#832 After Dark: Striving and Grateful
Emily has type 1 diabetes and a number of other struggles.
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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 132 of the Juicebox Podcast.
Emily is an adult living with type one diabetes, and she has had more than her fair share of problems, but she hasn't let them stop her from striving for more. Today while you're listening to Emily's story, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan, or becoming bold with insulin. If you have type one diabetes, or are the caregiver of someone with type one, please take a few minutes to fill out and complete the survey AT T one D exchange.org. Forward slash juice box. Completing this survey helps move type one diabetes research forward and you can do it right from your home. T one D exchange.org forward slash juice box. Just to let you know we're going to be speaking about a number of things in this episode drug use, suicide attempts, depression, anxiety, and things of that nature. Just want you to be aware
this show is sponsored today by the glucagon that my daughter carries G voc hypo pen. Find out more at G voc glucagon.com. Forward slash Juicebox Podcast is also sponsored today by the Dexcom G six continuous glucose monitor. That's right Dexcom makes the G six and the G seven is coming very soon. So head over now and find out more dexcom.com forward slash juicebox get the CGM that my daughter uses get index comm links to G voc hypo pen, Dex calm and all the sponsors are in the shownotes of the audio player you're listening in right now. And they're also at juicebox podcast.com. When you click on my links, you're supporting the show. So I thank you very much.
Emily 2:18
Hi, my name is Emily. I live in New York, and I've been type one diabetic for coming up on 30 years. Since I was three years old.
Scott Benner 2:30
Wow. Okay, well, that's a pretty long time. Does it feel like a long time?
Emily 2:38
Yeah, it does feel like a long time. How so? I just I can't remember a life without it. And it almost seems like it's been different chapters of diabetes. A little.
Scott Benner 2:58
Okay. Well, two ideas and we'll pick it apart a little bit. Does it bother you that you don't remember life without diabetes? Or is it comforting? Or would you not know?
Emily 3:12
I don't know. It? I think? I think not. I mean, I think both situations are difficult in their, their own way. But at least for me personally, I think it's difficult. I always wonder like, you know, what it would be what it would be like and
Scott Benner 3:40
is it sort of like a sense of, like, loss, like, you know, you lost something, but you don't know what it is? Right? Because you have no, you have no context for not having diabetes. I mean, unless you remember being two years old.
Emily 3:53
No, I don't I don't remember. I see pictures. But I don't actually remember anything.
Scott Benner 4:03
So do you do you think that you there's something to miss or do you think you're imagining something? I don't know if that's I think there's
Emily 4:13
something to miss. Yeah. And you know how it's affected my life. It's definitely impacted my life quite a bit. And it's just always something that's been there and it always will be there. So
Scott Benner 4:33
Right. Well, let's figure out a little bit about it. So have your your family ever share with you how they figured out you had type one?
Emily 4:43
Yeah, it's actually pretty strange. I think my father actually was type one diabetic as well. So he He, so I was three years old. He had type one diabetes. And I was told that his uncle, who was very influential in his own diabetes management, had just passed away. And my father had some underlying mental health issues. And he started having hallucinations after that happened that I was a type one diabetic. And he became very obsessive and started testing my urine constantly. And he brought me the doctor's saying, you know, you need to test her. And they all say, you know, you're crazy like she doesn't have type one. She's not diabetic, she's not showing any symptoms. And finally, he wound up bringing me to the Joslin in the Joslin Center in Boston. In March, my mother was actually giving birth to my, my brother, at this point, so my father was not with her when my brother was born. Can you do it he took me to Joslin and they ran a glucose tolerance test on me. And it turned out that I was a type one diabetic. So he was right, even though it's kind of crazy, but I wasn't showing any symptoms at the time. He just
Scott Benner 6:29
do you think he was seeing things that he recognized? Or do you think he was actually in the midst of some sort of break?
Emily 6:39
I think it was more a mental health thing. And I think he was just like, he was always a very anxious person. And I think he knew there was always a chance
Scott Benner 6:55
he just happened to be right this time when he when he does, yeah.
Emily 6:59
And I think some some things happen that really kind of like, broke him a little bit and being that he had underlying mental health issues that, you know, just manifested itself in that way,
Scott Benner 7:13
what were his struggles.
Emily 7:16
Um, over the years, he was diagnosed as bipolar. He was also he also had major addiction problems for most of my life. I think they started to happen actually more. After I was diagnosed with type one, which I don't know if that is related. I think it really broke him on I was sidenote,
Scott Benner 7:47
anyone else in your family have type one?
Emily 7:52
No, just just my father, one. My brother gets tested every once in a while. I have a younger brother. And but he's never showed any signs.
Scott Benner 8:05
Anyone else have any kind of mental health issues? That you're comfortable talking about?
Emily 8:14
I'm just I'm just trying to put you through a list. I don't have I don't have like a ton of family members. And I also don't know all of their mental health statuses but in terms of immediate family, it's just me and my father.
Scott Benner 8:30
Okay. And what's going on with you?
Emily 8:36
I also have bipolar. And it's an extreme anxiety.
Scott Benner 8:41
Okay, so significant anxiety, bipolar. How old were you when they diagnosed the Bipolar?
Emily 8:50
Bipolar was just recently it was last year, I had always been diagnosed with depression and anxiety. And but the medications never worked for me. So I wound up just going off and going, just completely cold turkey and I was not doing extremely well. So I decided to go back and see someone. And they diagnosed me as bipolar. They also diagnosed me with ADHD. I don't know. I'm not quite sure about that. But
Scott Benner 9:26
I don't think you have time to worry about ADHD. You have a lot going on. Can you can you talk about what what what? Oh, no, it's my question. What was going on in your life that got you to a depression and anxiety? Diagnosis first. Like how did it impact you day to day?
Emily 9:53
Um, well, I think it really started happening in high school. or that's also when I first started therapy, and I started on some medication. My parents relationship was really, like, really dysfunctional. So I was having a lot of issues there. Think the diabetes maybe played into it a little. I also I developed an eating disorder at a fairly young age, but it morphed into other things over the years. And eventually it did affect the diabetes, but not not for a very long time.
Scott Benner 10:45
So you in high school started feeling depressed? The anxiety? Yeah, amped up.
