#697 After Dark: Emily

Emily has type 1 diabetes and she is here to talk about her life.

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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 697 of the Juicebox Podcast.

On today's episode we're going to speak with Emily, she's an adult who has been living with type one diabetes for a large portion of her life. Today is the 26th installment of the afterdark series. And Emily is here today to share her very, very specific rememberings of her upbringing, and to talk about how they've colored her life with diabetes. Please remember, while you're listening 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. We're becoming bold with insulin. If you have type one diabetes, and are a US resident, or are the caregiver of a US resident who has type one diabetes, please go to T one D exchange.org. Forward slash juicebox. Join their registry. Take the survey taking the survey takes fewer than 10 minutes. Your answers to simple questions help people living with type one diabetes T one D exchange.org. Forward slash juicebox. I swear it takes no time at all you can do it from your phone. After you get done listening to me head over, I guess maybe you could multitask and do it at the same time. Today's episode of The Juicebox Podcast is sponsored by Dexcom, makers of the Dexcom G six continuous glucose monitor, learn more and get started today@dexcom.com forward slash juice box it is that that very same link where you might find out that you're eligible for a free 10 day trial of the Dexcom G six. The show's also sponsored today by Omni pod makers of the Omni pod dash and the Omni pod five. Find out if you're eligible for a free 30 day trial beyond the pod dash, learn more about the Omni pod Vive or get started with some Omni pod product at Omni pod.com forward slash juice box. If you're in the market for an insulin pump, I highly recommend it.

Emily 2:19
Hi, my name is Emily and I was diagnosed a type one diabetic when I was 10 years old. How old are you now? I'm 41. I mean, sorry, I was 41 years ago. So I'm 52 You're

Scott Benner 2:32
52? Do you know Emily? And by the way, you'd have no way of knowing this, that I interviewed someone yesterday. And today was there 52nd birthday. Oh, that's interesting. And at the same time only interesting to me, really. So now that I've shared it with everybody else. I was amused by it. And it I realized and quickly it has nothing to do with the podcast. So let's just keep moving.

Emily 2:53
Well, all the best people are born in the first quarter of 1970. I have three of my closest friends. were all born in the first quarter. So we get together each year for fun and games, usually in Oakland.

Scott Benner 3:11
What happens in Oakland is it isn't Oh, that's

Emily 3:13
just sort of the meeting point. I have a friend who lives in Oakland proper. And then another who lives in Danville and another who lives in Turlock, which is sort of central California.

Scott Benner 3:26
If anybody listening wants to kidnap your friends, they're a third of the way to it. So

Emily 3:32
I don't think these women will let themselves be taken.

Scott Benner 3:36
Well, oh, you're saying come get us. It isn't gonna work out for you. I gotcha. Exactly. Exactly. That's excellent. So okay, so diagnosed. 10 years old. Is that right? Yes. In the 80s. The early 80s. Yes. And anybody else in your family have diabetes?

Emily 3:54
Nope. I was the first one. Although my sister who was five years older than me, four years older than me, was diagnosed. That 10 years later, when she was in college.

Scott Benner 4:09
Interesting. So you in the early 80s, your sister in the early 90s? Yes, you as a 10 year old her is more like an 1819 20 year old. Yep. Okay, are you guys closer, you're pretty far apart in age. It sounds like, um, well,

Emily 4:24
we were always fighting. There's third oldest sister. And so she and I were more close because she sort of took me under her wing and would recommend, Oh, I like reading this book when I was your age, that kind of thing. Whereas my middle sister and I were too close. Where we actually would end up at that same school like we are at the same high school for two years and that he hated having to give me a ride around town and stuff like that.

Scott Benner 4:59
That sucks. If I would have just said, Look, if you want a car, you drive Emily. And that's that anybody makes a face no more car. That's the end of it.

Emily 5:07
Right? Yes. You met my mother apparently.

Scott Benner 5:11
That's maybe why she didn't enjoy driving you around. So okay, so you're diagnosed me, you're gonna have diabetes for a decade before your sister dies. There's no other diabetes in the family. What was it like having type one as a 10 year old back in the early 80s?

Emily 5:27
Well, it was all a big mystery. And I beginning to suspect it was a mystery to every doctor I ever had. Because we got we took a couple classes and stuff like that. But my parents were never, they never understood sort of what first of all, I was testing my urine with a test tube and, you know, I droppers and little pills that turns certain colors. And so you had a very wide range of what your color might mean, if it was dark blue, then you were really low or had been, you know, five hours ago. It was never explained to me the timeframe between when I tested my urine. And when that low had actually happened. Does that make sense?

Scott Benner 6:20
Yeah, you don't know. There's no context for you between the test and the event.

Emily 6:25
Right. And they never bothered to explain it to us. And my parents never realized. They don't know how they could have realized that they would be punishing me for something that I had done five hours ago and had no idea I was doing. So I was running high all the time. Simply because, you know, I had never learned any portion management because that was not in the cards in the early 80s for 10 year old. And so I just feel like every single piece of knowledge that we got that then was wrong and just set me up for failure. Yeah.

Scott Benner 7:07
Were you using early 80s? We're using animal insulin or we're using regular mph.

Emily 7:14
Yes, like for the first couple months, it was beef and then we got brand new pork insulin for a while and then I went to Cuba log insulin and mph or human. Insulin, probably starting in college, maybe?

Scott Benner 7:35
Okay. Oh, a lot a decade. Yeah, yeah. All right.

Emily 7:40
Well, I went to college when I was 17. So seven years. Look at

Scott Benner 7:43
you, smarty. So, so basically, you're shooting insulin in the morning, and at dinnertime. And, and you're, I mean, you know, I've never asked anybody this, but you get the pee in the test tube the way I assume right? You just hold it under yourself.

Emily 8:01
You get this hat. I don't know if well, you're if if you're a woman, and you go into the hospital, and they need to collect your pee, they give you this what looks like a plastic hat that you put underneath the seat in the toilet, and then you pee into that. And then you take out

a sample eyedropper and you take out the sample. So then you have this plastic head that's always in your

Scott Benner 8:28
bathroom. I was gonna say it's the plastic cats were usable, right?

Emily 8:32
Yes, but it still got gross. Even when you clean them.

Scott Benner 8:36
Anything up on Emily? I don't know. Yeah, it's a gross factor at some point. So you're basically using this thing, taking out the sample, dumping out the rest of it, rinsing it off putting it I imagine it starts not even getting put away. Right? It's just leaning on the wall in the bathroom or something like that.

Emily 8:51
Oh, yeah. It never had a place to be put away. It was always just stuck in a corner. Yeah. Have you ever

Scott Benner 8:55
noticed when they build houses? They don't think where would we put a plastic cat if somebody needed the bathroom?

Emily 9:01
Yeah. It's they're still not building them in there. i It's not fair.

Scott Benner 9:06
So it's still not out? Yeah, gosh, I mean, even that alone has got to be arduous as a young child, right? Just, yes, I drudgery.

Emily 9:17
Yeah. And the only time I was doing it was in the morning or at night. You know, I was only testing myself. At times when my blood sugar's or, you know, my blood urine. My urine sugars would be high, you know, like after I've eaten dinner.

Scott Benner 9:36
So you have a real chance for this test to come out looking positive anyway, because you're probably not using enough insulin. You don't have any idea about food or nutrition. So you're just basically testing at the highest points of the day. And then exactly right. Your parents see a color and get mad at you. Yes.

Emily 9:53
And so it took me 25 years to start. Seeing a blood test as being just information that I'm being given and not a judgment on what kind of person I am. Yeah. And it's still, I'll still fall back into that. Sometimes I just recently got a Dexcom. And I mean, I just got it. I'm on my second transverse.

Scott Benner 10:26
Second sensor, you're less than 20 days with it. Exactly. Wow. Okay.

Emily 10:31
And so and it's, it's driving me crazy, because I will see, you know, it tells you you're going up, you're at 190. And you're going up, and I'll be like, no, okay, I have to wait. I've taken my insulin I've eaten not do I have to wait for it to calm down and then I can't, then I'll be like, I'll take two, two units of insulin straight to get it down. But of course, that doesn't show up for another hour. And by then, I haven't gotten the hang of it yet. It gets very saddening.

Scott Benner 11:02
Well, so first of all, I know exactly what you're talking about. Because when you're presented with the data in a new way, it feels like starting over. Because even if you weren't doing it, you know, doing it doing diabetes, the way you were hoping to prior to that you were at least probably in a rhythm. Like you did it the way you did it. And it's, you know, what, what's expected happens, etc. And then you get a whole new set of data. And you're like, Oh, like this is I'm really bad at this is how it feels. I mean, they felt like that way to me, at least when I saw Dexcom for the first time. Yeah, you're making me think that Dexcom should make an ad where they're like, Dexcom better than a plastic hat to PN?

