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Scott Benner 0:00
Hello friends, and welcome to episode 717 of the Juicebox Podcast 717.

Today's guest is an adult who lives with type one diabetes named Miriam. And she's here today to talk about a number of things, including her pregnancy. 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, who are becoming bold with insulin. If you have type one diabetes, and are from the United States, or are the caregiver of someone with type one, you can go to T one D exchange.org. Forward slash juicebox. spend just a few minutes answering simple questions about type one diabetes. When you do this, you'll be helping people living with type one and supporting the podcast T one D exchange.org. Forward slash juice box. Are you looking for the diabetes Pro Tip series or the other series within the podcast, head to the Facebook group Juicebox Podcast type one diabetes look in the feature tab. There are lists of all of the series right there to help you get started. This 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 Juicebox Podcast is also sponsored today by Ian pen from Medtronic diabetes, there's a great explanation of the in pen at in pen today.com There are links in the show notes of the podcast player you're listening in right now. And links at juicebox podcast.com. To these and all the sponsors.

Myriam 2:09
Well, my name is barium and so I'm living with type one diabetes for over 20 years. And I'm from Canada. I'm in the area of Montreal. And I am interested in sharing a bit of my story and how I've gone through different life stages specifically my little story with giving birth to my daughter.

Scott Benner 2:32
That sounds good. Are you from Canada originally?

Myriam 2:36
Yes. So I grew up mostly in the Quebec area. And I've travelled a bit in and out of Canada, but mostly around Montreal area of my life.

Scott Benner 2:45
Okay, cool. Did we say how old you are? Are we not doing that?

Myriam 2:50
I'm in my 20s. Okay, that's actually not young anymore.

Scott Benner 2:54
You think in your 20s makes you not young anymore?

Myriam 2:58
I passed 25. So why

Scott Benner 3:00
No, no near him? I would I'd murder a stranger to be in my 20s. Again, what do you think? Oh, no. Who did nothing wrong?

Myriam 3:12
I hope not. I mean, every stage is good. And I tried to appreciate every stage. But it does kind of shock you once the years go by faster than you can count.

Scott Benner 3:20
Yeah, no, I know. I understand. And I probably would not actually, like, you know, in my fanciful idea, taking another person's life so I can be younger. I mean, I don't

Myriam 3:28
think it probably wouldn't work. Well, let

Scott Benner 3:30
me just say, you know, let's say we were in a magical situation where this happened. I'm pretty sure I wouldn't do it. There you go. I think that's as you would hope not that's as honest answers I can give right now. What do you think of that? I've never heard anything in my entire life. But my back and my knee are stiff. And you know, I'm on the back nine already. I know people don't think of it that way. Man. I digress. 14 seconds into your podcast episode. I was saying to someone the other day that I and this is because I'm now my mom is 79. Right. And I'm watching her have like a like a health issue. And I told my wife in a really, I am assuming was a serious moment. And I'm not sure if she thought I was being comical. But I definitely was not. I'm 50 years old. And I told her, I am going to start living like I only have 15 years left to live. And I was like then doesn't matter to me. If I live past the 15 years, I'm going to treat these 15 years as good, actionable, quality time. Like I'm not I'm just going to do that. And because they don't want to get to the point where I'm older. And I'm like, Oh, we finally did it. We saved up money and we retired and I'm already and then suddenly something catastrophic happens and what am I going to do that? My money is not going to save me that I save right. So I

Myriam 4:56
totally get that. I mean, I think we have a tendency to Always want to save up for retirement or save up for later, you know, we'll travel later. But that's kind of my philosophy to is just, you know, enjoy, do the most that you can right now. And it doesn't mean not saving up for the future, but it does mean you know, really living life to the fullest also in the present, because you don't know like, the future is non guaranteed. So you don't know how much time you will have or what you'll be able to do with it, or if you'll be healthy down the road. So yeah, I think it's really important to, to do the best that you can now and really enjoy life,

Scott Benner 5:31
right. And it's not like I didn't understand that all academically. But I don't I just made more sense when suddenly I saw my mom, like, my mom's older, she's not like in the even the prime of her retirement, but she was getting ready to make a move, she was gonna move somewhere, she's gonna travel a little bit, land somewhere else, then all of a sudden, like, none of that is possible. So I'm like, Alright, I am not, I'm not going to have that happen. So I'm going to save like I'm saving, but you know, I'm going to try to make a little more time for myself here at the same time. And this, I think this is interesting. This podcast is as a business on top of, uh, you know, something I just enjoy. And it is as strong as it's ever been right now. Like, I can't just, I can't set it down and say to myself, like, Oh, it'll be here when I get back. So I'm gonna have to do some pretty strategic planning around how I take time off, but I think it's gonna be worth it. So that's what I'm gonna do. That's the plan that has nothing to do with you,

Myriam 6:35
as they say, work is always always going to be there somehow, you know, in some form. And yes, I mean, there, it always seems like we have the perfect opportunity right now. But sometimes we we still need to be able to take time for ourselves and take time off. I am

Scott Benner 6:50
going to try to do that. We'll see if I will see how successful I am. Or if I'm just like, next time this year, I'm talking to someone else sounds like I go. You know, last year I told this lady from Montreal that I never did it. But okay, so how old were you when you were diagnosed?

Myriam 7:08
I was almost two years old.

Scott Benner 7:10
Okay. Wow. That's how old baby? Yeah, that's how old Arden was. Oh, wow. Do you have any other autoimmune issues?

Myriam 7:19
No, that I am very grateful for? Because I don't have any complications. And I don't have any other health issues, actually. Great. Well, that's excellent. That's enough.

Scott Benner 7:31
That's enough. Now are you what they call a couple married? Are you with another person?

Myriam 7:37
Yes. Yes. I'm married. Children. Yes. So that's, we have one daughter together.

Scott Benner 7:44
Congratulations. The baby cannot be that old because you're young. And you're calling yourself old. So?

Myriam 7:49
No, no, our babies a year and a half. Yeah.

Scott Benner 7:52
Unless I was thinking maybe you know, babies for you were calling or like a teenager already. Because you really did overestimate your own age. I feel like you basically were like, I'm on my way out. Scott. I'm in my 20s. No, no,

Myriam 8:05
I just had because my birthday was not so long ago. So that's why it's

Scott Benner 8:12
stuck in your head a little bit, didn't it? What's it sticks in your head a little like the passage of time it?

Myriam 8:19
Exactly. Yes. Yes.

Scott Benner 8:21
It does have like,

Myriam 8:23
our daughter is young.

Scott Benner 8:28
Congratulations. That's lovely. Any concerns about when you thought to make a family any concerns about diabetes being, you know, with your daughter at some point?

Myriam 8:41
Yes. I mean, it was one of our worries. I mean, I don't think we focused on it a whole lot because of the fact that I was like I was healthy. And I didn't have any complications related to diabetes. And I was eight. As far as like, my doctors were concerned, they were saying that I was doing a very good job managing my diabetes. So we weren't whole overly concerned about it. As far as her diet, developing diabetes, I think it came a bit later when she was born. And all that concern was more of like how my diabetes could affect her during pregnancy. And then doctors made sure to remind us a whole lot of times, about the concerns that might be related to, you know, having carrying a baby while having diabetes.

Scott Benner 9:36
I believe I know the answer to this question, but just so I'm certain Do you live in a part of Canada, where they manage type one like it's 2021 or they manage it like it's 1978?

Myriam 9:49
Well, it's hard to say because I haven't compared it with like other areas, but I would definitely say that it's 1970s More than 2020 As far as is like being updated or up to date on like literature and like the possibilities and all that it's definitely a bit outdated.

Scott Benner 10:09
What about insulin and technology? What kind of insulin are you using?

Myriam 10:13
I'm using humor blog, I've always used humor law will kind of just switch because now it's become a generic. So I had my log, I think it's called now. Okay, so still the same thing. And I want an insulin pump for I've been on now for I guess, about 1314 years.

Scott Benner 10:29
Okay. All right. So you've been pumping for a really long time? Yes. Either just places in Canada that will give you like, regular an MPH and give you a sliding scale and be like, there you go. Good luck.

