#726 Brusha Brusha Brusha
Trey Perez is a Pediatric Dentist and he has type 1 diabetes.
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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 726 of the Juicebox Podcast.
On today's show, we're going to talk to Trey Perez. He is a pediatric dentist and he has type one diabetes. So we're going to talk about, you know, his life and his job and what you might want to do to keep your teeth clean, and other stuff. It's gonna be way better than I just described. Gotta cut me a break because all I can think of right now is we make holes in teeth, which is an old crest commercial from I don't know how long ago. But anyway, Trey's a lot of fun to talk to, I think you're going to enjoy it. While you're listening. Please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan. Becoming bold with insulin, or making holes in people's teeth. We make holes in teeth. Do you not know this cartoon commercial? If I thought any of you had seen grace, I'd be like, brush up, brush up brush up, but I have no feeling that you're gonna get that reference either. Major is really coming out this week, isn't it? Alright, you're ready to get going. Here comes tray
this episode of The Juicebox Podcast is sponsored by Ian pen from Medtronic diabetes. The M pen is an insulin pen, but it does much more. You can find out all about those things at in pen today.com. Today's podcast is also sponsored by my daughter's blood sugar meter, the Contour Next One blood glucose meter. Contour next.com forward slash use box is the link you're looking for. It is small and easy to hold and beautiful. And I'll tell you more about it during the ads. Brush up brush up brush. What is that whole song? Brusha Brusha Alright, hold on a second. I can't even got started yet. Alright, so Greece is a movie. And during the movie, some of the characters are watching television. And a commercial comes on for old toothpaste. But the movie was set in the 50s. So what was it called in Patna or something like that? Hold on. Yeah, apama IPA, Na, it's toothpaste that obviously does not exist anymore. And there was a beaver called Bucky. Bucky had too big teeth as you can imagine. And he would say stuff in the morning ready for my day. I brush my teeth pressure, pressure, pressure, pressure pressure, and that is up and down around and around by the brush my teeth. But anyway, it goes on for quite some time. And like this guy flies in. He wants to like hear your favorite racecar? I don't think I can let you hear anymore without getting in trouble. Anyway, here comes try. Sorry about all this.
Trey Perez 3:20
My name is Trey Perez. I am a pediatric dentist. I am based in Brooklyn, New York. I also have a background in public health. I am myself a type one diabetic. So yeah, so I want to my goal is to you know, promote oral health and promote health in general. So I'm glad to be you know, part of this, and you know, talk with you.
Scott Benner 3:45
I'm very happy that you were willing to do it reached out and everything. So thank you very much. Trey, how old were you when you were diagnosed?
Trey Perez 3:54
I was 35. So it's pretty recent. I'm 37. Now so I just had my my diet birthday a couple days ago, it was actually New Year's New Year's Eve when it happened. So when I got diagnosed, so it's fairly recent for me.
Scott Benner 4:12
You know, it's funny, that would have shocked me had I not spoken to a woman who was diagnosed in her 70s recently. Yeah, yeah. So
Trey Perez 4:21
I've heard a couple people that you've talked to a little diagnose lately or later in life. And I was surprised because I mean, I know about, you know, I know about diabetes, you know, with my background and my education. So we used to be called juvenile diabetes. So we always thought it was happening in in kids and I thought I was when I was experiencing my symptoms. I was like, this is like diabetes, but I'm too old to have type one. My lifestyle was too healthy to have type two. I was I was very confused. I was in denial.
Scott Benner 4:57
Just based off the naming of the Have you been juvenile diabetes? That threw you off that quickly? That's interesting.
Trey Perez 5:04
Yeah. I mean, once, I mean, once I got diagnosed, then I did a lot of research. And actually, my mom pointed out that it's about 40% of people with type one are diagnosed 30 or older. So it's almost half, you know, so that's, it's actually not that uncommon man. And it can happen. And then I realized a little bit more it can happen at any age. You know, just one it does one little naming thing all those years, right, you know, and yeah, it sticks with us for this long. It's
Scott Benner 5:38
interesting. Okay, so how did you I mean, what was your first presentation? Like, what was the first thing that got you thinking something was wrong?
Trey Perez 5:45
Well, it was just classic symptoms. It was textbook symptoms. And it was it was strange. I could tell you the whole story I'm in. Remember, in June of ended June 2019. I went to the doctor and I got bloodwork. And I never get bloodwork because everything's normal, but you know, mid 30s, time to start doing those kinds of things. And everything was fine, like my blood sugar was in the 90s. Totally normal. And then in November, I went, and I did this dental outreach in Nepal. I when I came home, I was really tired, but you know, jetlag, and everything. I just assumed it was that, but then the jetlag seemed to linger for weeks. And I was going to the bathroom all night. No, chugging water, drinking anything I could, I was so tired. I got so weak, and I'm a big fitness person, I would go the gym all the time. And I couldn't after that I was so weak, so tired that I couldn't do that. That really affected me. I lost 20 pounds in you know, a couple of weeks, and people noticed that I looked different. And eventually, I realized something's going on. And I was in denial. And it probably because of that. I didn't go to the doctor as soon as I should have, but eventually I did. And I'm New Year's Eve 2019. That's when I got diagnosed. So the next day started doing the finger sticks and 2020 for me started that way. And then everything else. Everything else that 2020 happened and yeah, so it was a great start, you know?
Scott Benner 7:31
Almost quite literally two years, then.
Trey Perez 7:34
Yeah, two years.
Scott Benner 7:35
Were you sick in Nepal? No, I
Trey Perez 7:37
wasn't. And to be honest, usually when I go travel to places like that, it usually gets sick. So I was really happy that I wasn't
Scott Benner 7:46
maybe yeah, maybe your auto auto immune system was just like, on Yeah, serious overdrive at that point. Just swatting stuff away. Like, you know.
Trey Perez 7:56
Yeah, I think I've heard you say that. When the maybe the immune system gets bored, and it just starts doing what it wants. Because the funny thing is, I hadn't even had a cold and in years, I usually get a cold like every year and so I hadn't gotten sick like that, but I get sick with
Scott Benner 8:14
type one. Yeah, listen, Arden doesn't get sick ever. No. So I have a crazy, like immune system where I you know, if I get sick, like you know, like, something comes over your during the day and you know, five o'clock you're like wandering around. Like, I think I got it asleep like something's wrong. You know, like, I'm out of it. Like something's happened. I'll wake up in the morning, like it never happened. Yeah, that's good to see. You think it's good. I think it's why I'm probably gonna end up with tape on when I'm older. Because my immune system is like is what if it gets confused one day? You know, I know ya never know, I probably should do the antibody test. Actually. Already trial that if you're listening, I'll do it. I think I'm too old for this thing. But, you know, if you make an exception and send me a kid, I'll do it. Anyway, yeah, yeah. So okay, so you're diagnosed? And you're you're pretty far into your practice at that point. Right. How long have you been practicing?
Trey Perez 9:13
I've been practicing. I've been out of residency since 2015. Okay. Oh, that was four years at that time.
Scott Benner 9:20
Yeah. So you did you have your own practice? Are you working somewhere? How do you do it?
Trey Perez 9:24
No, I work part time in a private practice. And I work part time in the hospital, actually the residency program.
Scott Benner 9:34
Okay. How do you make the decision to become a pediatric dentist is it just because you want to see little kids high on gas?
Trey Perez 9:41
That that is very fun sometimes because they do they do some silly things. And that definitely makes the day a lot better. Now, I think I mean, being a general dentist is really hard. I think that's the thing. People who specialize in dentistry, sort of realize that being a a general dentist, you have to do everything. And when you specialize, you don't have to do as much. And so I mean, I like that, you know, with kids, that everything is shorter, you get to see more more kids in a day. It's sort of that instant gratification. Because, you know, with with adults, you have to do crowns, those take several appointments sometimes and with kids, it's, it's, it's a lot quicker. And kids are just people to get it might be hard, but kids are just, they're easier. It's sort of the adults and the parents that that actually make making more difficult.