Emily 11:44
Yeah, they should

Scott Benner 11:45
capture the 60 year old market. No problem. People would be like, Oh, they know about the plastic cat. Yeah. So so. Are you? Well, it sounds like you're not. But I would say that. The first hump you have to get over is to not see the data as like a report card, but just see it, like big picture, step back from it. Don't look at it minute to minute hour, look at it over 24 hours. So you can kind of get a feeling for like, Is my Basal right. You know, like, that's where I would start. Because, yeah, you know,

Emily 12:20
I don't even have enough. I have to my endocrinologist appointment is hopefully coming up soon. They haven't actually called me back to make the appointment yet, but hopefully, they'll be able to give me more information because I don't really know what I kind of know what Basil is, but I don't know. How to cook with that. I mean, no,

Scott Benner 12:48
no, I do. I was just gonna say you are from a time period of diabetes where no one let you adjust your your insulin, right? Yep. Yeah, you just go to the doctor and they tell you like, Oh, we're gonna make it. We're gonna make it eight now. Like, that's pretty much it. You go. Okay, that number is eight now. And you just go with it. What is your agency's been like over your life?

Emily 13:10
Oh, I'll tell you a story. I was seeing this diabetic nurse practitioner. And she said, You know, I think my last test had been at like 9.2 or something. So she says, Would you like to try this? drug? It's not. It's for type two diabetics. It's a shot. You take it when you take your insulin. And it's supposed to really help with control. And I'm like, sure. Okay. And so I took it for three months. And what it did was it made me so nauseous. I never ate. I was constantly throwing up. I why I stuck with it for so long. I don't know. But my blood sugar numbers were pretty great. And so then I went in, and I told her that I wanted to get off of it because I was literally throwing up every day. And she's like, Oh, okay, well, your numbers are really good. You're down to 6.5, which is ideal. And so she tried to talk me into staying on it because I wasn't eating and so I had lost all this weight. And my numbers were down.

Scott Benner 14:30
That's not a perfect I can't believe I can't believe that ideal was the word that was used because it's not ideal if you vomit constantly and that's why you lose weight and why you can't write why your agency is lower because you're not eating and there's no food your system. Exactly.

Emily 14:44
How can I even got a little certificate in the mail saying your agency is perfect well done, and they spelled my name wrong. I don't like your My name is right there like it's in the list.

Scott Benner 14:58
So Emily asked her Hearing that you were vomiting your way to a six a one C on some medication that clearly did not jive with your body. Well, they sent you a certificate of achievement in the mail and spelled your name wrong. Yes. Well, that's that's a copay well spent for you. Did you keep taking it? Or did you stop?

Emily 15:19
I stopped? Yeah.

Scott Benner 15:21
I have to tell you I would not. It's an interesting thing, that generational thing with diabetes because if somebody gave my daughter something, and it made her throw up, I'd stop giving it to her immediately. Like, I wouldn't care what they said. You know what I mean? But it's interesting that you persevered with it, how long did you do it for?

So I just checked out my link dexcom.com forward slash juice box, and somebody at Dexcom has spruced it all up. Thank you. Dexcom. It looks fresh and new. I was immediately greeted by a handsome photo of Nick Jonas, who, as you may know, has type one diabetes. After I swooned for a moment, I scrolled down, who do I see Miss Patti LaBelle, Patti LaBelle, seeing her gave me a new attitude, if you know what I mean. Here's the point. If you're using insulin, type one or type two, the Dexcom G sex is going to be a friend for you, you're going to be able to see your diabetes as it's happening. That's the speed, direction and number of your blood sugar. Is it 89? Is it 120? Is it 150? Is it 240? Is that rising? Is it falling? Is it rising quickly? Is it rising slowly, etc, etc. So on and so forth, so forth, so forth. Speed direction number, you see that on the Dexcom receiver if you like or you can see it on your supported iPhone or Android device, this is a big deal. To see your blood sugar without a finger stick to see it in real time to be able to set alarms and alerts. I want to know when my blood sugar goes under 80. No problem, you can get that you want to know when it goes under 60 you can get that you want to you want to know when it rises above 121 4150 to 100. Wherever you set those alerts. The Dexcom is gonna give you the little beep beep and let you know when it's happening. On top on top, on top of all these alerts and alarms, the Dexcom also allows you to share your data with up to 10 people if you'd like that means your kid could be at school and 10 family members. I mean, you probably don't know 10 People but I mean, you know I'm saying it could be up to 10 Could be your school nurse. It could be your husband or wife, a sibling, a friend an adult could have their friends looking up to 10 people can take a look at your Dexcom right on their phone if they like. Head over there today. dexcom.com forward slash juice box see Nick Jonas's smiling face. Learn more about the Dexcom G six, find out if you're eligible for that free 10 day trial of the Dexcom g six@dexcom.com. Forward slash juice box. On the pod is a tubeless insulin pump. It's a tubeless insulin pump that my daughter has been wearing for like 14 years now. been wonderful. She's had it on every day. You can check it out and try it for yourself. And on the pod.com forward slash juice box. Here's what you may be eligible, you'd be good. But I can't talk. Here's what you may be eligible for a free 30 day trial of the Omni pod dash. That's crazy enough. You can also head over and learn more about the new Omni pod five. That's an algorithm based system that makes dosing decisions for you in conjunction with your Dexcom G six. Are you kidding me? The future is now baby and it's here. Omni pod.com forward slash juicebox Get started today, learn more contact Omni pod and say hey, you know I'd like to try Okay, get to trial. He even think they'll send you out a like a little we haven't talked about this in a while. But I think they still do this. You can get a single pod like a dummy pod doesn't actually work. Just if you want to try it on aware to get a vibe for how it feels. All of this is at your fingertips. The internet is at your fingertips, you use your fingertips that's at your keyboard, and then you type on it. The va.com forward slash juicebox if you're looking for an insulin pump, in my opinion, you should look at the Dexcom. If you don't like it, it's cool. But I mean a free 30 day trial gives you plenty of time to figure it out. omnipod.com forward slash juicebox dexcom.com forward slash juice box links in the show notes of the audio player you're listening in right now. And links at juicebox podcast.com. Let's get back to Emily. And trust me. There's a lot more to talk about with Emily. Three months. No kidding.

Emily 19:48
And well. I would call her and tell her that I'm throwing up she's like well try staying with a little longer. It may just be taking you a while to get used to it. So I kept thinking it's not like I called her every week. She kept telling me to take it. Yeah. But you know, after the first week, she said, well take it a little longer see if you still have it. And I just kept thinking, well, maybe next week, it'll get better. What was the drug? I wish I could remember the name as long ago, right? It's i It's one of the ones that's has a commercial on it now. But every time I tried to look for that, like, they didn't give me the they gave me the off brand.

Scott Benner 20:25
Oh, you were using a generic of it? Yeah. And they didn't try. They didn't even try moving into the drug. Just generic only.

Emily 20:36
Oh, that well, that was Walgreens fault.

Scott Benner 20:39
You have it the doctor can say no generic substitutes. I'm saying like the doctor never stepped up. Did the doctor know you were taking the generic? Do you think

Emily 20:49
the Nurse Practice Nurse Practitioner was the only one I was seeing. And I honestly didn't, it didn't occur to me that it would matter.

Scott Benner 20:57
Gotcha. Might not have I'm just saying I was wondering if that was the that would have been the first thing I said if I was the doctor. So I was wondering if it got said to you. Alright, so. So this is pretty much your setup, like this is how it's going. You're Are you your Dexcom and MDI are Dexcom in a pump.

Emily 21:16
MDI MDI,

Scott Benner 21:18
would you ever use a pump,

Emily 21:20
my doctor keeps trying to get me to take a pump. But my I had a Dexcom, about 10 years ago. And I had a very bad experience with it, which I'm not having this time around. But it was with the the insert, I don't remember the name of the three pieces. But the the piece that you carry around with you, as opposed to the recipient,

Scott Benner 21:49
I'm sorry, the central know the receiver, the part that you carry to look at your numbers on the receiver, right? The receiver

Emily 21:56
was set so that it would be but certain times you couldn't change the beeps. And it was just constantly beeping. And I got so frustrated, because it would wake me up for no reason, if you like your blood sugar is on its way up, like I know. And I couldn't turn it off. And so I just said, No, I'm not going to do that anymore.

Scott Benner 22:18
Emily, you have gotten no help. Because those alarms are custom are customizable. You can change them.

Emily 22:24
Well, the one I'm on now I'm on the GS six, you can customize it except for what it deems is your lowest low

Scott Benner 22:31
5050 BMC. Yeah,

Emily 22:35
I consistently wake up at night, well, before I was on it, I consistently would wake up with my blood sugar being in the 30s. And I'd be pretty much coherent. And I would just get up and I'd eat something and I'd go back to bed.