Emily 10:53
Yeah, I was just always nervous. Always very. Just high strung? And, but, but also, yeah, very, like, sad and just not able, I had quite a few friends, but I just kind of, I never really felt like I fit in between my family life and being diabetic. And yeah.
Scott Benner 11:23
Is this something that the people around you would have noticed at the time? Or do you think it was fairly contained within you?
Emily 11:34
I think, no, I think people probably notice, okay.
Scott Benner 11:39
So kind of sadness. The, I mean, does it come across as like, just head down, not involved? Or
Emily 11:47
it comes? I get very emotional. Yeah, it would get very emotional.
Scott Benner 11:54
And that could swing in. Like, happy, sad, angry, anywhere in between.
Emily 12:00
Yeah. And I think it became even more prevalent as I got older, which is why I was probably diagnosed as bipolar. And also having that history in my, in my family with my father. And I think my father and I are very similar in some ways.
Scott Benner 12:17
Did Did your father's. Was your father ever diagnosed?
Emily 12:22
With bipolar? Yeah. Yeah, he was, he was seeing mental health professionals on and off for years.
Scott Benner 12:33
I was just, I was kind of trying to figure out why it took them. I would seems like about 15 years for you to get from these initial concerns to a bipolar consideration, like, were they never looking at your dad's history? As you know what I mean?
Emily 12:53
They always they were looking at my father's history, because I would always tell them that, you know, he was bipolar. I think that the the manic aspect of bipolar wasn't really focused on with me, because I was so depressed that I would always I would pretty much just show sign signs of depression, and I never
Scott Benner 13:22
you didn't have bipolar.
Emily 13:24
I didn't get the like, ups in terms of like, yeah, like crazy, you know, crazy highs and feeling great. I got them in terms of like, this frantic type of energy, where I kind of like it couldn't relax and very poor sleep, just just acting kind of crazy. But
Scott Benner 13:54
did you ever try alcohol and drugs to help you?
Emily 14:00
Yeah, you did, too. Yeah. To a certain extent Not, not. To my father's extent, and maybe I shouldn't compare them but. But I do struggle with my own addictions, whether it's in the past?
Scott Benner 14:20
Do they help? Or do they? Like are you are you self medicating in a way that it's actually valuable? Or is it just making things worse, or making things different?
Emily 14:32
Well, it depends on what it is I. But no, I don't think self medicating really works in the long run. Gotcha. But I also don't, you know, I am on medication for certain mental health issues and they do help. They do help quite a bit. But you know, I just I wonder about the effects of those as well, in the long run to you know, I don't know if he should be on anything like, long term.
Scott Benner 15:09
Well, you know, what the what I've always heard is the biggest concern with drugs that help with mental health issues is that you're having a problem. And then you're not thinking very clearly, and you're suffering. And then you get on the medication, and it alleviates those problems. And now you're thinking more clearly, you're not struggling as much. And you have the propensity to think, oh, okay, I'm better now. I don't need the drugs anymore. And of course, the drugs are the only reason you feel that way to begin with. And then you go off of them. Apparently, that's a pretty common issue. For people in your situation, you start feeling clear, and you're like, Oh, I'm better now. It's like, because you think of it as almost like a cut healing? And then you want to take the band aid off? Yeah. Has that happened to you so far? Or are you have you been pretty consistent with it?
Emily 16:06
No, I'm on and off. Medications, various medications for a long time. Gotcha. And some of them, I didn't go off the right way.
Scott Benner 16:18
So and that it's just like, I
Emily 16:19
don't want to take this anymore. So I'm not doing
Scott Benner 16:22
and then there's the impact from that by not titrating away from it. Is that right?
Emily 16:26
Sometimes, yes. It depends on the drug. But yeah.
Scott Benner 16:30
Are you in a relationship married? Or?
Emily 16:34
I'm in a long term relationship, I think, technically technically engaged for like, five years, maybe? I don't know. But we own a house. And you know, it's just not on my, like, it's not one of my top things to do right now. Being married is not. Yeah, you know, we're, we know what we are. And, you know, it doesn't mean anything to me. And, you know, it would be nice. At some point, we probably well, but
Scott Benner 17:10
yeah, you get a ring, at least.
Emily 17:13
I did. Yeah. It was a very, very nice spring, but was actually his, his mother's engagement ring. So it was very meaningful.
Scott Benner 17:25
That's lovely. Okay, so your My, the reason I asked was because I'm wondering how much a partner has to do with care? I mean, is this something that you sort of take care of by yourself? And you don't look for outside help? Or are you? Are you in it together more? Is he involved?
Emily 17:48
For the diabetes or the mental harm? So
Scott Benner 17:50
I'm still going with the mental health, but I was going to translate into the diabetes in a minute.
Emily 17:55
Okay. for mental health. Yeah, he's definitely involved in, in my health. He because he cares about me, and he cares about the diabetes and the mental health and he's also had his his own experience with mental health and mental health professionals. And, you know, he views it in a certain way. So sometimes he'll just check in with me or ask about the medication and look into that if there's any, you know, where side effects or anything so yeah, it's definitely involved.
Scott Benner 18:35
Gotcha. Okay, so how did all of this uh, now I'm trying to imagine all of this commingled with having diabetes in high school. And as a young adult, did you go to college as well? Yeah. Okay. So high school into college. You're having, you know, depression, the anxiety seems pretty extreme. So how do you, I don't understand how you can make it through a day of worrying about your insulin. What was that like? And, you know, Were there moments where you faltered.
Emily 19:14
I honestly like almost don't even remember the diabetes at that time. I just like, I just remember it. I carried around pens, and I gave myself insulin when I needed it. But I was never as concerned about it as I am now. Yeah, I just don't even think it was like a concern of mine at the time, especially because I didn't really care and I was diagnosed so young, and they told me like, they're going to have complications in 20 years. And I was like, Well, that makes me 23. So like, I mean, yeah, I'll be young. Like Cook, who cares what I do now? I might as well have fun.
Scott Benner 20:04
Because they felt like you were, were they telling you we're gonna have significant health issues in your 20s?
Emily 20:10
Yeah, they were like 20 years you'll have complications.
Scott Benner 20:13
Did you end up having those complications?
Emily 20:16
No, I actually don't have any complications. But I did have well, not long term complications, but because of my eating disorder past and that led into diet bulimia, and I got very, very sick and I went into kidney failure. And so so I did have some health issues because of the diabetes but but not long term yet, so I'm grateful for that. Surprise. I'm really surprised.