Scott Benner 10:38
Like you have a lot of stories about crazy people. Yeah. So you know, it's funny that you say that, because you're making me think about my current dentist, who I've had now for quite some time. Is, is an artist. He's just so good, and patient and methodical, but and you know, still has a great personality. And like, he's just the guy I went to as a young adult, we used to joke all the time, that I can't believe I'm saying this, we used to joke all the time that my dentist was on meth, because because he would, he would had four offices. And he'd filled them with people. And he would literally run from one to the other working on people. He'd come in, he'd see you go, I'll be right back, then you'd hear him in the next office. I'll be right back. But then he'd start your procedure. They go, I have to go for a second, then you'd hear him go into the other room and start another procedure. He was working on three, four people at a time. Yeah. And it was just always, like it never felt right. You know what I mean? Like he was in the middle of working on my teeth once and I heard him say, I gotta go, my buddy's bringing over a Corvette for me to look at, he went out a side door, looked at a car, like bought and then came back inside. And I just thought dentists were crazy. And then I moved. And I and people recommended the gentleman we use now. And I remember going once or twice and just thinking, like, oh, like you can be like a normal person to be a dentist or like I was just going off of my young adult like experience with my crazy running in circles, man. So I think it's a really big deal that you fit what you're doing. You don't I mean, because the guy I have now is very suited for this. Like I've had a root canal. And it's just like a walk in the park to him. You know what I mean? It's it doesn't hurt. He's great at the whole thing is I fallen asleep during a root canal. So I think that says something about him. You know, that's good. So I like that you found a place where you think you fit? You know, I think that's a that's a smart move. Not that you were otherwise going to be running in circles like,
Trey Perez 12:42
No, I mean, there's a lot of running in circles, no matter what it is. There's a huge amount of volume of patients that I see a day. Yeah, it's it is it can be
Scott Benner 12:56
kind of do Yeah. Is there truth to the um, I hate I know, this is such a weird thing to say before we get into about diabetes. But yeah, Is there truth in it like is being a dentist towards the top of the suicide list?
Trey Perez 13:10
I've heard that but it's also one of the top of the, the like, those reports about best jobs. Okay. If you look at those, it's like pharmacy and dentists are always on the top of the best jobs. So I've heard that statistic, uh, you know, make jokes about that all the time. But no, I don't think so. It's a pretty good career. Because it's, I mean, you're, it's not like medicine. It's more nine to five, you know, and there's not really there are emergencies, but it's not life threatening emergencies. And the way you have to deal with is not life. I mean, it is in some way life changing, but it's not like life or death. I know. And that's, that's a good thing. And, you know, if if, you know, technically we're surgeons, and I do go to the operating room, and I do surgery there, but it's not the worst thing that happened is not going to be somebody dying on the operating room table, you know, so I don't have to deal with that sort of stress. It's pretty comfortable. I honest.
Scott Benner 14:14
I'm wanting to share a joke. My friend, friend of mine is a pediatrician. And I, we were together once and I referred to him as a doctor and he goes, I'm not a doctor, I'm a pediatrician. And they said, Well, your father is a doctor Tunica. He laughs because he's not a doctor. He's a dentist. And
Trey Perez 14:30
I do that all the time, too. Yeah.
Scott Benner 14:33
It's hilarious anyway. Okay, so what was it like? I mean, at that age being diagnosed, did you have trouble getting started and acclimated or, or how did the beginning go?
Trey Perez 14:46
Well, it's weird. I mean, I sort of think about how my diagnosis and my transition compares to these children that get diagnosed. Um, I know I'm in the health healthcare field and I have a background of master's in public health and I've always conscious about keeping myself healthy. So. So, you know, making myself healthy with diabetes, you know, properly giving myself insulin and counting my carbs and making sure I have enough water exercise and everything. It wasn't too hard for Me, me, it was hard. I definitely had panic attacks when I was first injecting myself because it's not something I'd like to do. But I think I did pretty well with it. You know, adjusting to that is, it's a total 180 from your life, I like, the way I see is I sort of live my life a certain way, you know, for 35 years. And then now I have to change a lot of habits and I can't, you know, eat right before bed, you know, I can't have any late night snacks. I can't, you know, binge I can't just spontaneously eat without thinking about it. So it changed a lot. But I feel sorry, when I see kids that get diagnosed, you know, when they're little babies, and that must be tough. So, yeah,
Scott Benner 16:13
so there's no more like, I'm gonna watch a football game or grab a bag of chips and a beer and sit down and not think about it. And however,
Trey Perez 16:22
it's funny. It's funny that you say that, because I used to do similar things, you know, on Sunday afternoon to maybe just order a pizza. And just like lounge and watch football. You know, I don't do that anymore. I missed that.
Scott Benner 16:39
You miss it. You do, right? Yeah. Yeah.
Trey Perez 16:41
And if somebody you know, brings cake or cookie into work, or something like that, I'm like, I gotta think twice about, you know, eating it. I usually won't need that, you know, of course, I'll have cookies and cake. But it's not like, I have to think about it first, you know, I have to think about I can't just like, Oh, I'm gonna grab that. You know, there's a lot more thought that goes into day to day decisions.
Scott Benner 17:04
Do you stay very regimented during the work day so that you don't have like a blood sugar thing while you're working?
Trey Perez 17:09
Yeah, I, I'm a big fan of routine. And I eat almost the same thing every morning. I try to eat similar things throughout the day. I try to be as accurate as I can. But the routine definitely helps. When I go off that routine, that's usually when I see some spikes.
Scott Benner 17:35
And then you're Yeah, you're kind of stuck in the middle of a procedure, I guess. And has that happened? I mean, do you? Yeah,
Trey Perez 17:40
yeah. I've been scrubbed it in the O R. And then my Dexcom alarm went off. I'm like, I gotta go. So I had to take off my gown and everything and then go into the other room, I had some juice and just had to wait like 1520 minutes. For it corrected itself. Meanwhile, everyone else is in the or the kid is intubated. And everyone's just like twiddling their thumbs. But I mean, everyone's very, they're very gracious about it and patient about it. So that was good.
Scott Benner 18:12
But when you come out and talk to the families, you go, sorry, I know, that took longer than I had to drink a juice box before we start.
Trey Perez 18:19
Now. Luckily, I mean, it takes a long time to do what I do. So you know, a couple of 15 minutes, 20 minutes, nobody noticed. Yeah.
Scott Benner 18:28
Well, so do you tell your I mean, how open are you about it at work? For instance? Like I'm sure the people you work with know, but what about patients? And how does that work?
Trey Perez 18:38
No, nobody really knows what my Yeah, my staff knows. people I work with no, but no, I don't really talk about it with my patients. Now,
Scott Benner 18:48
I don't know why. I'm just wondering.
Trey Perez 18:51
Now if they had it. Then I would have talked about it with a couple patients who are also type one.
Scott Benner 18:57
Okay, so kid comes in with a CGM or something. And you might be like, Yo, I got that to kind of thing. Yeah.