Scott Benner 22:52
So, so Emily, there's a lot going on here, you are about to learn a lot with this Dexcom I tell you, first of all, please stick with it. Like unlike the drug that made you vomit, I think you're gonna have a good outcome with this. I stick with it because it sounds to me like you are using insulin in a way that is making you low at times. You don't need to be that I mean, 30 is just, I mean, 30 is a pretty big mistake somewhere. You know what I mean? Like, I don't know if it's with your meal or with your Basal insulin like I couldn't possibly tell you from here. But have you listened to the Pro Tip series of the podcast?

Emily 23:31
A couple. A lot of them. A lot of the the podcasts I've listened to just happen to be about things that don't really apply to me. At least I haven't I haven't heard ones that apply to me yet. But I, I listen to a lot of different kinds of podcasts. So I have to admit that I don't listen to yours on a regular

Scott Benner 23:58
route. So I'm gonna send you a specific list of management ones that might help you get your Basal insulin dialed in, and then give you ways to think about giving yourself insulin at mealtime. Because Because you shouldn't be at 30 like and I don't think you have to be you know, so I think somebody needs to help you a little bit and get you get you going in the right direction.

Emily 24:22
Well, I can tell you that. Now I'm I'm on a human log and Lantis at least four shots today. Because the Lantis is I use a pen so the Lantis is separate. And what I will tend to do is I'll be hungry, so I'll try to figure out how many cards I'm going to take. And I was given at one point, the ratio that I'm supposed to use. And so I'll figure out the carbs. And then I'll take my insulin and then I'll end up about halfway through getting or, like I have a really small stomach. And so I never finish a meal. And so the hardest part for me is figuring out how much I think I'm going to eat versus how much I do eat. And when I should be taking my insulin, so they said, Well tried take your insulin afterwards. And so then I do that

Scott Benner 25:23
not okay. So, again, the input, the information that people come back at you at is interesting, where they skip over the common sense and go right to the dumb idea. I've seen that this has now happened twice in your stories. It happened throughout my life, right? So yeah, so here's, here's a thought, if you don't know how much you're going to eat, why don't you Bolus half of it as a Pre-Bolus? And then if you finish it, put the rest of it in. Like you're not afraid of the needle. I mean, you've had years you don't get about, oh, I just cursed. You don't care about injecting? I imagine, right? Yeah, no, right. So do half upfront, give yourself a reasonable do you Pre-Bolus your meals at all?

Emily 26:03
You mean, take my insulin before I

Scott Benner 26:05
yeah, like but yeah, you do. But like 15 minutes, five minutes? How long do you do?

Emily 26:12
It's usually about five minutes. Okay?

Scott Benner 26:15
There's a whole world out there you don't know about I'm excited. I'm excited to send you these episodes. I'm gonna list them at the end of your episodes so people can hear them. But when we get off, I'm going to just send you an email with a list. Okay. Okay. All right. And I think that you'll be able to get your IP. So, Emily, this is interesting. For me, I didn't realize we were going to talk about this before we talked about the other thing. So in my mind, everything about type one diabetes is how you use insulin. And everything about the insulin is the timing and the amount, meaning you need to use the right amount at the right time. That can mean your Basal insulin Volantis for you. And that can mean your mealtime insulin. Both things need to be measured and used properly. So the first thing you're going to kind of work on is getting your Lantis, right. And your Lantis should be holding your blood sugar stable at a number, whatever your number is that you want. Like if you want to be 90 all the time, if that's your goal, if you want to be 120 all the time, if that's your goal, like whatever your goal is, there's an amount of Lantis that you can take that away from meals away from meal insulin, and away from exercise. Your Atlanta should hold you with that number. You should have enough of it in there to hold you steady. You should think of the Lantis as sort of like a giant unseen force standing over your top of your blood sugar pushing down with its palms, holding your blood sugar stable at a number not letting it rise up past that. That's its job. Now once you have that, right, you need to move on to understanding how to polish your meals right.

Emily 27:54
Did you say pushing down with its paws?

Scott Benner 27:57
With its palms? I'm sorry? Oh, yeah. Just like try to imagine Lantus being a giant. I don't know, like a god. Okay, well, I'd

Emily 28:05
like to think of it as a giant bear now.

Scott Benner 28:07
Okay, fine. I'm with you. All right, I thought I heard pause. And we I'm going with you. And this is a bear. Okay, it's a bear 10 times the size of you. And your blood sugar is this. I don't know, unforeseen ocean that's trying to float up too high. And the bear is just pushing it down, pushing it down, pushing it down, but not too far, just keeping it where it wants to be. That's what your Basal job is. It's to hold you stable at a number. Okay. And then once you do that, that's sort of not a variable anymore for you. Because you know, your Lantis is set up well and doing its job. And then you come along and look at your meal and say, Alright, this meals, 30 carbs, and you look at your insulin to carb ratio, you put your insulin in, in enough time. I call this a Pre-Bolus. I think it's a pretty common phrase write in enough time so that when the action of the insulin starts to work on your blood sugar at the same time, or very similar timing, the food starts to work as well. So think of the meal as a tug of war. So on one side of the rope, put the insulin and on the other side of the rope, put your your food. Now, if you inject your insulin and begin to eat right away, the insulin is not going to start working for probably 1520 minutes, maybe if you're lucky. And then it's not going to be at full power probably for 30 minutes, like when do you usually see a peak like 45 minutes maybe? Right and then, but the food hits you much quicker than that. So now you've put the insulin in, you've started the timer on the insulin and you've told the food go ahead and pull on the rope. While the food is now has a huge head start it's pulling on that tug of war rope and that flag is going more and more on the on the food side and your blood sugar is getting higher and higher. And you're seeing that now for the first time in your life. because you're really wearing a Dexcom. So even if you start eating at a 90 blood sugar, you put in the food you put in the insulin 10 minutes later, the your 90 is 100, then all of a sudden it's 105, then the arrow flips up diagonal, now it's 110 115 121 25. And then the arrow flip straight up, this sounds familiar, right, and then your blood, your blood sugar starts flying up. And now it's, you know, 30 minutes later, your blood sugar is 190. And the insulin is really kind of feeling itself now and it's at full, it's at, it's more full power, and it starts to pull down. So now the insulin is finally pulling on that rope. And then that arrow goes from straight up to diagonal up to level, because that are, if you can think of the insolence got a hold of that rope, and it's finally pulling back, and it's pulling that arrow back around. But at this point, you only gave yourself insulin for the food, with a 90 blood sugar as your math. But now your blood sugar is 190. There's momentum on the side of the of the blood sugar on the side of the food. This insulin you've used is not nearly enough. And that's one thing that happens to you. The other thing that happens to you, I bet is that that whole process happens, but you don't finish your meal, and then the food, then the insulin comes online overwhelms the number and crashes you back down again, Does that all make like sound like stuff that's happened to you?

Emily 31:22
It's like, you're reading my pancreas,

Scott Benner 31:26
I have to tell you, those other podcasts you listen to, are gonna have to go on the back burner for a while I'm late because we are going to get you straightened out. Okay. So

Emily 31:35
let's see. That's the whole reason I wanted to talk here because my therapist said, you know, the whole way you're dealing with everything as far as diabetes in chronic pain and stuff has to go back to the grief that you've dealt with. Since you were 10. And on, tell me about it. And, you know, my grief. Does a grief when you're diagnosed as a diabetic, because even if you don't understand it, you do understand that you no longer get to eat as many double stuff Oreos as you want. There's a loss there. There's a, you know, a loss about, well, now I have to start thinking about everything I'm gonna do for the next hour, day, week, month, year, I have to sort of plan everything out, like my friends make fun of me, because I'm one of those people who has a purse that has something for every possible thing that could happen. Because that's what diabetics have to do.