Myriam 10:42
Yeah, no, no, it's not that bad. I mean, I did have a good opportunity to because I ended up being on the insulin pump program in Quebec. So right when it started out, back in, like the tooth early, mid 2000s.

Scott Benner 10:55
Okay, what kind of pump? Did you get back then?

Myriam 10:58
I was first on the economists

Scott Benner 11:00
book recommended the pigs.

Myriam 11:03
Yes, yeah. I'm not even the thing I think is our

Scott Benner 11:06
before the pay Oh, before that even Wow. Look at you.

Myriam 11:09
And now I got no progress at all the developments of the prompts. Now,

Scott Benner 11:13
how many? How many different ones do you think you've had?

Myriam 11:17
Well, if I, if I really didn't start on the paying, I believe I didn't. So that would be four, because I went to the paying afterwards. And then I switched to Medtronic. And then I switched to tandem. And now I'm currently on tandem.

Scott Benner 11:30
Are you using the control IQ? Yes, I am. How do you find that to be?

Myriam 11:36
Um, you know, when I was pregnant, I was using the Basal IQ control, he was an out in Canada. Yeah. And I thought it was really neat for the low blood sugars, you know, preventing low blood sugars and stuff. Control IQ is interesting. For someone that's always been like super detailed and super like control oriented. As far as, like managing my range of blood sugars, I think it's a little, I have to do a lot of letting go. Because it does keep me a little bit higher than I would like. But the numbers are good as far as like, a one C levels and stuff. So the, my endocrinologist thinks is really great. And I mean, it is great in the sense that I have less hands on work to do. But it does give you give me more like high blood sugars. And I would like

Scott Benner 12:34
how would you describe your eating style? What do you what's in the mix during the week.

Myriam 12:40
So I'm vegetarian. So I do pay attention a lot to what I eat. And I, I tried to do a lot of whole grains and fruits and vegetables and beans and all that. I try to mix it up a bit. I do find that my breakfasts are very, I try to keep it very similar from one day to the other because I get a little bit of the Dawn phenomenon in the morning. So that is a bit of a I tried to keep it as simple as possible in the morning so that I prevent as much as possible the dawn phenomenon. So that's a lot of oatmeal. Very, lots of meals in this home. And then lunch and dinner are more very you didn't I tried to change it up with different grains like quinoa, rice and all that and mix it up with different types of veggies and all that.

Scott Benner 13:30
Okay, so I, I want to I want to delve into this for a second. First thing. This is just a small aside. When you said you're a vegetarian, the thought that ran through my head was oh, wow, they can grow vegetables in Canada. Which I quickly dismissed that thought but it was the first thought I was like, wow, how did they get through the ice to plant the seeds?

Myriam 13:55
I see all year long. In the Great North.

Scott Benner 13:59
I listen, you understand it academically I know that right? But the way it occurred to me,

Myriam 14:05
like I know and I mean, we are talking alright, and in the winter. So it does add to that feeling of like it's icy and cold. But we do get summer. We do have summer. I mean, we plant like in June and we pick like we pick the vegetables and wait, you know, by the end of like September we have to pretty much pick up everything except for like squashes and stuff. I think that's a short season.

Scott Benner 14:34
Yeah. All right. Well, still. It's uh, you said that you've always had kind of like a, you know, a kind of a tight control over everything. So I want to know a little bit about I mean, obviously, if you're diagnosed when you're two, you're not doing anything. When did you start getting involved in your management and when were you completely in charge of it?

Myriam 14:57
Oh, that's a good question. I mean, I would say Like, probably conscious, that like conscious involvement or like sharing into like the decisions, what I'm going to eat and all that. I feel like it was pretty young, like around 10 ish that I remember sharing like, Okay, this is what I'm planning to eat so that I could help my parents with the, the insulin decisions and all that. But then I got involved pretty much when I started being on the pump, which was around like 1314 years of age. And that's where I started, like, it started making more sense to me. If I and I was growing up as well, and it was a lot more information, especially because I was on the pump program, which to make it simple was like when the DUC de Quebec government was deciding whether they wanted to cover the cost of the pump for children are not. So it was a first like, free pumps in Quebec, which is what I was on. So that meant a lot of work, because it was like meals, you had to write down everything you had to like, write down student to decide all the basil plants, and all that, yes, all the details for the pump. And so that one meant a lot more work. So I think I kind of got involved, because it was a bit too much for my parents. But it also helped me to get more hands on experience. And then I, I think I became more autonomous probably by the end of adolescence, I think, yeah, like, on the teen years, that I was more on my own. And I was more like, out and about as well. So it kind of required me to be more independent. Yeah, so I think it just kind of came gradually, and just transitioned, as far as also, with the pump, it was easier, less intrusive for me. So that also helped with being more independent as well.

Scott Benner 16:59
So that's interesting. I'm certainly not about to, like, ask you to badmouth your parents, because I don't think that that exists here. But are you saying that you looked up at your pants and you're like, Oh, these two are not gonna get this, like, I'm gonna have to get it? Did you have that like conscious feeling?

Myriam 17:19
Not so much. I mean, I actually kind of looked up to my Mole on my parents, I think it kind of transition because my mom was really in charge of my insulin handling the whole process. I mean, both parents were really hands on. But my, when I was really young, or younger, my mom was more in charge of like, giving me the insulin shots and all that. And then when I switched to the poem, then my dad took on more of a responsibility, my mom kind of backed up a bit, because it was a lot of technology and a lot of details, which my mom was maybe a little less comfortable with. So it kind of transitioned already. I don't remember feeling like they weren't capable, I think it was just more of like, I can communicate like all of my decisions. So that, um, you know, at some point, it kind of seemed like we're done, though, like, sitting down and just re talking about it and all that. And so it just became more simple to just do it myself. And, I mean, it made more sense. So it kind of, I think it was part of my just teen years of wanting to take control also of my diabetes. But I don't remember thinking that they couldn't do it. I mean, I still talk to my to my parents about my, like, how it's going and I still talk about like technology advancements with my dad specifically, because he's always still interested in like, looking up at what's like newest and most cool, which is probably why I'm also I've also graduated, like from one pump to the other at some level because of also his interest in like technology advancements and all that.

Scott Benner 19:04
That's really interesting. So you and your father still talk about diabetes?

Myriam 19:07
Yeah, we do. Even on my mom, it's just not like the technology is not as much of her forte, but especially when my dad I, I forget what was the newest thing, but like when the control IQ came out, I talked to him about it. I was like, Hey, check this out. It's coming in Canada. And now, there's an app that's supposed to come out soon. What of course always comes out in the US first. So we have to be patient. But yeah, so and so I'll chat with him about it. And I'll be like, hey, what do you think, you know, do you think it could, you know, be a plus? Wow, that's right management.

Scott Benner 19:39
Does he seem does it seem like it passed him by already just these advancements, or does he keep up with the idea when you're talking to him about it?

Myriam 19:48
Actually tries to keep up with it? Yeah, and he'll read up on it a bit and you know, find information or posts about like, there are different blogs that talk about diabetes advancements with up. So he'll actually keep up I think he's been, he's really keeping up with it up to now. And he's, he's doing a really good job. And I think it fascinates him to to see, like how much things have improved and have gotten so much better in just a short period of time. And so it kind of makes him happier to, to, to see that I can get on these new technologies and use these new technologies as well.

Scott Benner 20:26
How does it make you feel that he cares about it in a way that that causes him to keep up with something that and honestly, he probably doesn't have to?

Myriam 20:37
It makes me happy. It makes me kind of if it makes me feel supported to, to have that, like input and to know that, you know, he cares, even like you say like he wouldn't necessarily have to now because you know, I'm grown up and I'm not even living at home anymore. And all that. I think yes, it makes me feel like he's part is still like part of my diabetes management team.

Scott Benner 21:01
Yeah. It seems sweet to me. I mean, it really does. I mean, you're still a young mom. So that whole, like, trust me right now your lesson. I don't know your life. But this beginning of it is a lot of just like keeping up. It's a lot of functional stuff, right? Like, feeding baby cleaning, baby, moving baby from this space to this space. Like when you get to the point where you sit back and you start to kind of I don't know, like appreciate the bigger picture stuff, like one day, I think you you you'll, you'll, you'll think back on this and probably make you cry. So it almost made me cry when he told me that he paid attention to it. I was like, Oh, that's really nice. Do you think do you think? Do they don't? Do they follow you? Do they know your blood sugars?

