#522 Night at the Roxy

Remember Zoe from episode 376, ‘Zoe & Roxy's Wild Ride’? This is Roxy.

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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 522 of the Juicebox Podcast.

Perhaps you remember Episode 376 where Zoey came on to talk about being the sibling of a sister with Type One Diabetes. her sister's name was Roxy, and Roxy through Zoey right under the bus, and right onto the Juicebox Podcast. So I thought it was only fair to get Roxy on to hear her side of the story. While you're listening, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, please always consult a physician before making any changes to your health care plan, or becoming bold with insulin. I have to tell you, I enjoyed speaking with Roxy so much that as I'm thinking back on it right now, I don't know what we talked about. I just remember having a good time. So that can't be a bad sign. If you're looking for the diabetes pro tip series, or the defining diabetes series, they're both available at Juicebox Podcast COMM And that diabetes pro tip.com.

This episode of The Juicebox Podcast is sponsored by touched by type one, a great organization doing wonderful things for people with type one diabetes, please learn more about them on their Facebook page, their Instagram page, or at touched by type one.org. While I have you I'd like to remind you that if you're a US resident living with Type One Diabetes, or a US resident, who is the caregiver of someone with type one, the T one D exchange is looking for you. They'd love for you to participate in a quick survey that can be completed in just a few minutes right on your phone or your tablet or your computer. After you're finished the questions. They're super simple, I did them in about seven minutes. You will be contacted annually to update your information and to be asked further questions. This whole thing is 100% anonymous, completely HIPAA compliant, and does not require you to ever see a doctor or go to a remote site. And every time someone completes the process using my link, the podcast benefits. So if you're looking for a way to help type one research, the podcast or both, nothing could be easier, or more beneficial. Please just go to T one d exchange.org. forward slash juicebox. When you get there, click Join our registering now and complete the survey. It's that easy. Past participants like you have helped to bring increased coverage for test trips, Medicare coverage for CGM, and changes in the ADA guidelines for pediatric Awan seagulls. It is difficult to find people like you to fill out these surveys. And that's why the T one D exchange has asked me to ask you. Hello. Hello. The only thing that stops me from seeing Roxanne is that it is David would call you a hooker and I have a terrible singing voice. You know you're not the first one to react to that. I just I stopped myself from doing it. I was like I sing so poorly.

Roxy 3:29
I know I don't want my parents were thinking but I go by Roxy for that very reason. Although then like when I was in college, I would get all these like Roxy strip club things under my dorm door and I was like this is not new better. I don't know. I mean,

Scott Benner 3:42
every person who walked by one of those handbells was like, oh, Roxy. Oh, I'll take one of those. Thank you.

Unknown Speaker 3:47
Yeah, exactly. Charming. Yes.

Scott Benner 3:50
This horrible place makes me think of my friend. Yeah, exactly. College students, man. Oh, lovely. Well, anyway, um, we're recording already, because I'm just getting the sound set up. Sounds good. Now be a bad time to come out for something weird. You know? Okay. Oh, is it it was too crazy. I'd be like, I have to keep this in.

Roxy 4:16
I'm surprised you're able to do this over zoom. It's really cool. I was like worried that I wouldn't have the right headset or something. I don't have headsets anymore.

Scott Benner 4:25
I have to be honest, the fact that I'm leaving this all in the podcast, the the little amount of effort that I put into setting up the recordings and how well 99.9% of them go. It's fascinating, because what I do is my wife asked me one time like why do you book appointments out so far in the future is like because it gets me the people who really want to be on the show. And she's like, What do you mean, I was like, but you know, anybody can say yeah, I'll do it tomorrow, and then follow through. I'm like somebody who can tell you in December that they're willing to record a pod cast in June, really wants to be on the podcast. And they'll put the effort in. It's necessary. Yeah,

Roxy 5:06
it's fascinating. I Well, yeah, I think I think that makes a lot of sense. I'm definitely that type. Wow.

Scott Benner 5:14
I weed out the pets this way. And so

Roxy 5:17
I really hate it when people like, or my husband calls them what it is like no second responders or something like they, they send an email, like, do you want to do this? And you write back? Yeah. And then they just kind of ghost at that point.