Scott Benner 20:54
Well, I mean, if somebody told me for sure it was gonna happen, and no, it didn't happen. And like you're saying, you weren't probably really on top of things to begin with. What was your management like in the beginning? I mean, 30 years ago, is definitely like regular and mph, right? When did you switch over to a faster acting insulin?
Emily 21:13
I have no idea. I have no idea. I remember using the syringes at first and then I don't know when I transferred over to pens. And I didn't get a pump for a really long time. And then I went off of it and on it and then eventually started listening to your podcast and heard about Omni pod and obviously want to try that. And it's been great ever since. And same with Dexcom. Cool.
Scott Benner 21:47
Well, see you made me happy. I didn't realize that you're listening to podcasts now download. Okay, so. Wow, it feels like oh, like, does it feel like a lot to you when you're recounting it? Or does it just feel like your life Chivo Cape Capo pan has no visible needle, and is a pre mixed auto injector of glucagon for treatment of very low blood sugar. In adults and kids with diabetes ages two and above. Find out more go to Jeeva glucagon.com. Forward slash juicebox. G voc shouldn't be used in patients with insulinoma or phaeochromocytoma. Visit G voc glucagon.com/risk. How would you like to know what your blood sugar is, without poking a hole in your finger, you can with the Dexcom G six continuous glucose monitoring system, which is available@dexcom.com forward slash juicebox. Not only does Dexcom offer zero finger sticks, but you can get your glucose readings right on your smart device that's your iPhone or your Android don't have a phone. That's okay. You can use Dex comms receiver. On any of these devices, you're able to set up customizable alerts and alarms, setting your optimal range so that you'll get notified when your glucose levels go too high or too low. And you can share this data with up to 10 followers. Imagine what that could look like your child could be at school, and their data could be available to you, your spouse, their aunt, the school nurse, anyone who you choose, my daughter has been wearing a Dexcom for ever. And it helps us in multiple ways. Around meals, we're able to see if our boluses are well timed and well measured. If they aren't, we can tell by how her blood sugar reacts and then go back the next time and make an adjustment. Without the Dexcom CGM. We're sort of flying blind, but not just at meals. Also during activity and sleep. The Dexcom offers us an unprecedented level of comfort and security, being able to see my daughter's blood sugars in real time. And not just the number. But the speed and direction is an absolute game changer if you're using insulin dexcom.com forward slash juice box head over there today to see if you're eligible for a free 10 day trial of the Dexcom G six. The Dexcom is at the center of how we've been able to keep our daughter's a one C between five two and six two. for over seven years, we've been able to minimize variability and keep her blood sugar's in a stable range because of the information that we can see with the Dexcom these are our results and yours may vary but using Dex coms feedback has helped my daughter without any food restrictions, live a more normal and healthy life dexcom.com forward slash Juicebox
Unknown Speaker 24:59
Podcast it?
Emily 25:19
Feels like a lot. It does feel like a lot, but I don't remember certain parts of it. Okay, as well.
Scott Benner 25:28
At what point? Does the eating disorder come in? Do you recall?
Emily 25:35
Um, it's started probably around like early middle school, I'd say I started having some disordered eating behaviors, and then it one two, it developed into more dangerous behaviors later on in my 20s,
Scott Benner 25:58
does it start with? Or is it a consideration around weight? Or is it a consideration around insulin?
Emily 26:06
It's a consideration about my body, especially at that time and, and food, because that was focused a lot on again, what because of the diabetes, but that became more of like, a focus of mine.
Scott Benner 26:26
So were you eating without using insulin? Or re you
Emily 26:30
know, not at the time, I was just restricting my food intake and exercising more,
Scott Benner 26:36
okay, restricting it about your body, not about not having to use the insulin.
Emily 26:43
Right. At the time, I didn't know about that. I wasn't aware.
Scott Benner 26:47
And then you became more aware in college type years.
Emily 26:55
Um, I don't know when I became aware of it, but I know that I started messing around with my insulin. More in my mid 20s. And then it became pretty severe where I was just not really taking anything and not that I wasn't taking anything. But I would just run my my background and salinity pretty much when Bolus for me.
Scott Benner 27:26
Did that impact your, your body the way you like weather? I'm trying to find the right way to say this. So I don't sound like I'm you don't I mean, so I don't sound like hey, this is a great idea. But did you did you because it's not. But did you see the effect like was their cause and effect like you stopped taking your insulin and the thing you hope would happen initially happened before you got into a situation that was more dangerous. Like I'm trying to figure out if your feedback loop was positive around it, or if it's if it happens for another reason?
Emily 28:02
I'm not quite sure I understand.
Scott Benner 28:04
Yeah, I'm sorry. I need to be more clear. Yeah. So you stop taking mealtime insulin. And then what happens after that physically?
Emily 28:14
Um, I started to feel very sick. My blood sugars were constantly high when I barely checked my blood sugar. So it's like, well, let me there's just going to tell me I'm high. Yeah, and it just it became a really severe health issue. I was constantly running to the bathroom. That actually became an enormous issue, the the constant urination and the excessive drinking. And I just always felt sick. And there were times where I had to leave work early. I was taking a lot of medical leave. I was throwing up I had to go to the hospital a few times. So yeah, it just became it became really bad, and no one really knew about it.
Scott Benner 29:08
And while that's happening, it doesn't. Does it occur to you, I should just start taking my insulin again. Or what's the thing that keeps you in that space?
Emily 29:19
Well, I should have said this before, but I I became very suicidal at one point. And so the fact that I already had the eating disorder, and then I knew about the diet bulimia, and I didn't want to take care of my diabetes anyway. It just it was kind of like the perfect storm where it's like, well, I don't care. I might as well have this eating disorder and do whatever I want and just die because I don't care. Suicide became a very painful way to live.
Scott Benner 29:58
I can't imagine actually, um, suicidal, like, in the, in the, in the sense that you just don't care what's happening to you as it's happening or, or suicidal in the, in the sense that you had a plan and you're trying to enact it. Does that make sense?
Emily 30:18
Yeah. No, I was I was actively trying to kill myself. I didn't want to. It was passive. Like I didn't want to have to necessarily do anything.
Scott Benner 30:33
You just wanted it to happen.
Emily 30:36
Yeah, so not taking care of the diabetes, it's like, Well, eventually I'll die. So I'll just, I'll just do that.