Myriam 21:51
Not so much. I mean, we don't really talk about it anymore. I mean, they know I have a good control. They know I've always been like meticulous about my diabetes, and they're happy about it. I think we're now we talked more about like the outcomes. Then we talk about a blood sugar that was in like, things like going well, I don't have any complications. And they're always grateful for that. But no, they're not like, asking for blood sugars and stuff. And I don't Yeah, I kind of have stopped sharing it, I guess. I don't know, I shared that more like with my husband, because he experiences it like on a day to day basis. So it makes more sense to share that with him.

Scott Benner 22:30
So one last question. I'm gonna get off your parents. It was a weird phrasing. But anyway. Do they have any autoimmune issues?

Myriam 22:43
No, they don't actually. I'm the only one in the family. Okay.

Scott Benner 22:47
All right. How much? Is your husband involved? Like, do you how, what do I want to know? How long have you been together?

Myriam 22:56
So we've been thinking, well, we've known each other for almost 10 years, we've been married for five,

Scott Benner 23:02
okay? And is he like an active participant or just a person who's just aware, tangentially of what's happening.

Myriam 23:10
He's, he has an active part has had like all along. I think it's been, like it's been, he's been more involved, like, actively, before we had our daughter. And it's really nothing against him. It's really just because of, you know, the, the amount of things that we have to do. But he's been involved a lot, I would say he's an emotional support overall, like, above everything else. And as far as the management, he's really gone a lot to also get informed and also understand, he played a major part as far as diabetes management, like in the end of my pregnancy, and during labor and delivery, because that's kind of a time where I zone out. And one of the requirements of like, being able to give birth naturally, or with my pump, without like, being on the insulin drip, was that I would have someone that was able to take over for me. And so then he really learned how the whole system worked and all especially because I switched like to the tableau pump during my pregnancy, which is not a great thing to do. But I still did it so that I could have like the Basal like you and all that. And he learned like the switch and he, he got familiar with it so that he knew like what changes to make and insulin corrections and all that but I really appreciate it because it helped me to have like, the dynamic that I wanted at birth.

Scott Benner 24:46
Right. And that is really why you want to come on the podcast to write is to talk about your pregnancy.

Myriam 24:52
Yes, well, I think it's a major like obviously a major event and I'm happy to talk about like all my journey because it's really a I think it's a special journey and is out itself and but I do think it was kind of a major breakthrough and a major event also through my pregnancy and birth.

Scott Benner 25:18
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just the way you answered the questionnaire to be on the podcast. I thought this is a person who planned her pregnancy really well thought about it a lot ahead of time. This was not like you didn't wake up on a Saturday morning and go hey, you know I think we should get a pregnancy test like this for a while. Right. So did you want to be a mom for a long time?

Myriam 29:40
Yes. So I wouldn't wanted to be a mom. And we wanted to be like parents like I think we talked about it way before we even got married and it was really something that we wanted and we did plan about it. We did talk like we mentioned earlier about how that might play out with me having died It is and one of the goals was kind of have to have the children earlier than later. Also to, you know, to not add two more complications possible, by waiting longer. But we also I was also studying and I was in university, so we wanted to, for me to be able to finish my bachelor's before to have a child just so that things would be organized and then process. And so that was one of our goals. And then yes, we talked about it a lot about just how it would look and what we definitely wanted it to be a part of our, our little family to have children as well.

Scott Benner 30:41
This is interesting. So you're like a super mature person, aren't you?

Myriam 30:46
I don't know. I don't know about that. But I do like to be organized.

Scott Benner 30:49
But I mean, your whole life. Like you have other brothers and sisters. I have one sister. Okay, if we made one of you the super, like, responsible one of the other one lesser, you'd be the responsible one.

Myriam 31:03
I mean, of the two, yes, I am probably the most responsible. I'm not my sister to hear that. I mean, we have both. Very, I think we just grew up being really responsible and like learning responsibilities early on. But I have developed I think this I think diabetes has contributed to my being very, very disciplined and very organized.

Scott Benner 31:27
If I spoke to your sister, would she call you like, type A and uptight? Or would she just say you're responsible?

Myriam 31:35
I don't know. And I mean, I think I'd be more of they're just responsible. Why?

Scott Benner 31:40
Okay. It's fine. I'm not saying you are, I'm just trying to get to the bottom of it. So because the reason that that made me think about that, because you're with this guy who obviously you know, you're going to be married to while you're in school, while you're in school, you have this feeling. And so you're younger there. And you're already thinking ahead, like, I want to have a baby, before my body has any chance to if it's going to break down in some way before it does. And like it actually feels to me like you thought I'm gonna put my body under this stress ball. It's young enough to bounce back from it better. Like those are all thoughts you had right? Pretty much. Yeah, I think I'm getting to know you here. All right. Because I don't know, that just seems like a lot of foresight.

Myriam 32:27
I do like to plan it ahead. And I think I want to put like the best chances. And that's really like a fresh thing. I'm gonna translate because I can't remember how to say it in English, but

Scott Benner 32:38
I was sad to get into French. Oh,

Myriam 32:41
my God. No, escape my mind. But like, mythos, makuti like to plan to put like, all the best, or all the best chances on your side. So why wait and like till until you have complications or more difficulties? And, you know, then when you can, you know, you're healthy in the prime of life and that you and you can, you can give the best chance to you and to your child as well.

Scott Benner 33:12
Yeah, I mean, listen, I love the way you're thinking. I'm just amazing. You're thinking that way while you're still in school. I understand when the other kids went to a party. Do you just look at them and think heathens? Like is that?

Myriam 33:29
No, I don't try to judge others. But I do. I made my own choices that I think I was like, I was already married while I was in school, too. So it just didn't. I had other priorities. And that's kind of what I would always say, and I did not party.

Scott Benner 33:45
You were married when you were in university. Yes, yes. You're so interesting. Okay. I also, can I say something? Let me just be honest, that I hate about your generation. You won't make fun of anybody like that even like, oh, that's for sure. Anyway, like, I'm like, did you like I'm clearly making a joke like, Oh, those people went to a party. You're like, oh, he then she's like, Well, I wouldn't want to say that about I really wish you would have had the opportunity to grow up when I was that because people would have like, talk people for no reason whatsoever. It was a ton of fun. And it just doesn't exist in the world.

Myriam 34:22
We can't do that anymore. It's just not part of like how we're trained or allowed to function.

Scott Benner 34:27
Trying to tell you it's fun. So I don't I can't do it either. You guys drugged me right into your into your into your apocalypse or whatever. This is what's happening right now. So okay, so you are way planned ahead and we're going to just obviously assume that this part of your your nature took over when you were planning for so what is the like, for diabetes and pregnancy? What's the what's the first thing you feel like you have to conquer when you realize you're gonna get pregnant?

Myriam 34:59
Ah, Ah, the first thing I think, is just really like understanding like, what part diabetes is gonna play in my pregnancy, like, my pregnancy. You know, like, it's the kind of thing where it's like, oh, I'm super excited, I'm pregnant. And the next thing is, okay, so what is this gonna look like? You know, it's, so it's a little different, I think then, you know, being pregnant when you don't have a health condition, or you don't maybe have specifically diabetes, who are just like, over excited to being pregnant. Period. I think I was super overexcited, and my husband as well. But at the same time, we were kind of like, oh, so what is this, you know, and then we started, we went back to the planning process of like, how it would look. And I mean, it was to the point, like, because I didn't want it to be overwhelming, like, even before I got pregnant, like, when we started talking about, okay, this is, you know, this could be a good time and all that, and we're really open to whatever would happen. But I started, I had already started talking with, like, my endocrinologist, because I knew that based on, like, my readings and all that, that it would be best, you know, you kind of have to have a good a one C level before getting pregnant and so that you have the best opportunities, or the best chances. So I would, I had already started to have that discussion to make sure like, we were already in the green light before, actually. Okay, like concretizing Our plans. So

Scott Benner 36:30
prior to you thinking about, like, concretely saying, We're going to start i By the way, I I feel like your conception was super boring, but that's we'll get to that later, as

Myriam 36:40
it wasn't just because we're talking about this part, as part, but it does. It kind of it kind of is a major part of our life, you know, we want it or not, I mean, sometimes it is frustrating, but unfortunately, or fortunately, I don't know. It is a major part of like every thing of every decision.

