And I'm in the future at the same time. So anyway, Merry Christmas, Happy New Year. Whatever you, whatever you, whatever anybody celebrates. I just thought, you know, it's always nice to start the new year or end the old one with Jenny. Oh, I just thought we could do that this time. Well, thanks. Thank you. I appreciate Yes, very much. Yeah, absolutely. Thank you. Bye. Bye.

Let me thank Omni pod for sponsoring this episode of The Juicebox Podcast remind you to go to Omni pod.com forward slash juice box to find out if you're eligible for a free 30 day supply of the Omni pod Dash. And don't forget to go to touched by type one.org and find them on Facebook and Instagram. I also just want to thank Jenny for everything that she's put into the show this year. And for the years before that. I guess the previous years would be the way to say that for like this year and previous years probably would have been a little smoother. I want you to know we're not like other podcasts over here at the Juicebox Podcast. Content keeps coming. I don't care if it's Christmas, New Year's, my mother in law's birthday or Halloween. Keep checking that podcast player. I'll be there