Scott Benner 30:44
And, and what's the end of that sentence? Eventually, I'll die. And this will all be over. Or eventually I'll like, what comes after that and your thought? People what is the goal of, uh, sounds crazy, but what is the goal of dying? What are you trying to accomplish?
Emily 31:03
I was just extremely depressed. And also my mother had just passed away.
Scott Benner 31:08
I see. I'm sorry. Okay. Well, I mean, okay, so we're halfway through. We should probably all just wave err on our face for a second and take a deep breath and start over again. Because you're not in that situation. Now. Is that correct?
Emily 31:27
In terms of not taking my insulin No, I'm very good about taking my insulin and watching my Dexcom I'm, you know, yeah. Much better a WHMCS. Sometimes the endo tells me that I'm just, I'm, you know, micromanaging and just don't be so concerned about
Scott Benner 31:48
it. I think your endo should shut up. But I think I think you're doing good. So does the endo know all this about you? Or do they just know you from the diabetes piece?
Emily 32:00
Um, I let my doctors know my history. But they I was not with this doctor. When, when that was happening.
Scott Benner 32:10
I say, Yeah, because I don't think it's a good idea to dissuade you from doing a good job for yourself. That seems that seems like a bad idea. And your mental health stuff is is currently being managed with medications. Like how would you classify your anxiety, depression? At the moment?
Emily 32:34
Like how am I doing with that? Yeah, how's it going? Um, I think that's a lot better. I still think it's um, I don't know, I've just never had the greatest mental health. I think the anxiety is the biggest issue I have really bad anxiety. But I don't think anxiety can really be managed medication very well, unless you're on anti anxiety, medications constantly, which I don't want to be. I don't want to be feeling like, tired and zoned out all the time. So it's just, it's just kind of learning to deal with it. I've been trying to do more exercises for, you know, breathing meditation. Stuff like that. I do have a PRN if I need it. But uh, I, I think I'm going to talk to my psychiatrist actually about switching me to something else because I don't think it's a it's a good medication for me.
Scott Benner 33:47
Gotcha. Have you tried that? Um, that rapid eye movement? Treatment? What does it EMDR? Maybe?
Emily 33:55
Four? I've heard of it. No, I haven't tried
Scott Benner 33:59
a lot of people who discuss things like you're discussing today. Bring it up to me when it comes up on the podcast. So I don't know if that's something worth talking to your psychiatrist about or not? Yeah, definitely. So explain anxiety to me for a minute so you open your eyes in the morning? And are you like completely consumed with things that you're concerned about immediately? I'm going to be late. I hope the shower is not full like is it down to the minute stuff or does it always just you know what I mean? Like when does it start and and what things I guess rev it up? Is it anything?
Emily 34:40
Yeah, it's it starts immediately when I wake up although again, I am trying to implement some things where that are good in dealing with the anxiety I try not to like, bounce out of bed immediately. Try to take My time and take a breath and kind of wake up more slowly and really be like present when I'm, you know, brushing my teeth, washing my face and getting ready for the day. Kind of get myself up. You know, I have like some rituals in the morning that I'm, you know used to doing and those are kind of comforting. But pretty much it starts the second I wake up, I'm constantly like, rapid heartbeat like frenzy kind of static feeling in my chest, checking off what I have to do today. Am I going to be late like? Yeah, that's. And it's stupid things. It's not like, I mean, some things are big things, right? But But yeah, I also get tied up in the little things.
Scott Benner 35:55
I know, some anxious people, and the closest I've come to ever being able to explain it, from my perspective, is that when I'm in the room with them, they feel like they're vibrating. Yeah. And I don't
Emily 36:07
I can't sit still. And
Scott Benner 36:12
it's almost like the look on their face. Like, like, I feel like they're, I don't know how to explain it. Like, I feel like every cell in them is moving in one direction than another direction and thinking about 63 things at the same time. And they can't they can never be where they are. That makes sense. They can never sort of stop and, and, and just stop. And those people that I know that are like that they seem to drink their way out of it. If I'm being honest, that seems to be not that I'm saying that's what to do? Because it obviously comes with its own set of new problems. But yeah, I can't imagine so you have sort of the anxiety exists all the time? Is any of the medication impacting depression? Do you feel depressed? Or has it been lightened? Or alleviated?
Emily 37:05
Um, wanted to say something about the inside. Oh, I just wanted to say that your description was pretty spot on in terms of how it feels. But in terms of the Depression, I think the swings, the mood swings are definitely more controlled. Now that I'm on the medication. I think I had a bout of depression, but I think it was caused by a medication I was taking, actually. So I stopped that. Talk to my doctor about that.
Scott Benner 37:46
And how does the now that you have a bipolar? Oh my god, this simplest, we're just fell right out of my head. Hold on a second. Give me a second only diagnosis. There's the word I'm looking for now that you have Wow, can you imagine I couldn't think of diagnosis. Now that you have a bipolar diagnosis. And I imagine that's being medicated. Is it? Is it consistency through the month? Or are there still ebbs and flows? Like could you and I have randomly set this up on a different day? And I'd be talking to a completely different Emily or is like how does that all work?
Emily 38:28
Um, there's ebbs and flows. I feel like but I feel like they're not as high. And lows. Lois. I suppose they used to be.
Scott Benner 38:41
So taking the spikes out taking the drops out, bringing you closer to the middle. It's it's a lot like diabetes. You're less Yeah. That's right. Yeah. But without the medication. Could you like what would be happening? Would you just would you be ranting if you were manic? Would you be? If I mean, how does it present? And do you even know what's happening?
Emily 39:08
Sometimes I don't sometimes my partner actually will bring it up. He's like, I think you're I think you're mad right now. Or, you know, you're you're just depressed right now or something like that. Sometimes he notices before I do. But I'm sorry, what was the question? How do I feel when?