Scott Benner 37:02
No, no, I think it's really important. That's why I'm happy to dig through it. I just imagine that you rang a bell with the key took your temperature and you're like, ring, it's time get over here. I know. That's not really what happened. I

Myriam 37:15
sound like that. But hopefully it was not like

Scott Benner 37:19
maybe you should ask him maybe be like, Yeah, I didn't feel like I was punching the time clock that day. All right. Alright, I'm here to work. But But seriously, what I want to know is, what was your agency prior to when you thought we're gonna have a baby?

Myriam 37:36
So I don't have the exact number because that's the thing I like I I was already, pretty much what my doctor said was that I was already in the green light. So I didn't have to do like any work. I was like, I was always around the six shows, I think I was like around 6.4 or roughly at the beginning of or before I got pregnant.

Scott Benner 37:58
Was that on control IQ or no Basal IQ?

Myriam 38:01
Neither neither either Medtronic still,

Scott Benner 38:05
yes. Okay. All right. When do you go on the Basal IQ, then?

Myriam 38:09
I actually worked on Basal IQ, like, when I was five or six months pregnant,

Scott Benner 38:15
ma'am, you're baller, you're just most people would not switch their pump in the middle of their pregnancy?

Myriam 38:22
Well, it's not recommended. I mean, I'm not making a statement like for doctors. But one of my issues was that, so I always want to be like in range, right? I've always tried my best to do that. And then when I got pregnant, it, it was more challenging, obviously, because there are all the hormones and especially like, as you progress, like through the second and third trimester, it gets more and more your body fights against you, that's pretty much what I'm gonna say your hormones really. And so it's harder to, like insensibility sensitivity to insulin is really reduced. And so that made it hard for me because I really didn't want to be high. Like I didn't want to have high blood sugars a lot of the time, which meant I was always like getting into a lot of insulin and all that. But the downside was that I was also going into low blood sugars. And so as doctors are always concerned about low blood sugars more than high, my doctor was really concerned about that. And so then she kind of recommended that as well. As far as like, maybe that'll help you. Like lower your level of low blood sugars.

Scott Benner 39:36
I want to make sure we didn't have a misunderstanding through language but what I called you a baller. I think it's amazing. You changed a pump during the break. I wasn't judging.

Myriam 39:45
I understood. Yeah, I

Scott Benner 39:46
was like, because you right away we're like, you went back to like NATO. Nothing here that Juicebox Podcast should be considered advice. I was like, no, no, no. Like, I thought that was amazing. That you were just like, I'm gonna change my pump. Now. I don't care if I'm pregnant or not. I'll figure this out like You're not scared of diabetes at all right?

Myriam 40:02
No, not at all in that, like, I meant that in the sense of like the doctors, like usually say, like, don't do that. But I was kind of like a that's an opportunity. Like, it's if it's time to do it, there's no better time than now to do it. And even if I'm pregnant, because it was going to help me do even better, like during pregnancy. And so because I think it had it just came out like it was just out in Canada. And I was like, Oh, I'm getting my hands on that.

Scott Benner 40:29
No, I like you, you're full of energy. So okay, so you were around a six or so prior? Did you feel any pressure to make it lower before you got pregnant? Or they everybody was? Okay.

Myriam 40:41
Everybody was happy. So I was just like, was like, it's fine. I didn't make more efforts to Lord.

Scott Benner 40:48
Okay. And then, of all the things that you were concerned about, about your diabetes before getting pregnant? Did any of them most of them, some of them come true during pregnancy? Or did different issues pop up that you didn't expect?

Myriam 41:06
I mean, there were nothing really scared me, like, I wasn't that afraid. I think what came up was more of like, the fear, like not it's not necessarily their fault. I mean, it's their job. But like the doctors, and I'm not talking like, I'm specifically on my endocrinologist, but I had to, like, I got on like, a team of endocrinologist for like, managing pregnancy diabetes, or, yeah. And so I think there was a lot of misconceptions. And then it was a lot of generalizations too, because they were managing, like, pregnancy, diabetes, and then I was a type one diabetes was also in that, like, seeing the same doctors. And so there was a lot of challenges more in the sense of, I was, I started being scared, and not because of my like myself, I mean, I was maybe concerned. And that's why I was really working hard. But there was all this fear of like, okay, I'm gonna get, like, high blood pressure, or I'm going to be bedridden, and all that, or I'm going to have to be ducted, which was the main thing that came back a lot was like, You're not going to be able, you're not going to bring this baby to term. And my answer was, on what basis and that was like, my answers throughout pregnancy was on what basis, and there really wasn't any basis as far as like, I was doing fine. Like the whole pregnancy, I was doing fine. But the the idea was, uh, we don't want, like any should occur before we do it. So we just want to do it.

Scott Benner 42:46
Were they planning for the worst all the time? Yes, yeah. Based on you think their expectations from their historical knowledge of other pregnancies? Or just do you think they just play from a scared position? Generally, did you get any feeling for that?

Myriam 43:03
I think that's kind of like their working like model in the sense that it's kind of like the protocol and, you know, risk management and, you know, so they're just always preventing the worst thing from happening. But, I mean, it was a challenge for me, because there was no real issue. And it's like, I, it wasn't all that different for me to manage my diabetes during pregnancy than it was before, except that I just had to make changes like more often. And I'd had to be like, more on top of it, but it wasn't all that different. And so to me, and one of the things was, like, right away having to be in the high risk pregnancy clinic. And to me, it didn't really make sense because I didn't see how I fit in with like, individuals that had like babies with malformations and individuals that had high blood pressure. And our I forget the the actual, specific terms for high blood pressure and pregnancy, but like, all these challenges, and I was like, Okay, I don't really see where I fit in, in that. And yet, that was like, the same mindset was, was present for me. As far as like, Okay, we gotta manage this. Like, we got to be on top of this and and so there wasn't a lot of freedom for just like enjoying my pregnancy, which I thought was like Central to being pregnant was actually enjoying the pregnancy. Yeah,

Scott Benner 44:24
preeclampsia. Yes. Is that blood pressure during pregnancy, right? Yes. And, okay. I'm gonna do realize for a second, I'm gonna say something that you're gonna find uncomfortable to answer, I believe, but what do you do for a living? What did you go to school for?

Myriam 44:43
I was studying in psychology, and I'm actually still studying now. I don't have I'm in my PhD now in clinical psychology.

Scott Benner 44:51
You're a thoughtful, intelligent person. Am I wrong? Or am I right?

Myriam 44:55
I would like to think so. I do like to your think your ability

Scott Benner 44:59
like, listen, part of the way I do this is on purpose so that it seems fresh while we're having the whole conversation, because it is like you and I did not speak prior to this. I didn't tell you I was gonna ask you some questions, you're not prepared for this at all. And that usually causes people to pause and formulate their thoughts. And I can feel that when I'm talking to them. But I have like, I have changed direction. I've brought your parents up. I've made it uncomfortable jokes about you having sex with your husband, and the second, my voice stops, you have a clear, concise and thoughtful answer. Raise your IQ in the 140s. What are we talking about here?

Myriam 45:40
I haven't taken the test and future psychologists I'm probably not gonna take it either.

Scott Benner 45:46
I think you should. I think you'd make me feel bad about myself if I knew you're right. What do you think of that? Are you? This is you though, right? I'm talking to you. You're not like putting something on. You're not extra focused. You didn't take like an Adderall for this or something. You're like, this is just who you are.

Myriam 46:07
No, I didn't do anything specific. I mean, I woke up this morning. And I was like, let's do this. Very much how unprepared I was. And I mean, I looked up. I was like, Okay, I'll pull up my book in case he asked questions. And that was pretty much it.

Scott Benner 46:21
I am super impressed with you so far. Just so you know. Thank you. Yeah. Is does your husband aware of how smart you are? Or is he one of the smart people to tell me the truth?

Myriam 46:33
He's also very smart.

