#696 Double Transplant

June 7, 2022Scott Benner

Michele had a kidney and pancreas transplant.

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Scott Benner 0:00
Hello friends, and welcome to episode 696 of the Juicebox Podcast.

On today's show we'll be speaking with Michelle who's had diabetes for well over 40 years, but most recently has had a kidney and pancreas transplant. She's here today to tell us all about it. While you're listening, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan, or becoming bold with insulin. If you're looking for the diabetes Pro Tip series that begins at episode 210 In your podcast app, you can also find it at juicebox podcast.com diabetes pro tip.com, or a complete list of the Pro Tip series and other series on the private Facebook group Juicebox Podcast type one diabetes up at the top in the featured section. If you're enjoying the show, please subscribe in a podcast app and tell a friend

this episode of The Juicebox Podcast is sponsored by Ian pen from Medtronic diabetes, vn pen is a reusable smart insulin pen that uses Bluetooth technology to send dose information to a mobile app. And I'll be telling you more about it later in the program. You can also go to in Penn today.com. To find out more. If you have type one diabetes, and are a US resident or are the caregiver of someone with type one, please go to T one D exchange.org. Forward slash juicebox. Join the registry, complete the survey. And just like that you've helped people with type one diabetes and supported the Juicebox Podcast, they're going to ask you incredibly simple questions about type one, you'll know the answers, they're not going to be difficult. The entire thing will take less than 10 minutes. It is completely HIPAA compliant and absolutely anonymous. T one D exchange.org. Forward slash juicebox.

Michele 2:32
I am Michelle. I have been a type one diabetic for 45 years. And in May of this year, I had a kidney pancreas transplant. So that's why I'm on to talk

Scott Benner 2:47
I Michelle 45 years. All right. This is oddly going to be easy. Because it's 2021. So I just take 20 away, right? And now I'm down to 25 years, then I take the one away down to no way then I'll take 20 More away I get down to 1980. And what am I left with five? Did you were you diagnosed in 1975 76? Close? I was feeling pretty good about that. All right. That's, you know, I was born in 1971. Wow, how old are you?

Michele 3:22
I am 59 years old.

Scott Benner 3:26
You weren't born that much before me. 1962. So I'm just gonna say that a little bit.

Michele 3:33
I'm proud to be this old. I'm lucky to lift as long as I have.

Scott Benner 3:38
I'll tell you right now that I know you're saying that because you have diabetes. Right? Right. And when you're diagnosed, I don't have diabetes, I feel the exact same way. I got up this morning and I was like, I had my pants right. And my back is stiff as it always is. And I think to myself, Do I like Go for it? And just like pick my leg up like a person and stick them through? Or do I lean on something just to make sure I don't stumble?

Michele 4:07
That's pretty sad, but understandable.

Scott Benner 4:13
People want to understand they get older, right, Michelle? Exactly. Okay, gives them something to look forward to. I look forward to having to consider putting your pants on.

Michele 4:26
Struggle some days.

Scott Benner 4:28
I am determined to to fix this somehow. I don't know what I'm gonna do. I'm thinking about different exercises to strengthen. I'm trying different stretches but I just My back is hurt since I was like 20 years old. So I would like that to stop one day. I would just like to get up one day and not think about that. But I'm complaining to a person who had a couple of their organs pulled out and replaced with organs. So why don't I stop that and ask you a little bit about what it was like to have diabetes for 45 years.

Michele 5:00
Well, I was diagnosed at 14. So that was interesting. Because if you're, you know, getting right into those teenage years, and now something's wrong with me, which was very shocking, because I had been held healthy, pretty healthy up to that point. So, you know, I diagnosed spent a week in the hospital went home, I only saw a primary care physician. And I would see him once a year. So he would do a fasting blood sugar. And send me on my way for with my one shot a day of beef, pork insulin. So it went on like that. Boy for probably 10 years or so. Up, a friend of mine was diagnosed. A couple years later, she was she was a semi close friend, but not real close. And she came back from being diagnosed and was like, you know, you have a lot to do. And I'm like, not really take a shot today. That's pretty much it. All I have to do. So I went on for many years really, kind of living a normal life. With this one shot a day that I had to

Scott Benner 6:25
do, yeah. But what was testing like, then, like, how were you measuring success? Or where were you not?

Michele 6:35
I basically was not. So they showed us how to do the urine test. But to me, it made no sense at all to do that, because I couldn't do anything about it. So if it came back, hi, what do I do? There's there was really nothing I could do. They didn't really talk about increasing insulin or decrease in insulin. You know, they had me on the one shot today. So it was very interesting.

Scott Benner 7:02
So you could see you take this injection, and then their advice was to do the urine test strip, and then, but then no matter how the test came back, there was no next step.

Michele 7:15
Exactly. Exactly. So I had to eat at certain times during the day because you'd have those peaks and valleys for the insulin. But I'm a pretty relaxed person. So I wasn't on a strict schedule. It was more if I felt like I was need to do something. I would eat something my mother would make me breakfast every morning. So I would have breakfast right away. But beyond that, I pretty much lived a normal life.

Scott Benner 7:43
Okay. All right, and how long with high blood

Michele 7:46
sugars? Yeah, of course.

Scott Benner 7:48
You were were those urine tests usually high?

Michele 7:53
When I did them, but I quit doing them pretty quickly after diagnosis. I didn't really pay attention.

Scott Benner 8:04
I hear you. So I get that. How many years do you think that you did that just didn't just did that contest and did your doctor ever up your insulin like based on like weight gain or age or anything?

Michele 8:18
I just saw him once a year. And I don't remember him adjusting it. It was always like you're doing fine. Keep doing what you're doing. And like I said he was a primary physician. I didn't even know about endocrinologist at the time. So he diagnosed everything from diabetes to cancer to everything in between. Okay, and

Scott Benner 8:46
let's say Say that again, for me, you saw him

Michele 8:50
from 1976 to probably through college. Okay. So ad one, ad two,

Scott Benner 8:59
so he's not an endocrinologist. He's just a row. Okay.

Michele 9:03
And just a primary care. What general practitioner,

Scott Benner 9:07
what other issues did you have during that time?

Michele 9:10
Um, really? None?