Scott Benner 39:30
Well, I'm interested in like, how it would present to me on the outside and if you even know what's happening, like I'm trying to, like me, I think most people don't understand this. They don't have perspective on it. And I would guess that in their mind's eye there you'd be ranting or raving or overly, you know, enthusiastic and shot out of a cannon and then suddenly depressed and quiet. Like is that how it goes or like What's the real life impact of it, not just what we
Emily 40:03
kind of, that's kind of how it is like, I'm really like, I'm doing a lot of things, I'm probably doing too many things and pushing myself too hard. I can't sit still and not sleeping, just really wired. And then in terms, and then I just kind of crash. Because it all becomes too much. And then it's almost like a burnout and I just get really down. And then I don't feel like I can pull myself to do anything. And then I get upset at myself for not being able to do anything. Because I mean, I don't like the anxiety. I prefer mania to depression, at least I get things done. And I'm a very type a person. So you know, I'm always afraid I'm not being productive
Scott Benner 41:00
enough. I say, does the anxiety feel different when you're depressed than when you're manic?
Emily 41:15
Probably a little I think it's more energizing when I'm, when I'm up and when I'm down, it's just
it's just kind of there, although maybe, maybe it's thought. I think the anxiety is there. But at the same time, I'm kind of like, very apathetic about things when I'm depressed. Okay, just don't really I start to not really care.
Scott Benner 41:44
The depression actually can hold down the anxiety a little bit. You care so little, you don't care that you're anxious? Yeah, I knew it was a good question. Because of how long it took you to answer. I was like, Oh, I asked a good question. So I was so proud of myself quietly in my own mind. But then I had to say it out loud. Because I mean, if nobody can hear it, what's the point? Emily? It's a podcast, right? So. But yeah, I just It occurred to me that I wondered if it was different. I mean, you might not even be able to, like, like in a in an in an OP by kind of manic situation. Does the does the mania kind of like, like squash the anxiety? Or is the anxiety just ramped up and faster?
Emily 42:26
It's just ramped up and faster. Okay.
Scott Benner 42:29
Wow. There seems to be there seems like there should be a moment here where I say, I'm so sorry, this is happening to you. Like, it just it seems, you know, exhausting. And I appreciate that. You're, you're taking the time to explain this to people. Because I imagine that that things like this, to some degree impact more people than we think. And it just doesn't get spoken about. It's also incredibly helpful to hear through the story that you're just a person. You don't I mean, like you. I don't know if that makes sense to you or not. But I think it's possible that people who have mental health issues get put into one silo in people's heads. And they're not even people anymore. You know what I mean? And that's just unfair, you're, this is no different than, you know, living with a broken leg for the rest of your life or something like that. Like there's, you are this person, you're a human being whose body is being impacted by something. And it doesn't make you any less of like, Emily, because you have a broken leg than if you are anxious or, or whatever else. So I just think it's great to share with people. I am yeah, I thank you. I'm super interested to know how with all of this going on, how did you grab ahold of your diabetes
Emily 43:51
um, after being hospitalized a few times because of not taking my insulin. I was put into a number of treatment centers, number of different hospitals. And I went through a bunch of them before one stuck. I always left AMA. So I never really pulled through with one I never thought they really understood the diabetes part of it. I really think it was it makes a huge difference. And I did after going to kidney failure. I went to a hospital, their behavioral and eating disorder Ward, I think and it was in it was an inpatient and it was a hospital. Saturday. So they also had, in addition to all the things that a normal Eating Disorder Center has like food, fishnets, therapists, they had an endocrinologist on board for me, as well, where the other places did not. And the endocrinologist just really helped me in terms of the diabetes, and yeah, that's what made me I think, really get hold of it. And it was still hard after that I was only there for a couple of weeks, because they only keep you an inpatient. Or maybe it was more than inpatient, because I've been an inpatient before, and that was actually a few months. But in terms of the hospital setting, it was only a few weeks, and then they released me.
Scott Benner 45:52
So you had somebody you had somebody there who understood diabetes, and could support that while you were going through the rest of it.
Emily 45:59
Yeah, that really focused on my insulin and like, showed me how I would do it and how to eat and how many carbs, and now that you have to count carbs, but but some of the things that the eating disorder places wanted to do, I just, I don't know, I just didn't think it went along with my diabetes. And when I had an endocrinologist there, it was more. The plan they came up with, it's more specified to me because I had this whole other issue as well.
Scott Benner 46:36
You know, you have competing problems, right? Because you have an eating disorder, which begs the idea that we don't want to focus too much on food, but then every time you eat, you have to super focus on food. And right, yeah, it seems just they fight with each other. So somebody was able to come up with a plan that sort of allowed both of those issues to work without them causing a problem. So you could count your carbs in a way that at least kept you close with your insulin without making you super focused on the food you're eating. Is that right?
Emily 47:11
Right. But they wanted to work with me about how I felt about the food, but also in terms about how to control my diabetes around that too, and how to feel. Okay with that, but I had to overcome like a lot of things to even want to do that. Because there were points where I didn't. I didn't want to so
Scott Benner 47:32
yeah, no, it sounds like, it sounds like a lot of moving pieces. And finally, they all sort of lined up with each other, I guess, in a way that allows you to, to meaningfully move forward. Is that fair? Yeah, yeah. No. So is it almost random luck that you that you found a spot that all this stuff kind of came together? Do you think?
Emily 47:57
Yeah, for sure. I mean, I don't. I don't know how I'm still here sometimes. But I mean, I obviously think there's always things that can be worked on. But in terms of everything, I think I'm much better where I am now than I was 10 years ago.
Scott Benner 48:16
This is the best version of you that's existed so far.
Emily 48:22
Um, in terms of my health, yeah.
Scott Benner 48:25
Yeah. Do you think there's a ceiling that you're not at yet? Do you? Do you still have room to grow on that?
Emily 48:32
I think everyone has room to grow. I don't think you're ever really done. So yeah.
Scott Benner 48:37
That's exciting. Do you feel excited about something like that? That idea?
Emily 48:45
No, actually, I, I think I have like a really pessimistic proofs. perspective of things because I actually didn't think of like that I kind of thought of it is like well, there's more room to grow. So I'm not I'm not there yet. So there's not I'm not doing as well as I should be.
Scott Benner 49:05
Oh, I see. So where I see it as this is exciting, because you can still build on this. You see that very same situation as way to go Emily, you're nowhere near the top. Is that Is that how it feels? Yeah, I'm sorry that you know, I didn't mean it that way.
Emily 49:22
Oh, I know you didn't. That was just
Scott Benner 49:26
your being listened. Thank you for saying that. Because that's, that's the parts of the conversation that I love the most. Yeah, just I guess that's just the difference between like the direction my brain goes in and the direction your brain goes in? Yeah. So how do you find this podcast?