Scott Benner 5:31
Because they're trying to get something going and and I have the luxury of having content. So I'm not running around crazy looking for somebody. It's also why you don't probably turn the podcast on when we can just go ooh, filler, because you know, I don't have to do filler because I'm, I'm literally recorded and I say it once in a while, but we're talking in December. And I think if I dropped dead today, the podcast keep going to like mid June probably. Wow. So

Roxy 5:59
yeah, I think my sister recorded with you in January. Right? I think that's right, because I remember I was I was flying Scott. That's how long ago this was. And I was waiting to board the plane. And I went on a trip on a trip in for work in January. And I heard that interview with one of the I'm forgetting her name now but the person who spoke about how worried she was about her younger. I don't remember if it was a daughter or son, her younger child and feeling neglected. And I was just laughing to myself. And I remember sitting there in the airport lounge going, I gotta get Zoey to do this because she will prove quite the opposite. I'm

Scott Benner 6:36
fascinated that you don't have died. Or that you have diabetes that your sister that you you were like, Hey, get on this podcast. And she's like, okay, and she comes on. She's like, the one of the first things she said was I don't really know anything about Roxy's diabetes. I was like, well, this will be fun. So, Nina, free to do to you. But I was very curious. But she was. It was interesting. She's like, I don't really know much about it. Thank you. Yeah, has it? Did it bother you as a child? Not that I remember. Okay, great. Well just feel the next 58 minutes was something different. But no, I yeah, I think seriously, it was good for people to hear. Because I think it's, if you're a parent, especially have younger children. It's a real like concern, I can see that, you know, like, doing this thing is going to make the other kid feel like they're you're not paying attention to them. I don't think for the most part, that is actually what happens.

Roxy 7:27
Yeah. And I think that's, I think that's so true, at least in our case, as well as it was very clear. I think it was interesting for me, though, because I think a lot about sort of how having diabetes as in has impacted my mental health. And I'm blessed to be a very, very, like mentally healthy person. I think I don't have a lot of, you know, I don't suffer from depression. I'm a little on the like, high strung side. But I don't think it's anything clinical. But even so, I think it's had like, a lot of implications. But what's interesting to me is how it kind of it stopped with me and my parents like, I don't think it kind of I don't know, like, rippled out beyond that. So and my sister certainly proved that.

Scott Benner 8:13
I'm stopping myself from laughing because you just described yourself as not clinically high strung.

Roxy 8:19
Yeah, exactly. Like I'm probably I'm probably somewhere and the anxiety spectrum, but I would qualify for anything. I've been to a therapist before and she was not terribly helpful. So I was like, Alright, I'm just gonna stick with a great seven.

Scott Benner 8:35
It's just a great 70s phrase is all that's the she's just a strong. I know that. I'm sure that's something I picked up from my parents. That sounds like Yeah, well, I'm 100% Sure. This is what happened. Yeah, that's why I'm like you're just a little high strung rocks. It's fine. To picture in your mother in a dress on a plaid sofa going, Oh, why is this one so high? Strong. Totally. Oh, my gosh. So let's dig in for a second. All right. Did you? Are you the you're the person and you'll forgive me? I get a lot of emails. But for about two emails over the last year. You and I have been married. You've corrected me like twice. That's you right?

Roxy 9:15
Um, about? Yeah, probably. Yeah, I missed out like social justice II type things and environmentalism. Yes. Yes. You've corrected that person. No, I wouldn't say corrected. I was just sharing with you about cow farts. And what's the other thing? Oh, yeah. Yeah, I guess I was pretty

Scott Benner 9:34
wiped up about really didn't like the way I spoke about it. So I must have used this. I really kind of thought about what you said. And I feel like it was just maybe like one sentence in the middle of an hour that you didn't like, but you particularly didn't like it. And so it's interesting for me, because I don't know what I think about everything. So sometimes you'll hear me talk through it. which I love. Yes, that makes your podcast great. Except you didn't like the way I talked through this one thing, and then you wrote me alone? No, I think I wasn't. I honestly don't even remember. Good. Well, I'm not bringing it up, then that's fine.

Roxy 10:11
Okay. Okay. Okay. Yeah, I greatly appreciate your the way that you think about things. And I also appreciate that you don't, that you're able to kind of like, walk a line in terms of not getting too political about stuff. But as you can probably tell, I'm a very high strung person now. I'm a very like, outspoken lefty, I guess. So I often AM, like, keen to speak up on about things that especially when I know people are well meaning and, and good at listening and learning, because I think I definitely feel that way about you. So that's the reason that I've,