Scott Benner 9:11
None. Okay. All right. So he just didn't do anything. You just kept injecting staying high and Japanese thing. winded. I'm like, I'm guessing that the technology changed somewhere and you changed with it or No,

Michele 9:23
I changed influence. I went to the you know, the synthetic insulin versus a beef pork. When that was available. I saw my first endocrinologist in the 80s because I went to was going to grad school. And I lived with my brother and sister in law and my sister in law was a nurse. So she recommended seeing an endocrinologist, which I went to his reaction was pretty much if you don't fix this, you're gonna die. Okay, and I, because he had me start doing finger tests, like at that point, the finger testing was available. So I would do it. And he had me doing it three times a day. And it was always in the two hundreds. But again, he didn't tell me what to do. And it was a little bit longer till they had that sliding scale, where if your sugar's this, take a shot, if it's this take a shot. So he didn't really give me a whole lot of information. So go ahead. Did you?

Scott Benner 10:33
Do you remember having any feelings about the information that you had gotten prior from the other doctor at that moment?

Michele 10:41
It was kind of shocking. It was like, Oh, I'm supposed to be doing something differently. I didn't know I had, I really didn't know. And but I thought I was doing what I was supposed to be doing. I, you know, do my show today and go on with life. I was went all through college that way. Did my shot a day if I like, spent the night at my friend's house or something, I just go back in the morning and take my shot. So it was just kind of a, you know, crazy time, or you especially now with all the technology that's available

Scott Benner 11:14
and what you can see now. Yeah, were you in your mid 20s. At that point, when you switch the insolence.

Michele 11:20
I was mid 20s. And then shortly after that, I was diagnosed with retinopathy. Wow. So that really scared me.

Scott Benner 11:29
Yeah. When you first get the hay, you're gonna die. If you don't do something talk. Do you even believe it?

Michele 11:37
I was kind of like, yeah, yeah, yeah, whatever. Like, I've been living this way. All this time. No one's ever told me anything differently. But I did what he told me to do, like, I'm a rule follower. So he told me to do this testing. So I did change the insulin I did. So that was my life. But, you know, once the right not that the came out. And I was dating somebody. And at that point, it was like, oh, I need to do something about this, because I don't want to go blind. So, you know, had laser surgery in both eyes. And that was probably 87. And, but I haven't had any eye issue sets. So they have been stable since then. I've got a lot of laser burns in the eyes, but the eyes have been very stable.

Scott Benner 12:34
Okay. Okay. Wow. That's crazy. Okay, so you're, you're so you're still doing it now. So now you're testing and you see your blood sugar's higher. But it takes more time to even get to the point where doctors are talking about making adjustments once you see your blood sugar.

Michele 12:53
Well, right. I mean, we they had the sliding scale, so then I would use that. Okay,

Scott Benner 12:59
about that point, what point in your life? Do you think the sliding scale popped up?

Michele 13:03
That was probably 8586 8586.

Scott Benner 13:05
Okay. That's okay. But it all makes a lot of sense. I'm just thinking back to when my friend was diagnosed in like 88. And I'm just putting the pieces together kind of backwards from what you're saying to this at all, that all lines up for me really well. But so when the retinopathy laser surgery in the 80s? Yes. What was that like?

Michele 13:32
It was a bright light flashing in your eyes. I probably had three times on my right eye, two times on my left eye, they would give a shot to numb the eye, kind of underneath that in their eye. And you would see bright flashes of light. I didn't like it. But I didn't want to go blind. So, you know, I kept going back for those.

Scott Benner 13:57
Yeah. And that and that. Plus, I'm imagining your control started getting better as well.

Michele 14:04
Right. You know, just because now I'm seeing of endocrinologist, I'm seeing a regular doctor. Then I met my husband in 87. We got married in 88. So he was there through the timeframe of the laser surgery. And, you know, shortly after that, I started talking about having a baby. Now my endocrinologist was like, I don't have time for you. So he ended up sending me I'm in Cincinnati, he ended up sending me to University of Cincinnati hospital that had a clinic for diabetics. And they were it was a study kind of measuring the effects of high blood sugar and low blood sugar on children that were born. So I entered that study and the doctors there saw me all you know quite often, even before I got pregnant to get the blood sugar's more in line, but they were proud played a Wednesday was probably still in the eights and nines at that point.

Scott Benner 15:05
I am fascinated that you there was a time where you could say to a doctor, hey, I'm gonna have a baby. And I'm like, yeah, get out. I don't want to be involved in this. But also that he sent you to a study, do you think he sent you to the study? Because they're like, well, this lady is going to provide good data if she gets pregnant, or do you think this study was meant to help you?

Michele 15:27
I really think that he, I think he didn't have time to deal with me and my blood sugar's so he sent me the study so they could deal with me instead.

Scott Benner 15:41
Alright, Michelle, are you telling me that that that standard care wasn't very adjusted, and you were trying to figure out something greater?

Michele 15:51
I believe once I knew better, I believe I stayed on top of technology and things like that. When I was pregnant with my first son, the nurse there had started wearing an insulin pump. And she suggested I get on it. But at that point, I didn't know how those worked. So I had my first child in 91. So I didn't know how the pumps worked. And my belly was so big, like, how is that going to fit on my belly? Because it was Medtronic back then. So I didn't start that till probably 9394, maybe 90, maybe 95 on the Medtronic pump.

Scott Benner 16:36
Okay. Wow. That's a that's really a tale. And now and you're still just, I mean, did you did you end up having a baby?

Michele 16:45
I had two sons. They were both healthy, healthy. They were big babies, but, but I was a big baby. So I'm, I'm sure part of it with the diabetes, but part of it was just having the genetics to have big babies. My first son was 10 pounds, or nine pounds, six ounces. And the second one was 1013. But I was 11 and a half when I was born, and my mother was not diabetic.

Scott Benner 17:15
Any other diabetes or endocrine issues in your family?

Michele 17:20
Yes. So my brother, I'm the youngest of eight. My brother, who is eight years older than me, was diagnosed at 14 as well. But he kept it really private. And he saw the same doctor as I did. So he had to boil his insulin needles and, you know, reuse the needle every day. So it wasn't a big shock. When I was diagnosed. We were all tested, when he was diagnosed. And none of us had it at that point. But I kind of had a feeling in the back of my mind that I was going to get it someday. I don't know why. But so when I was diagnosed, I was unhappy, but it wasn't a big shock. But again, I didn't see him living a very different lifestyle other than, you know, taking his shot every morning. Well, yeah,

Scott Benner 18:11
there was a lot of like, just masked ignorance right about what was Exactly, yeah. How.