Trey Perez 19:03
Yes. sort of show them mine. Well, then, yeah. So
Scott Benner 19:07
so so let me tell you something that happened to my daughter and, and I'll see what you think. But, you know, in the very beginning of all this, I really didn't know what I was doing very much. There were way more juice boxes than there are now you know, I would say at this point in Arden's life now, she doesn't maybe drink a juice box like maybe once or twice a week, you know, like for some sort of allow, but she was really little and there were no CGM. You know, those things were, they were plentiful. And one time she we were going along, everything was fine. And then one day she said to me, she was tired of the juice boxes and she wanted to switch to something else. So we went to the store and I let her pick something else. And within six months of that new drink being introduced into her life, Arden had like nine cavities on her baby thief. And at first First, I was just like panicked. I thought, you know, you kind of get lost in that my kid has problems. So here's more problems, I guess, I guess this is just how it's gonna be. And then it hit me one day that we switched the juice boxes. And so I switched back, she had the little cavities, you know, filled, and she's never had that kind of problem again, just do you think I'm right to think that it might have just been the switch? Yeah, really,
Trey Perez 20:26
to be honest, usually, like big life changes that like that, or diet changes, something like that, that usually triggers something. So but no matter what, when it comes to tooth decay, it's all about sugar. So and with diabetes and, and tooth decay, it's, you know, it comes down to sugar. So, no matter what I mean, juice, any sort of carbohydrate is can contribute to tooth decay, to carry so
Scott Benner 20:58
so so sugar that, so when you drink it, and then you don't have something else to flush your mouth out, it stays behind stays on the teeth,
Trey Perez 21:07
right? It's all about, like exposure. So for instance, if you have something that sticks to your teeth, the longer is sticking to your teeth, the more likely you're gonna get a cavity or if you have more snacks during the day, then you're more likely to get a cavity. And so with type one diabetic since we're, you know, snacking and having juice, and throughout the day that I think it does increase the risk, you know, for sure to have to, to have done a tooth decay. And I've noticed, you know, one thing that I I struggle with is, you know, if I have a low in the night, I'm really tired. And I'll, you know, have some juice or something. And then I noticed I shouldn't brush my teeth afterward. I'm like, two times. And I'm sure a lot of people struggle with that, too. Now, I brush my teeth before I went to sleep, but now I'm having more sugar in the middle of the night. And now that's gonna be sitting on my teeth till the morning. It's not it's not easy.
Scott Benner 22:09
Is there any value? I've heard a lot of people keep water next to the bed. And after they drink the juice, they kind of swish their mouth clean. Yeah, actually do anything.
Trey Perez 22:17
Yeah, I mean, if you're Yeah, so you're doing a couple of things, you probably rinsing the sugar off the teeth a little bit. And you're also sort of neutralizing the, the bacteria because it's actually to the cake is caused by bacteria. So it eats the sugar, and it ferments it and produces acid. And that's what breaks down your teeth. So it's not the sugar directly. It's, it's the bacteria in your mouth. But also a lot of these juices are acidic. Anyway, pretty much anything other than water is bad for your teeth. You know, juice, soda, they all are acidic, and those break down your teeth just like the bacteria do. So if you rinse out with water, that's good. In fact, if you brush right after you drink something acidic or right after you throw up, then that actually breaks down the teeth more. So doing something like having water is better. Because when you when your teeth are exposed to that acid, than the teeth are more vulnerable. So if you brush with toothpaste or toothbrush, and there's a braces that and those break down the teeth more when they're in that state. So water is good. The best thing is if you put like baking soda, and rinse with that, but that's kind of gross, but water is pretty good.
Scott Benner 23:39
Yeah, I don't find it when you recommend gross things to people. They're like, Oh, okay, let me I'll definitely.
Trey Perez 23:46
But just nobody wants to drink that. Yeah, no kidding.
Scott Benner 23:49
Would you would you you would just rent with the baking soda and water not? Yeah, swallow. Right. Okay.
Trey Perez 23:55
Just rinse it neutralize the acid. And that helps.
Scott Benner 24:00
Yeah, it's interesting, like, I had I know, I've talked about on here enough that people probably understand that my iron apparently was pretty low throughout part of my life. And once and I would have dental problems. And then I figured out that iron thing and got it balanced out. And the problems that I used to have pretty consistently just stopped happening. And I don't know if it's, I don't know if I'm just healthier in general now because of this, or if it was directly related to the, to the mineral, you know, to iron. But it's definitely I'm definitely seeing it, you know, like long enough now that I can believe in it. Like I've had a number of like root canals in my life. And it's not, you know, it's not lack of care. It's not it's just, it just would happen and then all of a sudden, you know, it's actually I don't think I've ever said this. It's my dentist that I spoke about earlier. The good one, not the crazy one who kind of saved me, because I came in just for you. You know, I don't know what I was in there for one day. But a procedure that took about 90 minutes. And inside of that 90 minutes, I got up out of the chair to use the bathroom like twice. And I do remember that I drank a ton of water before I went to the thing. And I, I mean, that was stupid, like, don't get me wrong, but I got to the dentist office, use the bathroom, went into the chair, had to get up in the middle of the procedure to go. And then after the procedure went again. And by the time I got out, the dentist pulled me into his office and said, Hey, my assistant says that's the third time you went to the bathroom since you've been here. And I left and I was like, Dan, do you have the you have the staff tracking people's bathroom habits? Like what's going on? And he goes, you know, man, that that really could be type two diabetes. And I was like, why? That's crazy. Like, I don't have I would know, if I had diabetes. I know what diabetes looks like, you know, and, but I got home. And I couldn't bring myself to eat. It was fascinating what happened because I just like Arden wasn't there it was the middle of the day, I did not have access to a meter. I couldn't check my blood sugar. And I just thought I don't have diabetes. That's silly, but he's like, go get a you know, get a physical get a physical. So he's pushing me towards the physical. And just somebody putting the idea in my head. I couldn't bring myself to have lunch. I couldn't like I'm like, what if I do have diabetes, I can't eat this. Like I started, like, over the next number of days before I can get to the doctor's office, I started eating like very low carb being very strange around food, like kind of in a panic.
Trey Perez 26:38
Well, yeah, that's what happened when I first got diagnosed to I didn't I wouldn't touch carbs for the first week. I was terrified.
Scott Benner 26:45
Yeah, it's because I mean, what was what was the? How did it feel to you? Like what was the thing you were concerned about?
Trey Perez 26:53
Well, once I found out what my blood sugar was, I was just totally shocked. I mean, I said it I was I was in denial. pretty strongly. And, um, when I, when I found out what it was, I was surprised it could even go that high.
Scott Benner 27:22
I'm fighting every urge inside of myself to just not read the in Pana toothpaste that from the 50s. Instead, I'm going to tell you about in pen from Medtronic diabetes, because they're one of today's sponsors. Here's what you get with the in pen. It's an insulin pen that connects to an app on your phone. That app is going to give you a lot of functionality, some of which is the kind of functionality you think of when you think of insulin pumping. Let me tell you more. When you pair your in pen, with the app, you get a dosing calculator, active insulin remaining a glucose history reports that you can share with your doctor or look at for yourself, activity logs. And actually more than that even, I'm not going to read them all to you because you're going to find them when you go to ink pen today.com and look around. If you're ready to try, fill out a tiny bit of information and hit submit, you're on your way to getting yourself an ink pen from Medtronic diabetes. Use the dosing calculator to take the guesswork out of your dosing the app uses your glucose levels and a carbohydrate estimate to recommend the dose that's right for you. It even considers the amount of insulin that's still working in your body to help you avoid lows. People who have insulin pumps call that insulin on board. And now you can to Medtronic diabetes offers 24 hour Technical Support hands on product training and online educational resources for the in pen which by the way, May. And I say May because it's an offer available to people with commercial insurance, but may cost you as little as $35. The in pen, that's right may cost you as little as $35. Head over now to in pen today.com To find out more. From time to time, I have this horrible feeling that this is no way to start to that. But I have this horrible feeling that there's something right in front of me that I'm forgetting or ignoring or just don't know to do. I don't it's not an omnipresent feeling. Don't worry, don't you don't have to worry about me. But I think about it. Sometimes I wonder like, what small changes could I make? That would have a large impact on my life. Hopefully I'm not the only one who thinks like this. But I digress. Here's my point. You use a blood glucose meter every day. It gives you important information that you make important decisions with and yet you have no idea if the meter you're using is the best one available. You don't even know if it's one of the best ones available. All you know is a doctor gave it to you. Well, here's the thing you You can know that it's not a not a, you know, thought exercise like the thing I was talking about earlier floating around the world like, should I go left or right up or down? Should I stay? Or should I zag? It's not that difficult. The Contour Next One blood glucose meter is a really good meter. It will give you really accurate results. You can use those results to make good decisions. Contour next one.com forward slash juicebox. I don't even I have no more to say, I guess. But I have to because there's time left. And I mean, they did pay me to talk about it. So let me tell you this. It's it's the best meter I've ever used. It is the easiest to carry the easiest to hold. It is the most accurate. I love the Second Chance test strips. I can't say enough about it. The Contour Next One blood glucose meter is simply the best meter I've ever used in the 14 years that my daughter has had diabetes. I do hope you check it out. Contour next one.com forward slash juice box. And I just want to finish by saying please don't like worry about every little decision in life. I was just being melodramatic. You know what I mean? Like, have you ever really thought about the decisions you've made? You understand? I'm saying? Although I did mean that, it really mean it would be easy to get a good meter.