Scott Benner 10:52
I would say, based on the first email, I'm guessing, and I have no idea but I'm gonna put your age about 20 years my junior, are you in your 30s? Yeah, right. Right. So it's, it's not because of your age, it's because of generational stuff. Like there's just a, I wish I so wish I could play you an episode that I recorded years ago that I'm not allowed to put up. So I recorded this great episode with this type one, whose partner was oh my gosh, I don't even know how to say it. This is how old I am. They they don't I guess they don't subscribe to a gender certification. I don't even know any the phrase that the terminology to use, right. But there was like a lot of like, gender non conforming, probably Yeah. And I tried so hard. And she did such a great job of explaining it to me. And I really did pick through it. But then at the end, these people were traveling internationally. And we're we're genuinely scared for people in other countries to know about their, you know, how they think how the how the one person in the relationship thinks about their gender. So she asked me not to put it up. And so I never did, but it was really interesting. Because as I'm like, wait, sheave them. I don't he like there was like a z. I just couldn't. I was so Roxy, I try so hard. Oh, funny. I've

Roxy 12:19
actually wondered if you will ever interview somebody who's gender non conforming? Well, you bring that up. That's so funny, because I think when was it? You somebody referred to their partner? And I was like, Oh, I wonder if they're like, or I don't remember what happened on one of the episodes. I was kind of like, Oh, I wonder if they just like don't if they use they, for instance as their pronoun. Um, but yeah, it's it's tricky. If you haven't been surrounded by people that you love that, that, you know,

Scott Benner 12:52
it has nothing to do with mine. It has nothing to do with my desire to not know exactly, yeah, my brain can't like maybe my brain can't follow through, it almost felt like she was holding up a piece of blue paper and telling me this is red. Every time I show you this, tell me it's red. And my brain would go blue. I know, I'm supposed to say red. And then I just I but she does such a good job of explaining, like I said, how her partner thought of things. And then at the very last second said, Please don't put that up. And I was like, oh, and it was it was so many years ago was like my old microphone, a different room where I recorded so this was a really long time ago. So a number of years ago, so it was not even like not even like, like in 2020. Somebody was like, hey, please say they or something like that.

Roxy 13:39
Okay, yeah, yeah, we sort of before people like put their pronouns in their zoom names and stuff.

Scott Benner 13:44
Yes, these people were ahead of the curve is what I'm yeah. And so I would anyway, anyway, that's how sometimes I feel what I'm talking about social stuff, like I'm on, I'm on what I think is the, the people's side of most ideas. I mean, if I'm being honest, I think I'm on the common sense side of ideas. That's how I try to think about things. I don't have a real, like if somebody from my political party says something ridiculous, I don't think, alright, well, I'll get behind it. Because I'm on their team, I think, yeah, we need more people like that, frankly. Yeah, I mean, I do.

Roxy 14:19
I think my husband is from the UK. And he he's very interesting, because he's, he's very progressive, very lefty, as well, but he kind of points out to me how I'm the sort of language of wokeness, for lack of a better word, is sort of a very American thing and a very, like college educated, you know, liberal thing. And he, I think, gets a little bit irritated by some of the language. And so it's I don't know, I was just having conversation with him last night about a project that I'm working on. It's an international project and we were trying to be quite deliberately inclusive by recruiting more people to work on this project that are not White people know, and I'm one of the people who is Swedish was kind of pushing back and kind of basically conforming to a more sort of colorblind approach of like, it's, we're nice, we're inclusive, it's fine. And, you know, and I was sort of saying, Well, no, we need to be, you know, this doesn't happen by osmosis, we really need to like put ourselves in uncomfortable position, potentially to recruit people like to actually kind of value that as something that we're recruiting toward our group. And it was a very kind of tense back and forth, where we were kind of agreeing, but I think some of the language got in the way. And so I'm quite conscious of, of that, that this isn't like, you're not going to kind of get people to think about these issues by being kind of jargony. And, and I don't know, abrasive. So I definitely understand that it's, it's super important to, to, yeah, have people who are, who are well meaning and want to learn, we all just need to be a little bit humble and open minded. And I think you're amazing at kind of talking about how you've evolved, and how your thinking is changing about diabetes and about other things. And so, yeah, so I just feel like,

Scott Benner 16:16
what's the point of learning something, if you're not going to apply it, that's, you know, kind of like, like, either find a, find a level and just sit there and coast to the end and just be like, kind of Comfortably Numb, unhappy, that's fine. Or, but if you're going to learn something, then don't go, oh, that does make more sense. But I have these deep seated long held beliefs. So I can't really do anything different. I also don't think forcing people is the way to go, either. There was some time in 2020. I'm bad with time. But it was sometime in 2020. On one of the social media platforms around diabetes, there was a big dust up about race. And then the push came to like amplify black voices. And I was like, Yeah, that's a good idea. And then I went back and looked at my podcast, and I was like, I had a lot of black guests on actually a number of them. Yeah, nobody mentioned what color they were while it was happening, and you probably don't know. And I thought, I'm not going to just run out. I thought it it felt to me insulting to just run out and go, Hey, you're black and have diabetes. Can you come on the podcast? I just I'm like, I'm not doing that. And then yeah, I think, no. And then I looked in I like, six weeks prior, there was a I had a guy on it was black, he was gay and black. I was checking all kinds of boxes. And so and it wasn't, by the way, didn't have him on because he was gay and black. I had him on because a friend of mine said, he's a really interesting guy should have on the show. And I was like, cool. So we did that. But I watched every other diabetes platform run to black content. I was like, I don't really think this changes anything. I think you're just satisfying the the the, the echo chamber that told you that this was an important thing to do right now, I don't think you're actually touching the people you think you are, I think you're just satisfying the people who are aware of it, I'm like, you gotta find that people aren't aware that there's a problem and find a way.