Michele 18:17
And the funny thing is, we're a very smart family. We're not dumb. So it just the information wasn't available. You didn't have Google, you didn't have your doctor wasn't telling you. You didn't know it just

Scott Benner 18:30
didn't exist yet. It just you were doing the best that that was available to you. Exactly. How is his health generally?

Michele 18:39
His is not as good. He lost a leg. And he has trouble getting around now. He's still alive. So he's eight years older than me. 67. But not very healthy.

Scott Benner 18:59
Okay. Did he ever make the switch like you did.

Michele 19:04
He finally he got on an insulin pump. Gosh, I don't even know 1015 years ago, but it was much later than I did. And then he did try. He stayed with Medtronic. And he did try their CGM. But really didn't use it very often. And I talked him into the Dexcom. And I'm not quite sure how often he is. He doesn't like to talk about itself. Yeah, so we don't spend too much time talking.

Scott Benner 19:39
I understand. Okay, well, I appreciate you sharing that with me though. That's it's valuable information for the for the big pick. So

Michele 19:45
that's one. Pretty much everyone. All my siblings have thyroid problems one way or another either low or high thyroid. I have a nephew with type one diabetes. And there's talk about an uncle that had diabetes, but there was it was never very clear about whether he was type one type two or what, how that was related?

Scott Benner 20:13
Sure. What about genealogy? Where are your people from?

Michele 20:17
We are from Slovakia and Poland to half of each interesting. Thank you. My grandparents actually came from those countries.

Scott Benner 20:27
My wife's mother grandmother, my wife's mother's mother is Polish, and she had celiac. And they call it the sprue.

Michele 20:40
That's a new one.

Scott Benner 20:42
I guess at some point, it was referred to let me check celiac sprue I think it's been kind of like rebranded as celiac disease. Yeah, but at some point, it was called celiac sprue pets. That was kind of the, the general term for it. And my, my, my wife's grandmother, who was a generally unpleasant person, just she, she'd be like, I have this sprue I can't eat that. And it kind of went like that. That's great. It really, it really hurt her at the end of her life, because she finally I think she finally gave over to the dieting but way late. And, and it just then she was so old that the dieting for celiac, I don't think she was doing it. Well, she just lost so much weight towards the end of her life. Right. But anyhow, okay, so that's a lot. But I understand I appreciate you filling me all in on it. Now let's get to the fun stuff. Michelle winters really get upside down. Because I'm assuming it happened at some point if you ended up with a transplant right.

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Michele 25:16
Okay, so I mean other complications along the way. I have had probably almost all my fingers operated for trigger finger. I had frozen shoulders and both shoulders over time. But see again, you know once once I got pregnant once I was past that I would stay up on technology. You know, I got the insulin pump as soon as I could I got the CGM as soon as I could switch to Omni pod is I think I got the CGM in 2011. Yeah. Got the Omni pod in 2013.

Scott Benner 25:51
So you selling you know, I tried to stay on top? Yeah, ya know, you did exactly what you hear me talking about, right? Like, I'm always saying, you know, pay attention to technology, you don't want to be using the last generation of stuff, you know, keep up with what people are doing, you know, don't switch just the switch. But when it makes sense, you got to keep up because, you know, as we move forward, better technology is going to equal better results and better results are going to equal better health. Right? Yeah. You saw that and you got to it, your your brother either didn't see it, or didn't care to see it one or the other.

Michele 26:29
And he was eight years earlier. So you know, a lot of damage had been done by the time the technology came around.

Scott Benner 26:36
Okay, so you still felt hopeful? You think when when this stuff was available to you, like I can still do something about this for myself.

Michele 26:44
I never thought I never thought I had a shortened life or anything like that. I really just thought, Okay, it's just another piece of me and something I have to deal with. As I move forward. Yeah. So so the eyes checked me. And then over time, it's been a slow progression with the kidneys. So you know, you get a test at the endocrinologist, oh, you're you're creating levels that are higher than they should be. And that went on for years. And then, at one point, I finally said to my doctor, I'm like, should I be seeing a kidney specialist? And he's like, Yeah, you could do that if you want, you know, as the numbers were creeping higher and higher and the creatinine levels.

Scott Benner 27:30
Michelle, test me. Oh, nephrologist,

Michele 27:33
nephrologist. Yes,

Scott Benner 27:35
thank you, Grey's Anatomy, go ahead, keep going.

Michele 27:39
So I saw him and I'm not quite sure how many years I saw him, but I'm still feeling good through all this time. And I didn't really, I really never felt bad. You know, I still exercise I still do all the things that I'm supposed to be doing. I eat right. So then, at the end, January of this year, the GFR, which is what they look at to determine if you need to go on dialysis or have a transplant, it went to 20 or 18, beneath 20. So once it's 20, then you're eligible to get a transplant. So I'm still feeling pretty good. But I knew dialysis is can really be damaging to people. Yeah, so I went to four different hospitals and started just applying for transplants. So I contacted you when I was still in stage four kidney disease. And everything went pretty quickly. So I had to have a majority of tests. You know, you had to make sure your teeth are good. You have to make sure your heart is good. You have to make sure you get a stress test. A colonoscopy like every test in the world. MRIs, CAT scans, they've done every test on me in between January and May. May the end of May, I was finally listed at a hospital for a kidney pancreas transplant. Actually, two of the hospitals would list me one didn't want to because they thought I was too old. But the one I finally went with was really happy with the condition that I was in. They see they said they feel a lot of people younger than me that are in lot worse condition than I was. Okay, so I was listed. And three days later I got a call to get a pancreas kidney transplant.

Scott Benner 29:53
Huh? No, it was so quick. Show. Let me tell you something. So have you heard me talking about my friend Mike? whose past? Yes. Okay. So when he realized he needed kidneys when he started doing dialysis, I would say to him, like, you know, are you on the list, you know, get on the list. And he would always say I can, it's hard. There's money, it's insurance. It's this. And he always felt like, like too big for him to conquer the process. And then you just described how important it was like you went

Michele 30:28
after this, right? Yeah, I didn't wait. But you

Scott Benner 30:32
just were like, I am going to go find out how to make this happen for myself. Exactly. Good for you. Wow. Okay. So

Michele 30:41
right, because the first couple of hospitals I called, they said, No, we don't do any kidney pancreas under over 50. If you're over 50, we don't do it. So then I started doing more research calling around asking, and one of the hospitals I actually went with, told me that they do, do pay increases over the age of 50. But they wouldn't listen to me for that. They would only listen to me for kidney.