Emily 49:46
How did I find your podcast? Yeah. I think I heard about its, I heard about it somewhere. And then I know I just looked it up. Have you started? started listening?
Scott Benner 50:05
What What made you want to listen to a podcast about diabetes, then?
Emily 50:10
I think I felt like really alone in this. And I think I think I might have started listening to your podcast around the time my father passed away. So I'm not that my my father and I didn't have a good relationship. But at the time, we had reconnected, and we're at least speaking with each other and trying to work on our relationship. But um, he was really the only person I knew with type one diabetes, and I guess we didn't really talk about it that much, because I really just, you know, I didn't care. I didn't want to talk about it. But, you know, we did have that in common. And in that respect, like, you know, after that there was no one to ask about anything anymore. Like,
Scott Benner 51:04
you lost your only connection to diabetes when your father passed away. Yeah, well, how did he pass by the way? A checker over this? I'm sorry. He was managing his own problems with that.
Emily 51:22
Yeah, he, he had. He had struggled with that for a long time, but I definitely think that yeah, I think he, I mean, he struggled with a lot of anxiety too. So I think he managed his own anxiety. With with that, and also I think he just had like, don't know, just just sad. Like, no, he had a sad life. So I think he was just medicating with that.
Scott Benner 51:58
Do you think? Did you experience anything in your life? That would be traumatic, prior to high school? Or do you think this is just baked into your DNA?
Emily 52:17
I don't think prior to high school, I had a lot of issues with trauma. I had a dysfunctional family. But like, I wouldn't say it was trauma. Yeah, not not in high school. It wasn't until, like, right after college, that I had, that, yeah, I started having some traumatic events in my life.
Scott Benner 52:43
I wonder about the anxiety if you if you grow up in a family that's just frenetic? And, you know, not I mean, there's a level of normal that a child needs, right. And, you know, if your father's you know, an addict, even just that, that's a, that's a lot. If he's anxious on top of that, or depressed on top of that, there's more and more, I wonder if that anxiety isn't your body's reaction to just expecting for the rug to be pulled out constantly. And then when the rug doesn't get pulled out, it can adjust backwards. Because you just maybe you just grew up in that space that you're and you're and you're more, you know, genetically predisposed to it to begin with, that you just can't adjust backwards for some reason. Like your, your body just won't like allow you to believe that. Nothing crazy is about to happen. I don't know if that makes any sense or not. Or if I, I could be 1,000,000% Wrong. But I just did something I wondered as you were talking. But But okay, so you I'm sorry. You found the podcast. And you sounds like you're listening to it for community did you find the management aspect of it? Almost by mistake. Like you weren't here to learn how to Bolus right you were here to find other people who had diabetes.
Emily 54:07
No, not not necessarily. I mean, I I like listening to other people's stories and kind of feeling, you know, like my sense of community that way, but I think also, that I was really kind of struggling with the diabetes and the diabetes also affected how I felt. So I was looking for a way to get better control and then also just just learning about the technology because I had no idea about Omni pod or I had had a CGM at one point but it was so inaccurate I never wanted to try it again. And just yeah, like let's Listening to you and how you manage Arden's diabetes and that that was even possible then I started really honing in on on things. Well,
Scott Benner 55:11
this is the part of the podcast where you told me what it is I'm doing so that I can know what I'm doing. I know that's a weird statement, but I I'm only putting out a thing that seems like the right thing to me. i It's not so well thought out. The you don't I mean, like, I'm not in the back room with a notebook going tomorrow, I'll say this. And that'll make people feel better. You know what I mean? Like, it's not that well thought out. And sometimes I need people to tell me what the podcast is to them. So that I can understand what it is I'm delivering, if that makes any sense. Yeah, I appreciate that. For you. I appreciate you telling me that. So that is something I've been wondering. You brought something up a second ago. I've been wondering about for like the last hour, which is did getting your blood sugar's more stable, impact your mental health positively or? No?
Emily 56:07
I don't know. I mean, I think I mean, I wasn't trying to kill myself anymore. But I think there was a lot I had to get over. And I think it brought some other
aspects of my personality that I didn't notice as much before out. Yeah,
Scott Benner 56:31
because you know, when somebody's blood sugar's high, or bounces around, you can see here, they can get kind of nasty, they can get short tempered, right? Like, yes, I'm nasty. I'm, I'm, I can be really nasty. Trust me. And so like, when when you get doing, your variability gets tighter, and you know, and you're not bouncing high and low as much those things should go away a little bit. I didn't know if the, excuse me, I didn't know Oh, hold on. The wrong time of year, I get so dry. I didn't know if the I didn't know if the mental side of it. The mental illness side of it was so impactful that you couldn't notice the changes from better blood sugars, but it sounds like you, you may have noticed them.
Emily 57:21
Yeah, and some, you know, some more positive and in some ways, I think some were negative, I think it definitely brought out more anxiety because then I was a little too concerned about the control. So when I went out of range, I got extremely upset. And yeah, just especially having the history that I did, like, part of it was like, if I ever go high again, I'm, you know, I'll kill myself because I've, you know, I can't get away with this anymore. Like,
Scott Benner 58:00
the idea of the diet, bulimia is such a, I was gonna say monkey wrench, but it's worse than that. But, you know, you, you need to pay closer attention to your blood sugars and how food works and how insulin works so that you can have this health success. But the the act of focusing on it is really one of the issues of having a eating disorder. And so but it sounds like you did it like so, just contextually five years ago, where do you think your agency was? Do you even know? Around 1515? And what do you think it is now?
Emily 58:38
Um, right now, I think it's probably around six to 6.5, which is a little higher than I've been running. But I think that honestly has to do with some issues around exercise that I just haven't figured out yet.
Scott Benner 58:59
Okay, well, first of all, good for you. That's amazing. I mean, kudos. You know, like, I mean, honestly, look back. Do you ever think You're welcome? Did you ever think you'd be a person with a six and a half? I wouldn't say,
Emily 59:13
oh, no, never. I mean, I cut it, you know, and, like, two thirds off my one save. So that's,
Scott Benner 59:21
you know, most people can't do that. If most people take two thirds off their agency. I think they're dead. There's no sugar in their blood. You're you had a lot of room to grow. And you really did. I mean, that's just wonderful. Did you have a chance to feel proud or accomplished?