Roxy 18:08
I mean, I'm sure that the point of doing that is so that you, you get a different perspective, right? Like, it's not just like, we want to check a box, it's like, we want to actually hear about people who are poor and have diabetes are we want to hear so I think if you're if you're thinking about it, or you know, I'm using your example, but in my example, you know, we were we're looking at, um, this is kind of a very niche interest, but this is we're looking at technical art history. And so I'm reading and doing a journal that that talks about that

Scott Benner 18:38
lady, what's going on over there? Yeah.

Roxy 18:39
And it's like, Wow, it is so white. I mean, this field is, and it's a publication as well. So it's like, you know, a real example of a situation where, where, you know, historically, there has not been a lot of, you know, discussion of like, for instance, graffiti art or like, you know, a lot of archaeological object, like there's a lot of places that we could go with this, that we could also just, we could also just kind of talk about white male painters that are in museum. So it's like, it's a very, I think, the your right to have sort of more goal oriented approach where you're like, I want to talk to somebody who has this particular experience. And I think you do a great job of recruiting pretty diverse voices. But maybe in general, I think the people that are

Unknown Speaker 19:25
more type A, or

Roxy 19:30
you have a lot of like moms that are that are like taking care of their kids and stuff, which is really awesome to hear their voice, like it's not like it's one or the other and you have so many you talk to so many people that I think you really do get a very good cross section of society in general.

Scott Benner 19:44
I like talking to the mothers who are real type A because I know first of all, they they either really no diabetes, or you can kind of gracefully and gently show them that maybe they don't need to be so Hi strong about this thing right here, right uptight about this thing. And it gets the so the people listening get to hear, hey, she was right on being concerned about a, b and c, but she could have let go of, you know, the F and G. And and and because there are people who are worried about things they don't need to be worried about, and you hear it if you listen long enough, I really do think that worrying about things you can't control is a bad idea. Like for yourself. Yeah, you know, for for for management diabetes, as well as you know, your soul. And, you know, so there's a lot of there's a lot of things I tried to sneak into the podcast, but I'm just saying that Listen, I've had on people from like every diverse nature. And I've also turned down people I've turned down every color and every everything that you can think of because they seem crazy to me. And I'm like a crazy person. I don't look at them and go white crazy person, like crazy person. I just go that's a crazy person. No, you can't come on. By my gosh, now I'm feeling very honored. You didn't think I was crazy. After all my emails, Rocky. Sometimes my next sentence was going to be I let a couple crazy people slide through. I promise I'm not crazy. I'm having a lovely time speaking with you.

Roxy 21:18
I know. It's really funny. I actually one of the things I was like, because, you know, I was like thinking about things I would be interested in talking about. And then I was like, okay, Scott totally doesn't want me to do this. So I'm gonna stop. But I was thinking about how like, you know, how difficult it is to kind of strike that balance between, you know, not getting crazy about diabetes and and how much I think your attitude, it's funny, you're very, you know, obviously vary on it and have a lot of ideas and have thought through all of these things. But at the same time, I think I've benefited very much from your sort of like, attitude of not worrying about things you can't control. That's something that I struggle with. I

Scott Benner 22:03
hear that a lot. Actually. It's one of the things about the podcast that I never expected that surprises me when I hear it. That just the I seem calmer, and so people kind of absorb that up when they're listening. Yeah, I

Roxy 22:16
think when I first started listening, I was sort of like, Oh, my gosh, these standards are just, that's never gonna happen. I can't know why these people, you know, this is insane. And then when I started, but then you said something like, and Arden will eat whatever she wants. And I was sort of like, wait a minute, okay, hold on. Like, there's a way to do both. That's amazing. Okay, I'm hooked. Now,