Scott Benner 31:08
So Wow. So this is exactly what he used to talk about. Like they always sounded like some people say they'll do both. Some people say they won't, blah, blah, blah, like and so you just had to keep looking to find somebody to do both. Exactly. Michelle, do you not have diabetes anymore?

Michele 31:26
You know, I asked that question yesterday. I'm like, am I type one diabetics? So the answer is, yes, I am still diabetic, controlled with a pancreas transplant. But I have not taken insulin since the transplant.

Scott Benner 31:44
Yeah, that almost made me cry. Michelle, actually, hold on, it might still give it. Hold on, I gotta do that wavy thing that you see ladies doing? Why does that work? By the way, we need to hear up if you just put some cool air on your face. It slows it down. I don't know. I don't either. But trust me, I do it a lot while I'm making this buck. Wow, that's incredible. Good for you. Do the downside of all this is.

Michele 32:12
All right, so there's lots of pills. So over time, I'll reduce the number of pills, because I'm only five months out at this point. So I have to take pills for digestion. I'm told those will go away. Eventually, I take anti rejection pills. So I have three different anti rejection pills, they need to take twice a day. I was recently told I have a low white blood count, which could be related to some of the medicines that I'm on. So you have to be very careful. I am constantly washing my hands. I'm constantly using hand sanitizer, wearing a mask, in crowds, and so on and so forth. So it's not just a breeze. There's still other things you need to do. But I'm feeling better every day. I've got a scar from my chest bones down all the way down. That's healed well. And I think because I was in good health forehand, at least I'm considered myself in good health. I think everything's feeling well. And doing well. Wow, congratulations.

Scott Benner 33:26
All right. So I want to walk through it. You get you get it all set up, and you find a place that's going to do both. Is it fair to say that without the kidney transplant, like what would your life have been like?

Michele 33:43
I had already been tested for doing peritoneal dialysis. So they were already talking about putting the tubes in, which would have been doing dialysis at home every night for eight to 10 hours every night and then another session during the day. So that's taking fluid into your belly, letting it sit there and draining it out every night and every day.

Scott Benner 34:13
And that's not necessary. Even if you did that every night and every day for your whole life. It doesn't mean that things wouldn't continue to go backwards, right? Correct. Yeah. So it's not like you're not stopping it in that even though that sounds like a unpleasant way to have to live. It's not like it would never get worse than there you would continue on. On exactly,

Michele 34:33
which is why I wanted the pancreas because I'm hoping to slow down some of the damage caused by the diabetes.

Scott Benner 34:39
Right. And surgeons must have felt comfortable about it because they gave you the organ Right? Exactly. Yeah. Okay. All right. So when let's start with the day you find out you're gonna get the surgery. What happened? Alright, you when Michelle we've got you know, you're on the list, right? So right Once you're on the list, is it's a matter of matching from donors, I guess,

Michele 35:04
yes, it's a matter of matching the blood type, as well as any antibodies that you currently have in your system. And I don't quite understand all of that. There's a lot of and I've asked, ask people, and they said, it's just it's very, very complicated how they match people with a donor, and you want to be as close as possible to the match, so that you're not rejected. I was lucky to have a B blood type, which means I'm a universal receiver. I can't give to any other blood type than my own, but I can receive from all blood types. So that helped.

Scott Benner 35:45
Okay. And then what was the, the amount of time between? Yes, you can be on the list and hey, we have your stuff.

Michele 35:52
So that was a Wednesday? Yes, you're, you're formally listed. On Friday morning, I got a phone call at 8am. And I didn't answer it because I didn't know the phone number. But then my husband's phone rang. And he answered it, and they're like, Okay, we have a possible donor. You need to hold on and look for this phone number and answer the phone. And if it is going to be your donor, you'll have to come to the hospital to tomorrow morning. So Saturday morning, so you have one day to get your things in order. And in February, I had a new puppy born, so most of that day. So the puppy was born in February, I brought it home in April, thinking I'd have all this time to train her. And so most of the day on Friday, I was trying to figure out what I was going to do with her because my husband works. He can't take care of her. I was working from home, which was helpful because I you know, I could do training in between the times and take her for walks at lunch. So my kids ended up like taking her the day I went into the hospital and drove her up to my sister's house four hours a day so that she could hold on to her while I was recovering.

Scott Benner 37:19
Let's be honest, though. Did your sister do a good job training the dog?

Michele 37:23
She She did a great job. Are you worried she ever lessons? Yeah, no, she did. She's she's an animal lover. She's had animals all her life. And I knew she would do a great job with her.

Scott Benner 37:35
So it must have made your boys feel good to do something. Like kind of like wholesome for you as you were heading into surgery too. I would imagine Exactly. Yeah. How about them? Do they have any autoimmune stuff? The kids?

Michele 37:47
They do not I had them in testing. I don't think it was called trial net then. But because I was in that program. I followed up at the Children's Hospital with testing from for them early on. They hadn't had any antibodies, or whatever the things are called for markers.

Scott Benner 38:06
Michelle, do you think it would be absolutely ghoulish if me if I said trialnet.org forward slash juice box right here.

Michele 38:13
Go ahead, go right. Are you telling? I keep telling my son to have his son tested? And so yeah, I'm all for trial on it. But that was probably the beginnings trial net wasn't really an existence, I think when they started because it was 9193.

Scott Benner 38:31
Okay. Oh, yeah, probably not. You were just getting that testing through a different way. You probably knew a lot of things because of the stuff you did earlier in your life. Right with research.

Michele 38:41
Right? Right. I kind of stayed on top of that. So yeah, they did that we I took them to Children's Hospital for years after that, you know, having them get different kinds of blood tests along the way. And then my younger son recently went back and had more testing done. And he still did not have the markers.

Scott Benner 39:02
So I'm good for him. I'd be nervous too. If you are my mom you understand? Yeah, no kidding. Let's look one more time. Okay, I'm sorry. So now we've got the dog squared away and we're sitting around Are you sitting in your house thinking this isn't gonna happen or it like is it hard to feel hope? Is it I

Michele 39:24
thought, no way is this going to happen? Because I've read you know, my kidney groups on Facebook, I'm on kidney pancreas groups on Facebook and you know the time it takes to get tested and the number of times people have to go and wait at the hospital and then it doesn't match for some reason. So I went on Saturday we went got there at 7am sat and waited and waited and waited they had to go get the organs. They had once they brought the organs back they had to so as I understand it, when they To acquire the organs, they have to wait for the heart to be taken out first, and then the liver. And then so the other organs get taken first, and then the pancreas and kidney come out. So each doctor team, oh, okay does their own organs, so they fluid back. And then another doctor had to take a final look at the organs to make sure that they were still viable when they were back in our location. And I don't know who my donor was, I don't know where it came from. I don't have any of that information unless the donor family wants to tell me Can we?