Trey Perez 31:19
And it's around 300. And but you know, I've heard it. I've heard stories where it's it's way higher. Yeah. after that. So it wasn't. Yeah, I guess so. But so I think my doctor, he didn't think it was to two eyes. So I didn't go on insulin right away. He put me on type two medication. And that sort of that did not make me feel good. So I was on Metformin engine nuvia like two weeks, I was like, this is not getting better stuff are getting worse.
Scott Benner 31:49
They do a C peptide on you ever.
Trey Perez 31:52
Um, I can't remember. I think maybe I don't know if they did it, though. That time but I think since Yeah, I think it's been done, right.
Scott Benner 32:04
I don't imagine. Yeah, I just I was in a panic, I didn't know what to do. And I couldn't bring myself to eat. I did finally get a, you know, an appointment with my doctor. I've told that story before I was told that I was coming in for a console. They explained to me that I you know, I said I want to get a physical and they're like, Okay, well, you'll come in and see the doctor 15 minute consults, then we'll Book Your, your appointment for the, you know, for the procedures and everything. And I was like, okay, like, that seems reasonable. It was a little odd to me, but I didn't think much of it was like, Alright, I guess that's how this doctor does it. So I show up and like 10 minutes into this conversation. He starts examining me and I was like, I thought this was a consultation before the, you know, before the exam was like, I got really confused. And then like, 20 minutes later, I like my pants are down, like bent over a table. And I'm like, I'm like, so happy that I didn't run here from like, you know, from something else or the gym or something like that just had this consultation with this guy. So I finally said to him, I was like, Yo, man, I'm like, I'm happy. We're doing this. I was like, but that's not what your staff told me. And he goes, Oh, I don't know why they said that to you. It's like, Oh, great. Okay. Thanks a lot. Anyway, I did not have type two diabetes. Of course, they found my iron to be really low. He immediately believed that I had cancer because my iron was so low. It seems like a jump. Yeah, it was a pretty so I suddenly was getting scoped and all this stuff. And of course, it was just low iron. And I had to go through all this rigmarole just to get an iron infusion. And I felt like I was gonna pass out by the time I think my fart and was 13 by the time I got an iron infusion. And what's the normal range? It it's it should be like, it should be not like 100 or, you know, 75 is considered low for a woman of menstruating age. Like that kind of stuff. Yeah, so I was just like, I could barely hold my head up. I was dizzy constantly. I couldn't stay awake. Maybe past like, one two o'clock in the afternoon. It was really I one day want to go back and find the podcast episodes where I'm like, I have to be like obliterated in some of them. Like from just no iron, but I don't know. Maybe I was pulling it together long enough to do them. Anyway. Okay, so what I mean is that is that the bare bones like overnight that's it swish with water after you drink a juice is really a great thing to do. What about throughout the day?
Trey Perez 34:37
During the day? Yeah, same thing. I mean, water is your best friend. I mean, I before getting diagnosed, I didn't drink juice that much nitric. Yes. You know, I have I haven't usually like if I've noticed my blood sugar getting in, down to double digits. I have little swig but you know, I do drink a couple times a week. It's totally, totally changed my life.
Scott Benner 35:04
Yeah. Do you have them in your car and in your bag?
Trey Perez 35:08
My gosh, I found that I found my jacket the other day. Okay. You know you're diabetic when you find juice boxes everywhere.
Scott Benner 35:16
I picked up art and art as like a little clutch that she has now that she takes to school and it has a juice box and I picked it up and handed it to her like over the island yesterday, and I could feel it wasn't heavy enough. And I was like, you don't have a juice box in this. And she goes, I don't know. I was like art. I acted like, you don't I mean, like, I acted like she went rock climbing without safety equipment. Make sure there's a juice box and she's like, okay, she drives now, you know, and meanwhile, they're in the door pockets of the car, too. Oh, yeah. So it's not like they're not plentiful. They're spread around the house like, like, you know, Apple seeds.
Trey Perez 35:52
And the funny thing is this Christmas. My mom and my one of my dental assistants, they both got me juice boxes.
Scott Benner 36:01
How pack? How was that for your mother? When you were diagnosed as an adult? Did she? Um,
Trey Perez 36:07
she Well, I think. I don't know. They seem to be okay with it. I remember visiting my dad. We went we went up to Maine. And when he got groceries, he's like, made sure he got you know, almond milk, nothing with any sugar in it. And he like labeled everything. It was pretty funny. This has sugar in it. This doesn't have sugar in it. Okay, thanks for that. I can read the labels, but thank you for writing it. Oh. They were super supportive. They're trying to help me in their own way he loves Yeah. It's wonderful.
Scott Benner 36:46
They're not very involved. Like they wouldn't know how to help you with any of this like big picture and understand it.
Trey Perez 36:51
Do you have any? No, I'm sorry. No, what do you say?
Scott Benner 36:55
I was gonna ask if you have any brothers or sisters?
Trey Perez 36:57
Yeah, I have an older sister younger brother. But I'm the only type one in the family.
Scott Benner 37:03
How about other autoimmune stuff? Celiac? My
Trey Perez 37:06
dad has. Yeah, it's all sort of colitis.
Scott Benner 37:11
Okay. Interesting. Nobody else though, right? Like, what else would we be looking for even like, like, you know, bipolar cousin. Like, these are the things I'm now I'm now interested in because I've heard so many people say it's so much obviously see, like hypothyroidism,
Trey Perez 37:31
hypo thyroid. My mom has type of thyroid.
Scott Benner 37:33
Okay. Hashimotos is just she just, she's not an autoimmune.
Trey Perez 37:39
No, not that I'm aware of tincher. So if I think it was my mom, and she just really talked about that. I was just home one time. I'm like, Mom, you're on Synthroid, she's like, yes, no big deal. Like, okay, it's, it'd be nice if you told us about your medical conditions, you know, your chronic medical conditions to
Scott Benner 37:57
your people you have, right, maybe I might want to look out for that for myself. Thanks.
Trey Perez 38:04
But you know, their baby boomers are a different generation. And they don't talk about that as much.
Scott Benner 38:08
Ya know, it's very, very true that some people just, it's not even conceivable for them to have conversations about their health with other people.
Trey Perez 38:17
Yeah. Meanwhile, I talk about diabetes all the time. My friends, like stop talking about it. On on the internet, you're talking on a podcast to millions of people. So just stop
Scott Benner 38:29
talking to people about your diabetes. Let's just talk about some other oral stuff, oral health stuff that I think just people in general don't know about that I know about, like, even like, having like a potato chip, right? Like it could get caught in a crevice of your tooth, and it stays kind of packed in there. And that's really bad, right? So what's your people do during the day? She like soft picks? Like, what? Like you don't I mean, like, what do you do if you're not in a place where you can brush your teeth?
Trey Perez 39:00
Yes, if you can get it out. That's better. Like I said, it's anything that's sticking to the teeth. The longer it's there, the more likely it's going to cause a cavity. And a lot of people think, Oh, my kid doesn't eat candy. Why does he have all these cavities? I'm like, Well, you know, I see kids all the time eating, you know, Cheerios, and go fish and chips, crackers. Those are all salty treats, and they cause cavities. People don't realize, you know, there's carbohydrates, and sugars in those starchy things as well. So you read, everybody has bread all the time. So it's any carbohydrate and if you can get it out, that's better. That's it. I mean, it is hard if you're at work or doing something where you can't brush your teeth. But you know, removing anything is going to be better.