Scott Benner 32:45
Well, Emily, not that people with diabetes don't need to be prepared. But I'm going to assert that it's more of what you have to do than what some people have to do. So my daughter is 17. She's had diabetes, and she was to yesterday afternoon, she came home from school at one o'clock. She's a senior and she's got an early release. They apparently are not teaching them anything in her last year. And she comes home and hurt her day begins basically her personal day and we knew my daughter had plans to go out with her friends that like they were going to go to dinner. So my daughter comes home. She had eaten something at school, we had not spoken to her about it. She had given herself a little too much insulin. So while she was getting ready, she took care of that with a little bit of juice, got herself at about a 90 blood sugar, took a shower, put her makeup on and got dressed. Her friend came and picked her up, they drove to a friend's house. Three, four hours later, they were having dinner. They ate at a restaurant from like six to 730 they went back to the friend's house, they hung out all night did a sleepover and she walked back in the door today at 10am. I did not speak to my daughter since she left the house yesterday at three or three I think maybe two and I'm going to pull up her her Dexcom in front of me right now. Okay. And over the last 24 hours after my daughter fixed the little low that happened when she came home from school, which was about 65 her blood sugar is for a number of hours from three o'clock until 630. Her blood sugar was 88 to 91. And then it looks like she missed a little bit on her dinner. And she had a spike but she spiked to 140 and that only lasted for about a half an hour. And then over the next 738 3930 She came back down. She looks like she caught it with a little snack. The drop around nine o'clock, and then she leveled out. And by 10 o'clock she was 75 and for the next 12 hours she was basically between 85 Have and at one point she got to 110. And that's a pump and an algorithm and a CGM working together along with her knowing how to Bolus for her meals, and how to fix her low blood sugars without causing a high one. That's all she knows how to do. She fixed her low without causing a high, she Bolus for her meal. And other than that she's wearing an algorithm. She's wearing it on the pod that's running an algorithm. And it is giving her insulin and taking it away and keeping her basil exactly where she needs it to be. That is a world you could easily live in. It is not that hard to get involved. If you have insurance, it'll cover a deck sound, you can get a pump, you know? Or you can or you can learn. I'm sorry, I'm sorry. I'm sorry. I didn't mean to step on you. But where you could learn to do it with MDR? There are plenty of people who do.

Emily 35:49
Yeah, I think I mean, I was really burned at the beginning with the the lack of information I got, and then I just I have a complete mistrust of doctors. I stay away from them as much as I can. Because I've never had a doctor really tell me anything particularly useful. When I was 13, I passed my first kidney stone, although that's not what I thought it was. I stayed home because I thought I had cramps. And then I was passing the kidney stone which have you ever passed a kidney stone? My wife has? I have not? Yeah, they're really horrible. Especially without pain medication. And sorry, I'm Flemmi.

Scott Benner 36:40
You're fine. I have an edit thing later, I'll listen back to this, no one will ever even know you cough. Don't worry about

Emily 36:45
okay. You can change this to say I'm Flemish, if you want. And so I called my mom at work. And I said, Mom, you have to take me to the doctor, I'm in so much pain. I'm pretty sure this is because I'm a bad diabetic, I'll do whatever you want. Just get this pain to stop. So she didn't it didn't occur to her that it was a kidney stone. It didn't occur to anybody that it was a kidney stone. They got me to the doctor, the doctor said, Well, have you been testing your blood because by now, blood testing had come out where you did these big strips, and you had to put like, half a gallon of blood on it. And then it would show you a color scheme. And I didn't do those because I didn't. I just didn't want to. I had sort of no one ever explained to me how that would be any more helpful than the urinalysis test. So I get to the doctor, and I'm still in a lot of pain. And he says, Well, what are your last blood sugar has been? I'm like, I don't know, I haven't tested on and he's like, why haven't you tested them? And I said, because I can I feel I can feel if my blood sugar is gonna go low. And he's he slams his fist down on his desk, and screams at me. Sorry, you're fine. And to a 13 year old, right? Like he went all he got credit for dinero in my face. And so I left that never getting help for my kidney stone, which I then eventually just passed.

Scott Benner 38:26
They didn't they just let you leave the hospital. They had me leave the hospital? Because you didn't test your blood sugar. They didn't check on the pain. Yeah. Emily, where did you grow up?

Emily 38:38
Northern California.

Scott Benner 38:40
Wow. Um, listen, let me say something to you. I didn't think this was gonna go this way. But I am sorry for all of the bad information that you have gotten over the decades. But I wanted to tell you that, that doesn't exist anymore. If you don't want it to the information is easy to come by now. It's literally in that I'm gonna give you basically, I don't know, 15 episodes of this podcast, if you listen through them, and marginally understand what you're listening to your agency will be in the sexes. It's it's the technology is so much different. But I think for you, if faced with that information, I think the 40 years of somebody or everybody may be letting you down. You just feel like maybe it's not possible, or is it? Or do you feel like it's too late because it's not too late. And it's incredibly possible? Like you should go into my private Facebook group and see that there are 20,000 people in there who are all either learning or doing and their blood sugars are not the way you describe. They are not living lives the way you think it has to be. Because you have diabetes. You just grew up in a bad time with type one, but you're still here and you're young, and it doesn't need to be like that anymore.

Emily 39:59
Well, I Appreciate that, and I will listen to the podcasts. Here's the kind of thing that I grew up with. I was diagnosed in December of 1980. And I turned 11, the next month in January, and we got a diabetes forecast magazine. Does anybody still get that?

Scott Benner 40:23
I don't know. But I was in at once. Oh, congratulations. I don't I didn't feel that exciting.

Emily 40:30
I had my doubts about this whole diabetes thing. When I saw there was a cover article that had the headline, I'm a diabetic, or maybe it was my daughter was just diagnosed diabetic. Can I still get a Christmas tree? Wyatt. That's what I said. And I, I it confused me. I'm like, why wouldn't we? Why wouldn't you get in? I knew enough about diabetes to know that Christmas trees have nothing to do with diabetes. And so anything I ever saw was either super, super scary. make no sense at all, or was super tweet like that? Just the sort of not

Scott Benner 41:18
helpful? Yeah. Exactly. The diabetes space is full. Yeah, yeah, I don't I don't do. So I'm just telling you there's a it's timing and amount, use the right amount of insulin at the right time. Your Basal right, you'll learn to Pre-Bolus for foods, you'll learn the difference between different foods glycemic index and, and load just meaning that, you know, 10 carbs of watermelons not going to impact your blood sugar the same way 10 carbs of white rice will. And then you stay flexible after that. And bunch of other stuff. It's a 681 say just good basil. Get your Pre-Bolus together understand how much insulin things need. That's pretty much it. Like there's not much more. I mean, listen, that's an unfair statement. There's a lot more to it. But that's the base of the that's the base of the building right there. You got to get that right. And then after you get that, right, the rest is a learning experience that you'll actually have time to learn because your experiences won't be so horrible. Like, you know what I mean? Like there's a difference between something going wrong and your blood sugar spiking to 140 which is what I described with my daughter's dinner last night, and something going wrong and you waking up in the middle of the night your blood sugar's 30. Like one of those things is an emergent disaster. And one of those is like, Oh, I got my Bolus a little wrong here. You know, so like, when you're constantly in the disaster, you can't see the lessons. You only mean like when you're running from the from the bear through the woods, in the woods or on fire? That's not the time to think the forest is a deforestation probably caused this, you know, like, this is the time to think I gotta run from the bear and the end The woods are on fire. I don't want to burn down. You're always constantly flight or fight, I would imagine. Yeah. And you need, you need to get you into a more calm place where you can actually watch something happen and say to yourself, oh, Emily, hmm, I Pre-Bolus 10 minutes here, and I spiked a little bit and then didn't get low later. I bet if I changed that Pre-Bolus to 15 minutes for this meal, the spike wouldn't happen. And I wouldn't get low like you can be a little more thoughtful about it when you're not running for your life.

Emily 43:27
Does that make sense? Yeah. Well, I think part of the reason I react the way I do to pretty much any sort of problem is, you know, my basically, I was diagnosed diabetic when I was 10. My dad died when I was 12. And so my fight or flight reaction is stuck at that age. So I feel like I don't quite under you know that. It's still a 10 year old me who was trying to fight with this diabetic stuff. Yeah. And is just so shocked. You know, I thought I was gonna die. My whole family joke that I would be the first one to die because of the diabetes.

Scott Benner 44:12
bunch of comedians who grew up with their Emily. Oh, yeah. Oh, yeah.

Emily 44:15
And so the fact that I've made it to 52 is so shocking to 10 year old me.

Scott Benner 44:23
Well, I'd start taking that as a sign if I was who am I? Am I dumb? I forget what those people said. And I'd get busy living. You know what I mean? There's a lot here.

Emily 44:37
The diabetes hasn't stopped me from doing anything except my mom sat me down. When I was in high school and said, you realize that you're going to have to have a job. The minute you get out of college because you need to have health insurance for the rest of your life. And she explained to me what insurance will do you know, once you get off insurance now this is a preexisting condition and you can't get on insurance again. Unless you have a job that recognizes you know that we'll give you health insurance. And then for six months, you're paying, you know, millions of dollars for your insulin, even though back then it wasn't as expensive as it is now.

Scott Benner 45:23
Yeah, device, get a job have insurance. I think that's valuable advice for a person that was type on.

Emily 45:27
Yeah, no, I'm really glad I know it. But having to do that kept me from doing what I really wanted to do. Like I ended up. It took me five years to graduate from college because I had to have a full time job as well. Because my mom stopped supporting me, and which was fine. I was an adult. But then, I had to start temping so I could get insurance. And I wasn't able to do I wanted to move to New York and become a comedy writer.

Scott Benner 46:04
And you got a job to make sure you had health insurance.