Scott Benner 40:37
Can we ask you about guilt? Like two things? So did you feel like you were jumping the line? Because it was happening so quickly? And is it a weird thing to be happy about somebody passing away?

Michele 40:52
It is. It is it's, it's odd. But the way I kind of look at it is they were probably already on life support when I got the call. So if it wasn't going to be me, it was going to be somebody else. So that kind of helps me with the guilt of taking it from someone named Michelle, I'm happy it's me. Yeah,

Scott Benner 41:17
I don't think you should feel guilty. I'm just imagining that it has to be a natural reaction.

Michele 41:23
Right? I think if I knew more about my donor, I probably have even more feelings about it. But at this point, I'm just happy. I'm blessed to be able to been on that list at the time I was and been available. I asked them when I was called, is there a backup? And they said, a backup person. Like if I don't give it they will get it. And I was the only person I guess in the country that was a match for this organ.

Scott Benner 41:51
Good for you. I mean, yeah, it's amazing. I would, I would have been like this is nuts. Just because you were probably just resolved right? Like this may happen. It may not happen. It's going to take years.

Michele 42:04
Right? I thought I thought six months, I really thought okay, it'll be a while. Because if it's kidney only the weight per kidney only is like five years plus. Or you can do a live kidney donor, which you can get quicker. And I did have people that said that they would get tested. No one actually had gotten through the testing yet because they don't test them until you're formally listed.

Scott Benner 42:30
I want to know what to ask you so badly. If you believe the people who offered or not, or do you think they do you do? Yeah, okay. I do. I do you know what I mean? Right? Like, I'm not being a I'm not being a jerk. I'm just like, I wonder how many people just out of like, you know, like, are like, Oh, Michelle, I'll get I'll do it. Yeah, I'll do it. Like, you know, do you mean yeah, that's what I was wondering. Oh, this is this is all kinds of

Michele 42:57
friends contacted me because I put something on Facebook just I wasn't asking. I just kind of did my situation update. And two of my friends from grade school that I haven't really stayed in too much contact with over the years. Both offered to get tested. How did

Scott Benner 43:18
that make you feel? Like I imagined it's a it's a wonderful feeling. But do you question it like, Have you ever considered like, I don't know if I'd give my kidney to somebody.

Michele 43:28
I was so grateful. So grateful. It just amazed me how generous people can be.

Scott Benner 43:36
No, it's really fascinating to me. i That's those people. I'd like to talk to one of those people. Somebody somebody that just said yeah, you can have one of my kidneys. That's you don't I mean, like that's a special statement. Right? Exactly. Okay, so you're it's five years of the five years for just the kidney what was what was the expected length for both again?

Michele 43:59
They didn't really tell me but they told me probably within a year, I would find a match. Wow. Because because it's two kidneys or two organs versus one. And pancreas is aren't in as high demand as kidneys are. Oh, I

Scott Benner 44:14
see by asking for the pancreas as well. It moves. So most people are just looking for kidneys. Right? Oh, so by by matching to you we don't waste the pancreas. Exactly. I'm getting it now. Michelle, I'm really coming online here with this. Okay. So, okay, so you're in the hospital. They're like, wow, this is gonna happen. Do you freak out? Are you nervous? Do you have any second thoughts?

Michele 44:42
We waited all day long and I didn't think it was I I tend to think of the worst outcome so that I'm not disappointed. I'm more happy so we didn't really know you know, we're waiting waiting. There's really no word or problem. really their Gosh, at their at 7am, it was probably 12 to 14 hours before they finally came in and said, Hey, listen, we need to do an enema because you're about to go into surgery. I'm like, okay, so all day long, they did not have me eating, but they just wanted to make sure your system is totally clear. And then it happened so quick, like they put me on a stretcher, wheeled me back, my husband saying goodbye to me, as we're wailing back. And I was knocked out.

Scott Benner 45:38
Is there any, any concern about just not making it through the surgery beyond the general concern about being put under?

Michele 45:48
I think my husband was worried about that. I really didn't think that that was a chance. So I just naively, but I just thought, hey, I'm getting this done, and I'll be fine.

Scott Benner 46:01
Did you have that moment on the gurney? When you looked at him? You thought he thinks I'm gonna die?

Michele 46:07
afterwards? Not at the time, but after a couple three comments, and I'm like, Ah, he didn't think I was gonna make it.

Scott Benner 46:16
I gotta be honest with you. I had my appendix out in an emergency situation. And I was like, on the phone to people. Like, I gotta say, oh, no, it doesn't seem crazy to me, they're gonna put you to sleep and cut your body open. I mean, I know people do it all the time. But it's some some people don't react well to anesthesia. So you know, I was doing my diligence column, my call my peeps, you know, let everybody know. But this sounds like it happened super fast for you. How long was the surgery?

Michele 46:51
The original surgery was seven or eight hours. And then the doctor came back and something was too tight. So then I was in surgery for another two to three hours. So in he had to bring the whole team back in, because they had gone home went to bed. So he had to bring the whole team back in and had more surgery. Meanwhile, my husband is there in the waiting room, wondering what in the world is going on going on? And only getting, you know, bits of information back? Oh, we have to take her back in. didn't really explain why they had to take me back in.

Scott Benner 47:30
Let me understand the process seven or eight hours for the surgery come out. You're in recovery. And pretty quickly. They realize you have to go back.

Michele 47:37
Yeah. And I was not awake. I don't remember being awake during that time. So I didn't know anything about it.

Scott Benner 47:44
Okay, something was too tight. And then they can you you know, it's funny as you're talking about this. I'm like, how do they do that? How do they perform surgery for seven hours?

Michele 47:57
I know they had two different surgeons, one for the kidney one for the pancreas.

Scott Benner 48:03
I'm just telling you, I can't stand that long.

Michele 48:05
Yeah, exactly. If you like, some special people. Yeah, they can be called at anytime, day or night, and they have to come in and do the surgery. So they're very special people are go collect, you know, click the organs for more, they need to be collected.