Scott Benner 22:35
you know why you know why people can't think that way is because everything. You might not believe this, if you're just listening, and you're just a consumer of audio, or blogs or something like that. But everyone you're listening to, I would say, not everyone, but most people you're listening to or consuming from I don't do this, but they pick a lane. And then just like you're talking about earlier with, you know, politics or social stuff, they defend that lane to their death. And so they just they make these simple, declarative statements, because they think those are easier for people to follow and understand, we eat low carb, if you want stable blood sugars, you have to eat low carb, but they say that then they defend it, then they say it over and over again, it's working for them in fairness, and it is a really realistic way to keep your blood sugar low and stable. Like I'm not saying it isn't. But when you start saying it over and over and over again, you're selling it as dogma, then just like, like people come by and say I can eat anything I want. Just because I have diabetes. I agree with that too. But there are too many people eating whatever they want. And their blood sugar's are bouncing between 340. That's not the same thing. My daughter eats whatever she wants, and we keep her blood sugar in a nice stable range. That all so that's why when I tell people what the podcast is about is learning how to use insulin. And then you apply it to whatever life choices you want to make. That is really how I think of it. I don't think it's how everybody takes it. But it's how I think of it, I think of it is I'm not a brand. And I'm not defending one narrowcast idea of how to manage diabetes. But that's also it's interesting. People would think of that content providers would think of that as an in specific and unattainable way to create something popular. They think you have to pick this one small thing and be this thing. And I'm none of those things. And this is the most popular diabetes podcast that's ever existed in the world.

Roxy 24:38
Yeah, that's a really interesting point. Yeah. And you definitely get that when you're when you're listening.

Scott Benner 24:44
So diversity in every walk of life is a good thing. You know, even how eat or how you use your insulin. Listen, I've been wearing a G six now for about four or five days. Oh, I know. I've been following you. It's been fun. I'm gonna tell you that With I'm as good at my body is as good at taking care of diabetes as I am at taking care of ardens diabetes. There are times when I look at her graphs, and I'm like hers are more stable the mind goddamnit.

Roxy 25:13
You know, the first morning I woke up after looking at yours and being like, Man working pancreas is there some. And I was I've been like, between like 80 and 92 all night. And I was like, Hey, this is good for

Scott Benner 25:25
you. By the way, another example of what we were talking about, because this is something that prior to this podcast, and this kind of ecosphere, I think, that I've built here of people, this would have been something if I would have just popped up on a social media platform and said, Hey, I don't have diabetes, but I'm wearing a Dexcom. And here are my my sugars, I would have gotten yelled at, by everyone. This isn't fair, you're wasting that you're wasting the thing, I need that transmitter like this would have happened, but blah, blah, right. But it would have come from all sides and they would have piled on. But there's a really good reason I'm doing this. And there's a really valuable reason for people living with diabetes that I'm doing it and the people who are listening, understand that I have not had one course word back. Everybody's just like I appreciate you're doing this. Thanks for updating it with your food all the time. I'm enjoying watching how your blood sugar right now. So my blood sugar doesn't spike. And it doesn't stay up for very long. But you can see that I ate a grilled cheese sandwich. I took French bread and cut like an inch and a half, two inch and a half pieces of French bread. slathered in butter threw a bunch of cheese on it a couple pieces of slicing pepperoni. And my blood sugar went up about 30 points. And it stayed that way for like six hours. Oh, wow. Okay, right. So yeah, look at that. But yeah, it was only like, 120. Right. And you're like, that's, yeah, that's significant. I mean, yeah, yeah. So it's not the number you should be looking at. It's the rise and the stableness of of how that food was pushing my so imagine if I didn't have a pancreas working. That's where you're gonna get a 300 blood sugar for five or six hours. Right, right. And then people like in a suddenly it fell out of nowhere, I don't know what happened. Well, your body, digested the cheese and then got rid of the bread. So it's not bleaching out the glucose from the bread. And you do know what happened, like pay it like this is what happened. You know. So in this timeframe, where this cheese and bread is in your system, you're going to need a lot more insulin, to tamp that number down while this process is happening. And if you can stop that insulin from being active about the time the sandwich is done, you know, being active, you win. Like that's it like you you don't have a high blood sugar and you don't crash later. That's what I wanted to show you the full thing. Yeah, isn't it great? By the way, I'm going to after this, my wife's gonna put it on, and she might have pre diabetes. So you're going to get right, and then we are going to start getting type ones that listen to the show, who want to like highlight a meal that they're good at. And then we'll we'll do that, like it'll pop up. And you'll get to see them do their meal.