Emily 46:08
Yeah. Instead, I started temping at a just marketing company. In San Fran, well, I had a whole bunch of temp jobs. And I started working for this marketing company. And that got me into databases. And now I do it stuff, which I mean, I'm okay at and I guess it's okay. But I sure would rather be

Scott Benner 46:31
doing something different, or at least at least trying the thing you were hoping to do. Yeah. Well, you talked in your note to me about grief. And you said that obviously being diagnosed was hard. And then your father passing soon after was hard. Did it keep coming after there? Or were there two were these two things just very present with you constantly growing up?

Emily 46:54
Well, my family didn't know the rest of my family. My mom and my two other sisters didn't know how to grieve. My dad's loss it so it got buried under about, you know, 15 miles of crap. And my mom ended up like, right when I felt I needed her most let alone my other sisters. My I was 12, my middle sister was 16. And my eldest sister was 90, and hang on a second. Okay. Because my mom wasn't expecting this, I think she sort of reevaluated her life, and realize that she was going to start spending her life for herself and not for her children. And she found this friend who was 12 years younger than her and they just started, you know, running off on trips and doing things like that. And I don't actually have a problem with her having done that. But she didn't allow us to grieve. She just said, Okay, move on with your life. I'm moving on with my life. And, you know, I barely saw my mother. Well, I wouldn't say barely. But she, she wasn't around as much as say, my friend's moms. And the last conversation that I remember having with my father was one that he was accusing me of, because my blood sugars when I did test them were high. He, he had the memory of my urinalysis being high, he had decided that I somehow had found a way to go to 711 and buy candy and I had it hidden somewhere in the house, which was not true. And that was the last interaction. I remember having with him before he died. How did he pass? He had a heart attack. He was a US only 49. And he was a five pack a day smoker, meat and potatoes guy, so it's not a shock.

Scott Benner 49:08
Certainly drinking or drugs going on in the house with your parents? No, no. Interesting. Okay, so your dad dies, your mom flips out. Do you remember your mom being a panic before your dad died or to just really get to her?

Emily 49:21
I think she didn't know how to deal with it. My entire extended family I've talked to like, I'm really close with my cousin. And she talks about how her family you know, our whole extended family doesn't know how to grieve. You just kind of you're supposed to push things down. The only the only thing you're allowed to do at family functions pretty much is laugh. We're all very happy, goofy and not recognizing the problems that everybody has. Which has caused several divorces and just weird

Scott Benner 49:58
things not going well. Right. And for you, the for you. I mean, let's be honest. Right? You feel abandoned?

Emily 50:06
Right? Yeah. Even though I mean, I wasn't really abandoned. It just felt like that.

Scott Benner 50:10
Yeah. And well, you don't have to stick up for anybody I understand what we're talking about. Don't worry. I know they didn't leave you on purpose. But I'm saying you the end result is you feel abandoned. Your dad left, he died, your mom left, she kind of went and took care of herself. And you may she might have physically been there, but she wasn't helping you. And you were only 12 years old at that point. Right. Right. Yeah. And so you grew up 1213 1415 1617? Probably with your older sister helping you more than anything else, then you go off to college. In the middle of being at college, your mom lets you know she's not paying for you anymore. Right? Right. Yeah. So that's an abandoned feels. That'll make you feel abandoned as well. And then you abandoned your dreams to take care of your diabetes. Right? So you hate diabetes. And you're probably not thrilled with your mom. But she didn't leave you leave you so I'm assuming you write that off in your head. Are you mad at your dad?

Emily 51:12
I'm getting there. Now. I romanticized him for a long time. But I took it all out on my mom, because she was the one that was there. And she talked about being abandoned by your mom. She drove me I went to UC Santa Barbara. And so she drove from the Bay Area down to UC Santa Barbara. And for some reason, she had decided that she was just going to turn it's like six hours, six and a half hours, right. And she decided she was going to do the drive all in one day. So we got up super early. Everything was already packed, drove down there. unloaded my stuff. And then I turned as I put the last box down, I turned around, she was already in the car, starting it up and driving away. And she yelled out the window. Right when you get work.

Scott Benner 52:03
Were you guys broke?

Emily 52:05
No. Well, okay. i We there were more money problems. And she led on she just didn't tell me. Right. So you know, if she had told me if she had told us we could have

Scott Benner 52:17
you know, understood maybe? Yeah. Was your mom a nice person?

Emily 52:24
Absolutely. Yeah, she was a nurse. That's why they caught my diabetes super early, because I started showing symptoms over Thanksgiving, and then was in the hospital by the second week of December. So I still don't have knock on wood. Very many. You know, I've never been gone into ketoacidosis. As far as I know. Okay. Certainly never been hospitalized for it. I by optic nerve is still perfect. My kidney values are fine, except for the stones. I don't have you know, I don't have all the things that are supposed to happen. You haven't

Scott Benner 53:17
had any you haven't any, like ill effects from diabetes yet.

Emily 53:21
Yeah, that I would have expect to happen by now, given the fact that I haven't even bothered to really pay attention.

Scott Benner 53:29
When did you start to pay attention? When did you actually start testing your blood sugar?

Emily 53:35
In 1999, I moved up into the Pacific Northwest and saw a doctor and they said you know there's much better insulins that you could be on there's there's much better things that you could start doing. And so they gave me a book blood testing monitor, whose name I'm forgetting off the top of my head. It's the freestyle freedom like where you can have alternative blood testing sites. So I started using my forearm rather than my fingers because I could never handle the fingers. Okay. And so once I could do that, I started testing my blood more.

Scott Benner 54:24
So Mm hmm. Basically, when 18 years without testing your blood sugar, and then I getting that timing right about 18 years. 81 Yeah, I

Emily 54:34
was 3020 years.

Scott Benner 54:36
20 years. Okay, that's 20 years you didn't test. And then for the last, you know, the last chunk here, you've been paying more attention. So in the last 20 years, have your agency still been in the nines?

Emily 54:49
Um, the mid 80s. Low 90s.

Scott Benner 54:54
How much effort do you put into diabetes every day? Not a lot. Not a lot. Okay. So it's, it's not. I see. Do you know other people with type one? No, no, you don't know anybody else with it? Well, my sister

Emily 55:11
I did. I didn't know her. She was also not a good diabetic. But she hadn't been diagnosed she had it way before she was diagnosed with it. Because she was on her. She was in college, and she was on her summer bikini diet and eating like 500 calories a day. So it wasn't as obvious. You know, she was losing weight, which she thought well that this diet is working right. And she thought she was paying a lot because she was drinking so much water. She thought she was drinking so much water because she had. Yeah, she was supposed to drink eight glasses of water a day or whatever. Yeah, it all

Scott Benner 55:51
covered each other. Do you guys ever talk about your diabetes? The two of you?

Emily 55:56
We would complain about it. She died in 2014. I'm sorry. Okay, well, so let me get the overall grief thing out of the way. So you can understand. Okay, so I got to college in 1987. Pass a couple of kidney stones moved back up to the Bay Area in 93. And my middle sister starts to be antagonistic towards me, because we each got an inheritance from our grandmother. And I used mine and took a trip and backpacked around Europe, whereas she was married. And so she bought a house. And so she was mad that she didn't get to go to Europe. And so she, we never talked about this, but that's how I sort of felt about it. She was just always kind of, she had I was staying in her house. For about three weeks or maybe a month, I was working three different temp jobs until I could get enough money to move out. And then I caught walking pneumonia. So while I was out with walking pneumonia, my sister thought I was making that up. So she, if this sounds so much more Maury Povich than it really was, but she had my mom kick me out of her house. She my sister had my mother kick me out of my sister's house.

Scott Benner 57:32
Okay, I understand.

Emily 57:34
Which I didn't know you can do that. By letter. I didn't get to talk or basically what am i Mom writes, you know, you've always been the funniest, but also the most selfish, like this really harsh letter. And so I we, we kind of had a falling out after that, although it would kind of go up and down in 2012, so I moved to the Pacific Northwest Northwest and my eldest sister was in Pacific Northwest already. And in 2012 My mother dies, surprisingly, like no one expected it at all. So that threw us all for a loop. And then two years after that, my middle sister dies. They're not sure of what we would have had to pay like 1100 bucks for an autopsy. And we didn't

Scott Benner 58:43
know I was married with the house one, right?