Scott Benner 39:53
Drinking water is a big part of it. Hmm.
Trey Perez 39:55
Yeah. So what happens is, if your mouth Have is dry, which it can be if your blood sugar is on controlled, or if you if you just dehydrated or if you're taking multiple medications, you know, dry mouth is pretty common and the wetter it is, the better it is for your teeth. So staying hydrated is super important. When your mouth gets dry, that's when the bacteria tend to grow more and cause more cavities. So it increases the risk.
Scott Benner 40:28
I'm envisioning a day in medical school where someone for the first time introduced the idea that the wetter it is the better it is and everyone laughed is that.
Trey Perez 40:40
As I said that I didn't realize when I'm gonna start using that though.
Scott Benner 40:46
I was gonna say either make a t shirt or stop saying that's hilarious,
Trey Perez 40:51
new phrase.
Scott Benner 40:55
Do people see the dentist often enough? And what about?
Trey Perez 41:02
No, I don't think they do. I mean, our recommendation whether it's a child and adult, you should see the dentist every six months. And that's because things can happen pretty quickly in the mouth. Like if you are if you do have a change of habit, or some sort of change of lifestyle. In those six months, you can go from having no cavities to having several cavities. And it's not just cavities, but there's periodontal disease, gum disease, and there's different levels of that. So in some ways that can be worse. Because you actually lose your teeth and it's can be harder to repair that but every six months no, just to checkup make sure everything's okay. If people are higher risk, they're supposed to come every three months after high risk for gum disease or caries, then they should be coming every three months just to monitor you know, do some sort of preventative treatments just to keep them deeper and worse
Scott Benner 42:03
probings like that but yeah, I'm getting older, I just my dentist basically strong arm me into a deep cleaning recently, and then gave me a tray that I put gel in and and I guess I'm forcing the gel down into my gums. And and I'm doing that because he told me to and I don't want to get yelled at basically. It is a hard thing to try to imagine, though. Like you don't I mean, it's not that I don't think it's that I don't care about my dental health. Like I don't think that's it at all. I think there are so many other things going on in the world, that it doesn't feel like an emergent problem. It's a it's almost the same as I just said this the other day. So I shouldn't say it again, because people here a couple of weeks in a row. But I think that part of the reason why there's more of a community around type one diabetes, is because people are very desirous of figuring it out quickly because it feels like a thing that could hurt you in the moment. Whereas type two diabetes, there's no, there's not as big of a community or hardly any. And you don't hear people talking about it very much. But it also doesn't feel like something to them, that's going to hurt them today. And so it's the idea of it happening in the future that allows you to kind of ignore it, if that makes sense or not. But I wonder if dental stuff isn't like that a little bit too. Because should should children be getting cleanings? Like if I baby teeth? Yeah. Should I be getting them cleaned? Yep.
Trey Perez 43:29
Like, well, just as a PSA, everyone should take their kid to see the dentist by the time they're one year. Okay. And they should be going from then on it should be every six months.
Scott Benner 43:41
Tell the people you're not just saying that because you have a car payment Right? Like you actually no,
Trey Perez 43:45
no, this is the American Academy of Pediatric Dentistry, American Dental Association, it's the recommendation but it's also the American Academy of Pediatricians the the actual, you know, MD Is it to them as well. They have the same recommendation.
Scott Benner 44:02
Track I grew up pretty broke. Yeah, I didn't see a dentist the first time till I was like 20 years old. They could no one ever took me to the dentist. They didn't mention it. It wasn't a part of my life at all. Like it wasn't even like, it wasn't like I thought like, Oh, I haven't been to the dentist. Nobody takes me it was just never brought up. I definitely could have used braces growing up. That is not something anybody could have afforded. I think it was a financial thing. It just nobody else. Yeah, I went because my wisdom teeth were impacted and I thought I was gonna die. So I have you ever heard this story? Not at all. I'm gonna give it to you real quick then because it'll freak you out. So I go into my dental my dentist's office, which is where I found the meth dentist. And I also shouldn't say that I'm sure he wasn't on that but he's actually a lovely guy just very amped up. And I guess maybe it was coke then. Anyway, up teasing I Go in there. And I'm like, I don't know what's wrong, a lot of pain. I'm very embarrassed to say I've never been to a dentist before had to say that to a person I didn't know. He tells me when Western teeth are impacted. And I have to go to an oral surgeon to have him removed. And I stopped him. I said, I can't do that. I said that, that I don't have that kind of money. And he's like, No, you really have to get this done. And I just I told him, I was like, Look, I appreciate your concern can't happen. I don't have the money. And just kind of out of nowhere, while everybody was staring at each other. I said to him, how much do you charge to pull out a tooth? And he said, $50 as long time ago, and I was like, Well, I can come up with 200 bucks if you want to pull him out. And he said, No, he's like, there. That's not how this works. You don't need me. He's like, That can't happen. I said, it's not gonna they're not coming out if you don't do it. So a few minutes later, he's loading me up with Novocaine. And then his partner comes out, stood behind me with his palms on my forehead to hold my head down on the chair, and he yanked out my wisdom teeth in the office. It was terrible. It was terrible. It was like one of the worst. Like, I just remember him pulling in my head trying to pull up and the other guy leaning down on me. And does that horrify you go ahead, tell your story?
Trey Perez 46:17
That I still have it wasn't diesel? I can't relate to that. They're fully in the normal. Just, yeah, I got lucky with that. And I don't deal with wisdom teeth. That's fortunately, that's something I don't have to deal with. Both
Scott Benner 46:34
of my kids have had them out like the what I would consider the modern way you show up at an office, they knock you out, you know, give you a little Jackson juice. And then, you know, you're you wake up 2030 minutes later, and you don't have your wisdom teeth anymore. Yeah, you know. So, but anyway, it just it was I kind of look on it as like a kindness back then I think he really believed me. I was like, Look, I can't, I can't afford to do this. And so he's like, Well, I'll try to help you. They did not come out easily. It was not another thing. But the recovery was fine. That's good. So you know, anyway, I might have gotten very lucky in that situation, if I'm being honest.
Trey Perez 47:09
Yeah, maybe that's something we struggle with, I think as a profession, because, you know, having it is very expensive. But still other surgeries, if you go to the hospital, that's even more expensive. But insurances tend to cover that and insurance tends not to cover dental treatment. And when it comes to insurances that do cover it, that it's limited on what they do. And it is a big struggle, because the patients don't know what's covered and what's not covered. And insurances don't want to pay. So it's a struggle for those who want to help everybody, you know, we want that's most of us just want to help people and some people are chasing paychecks. But, you know, that's why we got into his to help people. And unfortunately, there's a huge money side to it.
Scott Benner 47:57
And so there's just and do you think that that causes people then to ignore things until they're a problem that can't be ignored anymore? So we don't do as much preventative care, which would maybe stop it. Yeah, do the other stuff.
Trey Perez 48:11
I mean, just like in medicine, prevention is the best medicine. And a lot of prevention isn't just getting cleanings and fluoride and things like that. It's about education. And it's, I wish more people thought about their teeth, but a lot of people don't. And there's a couple of things. One is, you know, insurance of what's what people can afford. And it's also people think, like, you know, with baby teeth, oh, they're just gonna fall out. I know, it doesn't matter. You know, just, they're just do whatever I want. Yeah, yeah. And so people think about that about their adult teeth, especially older generations, they're like, Oh, well, my parents had dentures while my teeth are all gonna fall out. I'm just kind of, it's gonna be the same for me. But when I, when I used to work with adults, the denture patients, they're like, Oh, I wish I listened to my parents. I wish I took care of my teeth. Because having dentures having fake teeth, it's not the same. And they miss their teeth, for sure. And a lot of people wait until it's too late. Because they're like, it's just teeth. It's just a dentist. It's no big deal. You know, they don't people think we can fix anything. But it's a lot of things are very difficult. And nothing's as good as your own
Scott Benner 49:25
teeth, you know, and it becomes irreversible at some point. So
Trey Perez 49:29
yeah, yeah, I mean, you can come in, it could be a small little cavity, and you can take care of that. But if you wait long enough, that the whole tooth can be decayed, and that tooth has to come out.