Scott Benner 48:22
My mom has to have surgery next week. And my brother had already made plans to come in to be here a number of days prior to the surgery and after the surgery. And then they up and called us yesterday and said we need to move the surgery to the following week. And I said please don't do that. You know, like I my brothers. My brother's not a wealthy person. I don't imagine he bought refundable airline tickets. And you know, like, right, you know, stuff like that. And so she calls me back an hour later. And she goes, we're just going to do it the next day. And I said, Oh, that's wonderful. Thank you, the doctors just gonna tack it on to the end of his schedule. And I was like, Wow, what an amazing thing. You know, I'll just do one more surgery on Thursday so Bev son can fly in and see her before her surgery. And I was like, wow, yeah, some doctors are amazing. And some you don't get anything out of

Michele 49:12
and I think you know, they have a whole team of people. So I think you know, you've got the original the people coming in that are prepping you and the anesthesiologist and the you've got a whole team of people that do the the closing up afterwards. So I think everyone has their specialty that they stay in for some I'm sure they have breaks during those that 1011 hours

Scott Benner 49:34
still amazing. So you come out how long does it take you to come to and then what do they expect from you? They want you like nowadays they get you moving pretty quickly after surgery. But what was your process like?

Michele 49:46
I I was in the hospital for two weeks.

Scott Benner 49:51
About your I

Michele 49:53
had, like I had some problems. So I think most people are six to eight days. That's what they tell them. But I had some problems like at one point, I couldn't keep any food down. I got Botox in my stomach. Which was, you know, I joke that I got Botox, but it didn't make me look any better. I imagine what that was supposed to do is make your stomach more active to move the food through because I was having trouble keeping anything down. Then electrolytes were kind of out of balance. So I had to have fluid and magnesium and potassium and phosphorus and all those kinds of things added.

Scott Benner 50:34
Were you in danger? Or is this just things they had to do? It?

Michele 50:40
This was ask your question again.

Scott Benner 50:42
Were you in danger? Or were these just steps that needed to be taken? Because

Michele 50:46
no, I think this is it was pretty common. Okay. For the surgeries. Just did people have different kinds of imbalances after that type of surgery?

Scott Benner 50:58
Okay, two weeks, and, and when did the medications begin, right away, antirejection, all that stuff, right away, right away,

Michele 51:08
right away. And then for the first three months, they're really, really careful with you because you have so many anti rejection pills at the beginning. And they say really, within the first year, it's really important to stay healthy through that first year.

Scott Benner 51:24
Did you ever hear Nicole's episodes about her surgery?

Michele 51:28
I did. Yeah, I did. I've listened to you quite a bit. And I'm actually still listening. And I don't know why. It's kind of crazy. But I contacted you back in 2016. When I had my agency had gotten to 6.3. So I messaged you on Facebook. And you said congratulations. Then after that. I was volunteering with JDRF and trying to get people set up for booth at our JDRF tonns event. And I contacted you and you said you couldn't come out to get a booth. But you could maybe do flyers or something and you never sent them. And

Scott Benner 52:21
so I'm very busy. I'm a one man show here. I'm so sorry.

Michele 52:23
I know. Well, then then you came I think the next year or the following year and spoke at Cincinnati. JDRF. tell

Scott Benner 52:31
people how good I was.

Michele 52:33
You were excellent. Did you talk during the luncheon?

Scott Benner 52:38
I did I asked for that actually. Because while everybody's busy wanting their own little space. I'm like, I always think everyone there has to eat and they eat at the same time. So I get to talk to everybody if I eat if I speak during lunch. There you go. Yeah, it's a I remember that there's a big room. It was a really well run event as well. Exactly. Yeah. No, i i It's uh, as far as those things go, I think of that one is almost a gold standard. The person who runs that chapter is type A and the best way and that that event goes off very, very well. I you know, I met Chris Rutan there for the first time. I met him in person.

Michele 53:23
Yeah, I saw him speak when he was there.

Scott Benner 53:25
Did you Okay, yeah. Okay.

Michele 53:27
And then. So, so yeah, I was actually on a panel that day of adults with type one. So the night before they had that reception, and I met you briefly while you were there as well.

Scott Benner 53:44
Oh, at the home was someone's home. Yeah. What is? What is art asking me Hold on a second. I'm sorry. You're fine. She's like, can I call? Can I call who? Me? I'm sorry, this is out of nowhere. I'm trying to figure out what this is. She's had trouble with her loop app earlier. And I helped her through it. Okay, she's gonna call me let's find. Let's find out why together Michelle. I'm just gonna keep Okay. Well, I'm gonna take off one of my earphones. Hey, alright, what's up

Oh, are you home still

so, honey, the problem is there's a little bit of a there's a glitch in the loop app and I need to reset it. So we have to have your the Bluetooth has to be off for like 20 minutes before we do it. That's why I had you do it when you came home when you told me it was working okay, so it's not gonna work till we make this little adjustment in the timezone. It's a glitch in the app. So when are you coming home again? were you headed to a restaurant? Oh, okay, well shut your Bluetooth off. Bring the food home when you get here. Come right to me and we'll do the fix. Okay, and watch your blood sugar on your deck. Stop yourself. Alright, bye. Sorry, Michelle technology let us down there. There's a small glitch apparently in the version of the loop app that Arden is using. And if you try to change the insulin sensitivity, and the timezone in the app is wrong. It crashes the app. So anyway, I don't know if that sounds like gobbledygook to you or not. We should I lose you. Michelle. Michelle, the show my Hello Michelle. Hello. Hello. Hello. Michelle. What the heck? Alright, I'm gonna stop recording. Michelle. Michelle, Michelle. Michelle. Michelle. Hello. Hello, Michelle. Michelle. All right. I'm gonna send her a chat. And you hear me? Hello. This is the end. Aquarius? Why would that song pop into my head? On Aquarius. Michelle Deanna, I can hear her typing. And she's not answering me. See if I have a phone number for do. This is boring. There's no way I'm leaving this in. And yet every time I say I'm not going to leave something in. I totally leave it in

Alright, I've texted her. I said, Hey, it's Scott. I can hear you typing but you can't hear me. And then I said it out loud. In case you maybe would hear people do not want to make a podcast. It's a lot of work. And sometimes it's irritating. And annoying and weird. Why is she unable to hear me? Michelle? Michelle. Michelle. Michelle. Michelle. Michelle. Hello, Michelle. She is not here

all right. I'm gonna call her will she answer this while she thinks she's making a podcast? No, right.

Michele 58:47
I can't hear you at all.

Scott Benner 58:49
Oh, okay. Michelle. Huh? She can't hear me at all. Why would she not be able to hear me?