Roxy 28:07
I think that's such a cool idea. I mean, so when I first started listening, or I guess when I first got I started listening around the same time as I got a Dexcom which was maybe a couple Wow, lucky, I guess to almost two years ago, two

Scott Benner 28:24
months to get on the show. So yeah, nobody has rescheduled their recording as much as you Roxy Oh, man, whatever I'm just saying.

Roxy 28:36
But anyway, so I yeah, I it's funny, I got a new pump and a Dexcom at the same time, as my diabetes educator told me about your podcast. So I kind of had these like, this was like a very sort of defined moment of management changing because I had all these new tools. And I had, you know, this new information. And one of the first things I thought to myself is, gosh, I wish I could put this on my husband who doesn't have diabetes, because I would just love to see what happens. Like I just it's hard to shoot for something that you don't really understand. And my doctor had once told me Oh, yeah, you know, I I once went up to 180 and she didn't have diabetes, you know? And, and I was sort of like well, what like it's just I looked for research papers I looked for all sorts of stuff and there's nothing out there of just like here's what a working pancreas looks like. Yeah, so for me I was like so excited when you when you put it on because I thought you know that's that's actually like really adding to the body of knowledge and it's not like you say it's not to just be like Nananana booboo, I

Scott Benner 29:40
I have to tell you, it's obviously super helpful. If I if I had a company behind me supporting what I was doing. I would my diabetes space online. You know, if I had a blog that was really popular, would not look like all the other ones. The other ones are just they tell you what's coming and technology Some things people are upset about and talk about that, then they show you a lot of recipes, which gets great, you know, and then nobody cares. And by the way, my, the person that helps me with SEO, which means search engine optimization, which is to see kind of how things work, pick through a bunch of really popular diabetes websites the other day, and my blog, which I put, I'm gonna say 10% of my effort into is as popular or some of them as far as, as clicks go, not good for me. Instead, what I'm saying is, maybe they should be doing something people actually care about.

Roxy 30:38
Yeah, well, I have to say, I am a perfect example of somebody who had never had any interest in the diabetes community whatsoever. Until, and I think, partly to my detriment, but you know, I was very put off by, by that kind of stuff, especially by the recipes by the like, idea that you have to live a certain way. And I just always felt like I was failing in that kind of situation. And I did, I actually got to the point where I was due for a new pump. And I didn't know what pumps were on the market. And I realized I almost just got, I had a Medtronic, and I almost just like, upgraded to the 670 G. And it was really only because I was living. I live in Indianapolis, which is obviously the land of Eli Lilly. And one of my neighbors worked for Lilly, who does work for Lilly, and she and I were going for a walk. And she was kind of asking me about diabetes, or what I was what I was using and whatnot. And she was sort of, I was saying, Oh, yeah, my doctor says I need to get a new pump. And I don't really want to like research. And she was like, Well, you know, you really should. They're all these advances coming blah, blah, blah. And so I had actually, I realized at that point, I've gotten so far out of a loop, which which my dad was always really into technology. So he was always kind of pushing me to get the newest stuff when I was younger. And I had kind of just, like, settled into that this is what I do. I'm not in touch with any diabetics, I don't follow anyone on Instagram, I, you know, not not to be like a Scrooge. But just I think you kind of talked about this as well, like people, once they kind of get their routine and they've had diabetes for a long time, they sort of fall out of the spaces, it makes some and that was definitely me. So it really was like the fact that your podcast is so dynamic and interesting. And and, you know, information, learning how to use insulin, I had never been taught that. I mean, it seems almost insane to me now thinking about it. But you know, I'm a relatively intelligent person. I've like gone to school, like I could definitely I can learn to use insulin, but I had never been taught and I don't know why I never wondered, that's the thing that like, kind of is strange to me. Like, I'm so glad that you really did wonder because