Emily 58:46
Yes. Okay. And she's the one who also had diabetes. So when you have diabetes, and you die, they assign you we always used to joke that oh, you know, we get in a car crash they're gonna blame it on the diabetes right? And well, she was also on several different pain meds because she had terrible complications. She had a tracheostomy because of all the throwing up. She did, because she had What's that stomach disease when your stomach doesn't gastroparesis? Yes, she had gastroparesis. Her kidneys were basically shot. And so she died at the age of 47. It sounds

Scott Benner 59:37
like she was doing less day to day work on her type one than you were for sure. Well,

Emily 59:43
actually, she actually. I don't I don't know whether she was doing more or not. We never discussed it. But she had just always had because her diabetes had been noticed. Her diabetes had taken hold much earlier before she was diagnosed, that it just came with more crap. Like, I think even if she had a pump and the best everything in the world she still would have gotten gastroparesis, she still would have gotten the neuropathy. Um, yeah, I

Scott Benner 1:00:20
mean, I don't know how to say for sure what people what what things people would develop or not develop based on their care. I can tell you that I think if you get good care immediately, and you keep a onesies lower that that lowers your chances of these things happening but certainly it's not a not a foolproof system. But it sounds like a lot went wrong like it to me. I mean, a layman from the outside. It sounds like your sister's a onesies were really high. And it was just ravaging her in a number of different ways.

Emily 1:00:52
Yeah, she she would go into ketoacidosis. Like, every three weeks. Yeah. And well, the problem was that her doctors would fight with each other through her, like her diabetic doctor would say you need to do A, B and C and her her kidney doctor would say no, no, you need to do XYZ. In the meantime, she's in so much pain, and neither of them are giving her any pain medication. So finally she gets an okay, she's changes hospital and she moves up to, to Pacific Northwest. So all three sisters are together after mom died. And she lived near my other sister. And she was on disability. And so my eldest sister found her apartment and my niece was going to go over and just sort of help her out. You know, clean the cat box for her and stuff like that and hanging around and make sure she was okay. And within a month, my niece went over there and found her dead on the floor. And we don't know what killed her. But because she had a bottle of you know, legally prescribed methadone. They decided that oh, she she Odede.

Scott Benner 1:02:23
Was she a recovering heroin addict? Nope.

Emily 1:02:28
Methadone is a common pain

Scott Benner 1:02:30
is common for pain. Yeah. Oh, I didn't realize that. Yep. Okay. And it's really

Emily 1:02:35
good. I'm on it, too. And it's really good. It gives you it helps with just standard. Just the lowering of a pain

Scott Benner 1:02:46
changes your threshold.

Emily 1:02:47
Yes, exactly.

Scott Benner 1:02:49
What, what are you on it for?

Emily 1:02:51
I have chronic pain in my hips and legs and shoulders. My shoulders basically are like, stuck in Frozen Shoulder syndrome and have been for four years now.

Scott Benner 1:03:04
Well, that's a complication of type one frozen shoulder? Yeah, yeah, that's what they've told me. Are they? Did you get it looked at like by somebody who thinks they can treat it? Or are they just treating the pain?

Emily 1:03:17
Um, well, I have a pain management doctor that I also am seeing a physical therapist, I have a PHP, I'll be going to see an endocrinologist. Um, my pain is pretty well managed now.

Scott Benner 1:03:33
Okay. Do you have any considerations about like, maybe if you brought your agency down and got your variability a little stable, like your stability better than maybe some of your problems might alleviate? That would be great. Yeah. Because there have been people your age that have come on that I've talked about that. People with, with significant type one, complications, who were on their way to others, and then they found the podcast and got their agency down in some of those complications. I'm thinking of one person now whose vision was going and then he got his blood sugar down and stable and his vision stabilized.

Emily 1:04:13
Oh, well, yeah, that, that totally makes sense.

Scott Benner 1:04:15
Yeah. Do you understand? Like, why high blood sugars cause problems like this?

Emily 1:04:23
I'm in a very vague way I sort of pictured in my head as if Hi. I always picture my body's being sort of a cartoon. And so you know, like my optic nerve. High blood sugars. High blood sugar to me is like a cotton ball surrounded by steel spikes. So as it rubs up against the optic nerve, it shreds it. It's a sort of a weird No, no,

Scott Benner 1:04:57
it's not weird at all. It's how I think about it too. I I think of it as there's a certain amount of sugar that belongs in your blood. And that at the molecular level, sugar is jagged, just like you would see table sugar, but smaller. When you pack too much of it in your blood, you're basically being scraped or sandblasted from the inside out. Right? And, and all you need to do for that to stop happening and to give your body a chance to heal is to get a adequate, but not too low or too high level of sugar in your blood and find some stability, you don't want to be rocketing up and down, up and down. That's really bad for you as well. Right? Yeah, I. So Emily, in the last years, last couple of years, well, just the other day, actually, a company named Omni pod came out with a algorithm pump that will make your, you know, insulin dosing. Well, it adjusts your insulin as you go along during the day, you still have the Bolus for your meals. There's also a company named tandem that has a pump that does the same thing. Control IQ. Medtronic has a pump that does the same thing. There are three pumps on the market that do this, two of them work with your Dexcom control, like you on the pod five, like these things, if you got them on with even like reasonably good settings, I think your blood sugar would would level out, I think your agency would go into the sixes and stay there. And you know, then you'd really just have to worry about you know, your bolusing for your meals properly. counting your carbs, right understanding the different impacts of different foods and Pre-Bolus say a little bit. I really think there's a lot of success very available to you and everybody else, not just you. But you got to go get it like you have to. I mean, you got to go to a doctor and make them do it. Don't wait for them to suggest it to you. If that's what you want to do. But you're also at the same time you're battling all this grief. Right? You're in counseling. I guess how long have you been doing that? Um,

Emily 1:06:59
well, I saw one therapist for about 15 years, and then she retired. And so I've seen I've been seeing the one I'm have now for a couple years. Is it helping you? Um I'm having a slightly harder time adjusting to my new person. She's great. She's a little more in your face than I'm used to.

Scott Benner 1:07:31
What's the goal for you and you go to therapy?

Emily 1:07:33
Yeah, see, that's the problem. My goal when I was seeing my first person was to basically just express my grief and my rage and everything else in a safe space. And then prescribe antidepressants because I've been diagnosed with severe depression, surprise, surprise.

Scott Benner 1:08:01
How is your Shiva for your thyroid levels checked?

Emily 1:08:04
Oh, yeah, I'm on thyroid meds too. I'm on Synthroid Synthroid. Yeah,

Scott Benner 1:08:10
what's your TSH when it gets checked? Do you know it?

Emily 1:08:14
I don't know it off the top of my head. I get really bad about taking. I was only told recently that you're supposed to take your thyroid meds before you eat and right first thing in the morning like

Scott Benner 1:08:30
not not with any other medications or food. Right? Yeah. So you've been taking it? It's not been helping you? Right? Yeah. So one of the things that you might find with an unregulated hyper, you have hypothyroidism or Hashimotos. Have they told you? Oh, hypo. Okay. So with hypothyroidism, depression is one of the things that you that you get from having an unregulated thyroid very possible that could be from that. So taking your thyroid medication every day, at the same time, letting it stay in your stomach for an hour or, you know, at the you know, without putting anything else in with it. You might see an improvement just doing that for two weeks. And then continuing on but I mean, I'm saying in the first two weeks, you might see a real benefit that you have. Are you cold all the time? Does your hair fall out? Do you have dry skin?

Emily 1:09:24
I have dry skin, but no, my hair is okay. I'm not always cold.

Scott Benner 1:09:32
regulating your thyroids a really big deal. It also makes your blood sugar management easier. There's a whole series in the podcast about thyroid so you might like this podcast, you'd be surprised.

Emily 1:09:45
There's only so much self improvement I can do before I start to rebel because remember, I'm between 10 and 12 years old.

Scott Benner 1:09:54
Yeah, well, and we I don't know a lot about the psychology of people. Um, I'm certainly no expert, but I will tell you this, if you don't do something different, it ain't gonna end well. So, you know, you might as well like, I mean, if you're gonna find something to take serious, I would think that your that your physical health would give you the best chance. I would think that having solid physical health is attainable for you. I don't hear anything about you that says that you couldn't accomplish that. And then you would give you more time to work on your on your mental health. And you might, you might have an easier time with that when your physical health is is there. I mean, high blood sugars make people you know, it's altering in your mind. And low blood sugars are as well vacillating up and down blood sugars are hard on you. I think you I think you take your Synthroid every day, I think you listened to a few episodes of this podcast to figure out how to get your your insulin like regulated a little bit. And you might see a really different person 30 days from now, looking back at you. Are you up for that? Do you think? Or are you just gonna like like this thing on fire and ride it out to the end?

Emily 1:11:13
I don't know. I haven't decided yet.

Scott Benner 1:11:17
Well, that's up to you. But I'm like, No, but I mean, everybody in your life has gone, right?

Emily 1:11:22
Yes. After my middle sister died, and my niece found her. Two years after that my eldest sister died of a very rare cancer called gastrointestinal stromal tumor.