Michele 59:06
I don't hear you. Hey, Michelle. I

Scott Benner 59:08
know we're on the phone now. But I hear you fine. And you're not hearing me. So let me I hear you through the phone. Yeah, let me figure out why that is. I don't know why that would be on

Michele 59:19
mute somewhere.

Scott Benner 59:22
I'm looking that looks right. Nothing here changed.

Michele 59:29
The lower left hand mute my audios that

Scott Benner 59:33
No, I didn't mute anything. I actually was like, keeping you on. I was recording with you. I wanted you to hear the phone call. Like just because I thought I didn't know if it would be interesting for the podcast. Not like I'm not muted. I'm gonna mute myself now. And then unmute myself again.

Michele 59:50
I heard the first part of the phone call but then it went away.

Scott Benner 59:54
Wait, can you hear me now? Through your computer? No. That's insane. There's nothing different here. All right, well, that's no,

Unknown Speaker 1:00:06
I hear you now.

Scott Benner 1:00:07
Oh, okay, I'm hanging up the phone. Now you can hear me. Yes, that doesn't make any sense. But who cares? I'm sorry. So you, you didn't hear all that Arden's having problems. Her loop app has a glitch in it, and it crashed the app. So she's gonna have to come back here in a couple of minutes. You're gonna hear me fix the app again. But she'll be in person when that happens. So I don't think anything should change on the audio. Okay. Okay, I am sorry, that was so long. I forget where we were. But I hope you

Michele 1:00:40
I don't remember either. We talked about post surgery.

Scott Benner 1:00:44
You were going through your medications and and everything you were taking after post surgery, told me that you had some trouble digesting. And then

Michele 1:00:54
yeah, that was in the hospital.

Scott Benner 1:00:57
Sorry, we were in in Ohio. You were telling me about being there. And I was getting ready to ask you. Because you were talking about having seen the been listened to the podcast for such a long time. So why why are you still listening to the show?

Michele 1:01:12
Don't know? The stories are interesting,

Scott Benner 1:01:16
I guess. Yeah. Do you feel bad for not having diabetes anymore?

Michele 1:01:20
No, I don't feel bad. I do know that my body can attack my pancreas again, because I'm still have those more markers that I had before. Those don't go away. Yeah.

Scott Benner 1:01:34
Right. And so it is possible that you could just get type one again with your new pancreas. Right, exactly. Is that based on other transplants?

Michele 1:01:46
I haven't found them. People, like the hospitals will track transplants, like after one year after five years. And they don't do a great job of tracking things after that. Okay. Which is kind of interesting.

Scott Benner 1:02:03
Gotcha. Well, let's just say that would suck. And I hope that doesn't happen.

Michele 1:02:09
Me too. Me too. But I think the technology will be so much further by then. That it won't be such a pain.

Scott Benner 1:02:17
Yeah, well, I mean, you you really are pretty caught up where you are until all of this until you put your pump in a drawer, I guess. Right? So like retiring? Did you like fold it up and put it under your underwear or something like that? Or?

Michele 1:02:27
I wore the Dexcom for about two months afterwards? Because I was afraid it was gonna get the sugars were gonna go high. And then it ran out one time. And I'm like, I'm not putting that back on. Why should I wear it? Okay, so I quit worrying. It

Scott Benner 1:02:44
was pretty cool. It really is. How scary is it to have all this going on during COVID.

Michele 1:02:52
It's worse during COVID. Just I feel more isolated. I can't really it my problems are kind of like COVID, where you can't see COVID. And you can't see all the germs in the system. So you don't really know where it's safe to go and what's not safe to do. So if I'm in public, if I'm in a group of people, I'll wear the mask. If I'm just around a few people I won't. It's much more easy to find a mask than it was probably prior to COVID. Yeah.

Scott Benner 1:03:28
You go all the way using it again. And 95 mask? I do. Yeah, I would. Yeah, I put one over my eyes. If I was you, just in case.

Michele 1:03:37
I know. I work I work glasses most of the time. So I'm a little protected.

Scott Benner 1:03:42
I would wrap my whole head in one, just bubble wrap people would be like what's wrong with her and I'd be like, I just had a transplant. Get away from everyone get away from me. But the feeling of isolation is real. It's terrible. You know, so I feel free there. And you said the first

Michele 1:04:01
I just had a baby granddaughter. I have a three year old grandson and a newly born baby granddaughter, and I've gone over there and saw them. I wore my neck the whole time because I'm worried for her too.

Scott Benner 1:04:15
Yeah. But congratulations. That's lovely. Thank you. Good for you. How's your husband handle all this? Has he been helpful? Did he do like is he like, standard guy thing? Does he stand in the corner and wait for you to need something? Or has he kind of jumped into action?

Michele 1:04:31
He he tries to be helpful. I mean when I was in the hospital. So the hospital was two hours away from Cincinnati. And I had to go two times a week after I was released from the hospital. So I actually had my top four brothers and sisters are all retired and they spent a week to 10 days with me and driving me back and forth because I couldn't drive for a while and But he would when I was in the hospital, he would come home from work, drive the two hours, sit with me for two to three hours, drive home. And then you know, wake up the next day do the whole thing again. So he runs his own business. So he doesn't have the luxury of just calling in sick, you know, he's off to do the work.

Scott Benner 1:05:20
Somebody got paid for those pills.

Michele 1:05:22
Exactly. Do you and I'm still working. So I carried the family insurance, which is good.

Scott Benner 1:05:30
At this point. Yeah, good for you that you're able to work through the they gave you would you take like FMLA little medical leave, and then come back start

Michele 1:05:39
short term disability for the first three months. And then I came back and they're allowing me to work for from home for six months, because the hospital requested that I do that. Excellent. How do you like working from home? I love working from home. So I've been working from home for a year and a half now. And it's awesome.

Scott Benner 1:05:58
I have to admit, I enjoyed myself. I don't know like the best probably is just very, you know, I don't know how interesting this is to people. But I love that I can get up in the morning, do a bunch of my work, record an episode, go, you know, grocery shopping, if I have to then come back and start working again. Like it's so it's so nice not to have to do stuff like that. At the end of the day when you're exhausted. It's so much easier to work until you're tired and then stop at the end. I do find that I work too long. Because I because my job's at home. Yes, but But I do like the knot. I do like that part of it like getting to break up the day. I do wish I had to move around more though. And that that. Well, that's right.