Scott Benner 49:40
I am. You just shocked me a little saying that people kind of pre plan to lose their teeth as adults.
Trey Perez 49:46
Yeah. I mean, there's some people, you know, depending on the culture and the way they grew up, they definitely see that.
Scott Benner 49:53
Yeah, it's unfortunate it is. That's sad. It doesn't have
Trey Perez 49:57
to be that way. It doesn't have to be that my grandfather died. While he was like, I think a three when he he died and in the nursing home is last few weeks. So there he the nurses like wow, he has all his teeth. So you can you can live, you know your whole life and have all your teeth,
Scott Benner 50:17
right? Are you the first one? Actually my father is a dentist. Yeah. That happens kind of that's that's the thing that happens, right?
Trey Perez 50:26
Yeah, he's actually Oh, he's retired or semi retired now, but he was a dentist in a prison for 32 years.
Scott Benner 50:33
Wow. Yeah. Your dad had diabetes. That sounds like an interesting story. My wife says, Honey, I was interviewing a person recently who is a sex worker and has type one. And my wife's like, how much to talk about diabetes. I was like, not that much. And she she goes, this is a podcast about type one diabetes sounds like it's about people who have type one diabetes, I was like, I'm not getting involved in somebody's really interesting life story and stopping to be like, so what's your Basal rate look like? It's like, I was like, We want to hear the, you know, the interesting stuff. I seriously like, tell your dad, if he ever gets diabetes, I should be his first call. Because I want to hear that story. So I mean, big picture. You know, if you want to leave people with a with a message here about themselves as adults living with type one, or people who are, you know, caregivers for children, you know, what are some really big just go over and again, for them? Like, what should they be doing to help themselves with their, with their oral health?
Trey Perez 51:35
Well, it's, you know, managing your diabetes is super important. When it's not managed, well, then, you know, you're you get dry mouth, and you know, your risk for tooth decay goes up. And also, if you are drinking a lot of juice boxes, or juice or snacking, then you have to be careful with that. But people just sort of, you know, brushed teeth aside, and I think the same goes for podiatry. People don't really think about your feet is that important, or, or going to the dentist is too important. But these are things you use every day, use your teeth every day, all day, you use your feet all the time you're walking, and you don't you sort of take it for granted. And, you know, things could be going wrong that you don't see. So it's definitely easier if we catch something early than waiting till it gets too big. So I think we sort of as a society, or as a culture, just, you know, sort of brush those things off that though, they're not as big a deal. And people only want to go see the dentist to the podiatrist when something is wrong.
Scott Benner 52:51
But yeah, checkups are really big deal, because actually, you just discussed Heath the way we used to talk about my little brother growing up, we used to say that Rob has two states of being he's either in trouble or currently getting in trouble, and you don't know about it. So he's an adult now and doing much better. But, but so your teeth are either, like something's happening, and you don't know it. And that's the time to find out not after it's happening. Right, right. Yeah.
Trey Perez 53:19
And tooth decay is the most common chronic disease in childhood is five times more common than asthma. And everybody knows somebody that has asthma. So if you know someone with asthma, that means, you know, every kid almost has a cavity by the time they're five, some not every but it's that's what it seems like sometimes it seems. I think it's about you know, 40 depending on you know, where, where the study is from, but you know, it can be like 25% to 50% of kids will have a tooth decay by the time. They're five years old.
Scott Benner 53:54
Okay, wow, that's I didn't realize that. Simple things. So keeping your mouth wet, dry. So dry mouth is a is an example of something you should be concerned about. I guess kind of a chronic bad breath is probably another thing you you have to pay attention for. Right? Well,
Trey Perez 54:09
yeah. So when it comes to bad breath, that's a big complaint that people have all the time. And usually, if you think about it, things that smell bad, like the garbage or the bathroom or something, it's all because it's the one thing it's bacteria. So if there's a lot of bacteria, and they're growing, they're sort of they're creating this bad smell. So it's and things are breaking down. Like there could be stuff in between your teeth. There's food there, and there's plaque there. That's usually where people neglect it the most. Some people will be great at brushing and I can tell and then but they're gonna start to bleed once I start doing anything and ask them if they floss and they say no, seems like nobody flosses. But if you're not flossing, then you're not cleaning the whole tooth. And it's sort of like I think like, if you're not If you're not flossing, you're only cleaning about 70% of it to. So that's like, to me, that's like taking a shower, but you're not cleaning your armpits and your other areas that might get smelly. It's just, it's those are like the worst spots because that's where all the food, that's where things are accumulating. And that's, you know, where things are breaking down, the food's breaking down, the bacteria is growing. And that's where you get this bad breath. So it's usually poor hygiene from bad breath, if it's, if it's not, if that if the hygiene improves, and nothing. The bad breath doesn't improve in a couple of weeks, because that's as long as it should take if you're doing everything properly. You know, Gingivitis would go away in two weeks bad breath should go away. So if those doesn't improve, then it's usually like a GI thing, but that's pretty rare.
Scott Benner 55:49
Well, you know, I have to be honest, like the you said, the simplest thing today, as one of my big takeaways, and I don't understand why in my entire life, I haven't put this all together. But the idea that it's not, not so much the sugar, the carbs, but the fact that they sit in your mouth, and then they break down and it's the process of it breaking down. That's dangerous for your teeth. Right? Like I yeah, like when you said that I was like, oh, like, I'm surprised. I didn't outloud go. Oh, geez. I just thought like, there was something magical about the sugar. That was bad, but it's not. It's just, it's food for bacteria. And then it's the waste from that process that's really causing you problems with your gums, your teeth, your breath, like the whole thing. Exactly. So just don't leave stuff behind in your mouth. And you'll be okay.
Trey Perez 56:33
Right? I mean, if you leave, you know, fruit, like, if you leave like a banana peel out on your, on your counter after you eat it, then it's gonna rot. There's gonna be flies attracted to it, there's gonna be, it's gonna smell gross. And that's, I mean, if you leave food in your mouth, similar is gonna happen. You're gonna back to your grow. You're gonna it's gonna smell it's gonna be pretty gross.
Scott Benner 56:57
Is this a this thing I'm about to say to you? Is this. Is this bowl, or is there? Like, what about people who pop gum in? In lieu of brushing? Is there any help? Is that actually doing anything for your positive?
Trey Perez 57:08
Yeah, if it's sugar free gum, especially. Because it's stimulating your saliva. So if you have no more saliva, then you're washing things away. And there's a lot of good things in the saliva. The saliva, there are immunoglobulins. So it can that helps. And then, you know, more fluid is good. There's more minerals, you know, that help strengthen the teeth. There's a few of xylitol gum, that's good. Xylitol is a sweetener, but it's not it doesn't contribute to tooth decay. The bacteria don't eat it, and dissolve the tall. It's believed that it helps prevent cavities helps with the bacteria in the mouth.
Scott Benner 57:54
My dentist has small individually wrapped like Chiclets on his countertop, and it's gum made bizarre. I just realized while you were saying yeah, yeah, I thought he was just trying to be polite, but a little bit of both. Yeah, perhaps. Right. So hey, you said you have a Dexcom. Right. But do you have a palm? Do you use pens?
Trey Perez 58:14
I've been using pens. I did try the Omnipod. And I just didn't love it.
Scott Benner 58:20
You didn't like wearing a pop? No.
Trey Perez 58:23
It was an issue for me. I did do it for about a week. Okay. Like a month ago?
Scott Benner 58:28
The adhesive was a problem for you.