Emily 59:41
Yeah, yeah, I do feel proud and accomplished. But I think I'm just more aware of it now. And sometimes I struggle with
Scott Benner 59:53
the being aware.
Emily 59:55
Yeah, just being aware that I'm diabetic and all the time. extra things I have to do. In order to kind of keep it in control, at least I find, you know, I know you seem to be very good at, you know, just keeping our hands blood sugar under control, I feel like I don't know, I find sometimes structure works a little better for, for me, it's hard for me to just go completely off off track and my number also get kind of crazy. Some things are just easier than others, though. Do you
Scott Benner 1:00:40
follow any sort of eating style that? Or do you eat kind of just a hodgepodge of everything? Or is any? Yeah,
Emily 1:00:50
no, at this point, especially with like, the eating disorder background, I really don't follow any type of diet and I just honestly, I just tried to stay away from that stuff completely. You know, I just tried to eat balanced meals, and you know, enjoy my food. And yeah, it's really about balanced meals. And I still sometimes struggle with the food, sometimes for different issues than necessarily eat eating disorder issues, but just just not being hungry or, or whatnot, or the anxiety, the anxiety, it's feeds a lot into my appetite. So I'm, I'm very aware of food and food around blood sugars. And when I when I do have a meal, like I make sure it's balanced that I don't say, you know, I'm not allowed to eat pasta or anything like that. But I do notice that certain things are easier on my blood sugars than others.
Scott Benner 1:02:04
Tell me about anxiety impacting eating. So do you eat more when you're anxious?
Emily 1:02:12
Do I eat less? Surely it depends. Because I'll swing. I've I've had a history of swinging both ways on this, but right now I feel like you No, I feel like the anxiety needs to be
Scott Benner 1:02:28
okay. So I have you danced around this about 45 minutes ago, but I'm going to ask the does weed help anxiety?
Emily 1:02:38
Not anymore.
Scott Benner 1:02:39
anymore. Emily's like there's not enough weed in New York to come. Did it at some point?
Emily 1:02:50
Yeah, at some point. I think it did. But I I think it became too consistent. And at that point, I was like self medicating. So
Scott Benner 1:03:02
okay, and then it. So it because I heard you earlier, stop yourself from telling me what drugs worked for you. Like what, like, recreational drugs worked for you. It was almost like you're like, Vicki, we're trying to be proper. I don't I didn't. I didn't know you well enough at that point to make the assertion, but I felt like you're like, Well, I don't want to say that to people. But it's just, I mean, it's been in my head the whole time wondering if you try it or not. So that's all it's just, it's funny if you had to if you took anxiety, depression, ready, anxiety, depression, type one diabetes, and I told you, you could throw one of them out of your life. Which one would you throw away?
Emily 1:03:50
I feel like also they go along with each other sometimes. But um maybe the diabetes because? Because I feel like if I throw away the diabetes, maybe some of the other issues with lessons.
Scott Benner 1:04:02
Yeah. fewer things to feel anxious about.
Emily 1:04:06
Yeah, gotcha. Things to feel anxious about.
Scott Benner 1:04:08
I've just been wondering the whole time we've been talking like if I magic if I gave you a magic wand by the way, what a crappy magic wand. It only works on one of three things. But But what you would what you'd want to get rid of? I have to tell you, I if you made me bet I would have bet anxiety. So that was interesting. I said diabetes. Yeah, I wish I could
Emily 1:04:30
say it was close to it's really debilitating. Sometimes. It's really crippling. And I don't
Scott Benner 1:04:37
I'm not asking you where you work, but what kind of work do you do?
Emily 1:04:42
I'm not currently working. But when I I moved, but I used to live in New York City. And when I was working there, I worked for a publishing company. I have a background in art. I'm more specifically in graphic design. But actually I think I'm, I applied to grad school because I think I want to go sort of a different direction with my degree. So
Scott Benner 1:05:12
I was wondering two things. So when you said New York, I didn't know if you meant the city or not. But I heard a siren earlier. So I thought maybe still, maybe you're in a barrow? I'm just guessing. Oh, no, no,
Emily 1:05:24
I was I used to live in Brooklyn and then moved to Upstate.
Scott Benner 1:05:31
But does six years or something? Okay. Does the city itself because the city's frenetic place? Oh, yeah, you step out on the sidewalk? And, you know, there are just countless people and machines and noises and and did that balance out your anxiety? Or did it add to it?
Emily 1:05:54
No, I actually think that bounced out my anxiety, or at least it helped me not notice it as much because that's just the way things were it was always go go go in the city. Yeah.
Scott Benner 1:06:04
Because if you're vibrating in New York is vibrating. Maybe you can't tell is what I was thinking. Yeah, so maybe quiet is worse for you? Because yes, it is. Okay. I'm figuring this out. I'm getting, I'm really getting Do you feel like I'm doing okay with this, by the way? Because I don't know anything about any of your problems. I'm just trying to pick through them.
Emily 1:06:26
Oh, yeah. No, I think you're doing great. I hope. I'm not rambling too much.
Scott Benner 1:06:32
You're not rambling at all. I would stop you if you're rambling. I'm not good with rambling. I would, I would definitely stop you don't worry, though, I'm having a really interesting, good time talking to you. Okay, so I was I asked that initial question, because I was wondering how difficult it was to hold a job with all this going on.
Emily 1:06:55
It became very difficult. And that's why when, at one point, I was taking so much medical leave, eventually, I just we came to the conclusion that I was just gonna leave on my own. Because honestly, honestly, if they would have been able to fire me, I think they would have fired me at that point. Because I just, I was taking so much time off, I really couldn't perform well. And, but but because of the diabetes, and because of the mental health issues, they really couldn't fire me for medical reasons. So I agreed to, to
Scott Benner 1:07:45
tell me this, if you put yourself in their position in the employers position, and we take out all the other stuff that considerations and protections that people have, just based on the work you were able to do because of your situation. Would you have fired you? Yeah, okay. That's what I was trying to figure out. Alright. So you were not a valuable part of the organization at that point?
Emily 1:08:04
Yeah, I don't think so. Not, not with the amount of time I was taken off.