Scott Benner 46:36
Okay. All right. Well, listen, tell this kid, I'd like it to invent a way to melt the ground in Canada, so we can have vegetables more throughout the year. I can do? Like bigger because of how big its brain is. Your baby, does your baby have a giant head to hold all the brains? Oh, I'm just gonna

Myriam 46:57
bring up her home. She has a pretty time, right?

Scott Benner 47:03
We squished it in there. I imagine it doesn't even fit in a regular size head. I literally I mean, honestly, it's just, it's, it's evident. It's very, it's just it's so easy to talk to you. Because you know, what you think you know how to articulate it. It's just I'm having a very good time talking to you, which is probably not I probably shouldn't break that wall while we're having the conversation. But I just want to tell you that I'm having a great time. And I appreciate it. Thank you very much.

Myriam 47:29
I mean, it's definitely a very, I'm very happy to be talking with you as well. And I'm happy to be sharing and to be having this conversation is really a shared feeling, I think,

Scott Benner 47:39
Oh, I'm glad. Thank you. You didn't even like do the ham fisted thing of going, Oh, Scott. That's why I listened to the podcast because you're so smart. Like you didn't do any of that stuff. You're you're really thoughtful person. You don't even like and you joke around enough in a intelligent way. Even I like I'm gonna tell you right now. I just That's it. I'm sorry. I'm done. I'm I'm gushing over you and I shouldn't be. You're terrific. So thank you. Absolutely. It was my pleasure to say you were okay. So we make the baby. Right, E equals MC pregnant. And then using I'm sure it was a lovely evening. And so where was it an evening, we made Arden in the basement on our way to trick or treating with our son.

Myriam 48:30
And it was really weird because even with all this planning and all this that seems so like, like, plan and organizing. Like, we don't actually know the data. She was me. Okay. We were trying to time nor the place.

Scott Benner 48:44
We're trying for Arden to be born in the summertime. So we had like this late fall like we were trying to get pregnant in the late fall. And my mom was at the house and we were getting ready to go trick or treating with Cole who I mean honestly could have was probably like three years old. My wife says to my mom, hey, can you like take him outside? We'll be out in a minute. I was like, What are we doing? And she's like, come here. Okay. Anyway, it was we don't have

Myriam 49:15
our very fun stories of

Scott Benner 49:16
Yeah, it was hard to get rid of that sofa.

Myriam 49:20
I bet. Memories just

Scott Benner 49:23
sentimental feeling. Yeah. Rushing to make a baby before going out to trick or treat. Anyway, babies here. When's the first time it gets hard? When do the hormones really hit you?

Myriam 49:38
And your hormones as far as like diabetes or as far as like pregnancy hormones just in general?

Scott Benner 49:44
Well, no. When does the blood sugar start getting difficult?

Myriam 49:47
Oh, okay. Yeah. Well, right away actually. Because I, the first trimester I was low, low, like really low all the time. It was very aren't actually because, I don't know, it's like I, I developed like a hypersensitivity to YES to insulin, but not in a sense that I could like control or like I could like just say okay on lower everything it was trying to just like, out like anytime, anywhere and like, just very it was haphazard and it was very challenging to, to know where to position myself. And at the same time I was like, okay, like, if it is gonna get high, you know, it's gonna get hard at some point, it's gonna get hard, right? It's gonna go. And so then I kind of had that trouble. I was like, I can't lower too much. But in the end, I was just really thoughtful about the beginning and I just needed to lower my, my insulin levels. And how long does that lasted for three months, three months.

Scott Benner 50:45
Okay. I wonder if I wonder how that works? Like, like, functionally, I wonder if it's that your sensitivity lessened? Or if there was a lack of something in your body that that used to exist that didn't anymore in that time? Do you mean like, oh, like maybe your need fell? Not your sensitivity heightened? Or maybe I'm wrong? Maybe it's vice versa? I have no idea. I'm just it's an interesting question. I guess either way, it doesn't matter if you combat it by lowering your, your Basal. It'd be

Myriam 51:17
hard to know. I mean, yeah, I mean, it it is a good argument to because I mean, obviously, you know, the first trimester are a bit more sensitive as well. I was slightly nauseous, too. So I mean, obviously, also, the amount of food and the type of food has changed as well. So there are obviously different factors involved. And I argue it as being sensitive. Anybody? It might be a lot of different things as well, for sure. Yeah. Because I can't actually test it.

Scott Benner 51:47
It doesn't matter. In the end, in the end, you changed your insulin to meet the need, the need was less. But you did think about like, when you turned it down, you thought about like, when's it going to come back? Yeah, that was in your head. Okay. When are you? Was it so much less that it was like managing a different person? Like, was it like, I guess my question is, like, if your Basal was like a unit an hour, did it become point nine an hour to become point five an hour?

Myriam 52:15
It was more like small changes, I would say. Yeah, so a lot more small changes, I think the major thing that changed was probably more of like the insulin to carb ratio. So just like how much insulin you get at meals, but ya know, it didn't see it wasn't all that bad, but it didn't seem like managing an odd an odd version of myself. Okay? Because it was like, unusual. And it didn't, it wasn't like obvious that, like you usually see, okay, like, in the evenings, I'm always high. So now I'm gonna like change my, my basil or carved race. But then this was more unusual. And like, I couldn't really put my finger on it easily. So that was a bit odd. So it didn't feel like it. It was something that I had never really encountered in that way. So it didn't seem odd at first and kind of challenging. And I think that's why it took me a while to just realize what I needed to do as change or like, just realize what I was into.

Scott Benner 53:19
And then the shift comes the second trimester, it goes the other direction. Does it go significantly in the other direction? Or is it more small changes, like you're talking about?

Myriam 53:27
So in the second trimester, I'd say I was pretty much like, I felt like I was back roughly at what I was like pre pregnancy. So I was bringing up my my insulin levels was a little late. But surely like every other week, I think, even every week, sometimes I was but at the beginning, it was more like every other week. And I was just bringing it up slowly but surely, until the third trimester, and I had the third trimester, that's where it started being like, tougher, I would make more changes more often every like other day or a couple of times a week. I was getting like input from, like, diabetes specialist, nurse, and also my endocrinologist. And so that kind of helped me. But I was also doing it by myself and figuring out like what needed to be changed or improved. It wasn't until Yes, I think it was progressive. So I think like the gap between like pre pregnancy or like beginning and end was probably bigger than I felt it. But since it was like gradual, it didn't feel like I didn't get like a big jump in, in blood insulin levels, even at the end of pregnancy. But I did. Yeah, I increased pretty much all the way to well, almost the end and then at the end it kind of plateaued and even lowered a bit.

Scott Benner 54:48
x okay. Yeah. At the end of this, did you breastfeed them?

Myriam 54:53
Yes, I did. Yeah.

Scott Benner 54:54
Okay. Did you notice your needs changed during that again?

Myriam 54:58
I'm not Really, I mean, yes or no, it was kind of an odd situation because even like right after birth, they expect your blood sugar's to go. Like to change radically. And in my case, it didn't really. Like it didn't change radically back to pre pregnancy levels. And so I ended up being in a high blood sugar because for a while, like for quite a few hours, because they started to bring back everything down, like put it back to like pre pregnancy levels, when in reality, that wasn't what I needed. And that's what I felt, I felt like I can just hide, like, just leave my blood sugar, like just leave my controls like how they are. And I'll just handle that, like later on when I get low. But yeah, so I, it was progressive, it was progressive. It progressively went back down. But not, again, it didn't drop right after giving birth. I think that's there's a lot of hormones involved in all that. So,

Scott Benner 56:01
ya know, it makes me it makes me feel like, yeah, sure, there's a way we expect this to go. But you still have to stay flexible and make decisions based on what's actually happening. It's not it's not just gonna follow like, you know, a rule book, necessarily.

Myriam 56:18
No, absolutely not. And that's what kind of frustrates me with, like, protocols. And I know there's a reason for them. And I know there's a use for them. But it kind of is what's frustrates me because like, I wasn't told, I think once like, I don't remember consciously being told once that like, during, like the, like after birth, your blood sugar's my stay up, it was just like always, Okay, be careful with their family go down, go down, even like during the birth process, because in the real process, the opposite during labor and delivery, your blood sugar's are gonna go up, for sure, you know, but then you're like, I'm sorry, they're gonna go down again, they're gonna go down. And that's like the argument, but there's like, just one sided. And you might get either one. And I got opposites on both ends, because I got high blood sugars during pregnancy and high blood sugar after pregnancy. And like after birth, rather, and it didn't. It wasn't like, in the book, it wasn't textbook. I wasn't a textbook case.