Trey Perez 58:31
Yeah, that and I kept knocking into things and couldn't get you started. Yeah, I couldn't get used to
Scott Benner 58:37
it. Listen, it's not for everybody. That's actually you know, as you're spouting off, I didn't mean spouting off bad, but like running through statistics about things that happened in dental care that we don't know about. Actually, far fewer people were insulin pumps than you think. So, you know, it's it's more common for a type one to be MDI, actually,
Trey Perez 58:57
yeah. Yeah. I just wanted to try it. See if I like to. I did meet a guy at the gym a couple of weeks ago, and I see him every once in awhile. And he's a type one, two, he saw my Dexcom and he made a comment and he has the the FreeStyle Libre. And he's doing daily injections as well.
Scott Benner 59:15
Right. How soon after your diagnosis. Did you have a CGM?
Trey Perez 59:20
I think it was a year later. How do you guide? Yeah, I think it was about this time. Last year that I that I started it.
Scott Benner 59:28
Did you honeymoon at all in the first year? Yeah,
Trey Perez 59:31
I did. Like a lot. And then when that honeymoon phase ended, that was tough. I could I definitely saw that happen. And that was that was like February and March last year that it ended.
Scott Benner 59:44
Do you find it easier to manage with the CGM than you did without it?
Trey Perez 59:49
Yeah, okay. And mainly, I mean, for so many reasons. But doing a finger stick, it takes a little bit of time, you know, just to Open up everything, clean your finger, do those stick, wait a couple seconds for it to turn on. And then it takes like a minute to do it. And this is just like on my phone. Yeah,
Scott Benner 1:00:11
it's like, okay, you know, people have had diabetes for longer just heard you say clean your finger and they're like, finger.
Trey Perez 1:00:17
Well, I don't always do that. But
Scott Benner 1:00:20
I know. I just said that because you were a doctor.
Trey Perez 1:00:24
Yeah, I'm just trying to be doing things by the book, Leading by example. Right? I don't always do that. I don't, I probably don't more than I do.
Scott Benner 1:00:36
I would, I would say it's probably been 2012 is probably the last time I bought an alcohol swab. Yeah, we definitely don't use that stuff anymore. But that's, uh, it was around them, sort of what you were talking about, like, you know, we used to, like, clean, Arden's fingers with and you know, her sights and everything with alcohol, and she just started having like skin problems, you know, because we were drying out her skin constantly with alcohol. Oh, yeah, I've noticed that too. Right. I did a little research and I found out that in Europe, that's not the standard of care. The standard of care is warm water. Mild soap, like clean. Yeah, pat dry that
Trey Perez 1:01:18
I heard. I've heard you say that. And since then, I stopped doing that. Because I didn't notice getting some irritation with it.
Scott Benner 1:01:26
Yeah, totally with the alcohol over and over again. Yeah, no, I you know, Trey, I'm not a doctor like you. But that's I'm just saying what we do. I'm just a dentist. I'm just a guy with a podcast. So I think you've got me by a couple of years in college at the very least. Difficult, difficult major. Right? Dentistry? Yeah, yeah.
Trey Perez 1:01:50
Yeah, there's a lot to know. I mean, going through college. I did. I did biology, cellular and molecular biology. So I learned about I started with that. But then when I got to dental school, dental school was like college on steroids. Like I had to. I had no time for anything else. You know, it just had to, that was my my life. In college, I had, you know, jobs and things outside of school. But that, you know, dental school is just my full time job. Yeah. Studying and everything.
Scott Benner 1:02:22
Has dating changed with diabetes at all. Dating? Yeah, seeing people like that. I mean, if you do, yeah.
Trey Perez 1:02:32
It's something I do. Talk about. So I'm comfortable talking about it. So yeah, a lie. Well, I, I mean, I can't remember what was like dating before, but it's something that comes up, I guess, pretty quickly. It's like, oh, what do you what are you doing there? And while I'm injecting something, so yeah, it definitely plays a part. But it hasn't really made much of a difference, I guess.
Scott Benner 1:03:00
Well, you're also showing up with the dentist thing. So they're gonna hang a little longer to see what's. Yeah. Everybody knows the story about like a dentist wife who has a great car, like they're like I can put up with this guy in Jackson's. Yeah, you get a little leeway? I would imagine. Yeah. Do you see you? I mean, you're not hiding it. Obviously, you go out, you're eating people are gonna see it. Do you don't lead with it? I imagine you don't be like, Hey, I'm trying you want to go out? By the way? I have diabetes? wouldn't think it would start like that.
Trey Perez 1:03:31
No, sometimes it would, I guess. But no. Has anyone
Scott Benner 1:03:34
been put off to the point where you think you didn't see them? Again? Because of it.
Trey Perez 1:03:39
Now, I don't think I've got I mean, I haven't been doing much dating, but because it goes to sample sizes, too. Yeah. Just too small for that. How are
Scott Benner 1:03:49
the borough's the city now, in the beginning of 2022? Is it? Are there a lot of restrictions? What's it like seeing patients with COVID?
Trey Perez 1:03:58
Well, that's, that's been difficult. I mean, I have to wear a lot more PPE than I did in 2019. But I've gotten used to it. It's just, you know, how we practice now. It's probably how we should have practiced before because we're looking in people's mouths. And, you know, kids come in, kids are always sick. If you've seen like 2030 kids a day or more than, you know, you're more likely to get sick. So I'm comfortable with the by now people. It's sort of fluctuated with the volume that we've seen. Lately, I think people are a bit more nervous to go out of their houses because this Omicron variant but overall, like we really haven't missed a beat me it's slow down here and there. Now in the beginning, we everybody had to get shut down. But you know, summer of 2020 everything was, you know, back to 100%.
Scott Benner 1:04:57
Did you realize or did you lose people or There are people that didn't come back.
Trey Perez 1:05:04
Yeah, I'm sure there were some people moved out, a lot of people did move. And then people, people are a little bit nervous to go out. But overall, you know,
Scott Benner 1:05:14
I was talking to an emergency room physician who told me that some of the problem they're seeing right now with crowding has less to do had less to do with COVID. In the moment when they said this to me, and more to do with the fact that people had ignored their health for so long because of COVID, that it was kind of catching up to everybody. At the same time, people are having a bunch of emergent problems, things that they tried to ignore to stay out of doctor's offices with COVID, which I thought was kind of fascinating. And I didn't wonder too, if it creates a malaise, like, you know, you go a year without getting your teeth cleaned, all of a sudden, like my teeth aren't falling out. I'm good. I don't have to do that anymore. Like if it if it kind of falsely tells you. This is something I can ignore, when it's when it's obviously the opposite.
Trey Perez 1:05:59
Yeah, I've seen a few cases like that where people have come in, and I didn't want to come in because of the COVID and spend two years and yeah, now this is just really hurting me. I want to get this fixed.
Scott Benner 1:06:08
Arden's getting her teeth cleaned and a couple of days and she she said again, she's like, this is okay, not that she's done it a number of times already in the last, you know, year and a half or so. And I've have I've had dental work done and everything and I said to the, to her kind of the same thing you were just talking about, I was like, I think that dentist office might be one of the safest places around I was like, these poor people are wrapped up like, you know, frozen food at this point. Like you can't even say, you know, yeah, yeah, that's been shielded.
Trey Perez 1:06:37
Yeah, it's hard, interacting with people because having the bedside manner chairside barrier is important, and they can't really see me smiling or, you know, talking and so that's been difficult. The communication has been a little bit more difficult. So, yeah, I missed that. And, hopefully, I mean, who knows what's gonna happen?
Scott Benner 1:07:02
I have no idea. Honestly, there's part of me that thinks that this is how things are going to be for a while. And yeah,
Trey Perez 1:07:07
I think so too.