Michele 1:06:43
I did get my puppy back. And she has way more energy than I ever expected. So I get out at lunchtime and take her for walks. I'm up to like, I don't know, a mile and a half a day taking her for walks. So that's good.

Scott Benner 1:06:57
How long did your sister have the puppy?

Michele 1:07:01
About three months? Wow.

Scott Benner 1:07:02
Did she have trouble giving it back to you?

Michele 1:07:05
I think she was ready for me to get her get her back.

Scott Benner 1:07:09
So not attached. She's like, Please somebody come kick this

Michele 1:07:12
off. She was shocked at the puck he still remembered me. But she did. We met about halfway and picked her up. And she still remembered me and came home and is very attached.

Scott Benner 1:07:25
That's excellent. Good for you. Is there anything? We haven't gone over that I've missed? Because I don't understand the whole process?

Michele 1:07:33
I think we hit a lot of things. I don't I don't have anything that I can think of off the bat.

Scott Benner 1:07:41
Yeah, what is your moving forward look like? Oh, you thought it's something go ahead.

Michele 1:07:46
I was just gonna say the reason I wanted to why I didn't really want to be on the podcast. But the reason I contacted you was because you can't find anybody going through the kidney issues. Like there are a lot of people online but no podcast, no type one diabetes, talking about complications and things like that. And I wish I you know, I listened to Nikki, listen to her calls, but having people with real life experience is so difficult to find. So I broke down and said, Okay, I'll be on the podcast and contacted you and you're like, Okay, set it up.

Scott Benner 1:08:30
Let's go. I'm very grateful for this. And I agree with you there aren't I mean, listen, if you have a four year old that just got diabetes, I don't know how fun this is to listen to. But, you know, I think there's some solace that comes from the fact that you were diagnosed, you know, in the 70s, your care is nothing like care is now. But in fact, there are still people who don't, who don't pay attention and or don't have the tools or don't have the knowledge or whatever you want to say, to create, that you still can create this problem for yourself in modern times. You know, and so it's, it's good for people to know what could happen, you know, people who are like, Oh, my blood sugar is just 200 all the time. Well, that's what yours was. Right? You know, and,

Michele 1:09:16
and I was just naive. I'm sure there was more things I could be doing. You know, the more I talked to people or volunteer with JDRF there are people that have been diagnosed as long and knew more than I did at that time, right? Yeah, yeah, I just didn't have the the contact

Scott Benner 1:09:33
information just did not have access to the information. That's why I like to have people on to talk about all kinds of different things. Because I know there are some people are going to be like, don't you know, why are you telling me about complications, but it's so that you understand the big picture, and so that you can then apply it back to your life and think maybe I am missing out on something the way Michelle was missing out on something. Great. Did you enjoy Mike's episode about complications? Which one was that? Very recently it was an after dark about complications. Oh, yeah, yeah. I listen to that one. Yeah, that's the kind of stuff that has to be said once in a while, like you said, because nobody talks about like, I mean, I'm, I'm nearly 600 episodes into this, as I'm recording this right now, no one's ever no one has ever once contacted me and said, I want to tell you what it's like to be on dialysis. You don't think there are people listening to this show who have been on dialysis who are on it now. And no one's ever reached out and said they want to talk about it. And I understand that, but I'm saying there are plenty of people out there that might benefit from hearing from those people as well. Exactly. Yeah. I'm glad you did this. Thank you.

Michele 1:10:42
You're welcome.

Scott Benner 1:10:43
Let me just ask you a couple more questions, and I'll let you get back to your life. So moving your your new lease on life, moving forward, is your it's about staying healthy, staying away from being ill taking your pills, but what other milestones are you looking forward to or having to reach?

Michele 1:11:03
I want to start traveling again. So we're possibly doing something in February, we'll see. I still have to make reservation. So we'll do that. I'm spending more time with my grandkids that's on the top of my list.

Scott Benner 1:11:20
You want to travel somewhere warm?

Michele 1:11:21
I want to retire soon. But it's kind of out of the picture right now. It's I carry the insurance. And I'm too young for Medicare set. Well, I actually I'm on Medicare for three years, but my insurance is primary and Medicare secondary for 30 months. So how did you get on this early because of the end stage renal disease. So as soon as the transplant hit, I'm eligible for Medicare for three years. Gotcha. Okay, that only takes me to age 62. So it's still another three years in between till you can go on or I can get insurance.

Scott Benner 1:11:55
Right, right. I understand. Wow, that's a little scary to me. Yeah. But you'll you'll, it sounds like it. Listen, I gotta be honest with you, Michelle, you kick an ass. So I don't imagine you can't get any of this done. You took the bull by the horns about 16 times in this story. And ended up getting everything you needed. So I'm really impressed with you. Seriously, thank you. Yeah, thank you. Good for you. All right, I'm gonna, I'm gonna say thank you and let you go. I really appreciate this.

Michele 1:12:27
Okay, thank you. I appreciate all that you do. Oh,

Scott Benner 1:12:30
it's my pleasure. It really is. Hold on one second. I'm gonna say goodbye to you like privately. Okay.

A huge thanks to Ian pen from Medtronic diabetes for sponsoring this episode of The Juicebox Podcast, head over to Ian pen today.com. To find out more, you can also find those links in the show notes of your podcast player, the one you're listening in right now probably at juicebox podcast.com. Don't forget if you're a US resident, please go take the T one D exchange. Survey. Take it from me t one D exchange.org. Forward slash juicebox. Thank you very much for thinking about doing that. Alright, so we thank them pen. We thank you. Who do I thank you. I will thank you in a second. We asked you about the T one D exchange. What else should I say to you before I let you go? I don't have anything. Oh, my goodness, my mother, where are my manners? I want to thank Michelle for coming on the show and sharing her story. How crazy is that? That she got that transplant so quickly. Absolutely stunning story. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast. Oh, I'm sorry. You know what I Michelle sent me a note later she said when we were talking about other autoimmune stuff in her family. She neglected to talk about her sister who had Ms. She said it progressed very quickly. And she passed from it at age 48. Her sister was six years older than Michelle. She asked me add that and I wanted to wanted to do that for Okay, so again, thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast. If you're enjoying the show, please subscribe or follow in a podcast app like Apple podcast, Spotify, Amazon music, wherever you listen in an app. If you're enjoying the show, tell a friend about it. Or an acquaintance or anybody you think might enjoy it. Tell your doctor about it. Tell somebody Thank you. This show grows when you share it with people and that's why I asked you to do that. Alright, that really is that now I'm gonna go I hope you have a good day.