Scott Benner 57:24
How about how about the days after, like, did breastfeeding make you low?

Myriam 57:29
It did a bit, it was hard to like to know because, you know, there's like all the sleep deprivation involved and all that. So that that was that was another story. And managing diabetes right after birth is not any easier. It's worse than during pregnancy, actually, at least for me, it was because then there's all like the sleep and there's like, waking up at weird hours, and then you're hungry, but you don't know what time it is and all that. But yes, sometimes when I was breastfeeding the first few days, I would get low or right. Laughter. But it's like, quickly, like in the few weeks that went after I didn't notice it anymore. It wasn't like major drops. You figured it wasn't? Yeah, I don't know. I mean, it didn't seem like it affected me that much. But I kind of adjusted and tried to be careful if it if it wanted to go in that direction. You know,

Scott Benner 58:23
like, just recently in an episode, Jenny described her diabetes as like getting a newborn baby, like having a newborn baby to take care of sudden it's almost like getting diabetes toys, or two babies are gonna look at it.

Myriam 58:35
That's exactly how I felt actually, yeah, after birth, I felt like I had two babies to take care of, because my diabetes was out of whack. And then I had a baby that had no idea how this world function. And so now I was trying to help both. It's crazy, because now even my daughter now sleeps full knows what sometimes I still get woken up like, three, four times a night because of my diabetes. And I'm like, just let me go to sleep. I should keep my baby and my diabetes.

Scott Benner 59:05
diabetes to sleep through the night to can you Ferber eyes? It is that?

Myriam 59:10
Yes, that's what it means. Like, you're off duty just off duty at night. What that

Scott Benner 59:16
that old book from the 60s they would tell you to let it cry. Right. And then there's stuff now there's Ferber eyes. I think that's carburizing. Right. And there's some people who sleep with their with their babies and keep the keep the baby next to the bed and like a little thing and what how did how did you? I mean, this is how did you do that? How did you get your baby to sleep through the night? What's the process you used?

Myriam 59:39
Ah, well, the process was gradual. So we had her like in the room but in our own bed like the first six ish months, I think because like she would wake up like every three, four hours at night. It is. It was just it made more sense. But it was also like the recommendations that we had had from our, from a few like professionals that, okay keep her in the room, but like don't keep her in the bed. And we really made an effort to do that. Because apparently it helps also with the, like, gradually sleeping through the night. And that like six, seven months, like we were like, We were overwhelmed. We're really tired. I remember them. So

Scott Benner 1:00:21
yeah, I know that I remember that feeling of the first time like, like, we put called to bed and he didn't wake up a few hours later. And then a few hours later, he didn't wake up and you're like, Oh my God, is he gonna stay asleep? This is amazing.

Myriam 1:00:34
Yeah, then you can sleep for the whole night because you're worried about the fact that they're asleep.

Scott Benner 1:00:39
But then once you get over to it, you're like, you're so exhausted. By the time it it's usually like that first six months, and you're just so exhausted by the time it's over. I don't it's it's crazy. It really is. And and I didn't have to raise a baby. You know, the first time with diabetes. The second time aren't, too. And so I did get to I mean, in fairness to me, I got to sleep for a couple of years.

Myriam 1:01:05
Well, those that are adults, we yeah, we ration our sleep a bit more.

Scott Benner 1:01:09
I'm I don't know for everybody else, but I can walk through my house in the pitch black dark. I don't need, like, I don't need like, Oh, I know where I'm at, like, I know how to do it. Does anybody else like do that thing where you kind of like, bring your forearm up a little bit to like, touch the wall corners. And like there's one one hand or? Yeah, there's one door in the hallway. Nobody ever closes. I'm always completely aware of that. I reach out with my hand as I approach it to make sure I'm not going to walk into it. And yeah, I use the smoke detector lights as as like mile markers. Yeah, yeah. I wish that wasn't something I knew how to do, by the way. Like, wish I just, I would just go to sleep and never wake up. Arden needed insulin this morning at 530 in the morning. Oh, and I was like her blood sugar just kind of popped up out of nowhere. And I was like, and then you have that thought in your head like, oh, you know, she'll be awake soon. She'll, she'll Bolus. I was like, now I'm gonna do it now. So anyway, yeah, it'll it'll. I don't know. I'm just gonna say it'll get better, but it probably won't. Do you think you're gonna get

Myriam 1:02:21
more? They'll get more independent, you know, as they grew up? It's kind of I mean, my parents don't remember all the pain that they went through. I tried to ask them sometimes, and they don't remember. They're like, Oh, it was fine. We just took it a day at a time. I'm like, Oh, yeah. Are you sure it feels like it would have been a bit rough at some point. But you know, we all forget that at some point, apparently.

Scott Benner 1:02:44
Does it make you does it make you feel good that they don't remember? Or are you looking for somebody to commiserate with?

Myriam 1:02:49
I think it's better than they don't remember it? Because I feel like it probably was hard. I mean, I little part of me would like to know, like how bad it was. But at the same time, I'm like, you know, if they still remember now, it's, it would be like really, really bad. Yeah. So they probably focus on the good moments, which is a good thing. Yes. I'm happy about that.

Scott Benner 1:03:09
Alright, so now based on the rest of your conversation, you already have your second third child planned out? Are you just having one? What's the deal?

Myriam 1:03:17
No, well, no, not yet.

Scott Benner 1:03:20
You said, Well, hold on. Don't lie to me. Is it just something you haven't told your husband yet?

Myriam 1:03:27
Oh, no, nothing like that. It's just because I'm back in like, I'm in my PhD now. So I'm trying to get ahead a little bit before, before we have another child and go through this whole process again, because that's the thing too, I'd like to have more time, which was one thing I did have with my first pregnancy of like, during pregnancy, I wasn't all that busy. And so I had a lot of times like exercise and to handle all the appointments and all that. And so I had a lot more freedom. I didn't and so I'd like to have a bit of a structure like that as well. Where I am not like in you know, in school like five days a week and handling a child that's already there. And also a pregnancy I think that will be

Scott Benner 1:04:12
are you hoping to go into practice? Or are you going to teach What's your idea for after?

Myriam 1:04:17
My goal is to go into practice once I finish Yeah, well, there's

Scott Benner 1:04:21
all those people who have PTSD about like polar bear attacks and stuff like that. You have to help right.

Myriam 1:04:29
What about polar bears? I don't have any around here.

Scott Benner 1:04:32
Beavers. What about a beaver?

Myriam 1:04:36
No. That's where I was. I'm concerned I've seen so

Scott Benner 1:04:42
I am strongly, strongly, strongly thinking about calling this episode beaver stone attack. Gotta be careful while you're talking on the podcast.

Myriam 1:04:57
I mean, that would be a very Canadian. Turning on title.

Scott Benner 1:05:01
So you just said that I was like, oh, that's what I'm gonna call this episode. Is there? I know you're like, is there anything about the process that we didn't speak about that you wanted to?

Myriam 1:05:16
I won't, the only thing I can think of is really about like, just the fact that, you know, even with all the pressure of like the hospital, or like the staff and all that, like I was still able to, to make it a, like a natural labor and delivery process. And I didn't have to be like, induced or have the insulin drip and all that. And I think it's a message that doesn't get out all that much. Like, even when I was pregnant, that it was really, really, really hard to find any, like good stories. I don't know, if you've been able to find any, but like, personally, I have not, or just like one from like 20 years ago, like one person who was able to that had type one diabetes, and was able to give her the way they wanted when, like in which was naturally and all that. And I think that's also what really encouraged me of just being able to accomplish that. It was like a major, major accomplishment. And I always kind of like, look, it's possible. And that's what I was also like telling the medical staff and all that, like stop saying that there's only one way to do this. And there's only like one outcome possible. It's like there's, it's possible to have a healthy pregnancy as possible to have help with the labor and delivery process. Even with diabetes, and maybe even because of diabetes, because you you end up being so much more careful about what you eat, what you exercise, like how you exercise and what you do and how you try to reduce your stress and all that. And I think even like healthy moms, maybe don't spend all that time to think about every little action in their pregnancy. And so I think it's even like a benefit to have, ultimately, diabetes if you want to, like see the silver lining in a very difficult situation. Because it helps you to be very, very focused.