Scott Benner 1:08:09
Yeah. Well, you can't do your job. If you're not at work, that's for sure. Well, that was very, it's very kind of you actually, to not sit there and fight with them and, and create another anxiety point for yourself. You know, it's I think it's kind for you in the business. And I think it was kind for you for yourself, not to put yourself in another, you know, embroiled moment of any kind. What's the so as a person who's been through this whole process, and as we said it pretty, I mean, you're, I think you're your best version of yourself, based on what I've heard, I don't want you to feel like you're like, oh, not Yeah, it's gone. But I think you're doing really well. Not to say there's not more but if somebody's listening to this, and they're at a different part of this, you know, where you were in the past? What's this? What's the secret? Like, how do you get out of this? Or as far as I don't,
Emily 1:09:11
I don't think I'm out of it. I think it's just constantly striving to be better. And some days it's harder than others maybe some days I take a step back but you know, realizing that even though I have the same anxiety pushing through it as is better than then laying in bed all day and not leaving my house and being scared of what's going to happen with blood sugar's or what's going to happen just outside in the world. It's it becomes crippling, so I think it's just Yeah, it's just continuing to work on that stuff. But I would say that it's like, it's a long process.
Scott Benner 1:10:10
Yeah. So is it if I characterized your life as being underwater, but figuring out how to come up above the water, and figuring out how to come up above the water for longer amounts of time? That's pretty much the goal, right? Like keeping your head up for as long as you can. Yeah, okay. And, and those periods of time are growing for you, where you're above the water.
Emily 1:10:37
Yeah, I think so cool.
Scott Benner 1:10:42
When you do something, like when you have this concern, that something's gonna go wrong, or it's gonna be bad, and then you do it, and it doesn't go wrong, and it's not bad. You don't? Do you gain anything from that? Like, does it propel you forward a little bit? Or you don't, I mean, like, I don't know how to put this. You know, if I opened my door and walk out of it, and I do it 1000 times, and nothing hurts me. At some point, my brain just says, walking through this door to safe. And I never concern myself with it. Again, if I was concerned at the beginning, but you don't get that right, you don't get the part where it just stops being a concern.
Emily 1:11:24
I don't think it stops being a concern. But I think I learned how to deal with it better. And I also recognize that when I do when I am able to do those things that I feel better about myself. Okay.
Scott Benner 1:11:41
Is there any aspect of life where this doesn't exist for you? Like, like, Are you like, I mean, I don't know, like, do like parachuting or driving your car really fast? Is there any place I could put you where just this all goes away? Anxiety, everything, like, is there? Where's your happy place? Do you have one?
Emily 1:12:06
I don't, I don't think I've figured it out yet. Honestly. I think there's been like, a lot of things in my life that have definitely really influenced me and changed me. So. I don't know. I think I think there's again, like still work to be done. And I have to find that.
Scott Benner 1:12:32
Well, I I wish you a lot of luck. I think it's amazing that you've come this far. I really appreciate that you came on the podcast and talked about it. I want to ask you if there's anything that we didn't talk about that we should have anything I missed?
Emily 1:12:49
Um I don't think so. I think it was, I think the overarching thing was just you know, that you can go through trauma and and be in bad places and you can still make it out. Okay. Yeah.
Scott Benner 1:13:17
Well, I think you definitely got that across. I that's what I got from listening to you. By perfectly honestly. I, I mean, seriously, like, there's I don't know, I just it there's, there's somehow there's a triumphant story here, even though you don't feel like you've reached any kind of real triumph. But I mean, I see it you started in such a place that, that I think where you are now is a is a significant upgrade for you. And like you said, I don't think there's an end to it, you can keep going. So who knows what's next? I think I, to me that this is an uplifting story. I'm sure you're just like, Oh, God, I just bored everybody to tears, or I just made everybody sad or whatever. But I don't I don't see it that way. I see this as is as explaining something that most people don't understand. And there are aspects of your life, even though they're magnified, that I think any person could listen to, and find commonality with their own life. You don't even get your stuffs just at 100. But everybody has this stuff. There's just maybe up at like nine or 10 on the volume. You don't I mean?
Emily 1:14:31
Yeah, maybe but when I try to put my own struggles in perspective, I mean, they're things far worse and I have plenty to be grateful for as well. So certainly try to remember. Remember that so I don't I don't know if I'm at 10 But I don't know. No, you don't
Scott Benner 1:14:50
I mean, like like, I think to some degree, everyone has anxiety about something. Yours is just like, you know if my anxiety is on a train Sister radio yours is on stage with the Rolling Stones in the 70s. And years has just turned way up. But I'm saying that I think anybody who's really listening, could hear about your life and find similarities in their own life. Maybe it's not to the degree or says that, but I still think they're there. And I think that's valuable because people aren't very introspective. Uh, you are obviously very introspective. Almost a little too introspective. Well, I would listen. Yes, probably. But I understand it. And whereas other people don't spend any time thinking about themselves, and they should, so hopefully they will after hearing. Yeah, thank you very much. I really appreciate it. Thank you. Was this hard to do? It was,
Emily 1:15:52
yeah, it was hard. Honestly. I think. I mean, I was really anxious but also I thought I was going to be like, way more emotional. I definitely thought I was gonna cry.
Scott Benner 1:16:02
Oh, do you want to cry? I could make you cry.
Emily 1:16:06
Cry. Cry in public.
Scott Benner 1:16:09
But no, no. Where are you at right now doing this are you at home? Yeah, yeah, I'm
Emily 1:16:18
at home. Okay. Yeah.
Scott Benner 1:16:18
No, I didn't want you to cry. I'm I'm glad you felt comfortable getting it out. I just, it's um, I don't know. It's it can't be an easy thing to sit there and mine your your soul for your stories, you know? But I thought you did a really good job. I appreciate it. Thank
Emily 1:16:35
you. That's cool. Yeah, it's not it's not easy for me to think about things in the past sometimes or recall things that I didn't go through.
Scott Benner 1:16:47
You certainly did. I thought you were terrific.
A huge thank you to one of today's sponsors, G voc glucagon, find out more about Chivo Capo pen at G Vogue glucagon.com Ford slash juicebox you spell that GVOKEGL You see ag o n.com. Forward slash juicebox. I also want to thank Emily for coming on the show and being so open and honest. And of course Dexcom makers of the Dexcom G six and the forthcoming Dexcom G seven head now to dexcom.com forward slash juicebox. Get yourself that CGM.
If you're looking for more after dark episodes, you can find a complete list at juicebox podcast.com. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast.
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