Scott Benner 1:11:41
Emily, I would take the fact that you're still alive as a sign that you're supposed to be here. I mean, because everything around you is a show due respect. Yeah. I mean, it's a it's a dumpster fire. And, and you're, for some reason, standing up in the middle of it, and you're okay. And you're at the very least alive. And I don't know, like, I mean, it's a really weird thing, because I'm not judging you at all. Like, if you just want to sit back and be like, I got a crappy hand dealt to me, and I'm just gonna ride it out. I wouldn't know. I mean, I couldn't blame you. You know what I mean? I don't know what you've been through with it. Maybe it's more than you can overcome. But, I mean, I think it's obvious that, that this path is going to end poorly. I mean, you've seen that with everybody in your life, basically. You might as well try a different path. I mean, what do you got to lose? Really?

Emily 1:12:35
Well, that's true. It's just a, I don't have a keep to itiveness that, you know, I get on these kicks where I'm like, Alright, I have found the solution. I'm gonna do this. And then like, after a week, I lose interest. And I don't know if that means. I don't know what that means. Or where I got that from. You know, my dad always thought it was because I was lazy. My mom always thought it was because I was lazy.

Scott Benner 1:13:01
I think my play pop psychologist with you. I would think it's because that somebody has sent that expectation out for yourself. So you're just trying to you're just trying to prove them right? I think you're just i All that sounds like nonsense to me. Like you're a reasonable person. You were here when you said you were gonna be today, right? You get your insulin, you buy your your CGM, as you go to your doctor's appointments, you get up in the morning you eat every day, you're, you do plenty of things you don't I mean, I feel I should get a cookie for that. Well, good, then have one I don't give it. Like definitely have a cookie like, like, feel good. Pat yourself on the back all day long. If you want to, I'd wear a shirt that says Emily rocks. That's fine with me. You know what I mean? But what I'm saying is, is that if you grew up with a father telling you for too, you know, for two years, every time that that test came back, hi, it's because you're lazy. First of all, no offense to your father. He didn't know what he was talking about. Either. It either did the medical community at that point? You were a child. So you're being told every day you're doing something wrong. In fairness, you didn't know what you were doing. So it's not like you were actually doing something wrong. It wasn't even willful, you're just doing what you were told to do. It was ending the way it was always going to end. Because you were set up for failure to begin with. And then along comes this person to tell you it's your fault. So they don't have to feel bad about it. Because what he really is thinking is, oh, I'm failing this little girl. But I'll put it on her. So he puts it on you. Then your dad dies, and your mom puts it on you. Right? And then life puts it on you. And you're just you're just living a self fulfilling prophecy of of you're trying to make them right. I'm lazy things don't go right for me. My sister died. My other sister died. My mom died. This is my lot in life. I'm gonna die. Here I go. I don't think any of that has to be true. Well, I will die. Well, it doesn't need to be today. You're 52 Well, no,

Emily 1:14:56
I don't think it's going to be today. Yeah, like let's

Scott Benner 1:14:59
like let's Let's get into this. Like, I'd like to see you back on this podcast 10 years from now be and look at me still here, baby. You know, seriously like, and I'm telling you, the only thing you need to do is understand a little better how your insulin works. Take your Synthroid on time. Do it every day. Don't don't I mean, look, if you're going to tell me that I'm going to get bored, then there's nothing I can tell you in return. I don't think there's anything your therapist is going to tell you in your return. You got to you got to prioritize you, and you got to stop listening to ghost voices tell you you're bad at this. That's how it seems to me, but I've only known you for an hour, 10 minutes, 17 seconds. So

Emily 1:15:36
it's still it's up? 17 seconds there.

Scott Benner 1:15:39
That's where I really started understanding.

Emily 1:15:41
Yes. I was gonna say something, and now I've just forgotten. Okay, well take your time.

Oh, my mom told me something really weird when I was, like, 30. She died when I was 32. So we were at a family function. And she she said, oh, did I ever tell you the plans that your dad had for you? And I said, plans. And she said, Well, he had decided that after graduation, you are going to go to school at UC Berkeley, which was laughable because my grades would never let me get into UC Berkeley. But they had both gone to UC Berkeley. And you would live at home until you met your husband. And then he would hand you over to your husband. Not that my dad was one of those religious people who thought you know, the man is the head of the house kind of crap. But he thought that I would need to be watched over my entire life. And so he would do the watching over until my husband did. And that floored me.

Scott Benner 1:17:09
Emily, would it hurt you to know that I think it would have been better if you were born and then left in the woods to your own devices? Well, I think if you would have grown up feral you might be in a better situation.

Emily 1:17:26
See, but my parents were both great. I don't want Oh, they were doing the 70s that they weren't

Scott Benner 1:17:32
Yeah, looking. I was born in the 70s to trust me, I know what you're talking about. Like, nobody was thinking about anything very deeply. You know, it's people were not, you know, if your kid wasn't dead, you're taking care of them. You know, the, the idea of you go to go into college was like a great thing. You know what I mean? Get out of here, we're not paying for you anymore, you know, be gone with you. You'd probably the only thing I think that you could hear today that would make you cry is that I'm considering after talking to you getting in a car and driving two hours to take my son something he needs a college. And I would think that, like that seems like something that no one would ever do for you. And, and it's just that I've made a decision to like, I've made a decision to be the kind of parent I think you wanted to have. And you got the kind that that you know, either got sick and died or was like, Oh, I'm gonna get sick and die one day, I better have some time for me and they stopped making time for you. You know, but you could do it for yourself. Do you have kids?

Emily 1:18:36
No, no, I have never really wanted children. And then

Scott Benner 1:18:42
that's cool. Like, I mean, are you married? Are you with anybody? You by yourself? I

Emily 1:18:45
am. I am married. I'm actually married to someone I went to high school with although we weren't dating at the time. But yeah, we just weren't interested in kids. I like cats better. And then I just thought my genes are not the genes that should get passed on. Respectable the future

Scott Benner 1:19:04
respectable decision. I wouldn't. I wouldn't say anything bad about that. Can we put this guy in charge of the Synthroid. I like him having a job in this.

Emily 1:19:12
Oh, he can tell when my blood sugar's low way before I can.

Scott Benner 1:19:16
I want him to charge to the Synthroid. I want him in charge of the Synthroid, I want you taking that Synthroid every day for 90 days. And then I want you back at your doctor to get a blood test to see where your TSH level is. And if you're, if your TSH is over two, I want you to tell the doctor I want my TSH to be two or below. And then let's get my medication. Right so that happens. And in those 90 days, too, you start taking a little better care your blood sugar's I'm telling you you're a different person after this is over.

Emily 1:19:43
Okay, well, I will tell him he gets up. We both work from home, but he gets up about an hour before I do. So I'll just tell him to wake me up and make me take my

Scott Benner 1:19:53
pill, stick that thing in your mouth, drink a little water. Make sure you have enough and then whatever. And that yeah, that hour over be perfect. I seriously, nothing wrong with needing help getting this going. You know what I mean? Nothing wrong with that. Let him help with that. And, you know, we'll tasked you with listening to a couple specific episodes of the podcast and see if you can't figure out how to use your insulin a little more effectively. This all makes sense to you. Are we gonna get off this? And you're gonna be like, Yeah, screw that guy.

Emily 1:20:22
No, I mean, I feel very motivated at the moment.

Scott Benner 1:20:26
Good. Well, great, then that's it. Let's leave you right here, then. Let me not let me I've done my job. There's no more talking to do. Excellent. I do want me to tell you the episodes I think you should listen to.

Emily 1:20:39
Um, weren't you going to email them? I don't have anything to write.

Scott Benner 1:20:44
We're just making the podcast. You don't have to write it down. Don't worry. Okay. Okay. Yeah, we just want the pelota here. You know what I mean? Yes.

Emily 1:20:50
Oh, sorry. Yes, please. i Please tell me them right now.

Scott Benner 1:20:53
See, look at you're getting a no. All right. So I think there are a number of different places and ways to begin. Do you? Are you comfortable with terminology? Do you think you know, the terms that you need to know for diabetes? Because if not, I have one? Yes, you do?

Emily 1:21:15
I think I think so. I mean, I was on one of the Facebook groups for a while until I realized that it wasn't the face group for me because it was mostly people talking about taking care of their diabetic children. And I didn't feel like I really had fun. I can't tell anybody how to take care of their diabetic child.

Scott Benner 1:21:36
May I, Emily, you're thinking about that backwards. So it doesn't matter if their kids are adults. By the way, there are a ton of adults in there. They're just quieter. They don't They lurk more than they talk. But the point is that taking care of a five year old diabetes, taking care of your diabetes, at its core is pretty much the same thing. So I let the let the other stuff go just look at the focus. But if I said to you, Bolus, you know what a Bolus is, right? Yes. Okay. Basal.

Emily 1:22:06
Bolus is the current that you you are based on that give you getting the most Okay. Basil is the kind you take would be taking your short acting insulin Bolus is belonging acting.