Scott Benner 1:07:11
Yeah, I understand. I like how important it is to you for people to hear a good story too. And I've heard a number of stories that are that are positive. And it is definitely doable. It's a lot of work, obviously. How was the baby's birth weight? Was it like a normal birth weight?

Myriam 1:07:29
Yeah, she she was 636 pounds three ounces. She was born at three weeks. So Oh, wow. Put on the fat? Yeah,

Scott Benner 1:07:39
it's like a little baby making machine over there. You're just a really nice job. Did it feel like an accomplishment when it was overdue? Did you feel like, wow, this was a lot of effort. And I did it? Or did you not even have time to feel that way?

Myriam 1:07:54
No, I really felt it. I was very, very, I felt accomplished, very proud of the whole process when it was all said and done. Like even in the hospital because it was just it was so unique. And even just the whole process was very unique compared to even regular, like labor and delivery processes. Like even the doctor was just like, I've never seen this before, like, what happened. And even the nurse like was going off shift. And because they were switching before I was getting ready nurses like I'm staying here, I want to see this baby come in this world. And so I think that it kind of was the fulfilment of like all the effort and all the work that was that I put into it. I mean, I would have liked it to be more enjoyable in the sense that to not feel all this pressure or all this fear during pregnancy. And that's probably the only thing that one of the things that I would definitely wish could change. But even with that, it's still

Scott Benner 1:08:58
well, how could How could that change? Should the doctors just be prepared themselves but not worry out loud? So much? Like, I mean, you want to be informed, right? But you don't. You don't want somebody to like, I don't know what I'm like, you don't want somebody to rain on your parade. You just want to understand what could happen and then have somebody tell you, but we're gonna act like that's not gonna happen right now. Like, is that the? I don't know. Like, I'm not sure.

Myriam 1:09:25
Well, you know, like, I think it's maybe just Well, one of the thing that we noticed during pregnancy was just, if doctors took more time to like, get to know the context and get to know the couple. It would make a big difference. And that's at least that's what we experienced like, and we had to do it kind of intentional, very intentionally, actually not just kind of, but like because we were in the like the high risk clinic or Pregnancy Clinic and the gynecologist would see us would come from Five seconds, you know, and look at the scans that the technician had done and say, okay, look, everything's good. Okay, and I'll take this pill, you know, because you're diabetic, and you have to take that. And you should already started. And you know, it was just kind of like this really quick and very protocol are very clear, very directly type of interaction. And then when we were like, Okay, this is not gonna work, like really need them to understand, like, our perspective and what we want. And so then we had, we asked the unconscious, like, come back and actually have a discussion with her, of how we wanted our pregnancy and how maybe my situation was not typical, because I was exercising daily, and like, my numbers were perfect. And, you know, all of that. And so when we gave her like, the whole picture, she was like, oh, like, okay, like, she realized, like, we're not like, we planned this, like you've seen, you know, kind of gave her this picture of like, the context of like, who we are. And like, this is not like, haphazard, it's not like maybe we made on the corner of St. Louis to get something that was fine and organized. And I was around that, too,

Scott Benner 1:11:11
do you think are made on the street corners?

Myriam 1:11:15
On any one, we had that conversation afterwards, she respected our decision, and she respected and even at the end, like when we were at 37 weeks. And she was like, Okay, well make like a more in depth. Scan, not scan there. But forget the word now. It's been too long since I've given birth. But, you know, she, they looked more in detail, and she made sure everything was okay. And she's like, okay, everything's okay. Now, if you were any other woman, I would not I would book an induction now. Like in the next few days, but I know, like you had expressed your decision. And so now like, what, are you still following that decision now? Or are you ready to change? And I was like, no, like, this was our decision, we're still keeping it, there's no indication, no reason for it to change. And so she was like, Okay, well, I respect your decision. You know, it was really like, do you think of the involvement that I think they could have?

Scott Benner 1:12:20
Yeah, it sounds to me, like your experience was that physicians took all of the bad experiences they've had in the past and applied it to you before they even knew who you were, like, like, maybe everyone doesn't do the exercise, and everyone doesn't eat well, and everyone doesn't keep their agency in check and stay on top of their insulin, but you were going to, and they just didn't know that about you. So they planned for what they see most frequently. They just did, but they don't know you well enough, you think to adjust to like, you don't mean like they don't spend enough time with you. Because, listen, I don't want to take credit here. But I talked to you for about 20 minutes. And I was like this lady's really smart. And then well thought out and inconsiderate. And like, I don't know how your doctor couldn't figure that out about your faster. You don't I mean,

Myriam 1:13:11
but they just don't have the time. I think they don't have or they don't take the time. I don't know. I'm not like blaming them for tensions. Yeah. But I think it's just Oh, it's just another woman with another baby. And it's just like, Let's

Scott Benner 1:13:22
go diabetes. And this is going to be a problem. And here's what the problems are going to be. And this is how we take care of the problems and blah, blah, blah, blah, blah. Instead of seeing that maybe it doesn't have to be like that all the time. I wonder what that experience with you. I would I would hope and wonder if if the the experience your physicians had with you would make them rethink how they talk to other people. Because I think that when you plan for failure, you kind of preordained it a little bit to like you give people permission to fail when you tell them they're going to that makes sense. Yeah, that's

Myriam 1:13:58
kind of a self fulfilling prophecy. You know, you kind of you're you're planning, you're kind of planning for failures, pretty much what ends up happening, you're planning for when the failure will occur, and not if, and I think the difference is huge. But it's not so clear. Like once you're in a high risk clinic and all that, it seems like the if becomes the win, and it's just always planning for, okay, we got to make sure nothing happens. And it's unfortunate because it creates it. So it's kind of like everybody's in the same mold. And everybody's just the same. The same, like a cookie cutter. And the challenge too is and that's kind of brings me back to when you were asking like are we in the 1978 or in the 1970s? And I mean, the challenge do is that even like, like doctors, we say it's like literature, scientific literature and all that and even the science the scientific literature, now has articles that talk about like comparing induction versus no induction Um, for individuals with diabetes and different things like that, and ultimately, you know, the results show more and more that it's not really all that necessary. I mean, there are situations that it is, and it's a procedure that's necessary in in even for individuals who don't have diabetes and certain social circumstances is necessary. But generally, even with individuals with diabetes, it's not like decision by default. And yet, like in the, in practice, it's like, doctors are not so comfortable with that nuance, or they're not necessarily offering that nuance, and it's much more the protocol like this, whatever has been done, continues to be done. Now, even if technology has changed, you know, just, I mean, research is not all that developed with insulin pumps, because it's still fairly new. But nonetheless, like, a lot of research now show, a start, you know, is starting to be produced with different insulin pumps, and like Dexcom, and all these continuous glucose monitoring systems and these these things to make a huge difference, even in pregnancy, you know, just being able to see your blood sugar's like 24/7 all the time, and then having some of the pumps that connect, you know, adjust blood sugar, insulin with that. I mean, that's it has nothing to do with how we're handling diabetes 510 years ago. So it should make a difference. And it does make a difference. But it's not like,

Scott Benner 1:16:36
takes the time for the industry to catch up the doctors really, trick Yeah. And it should be a to me, it should be a an indicator to the pump companies, everybody making an algorithm that you have to have to keep innovating these algorithms to allow for tighter and tighter control. Because people are going to want to wear them when they're pregnant. So and yeah, you don't I mean, you need to, you need to be able to give people more more access to their target ranges.