Scott Benner 32:48
it's I don't know, either. Look, it's funny you bring up Indianapolis because in the day back in the day, I've been to a number of diabetes blogger summits that are were always run by pharma companies. They pull together 20 or 30, people add, I guess, popular blogs. And you would sit there and kind of brainstorm how to help people with diabetes. And I'd listened to the room and think that's not right. No, don't do that. And once or twice, I'd say something. And then I was like, Huh, no one cares what I think. And I just shut up. And I just kept listening and thinking that's not right. Like I as a as a theory. I like supporting people emotionally. I think it's a great idea. But chicken and egg, right, like, so if somebody is down, and you want to lift them up, that's great. But if the thing that's pushing them down is still there, and then they just go back down again. So what if we figured out what was pushing them down? And got rid of that? And what if we had to ignore that they weren't happy at the moment to get to that thing. And just okay, we're going to ignore their feelings for a second and get to the problem. It's it's sort of like rushing into a car accident. And a guy's pinned under a steering wheel. He's like, This hurts. This hurts. This hurts. Do you do something for his pain? Or do you get the steering wheel out of his chest? Right, like, so. I just looked at the way people were living with diabetes. And I thought, why don't we get rid of the problem? And stop just treating the symptoms? That that's just how it seems to me like people are sad. It's just the number they'd say stuff like that all the time. Like, they need to know they're not alone. I'm like, wouldn't it be better if it didn't matter if they were alone, like, like, let them decide if they want to be like alone or in a community. But one way or the other if your blood sugar is going from 40 to 300, and back the ad and then up to 250 and then down to 40 all day long. You don't. You don't have an opportunity to live, let alone try to find out why you're sad. You're sad because your goddamn blood sugar's jumping all over the place. You don't know what to do about it. Like how I could never understand. Like, I just sit in a room and I'm like, I don't know what any of you were talking about. There was always like, a third of the people were just trying to figure out how to make their blogs more popular. That was interesting because none of their blogs exist anymore. Because you can't keep it was like vaporware. Like they would say diabetes words out loud. And I'm just like be but you're not helping anybody. You're just, you're just finding a bunch of people are in a bad place and going, Hey, look over here, I'm in a bad place to, like, okay, now what?

Roxy 35:20
Yeah, that's not helpful, right? No, I think that's an interesting point. Because I've thought about this a lot. So, since, I mean, I've always had a lot of technology for the time, but I got diabetes, when, you know, there was a very little technology to have. And so I've kind of seen the evolution of a lot of technology and lived with it. And as and as I think, because I am a very type A personality, I think my parents were very aware that I was, you know, very keen to achieve as a child. And I think they were slightly worried that I would be so focused on numbers, because, you know, I was like that kid who always got A's all the time, you know, and would like cry if I didn't do well on a test. And my dad's like, Who cares? You got to be like, chill out. So I had, I think, coming from that perspective, I think they were quite worried, particularly at that time, when there weren't CGM, and there weren't, you know, there was no real way to both live freely and have the kind of control that we can achieve now. And I think, so I should say that I never had blood sugars that were going from 300 to 40. Like, that would be horrible. And I totally, totally agree with you. But I definitely think that I lived a little bit I had I had, you know, higher a onesies not anything crazy, ever. But like maybe in the high sevens or maybe eight I don't know, something around that for a good part of my childhood. And then, um, but like, mostly I've been pretty, I've had pretty good control, right. But but I think it's interesting now that I've got the technology because I find that my mental health is a little bit. I don't want to say worse, because there's so many things that are so much better. But I do find myself focusing on it in a kind of like, punitive way. And I love that you always kind of talk about like not thinking of it as a number or not just thinking of it as an information. And I think as I get better at it, I guess I guess what I'm trying to say is that like, once I saw how how a perfect Bolus looked, I wanted every Bolus to be

Unknown Speaker 37:33
like that.

Scott Benner 37:34
Yeah, well, I can't picture insanity. All I can give you is the tool.

Roxy 37:38
Yeah, yeah, exactly. Exactly. So no, I'm just saying from my, I'm interested as a person living with it. That, um, that my like, I have, I don't know, I feel like I've benefited so much from from the technology and from the information like I would never give that up. But it's interesting to think about, like, how do you kind of balance that? How do you not just live your life as if you're your sole purpose is achieving a target? No. And I think I think it does get much much easier once you've learned the information. And once you've learned how insulin works, and you've done the experiments, I guess for me, it was it was helpful to think about it as an experiment as like a kind of, I guess that story that you tell about? Was it you or Jenny, somebody was talking about just like repeating the same food over and over until you get it right.

Scott Benner 38:27
Yeah, that's what I tell people when they're struggling. I'm like, make the same meal weekend, and just keep practicing it until you're finished till you figure it out. Yeah,

Roxy 38:35
yeah, I guess so. That's that's been, I think, kind of changing my my mindset to have that attitude has been has been helpful. And I'm, but I definitely have more frustration. Now. When I don't, you know, I just have like, a couple weeks, every so often where things get wonky, and I have to change things. And in my logical brain, I'm like, okay, just calm down, and, you know, make the adjustments. But in my, I guess, I mean, maybe it's just because having this going on in my body, I'm not thinking that clearly. So it's like a combination. I think almost there's a degree to which if somebody else could do the thinking, for me, it would be helpful, because I do get to kind of, like rage Bolus, like I mean, I am the quintessential rage Bolus.