Scott Benner 1:22:19
You have those backwards. Okay. Okay, so Basil is your Lantis. Bolus is your humor log. So just having said that to you, I'm going to tell you that there's a series of very short episodes called defining diabetes, I'm going to send you that list. Okay, okay, there's three, five minutes long, they're going to pick terms and they're going to define them for you, it's not going to be boring. And then you'll you'll kind of have this idea of like these, these things that are going to come up in these other episodes. Once you have those, you move on to the Pro Tip series. And the Pro Tip series is just going to walk you through basically how I think about taking care of my daughter's blood sugar, it's going to be me, and the CDE named Jenny. Jenny's had diabetes for like 33 years. She's delightful. She's from the Midwest, right? So you can't help but love her. And I don't think they're boring. They're going to it's going to be one of the episodes is going to be how to start over one's going to be about MDI about Pre-Bolus thing about insulin pumping. And then some other ideas, some variables that might impact you how illness exercise, how those things might help, you might might impact your decisions. That's it. There's, there's not many there. I think if you listen probably to the first like 10 or 10 or so you should be in a better situation. So I would have you listened to the defining diabetes first than the Pro Tip series. And then if you like them, or you see them helping you, that's when I say just jump in. Because even if you think about your episode right now, like, if I asked you when this is over, what's this about? You're gonna say, I got diabetes, when I was younger, I've had a lot of grief in my life, and I'm struggling, right, except there's a ton of management conversation in this too. And that exists in every one of those conversations. So sometimes just hearing people talking about it, normalizes it. And that makes it feel you know, like it's not work it just I don't think of diabetes as work like you don't put much effort into diabetes you said but you don't get a return. I probably put about as much effort into it as you do. And my kids a once he's in the fives. And she doesn't have any diet restrictions. She had like some pasta and bolognese sauce last night when she went to that restaurant.

Emily 1:24:35
Yeah, but did she have a Christmas tree?

Scott Benner 1:24:38
Every year? Every year Emily, I swear to you, that's a wonderful, I wish I could find out what the hell that was about. Like you can have a Christmas tree with diabetes. Shame on anybody who wrote that episode. That article by the way.

Emily 1:24:51
That was not that was a joke in my family for years.

Scott Benner 1:24:57
Well, it should have been that's ridiculous. Alright, so hold on, I am actually creating. I am going to create an email to you right now. So that I said I literally don't forget, because I'm so hungry. When I get done here I am 100% gonna go eat something. Okay, do you feel okay about all this? Is there anything you want to talk about that we haven't talked about?

Emily 1:25:21
I just want to end on a funny story, if I may, please. Okay, so we took a trip to San Francisco, once my, everybody in my family it because I was like a, I think 11. And so we all went to Fisherman's Wharf, there was a favorite restaurant, my family would go to, and I was sitting, my mom would usually give me my insulin. When I was 11, just because it was easier. I mean, I could do it myself if I want to do but she just wanted to. So I was sitting sort of next to the wall, and my three, two sisters were sitting next to me. So it wouldn't really easy for me to get out and go to the bathroom and shoot myself. So mom, we had ordered our meal, and mom's like, Okay, I'm gonna shoot, you shoot, you now. Just get under the table. And I'm like, Get under the table. She's like, Yeah. And I'm like, okay, so I get under the table, and I stick my arm out. And she shoots myself, she shoots me, and I pop up. And the weight person is there ready to put my food down. And so she had a way person had shown up while I was under the table, saw that I wasn't there, turned around, picked up my plate and went to put it down, down. And then I was there. And she nearly jumped out of her skin. And we thought it was hilarious.

Scott Benner 1:26:50
Well, I'm, I'm sad that they made you get under the table to get your get your insulin, but at the same time, I think the story is hilarious. Yeah,

Emily 1:26:59
that is the kind of person my mother was she just caused very funny things to happen.

Scott Benner 1:27:04
So Well, it sounds like she was lovely. It sounds like in general, you guys were overwhelmed with diabetes. And we're not getting any help. And I hope that somehow this has been helpful to you. Yes, I really.

Emily 1:27:16
And I would like to add to anybody listening. I did and do love everyone in my family. So well, the little things that I'm talking about.

Scott Benner 1:27:26
Yeah, for context. Look, look, I have to thank you for your honesty, because you really were able to come on and tell stories that, you know, didn't shine people in the brightest light all the time. But you there's no need to say. I mean, to me, there's no need to say what you said. Because I don't think that what you said is an indication that you didn't love and respect and care for your family. I'm just saying that. You know, sometimes people are outmatched by the things they're asked to do in life. And sometimes those things impact children. And you were around some people who got outmatched a couple of times, unfairly points even to them. And then it just had the impact on you that it had. And it's not fair to you either. So you don't need to. It's not just because that's how their life went doesn't mean that that's how your life needs to go. I guess. If there's one.

Emily 1:28:15
Do you still think this is an an after dark episode? Oh, yeah. This

Scott Benner 1:28:19
is very sad. I'm incredibly sad. You're a little girl who? Listen, let's not go over it again. But no, I think it fits well. In the after darks. Have you heard any of the after darks?

Emily 1:28:33
Yeah. The one that caused me to write my email was the one with the woman who was a recovering heroin addict.

Scott Benner 1:28:43
Yeah, that one's tough. They're all tough. Have you there's a ton of them. There actually, are, I think of some of the best podcasts that we have. Because like yours, people come on, and they, they've gotten to a point where they recognize that they're going to be incredibly honest, because that's what people need to hear. So I appreciate that you did that very much.

Well, I'm gonna thank you for listening first, and I'm gonna thank Emily for telling her story. And then I'm gonna thank Dexcom and Omni pod for sponsoring this episode of the podcast. So here, I guess I don't have to do it. I pretty much did it. dexcom.com forward slash juice box, go check out the Dexcom G six. See if you're eligible for the 10 Day Trial Get started today. Omni pod.com forward slash juice box may be eligible for a 30 day trial of the dash. You can check out the Omni pod five, two. And what else you can get started with my link Omni pod.com forward slash juice box when you support the sponsors. You're supporting the podcast so thank you for using those links. Speaking of the sponsors, I almost forgot that I am contractually obligated to say this For full safety, risk information and free trial terms and conditions, also visit omnipod.com forward slash juicebox. All right, now we'll get to the other stuff. All the episodes that I spoke about with Molly are available at juicebox podcast.com, diabetes pro tip.com. Or you can join the private Facebook group, and then scroll to the top and click on the feature tab where they're listed for you. These are going to be the diabetes pro tips. This will be the diabetes Pro Tip series, The defining diabetes series and there's a lot else there's a lot else that's not English, there's a lot more, check out those lists in the Facebook page or on the website. If you're enjoying the podcast, please tell someone else about it. Please, please, please share the show. It's how it grows. And it is really growing. And it's because of you. And I can't thank you enough. Oh, what else? Seems like there should be more but this about an hour and a half in you probably get a little tired of me by now. So maybe I'll just let you go. Does that seem fair? I'll bring up a bringing another podcast very soon. You can check that one out too. Before I go, let me thank somebody in the Canada for leaving a really wonderful review of the podcast says I do not listen to podcasts. That's actually not what it says. It says I did not listen to podcasts before my daughter was diagnosed type one in February 2022. Now I listen to the podcast religiously and find that I have learned so much about good diabetes magic management, from the pro tip episodes, the pumping episodes and the ongoing exploration of how others with type one manage their disease. I am less than six months out with my kids diagnosis and feel like a mini expert on how to manage her disease and how to teach others about how to manage it. Isn't that lovely? That's all the way from the Canada that's a foreign country. Did you know The Internet even worked like that? I want to thank whoever JoJo jammer is by the way JoJo jammer cool name for leaving this wonderful review takes a few minutes to leave a well thought out five star review that helps other people see the podcast and think maybe I'll give this a try. So if you're looking for ways to promote the podcast, leaving a great review is one of them. telling a friend is one. Tell your doctor. You can go out the window if you want. I don't think it's going to reach anybody but do that. And while I'm thanking people here at the end. Do you know the there'd be no way for you to know I've never said this on the podcast I don't believe I think we're up to like six states in the United States where somebody has a Juicebox Podcast license plate, a vanity plate, like someone they say like juice box or juice box. Like stuff like that. I tried to show my children because I thought it was really cool. And they were like what what are people doing? I was like, I don't know, isn't this really great? They love the park so much. They did a plate for their car with it. Anyway. It'd be cool if you guys all did that. So couldn't you free time or whatever. Go get a different license plate. I'd like to have like a collage of all 50 states and not for nothing. There are license plates on cars and other countries too. So you know what I mean? Anyway, if you do that, thank you. It's very cool. It's heartwarming, but if you definitely do it, send me a picture, please. All right. Now I'm really leaving. I'm out of here. What do I have to say at the end? Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast.

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