Myriam 1:17:04
Yes, because there's a thing with the control IQ, for example, now, it's still it's higher, the range is higher than what you would want in pregnancy, specifically, but it still just already makes a difference. And I you know, I think even in companies that make insulin pumps could also even do research like, that involves specifically pregnant women, I know, it probably wouldn't make, like as much of a difference for them. But it could be really interesting for the scientific world and the community to be able to have that information as well and not have to only do like independent studies. Because a lot of times, like don't exclude, like pregnant, like, don't use that during pregnancy, or don't use that. And you're like, okay, but it's just because it's they weren't included in the sample, it doesn't necessarily mean that it's dangerous. Yeah. Right, or that it shouldn't be done. So I think if they would make research or studies just for these individuals that could help as well to, to support like the the advancements and the use also, these insulin pumps and technologies that really make a difference,

Scott Benner 1:18:09
it would also help with the doctors just, you know, what's what I want to say, got the stick out of their butt, and, and just realize that they can use it off label well, and don't be, don't hide behind the fact that it's not, you don't I mean, doctors can give you a pump off label, they can, they can do anything they want off label, to be perfectly honest, they could, you know, there are people who get Metformin for weight loss that has nothing to do with diabetes, for example, like that's an off label use of a medication, doctors can use their, their expertise to make decisions like that, instead of just hiding behind the label and going, Oh, that's not for you. So I can't do it. And it's a little late. But I know you're you're too nice to say anything mean about anybody. Because you're Canadian, and you're from this generation, so you have no ability to say anything.

Myriam 1:19:02
I know then, like, there's definitely a need for progress. And there's definitely a need, you know, for Yeah, go, you know, doing more than what, like the minimum requirements of the job. And I think it's a challenge for the medical field and the like, I think one of the only ways for them to gain like confidence in doing that is also for like spending enough time with the individuals and getting to know, but also getting to know like the technologies that are available and all that so that when you're like I'm an insulin pump, they don't look at you like oh, what's that? There's that too. Also being up to date, especially if you're working with, you know, pregnancy population, it might happen more and more. I mean, there are a lot more type one diabetes and visuals nowadays and a lot more that want to be pregnant and that have children and so that kind of becomes like you kind of have to inform yourself on that as well so that you're, you're up to date on on what works and what doesn't? And what are their legitimate fears? And not just the literature fears? Yeah, no. Yeah, I agree because like one of the big arguments and is also like the size of the baby. So usually like because you get a lot of insulin resistance at the end of the pregnancy, there's a danger also for babies do become really big. So also their reason for like a need for like C section or whatnot. But that's related to like your a one C level. But even like the studies that they use, while they're looking at like a onesies that are different from like the general population. But if you're like using a system like Dexcom, or whatnot, or using like Basal IQ and all these different technologies, or even just an insulin pump, you have so much more control that your agency can stay fine during pregnancy, like my agency was even at the end was like I'm five. So there's one you see that and then you look at, okay, so the danger of getting a big baby is not really in the books anymore. Because while you're handling like your agency is like somewhat nondiabetic. And so there's, it's, you know, it's putting things in perspective and not just going limos, your risk is higher of getting bigger baby, like, okay, but like, compared to what, right

Scott Benner 1:21:20
compared to the past when people didn't have these pumps in the fast track the insulin and the CGM and the knowledge and all that stuff and stop treating 2021 Like it's 1975. That's all. It's not that hard. Jeez. All right. Hey, I have a question. I'll let you go there. Because you have to get back to your life doing whatever it is you do. And assuming it's it's, it's taking care of that baby and writing papers, but that's

Myriam 1:21:46
pretty much off right. And I just got on holiday. So I'm not writing a paper this holiday season.

Scott Benner 1:21:53
My son just wrote his last one the other day, and he seemed pretty thrilled. Yeah. So the podcast, like, why are you on the podcast? Do you listen to it?

Myriam 1:22:04
I did find it. And I specifically found it during the end of my pregnancy. I was really looking like I was saying, like for support and stories and encouragement. And that was pretty much what brought me I really enjoyed the podcast app on my phone. And so I, I looked for a lot of different resources. And that's how I found your podcast, and I thought it was a really, really nice endeavor.

Scott Benner 1:22:27
Thank you. Oh, that's lovely. See, that's a nice answer. I appreciate that very much. It is a nice endeavor. Pete more people should just refer to me as a nice endeavor I would enjoy.

Myriam 1:22:38
It will be your your slogan.

Scott Benner 1:22:40
Well, no, I love that you've that you just wanted to add like a story about a birth that went well like to the, to the pot of stories. So I really appreciate it. I just never know, I just usually, it's funny. I usually just assume that people want to be on the podcast because they listen to it. But a couple of times this year, people have been like, not on your podcasts. I'm like, Well, how did you like, they're gonna listen to it. I just, I had this thing. And I wanted to tell somebody, and this seemed like the place to tell it. And I was like, Oh, wow. Okay, so I just I like to check to see what happens. So that's excellent. I really appreciate it very much. I am done bothering you. If you were done telling me things. Do you have anything else you want to talk about?

Myriam 1:23:23
Well, I was just gonna say, I mean, I encourage you to keep going with your new endeavor. Because I think it's a really, it's a really nice, it's really nice to have that support in that area that's placed where you can just talk and hear other people's stories, too. I think it's kind of hard. Nowadays, especially to hear like I was saying, like positive stories and all that and I'm grateful for, for that. And I'm grateful for the opportunity also to have been able to share that story. I am working on publishing a book about that story, too, in the near future. And I hope that we'll also be able to encourage people to continue in that direction and just taking charge and being able to also share their story and also have a story that's really meaningful to them.

Scott Benner 1:24:08
Will you write that book in Canadian or in English?

Myriam 1:24:15
Do you think it'll be in Canadian English?

Scott Benner 1:24:18
Do you think in English or in French?

Myriam 1:24:21
It's an English it's currently an English?

Scott Benner 1:24:23
No. Do you think in English or in French? Oh,

Myriam 1:24:25
oh, sorry. I actually think in both like when I speak in English, I usually think in English and in French, I think of French

Scott Benner 1:24:32
does that bounce back and forth though? It depends on what you're speaking at the time.

Myriam 1:24:35
Yes, well, you know, I I attribute that to the fact that I learned early on. I learned English from young but yeah, sometimes we lose words especially when you're bilingual or trilingual, you lose like the words you want to use your own remember and like the other language and that goes both ways.

Scott Benner 1:24:52
Are your parents French?

Myriam 1:24:55
Yes, well, my they're both Quebec Wah, but my dad I grew up also bilingual.

Scott Benner 1:25:03
Is anyone from France?

Myriam 1:25:07
Like my mom's family, but like from way, way,

Scott Benner 1:25:10
way, way back? Okay, but your parents from your parents were born in Canada? Yes, yeah. Okay. So I was trying to figure out it was, it was extra nice talking to you today because I have, there's this lovely woman named Isabel who's helping me with my Facebook page. She has type one, and she's Canadian, but French, and so your accent reminds me a little bit of hers. So it made it like extra nice for me today.

Myriam 1:25:38
My pleasure talking with you as well. I'm very grateful for the opportunity.

Scott Benner 1:25:42
No, it was my my absolute pleasure, I appreciate very much that you took the time to do this. It's a really lovely thing for you to do. I think that you're 100% right? That being pregnant with type one seems very scary that it can become even more so when doctors lean into the idea that this isn't going to go well. And then it takes what could be a really like a wonderful memory and and you know the beginning of you building a relationship with a child and turn it into a tumultuous affair instead of it being the thing that it could be in it should be so I really appreciate you doing this. Thank you

Myriam 1:26:20
was a pleasure. I hope it encourages mothers out there future parents as well that it's possible and it's not all doom and gloom, but there are really opportunities and possibilities for it to be a joyful and successful journey as well.

Scott Benner 1:26:36
Yeah, I agree. Okay, hold on one second for me. Okay. Sure.

A huge thanks to Miriam for coming on the show and sharing her story. And a big thanks to today's sponsor in pen from Medtronic, diabetes and Dexcom, makers of the Dexcom G six head to in pen today.com To get started with the N pen or and Endor Why not both dexcom.com forward slash juice box to get yourself one of those Dexcom G six continuous glucose monitoring systems. I want to thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast

is usually about here where I tell you about the Facebook group and other stuff. But if I'm being honest, my son wants to have a couch and my daughter needs help with her college stuff. So I gotta go. Don't worry that informations on the end of some other episodes. You should go listen to one of them.