Scott Benner 1:07:09
All right, I'm gonna let you go in a second. I have. I just want to know, like, Tell me some of the craziest things kids have said when they're on the gas. Like, have you ever heard something that like, put you back cursing, weird sexual stuff, anything like that? Oh,
Trey Perez 1:07:23
no. One time this kid when they're sedated, it's funny. When kid was like singing frozen, it was really cute. The one kid had to wrestle him a couple of weeks ago. And he he, after he got in the chair. He said, I'm sorry, I punched you. I was like, Don't worry, you didn't punch me. I dodged it. VTT definitely get you keep he was swinging. Yeah.
Scott Benner 1:07:54
I stopped losing. I stopped my son from like popping a lady trying to give him a flu shot when he was about seven years old. I just, I saw it happen. I reached out and I grabbed his arm was like, It's not her fault. Yeah. So. So when Arlen had all those cavities, and I talked to you about back then, you know, we went to a pediatric dentist and a guy that we, you know, trust and had used in the past once or twice with my son. And he was so uncomfortable with the idea of, of making Arden incapable of drinking juice, because she was little when it happened, like she was really little, that he said, You know, I need to do this in a hospital setting where they can regulate her blood sugar if something should go wrong. And just like you said, our insurance did not want to pay for that. The way I finally got around, it was just dumb luck. My wife's company is large enough that they actually, I don't know if people understand how insurance really works. But when you're, you know, when you're with a bigger company, the insurance company really is just sort of managing the billing and the price settings and things like that. But your company just writes a check at the end of like, every quarter for how much money they owe the insurance company. It's a weird thing. It's just my my wife's company is one of those. So I appealed to her company. And they just said, okay, and gave us a waiver for it. It was like a $14,000 procedure, because of the hospital when all was said and done. And we were looking at trying to pay that ourselves, which was not going to happen, like we weren't going to come up with 14 grand for this. And I went to the company and explained what was happening. And we went through a little bit of a process and we got a call one day and they're like, Okay, you can book it, we'll pay it. And so basically, it was just the company telling the insurance company, let them do this, we'll pay for it. And that that's how it worked out. I'm not certain you could get that accomplished every day on everything that you want to get done, but it is how it worked for us in the situation. And then we got to the hospital. And it was well before we didn't I have a CGM she was really little. So they, you know, they hooked her up and had all this stuff ready to manage your blood sugar with and got her through the process. And you know when it was over, he said, You know, I feel bad that we had to do this I was just scared. But then moving forward, she had to go to the dentist's maybe a couple more times for to see him to, you know, have a cavity filled or something like that across the years. But then once we had a CGM, I was able to say to him, Look, I can manage this here, without her needing to take anything in her mouth. And I was doing it back then with like, Temp Basal. Like I was taking her insulin away, making sure she wouldn't get low during the procedure, stuff like that. He was completely comfortable with that. Nowadays, like when Arden goes to the regular adult dentists, like, I mean, she's using a loop system, we don't even really think about it, to be perfectly honest with you, I just take her it's usually kind of fine. But it's been a it's been a long process. diabetes has touched. Everything we've done over the last 15 years. And going to the dentist was, you know, was definitely one of them. It was scary. I can remember being really frightened back then about the finances, about her health thinking we couldn't afford it. And, you know, if I wasn't who I am, I don't even know that I would have thought to reach out to the company and do what I did. I'm just very. I don't know, this push it. Yeah, I'm not sure. It's,
Trey Perez 1:11:25
it's good that you did that. Because insurance companies, you know, if you if you push them enough they can they'll do things like that.
Scott Benner 1:11:31
It turned out it wasn't the insurance company I had to talk into the insurance company said, Look, we said no to this, because that's not covered. That's not part of the plan that we agreed to with your with your employer. So I just went to the employer and got them to change the thing for art and one time that they would agree to. And that was that was that was really weird. To be perfectly honest. I'm still struck by how strange it was, all these years later. I basically went to a company and said, like, can you please pay for this? And they were like, Yeah, sure. So.
Trey Perez 1:12:03
So how old was she when she had that?
Scott Benner 1:12:07
For four, five, maybe like she was really young, she had a bunch of cavities. And they came all at once out of nowhere. And I think they were from this iced tea juice box that she was drinking. Yeah, very likely. It sucks. But I mean, she's good. Now her dental health is great now. But she also doesn't. She doesn't have as many lows. And she doesn't, you know, she's not snacking in the middle of the day constantly. She's not drinking juice or taking in a bunch of sugar, you know, at random times, and she takes good care of her teeth otherwise, good morning and night. Or should people be brushing in the middle? Be honest, like what do you do versus what do you tell people?
Trey Perez 1:12:45
I, I do what I tell people. That's something that I've always tried to do, you know, practice what I preach. So you should be flossing once a day. I usually floss at the end of the day, you know, to clean off all have food in the plaque in between my teeth. And I usually brush after that. And brush twice a day for two minutes should be like the last thing you do before you go to sleep. Make sure your teeth are clean before you go to sleep, because if they're not then all that stuff that's been on your teeth all day. You're just sitting there and the bacteria is commenting and just breaking down your teeth. So the most important time is that night. And then if you can do it any other time after you eat, then that's good bonus. You just want to clean your teeth off anything. Like we've said it's anything that sitting on your teeth is is not good.
Scott Benner 1:13:39
Flossing, wax floss the best just the there's it doesn't
Trey Perez 1:13:43
matter. It's like whatever works for you. Okay, like whatever you use, that's gonna be best that I've had. I think I've waxed floss because sometimes just easier to slip in there. And so whatever works.
Scott Benner 1:13:56
Gotcha. Okay. All right. Did we not say anything that we should have? Have I left anything out?
Trey Perez 1:14:01
No, I think that's pretty good. I think I got everything I wanted to talk about.
Scott Benner 1:14:05
Are you amazed that we talked for this long? Because the beginning you were like, I don't know what?
Trey Perez 1:14:09
Yeah, and it came up more naturally than I thought. So. I'm pretty good at this tree. Don't worry about it. Yeah, I know you are.
Scott Benner 1:14:18
I know what to do. The whole time. I'm just thinking like, maybe if his dad worked on a person prison that had type one I could make that count. I'm telling you like a prison dentist sounds like a badass job to me with like a lot of crazy stories.
Trey Perez 1:14:33
He didn't really talk about it much so. But I'm sure he did have some stories. No, my dad's pretty reserved guy, so
Scott Benner 1:14:43
yeah, all right. Well, then I got it. I don't need him. I need more people like the sex worker. But yeah, when I pause this, I'll tell you the word that I had to bleep out of that episode The most before I let you go, but I'm not gonna waste it here. People are gonna have to listen to the episode to find out. But Trey really I appreciate this man. Thanks very much for coming on and talking about all this. Yeah, my pleasure. I'm happy to do it. Excellent. Have a Happy New Year. Happy New Year to you too. Thank you so much to Trey for coming on the show and talking with me today. And thanks to Ian pen from Medtronic. diabetes. Don't forget to go to ink pen today.com to learn more. I also want to thank the Contour Next One blood glucose meter. Make your next existential decision at contour next one.com forward slash juice box. I want to thank you so much for listening and remind you to go to T one D exchange.org. Forward slash juice box and fill out the survey. I'll be back very soon with another episode of The Juicebox Podcast. Are you enjoying the show, please share it with a friend or a stranger. I don't care if you know them. And don't forget to subscribe and follow in your audio lab. If you're looking for community around diabetes, check out the Juicebox Podcast Facebook page Juicebox Podcast type one diabetes is a private group on Facebook with over 26,000 members, you can be one of them. People talking about life. Insulin, they're drilling down on ideas about how to bolster things. And just having regular everyday conversations that nobody but people who live with diabetes may understand Juicebox Podcast type one diabetes, as a matter of fact, at the top of that page, there's a featured button when you click on it, there'll be lists in there of different series within the podcast. So if you've been having trouble finding the day, the day that the diabetes Pro Tip series, or the defining diabetes series, the variable series how we eat any of the series throughout the podcast, you want to check out the afterdark episodes for instance, but you don't know where to find them. Go to the Facebook page, go to the feature tab lists a plenty are there
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