Scott Benner 39:23
You're saying that you don't notice it happening till it's happening. And so when you're looking from the outside, like when you're helping a child from, you know my perspective, I can see things coming that my daughter would never see, like, let's say, and this is completely farcical. No one in my house would be like this. But imagine that one day you saw a woman who was just very kind and loving. And you were able because of years and years of perspective to know that the next day that person was going to be very short tempered. Because that's what happens when you know that day happens this day, always fine. That day, yeah, that person doesn't know on the happy day that it's a happy day, as much as they don't know that it's a nasty day on a nasty day. They don't know that about themselves. It's not happening, I can see that happen and say, okay, tomorrow, I'm going to walk around on eggshells, because I know that's coming. Now, sometimes I'm not smart enough to remember sometimes I get sucked up into the happy day, and I think it's gonna last 48 hours. Sometimes it doesn't. And similarly, I can look at my daughter and see situations in her personality, or other things, she says, or does that make me think, oh, she's ovulating now. I'm gonna have to turn up our basil a little bit. But she doesn't know that about herself. Like she would know if she looked on a calendar. But she wouldn't just know because it's her. You know what I mean? Like, it's just, or Yeah, and

Roxy 40:49
there are even like irrational things that I'll do. Like, I've, I've spent a lot of time thinking about like preparation for exercise. And I figured out I have the T slim pump. And I figured out that I have to turn off, like, absolutely love the control IQ. I'm like, bring on the algorithms, the more the merrier. This is one instance in which for some reason, the algorithm doesn't work. So I, if I'm riding my bike to and from work, like when I'm coming home, I'll have eaten lunch, you know, and the insulin will have mostly worn off. But sometimes there's like that tail. And that if I then ride a bike, it'll just, you know, completely tank. And so I know I have to turn the insulin, I have to like, Temp Basal back and forth. This is super annoying about the control IQ. Nobody who's like, developing this kind of technology thinks that makes any sense to have templates and an algorithm because they're like, well, we have activity mode for you. So you should put it in activity mode. But activity mode somehow just like drives me up like crazy. And it does, it really doesn't make sense. I don't know why. I mean, maybe there's, I'm sure there's something in the algorithm, it's just a bit more aggressive than I need. Yeah, so I and theoretically, you could just put it on not as far in advance because normally I'll temp, I'll like do a temporary rate of like, 50% about two hours before I'm going to ride my bike. But, and I always know like, I basically going to double the power of that insulin if I'm going to exercise and I still have a little bit left in my system, but once every single time or not every time but frequently, I will kind of look at it and go like maybe this time it'll be okay. Like maybe this time the the point six that's left won't act like a unit and a half or whatever, it'll it'll just kind of go away and I'll just start writing and then I'll you know, get home and be low and it's like, come on, you know this until I'll do these sort of irrational things with like wishful thinking that I'm sure if I was taking care of another person I would never do

Scott Benner 42:51
the maybe this time wishful thinking those two phrases go together so well around diabetes. It's like it's like oh, my blood sugar's you know, got a little low. It's but it's 75. I'm just gonna eat a half a gram cracker. Maybe I won't need insulin for that half a gram cracker? Yes. Oh my gosh, yes. But yeah, because graham crackers are harsh, by the way, and they need to be covered with insulin. And yeah, but people do it all the time. Like, I'll just take a little bit. I love it. I love when people can't figure out that, you know, they ate a handful of jelly beans because their blood sugar was 50 and then ended up being 200. And then the next time they're 50 they don't just think well, I wonder what would happen if I had a third of those jelly beans.

Roxy 43:32
I tell you I mean some of the things I think back to when I was in college and I would get up in the middle of the night I had a friend who would you know work really late and I was always Early to bed. But I would get up because I below and so we would sometimes like run into each other in the kitchen and she's coming in from the library and I'm like sitting there wolfing down, you know the amount of cereal I would eat and then just go back to sleep like I mean it's insane I must have been just like driving my blood sugar up to a million I don't even do well and I wouldn't do it differently the next time like I think it's partly that like low low brain like eat the whole kitchen. Um, but but even with even when I'm not low I will sometimes make a sound like I'm you know, completely hopeless but I'm really not but I will sometimes have wishful thinking around around things like I'm going to go out for a walk and I don't really want to eat before it so even though I have a half a unit on board still I'm just going to turn off my basil and see what happens. You

Scott Benner 44:28
know what will happen is you'll get low because the Temp Basal won't catch you in time and then you'll get high after Yes, I think Listen, the other night Arden's blood sugar got low, and she was you know, eating food to take care of it. And it was a significant like, you know, it was a persistent low. And she's, she looks at me and she goes, take this from me. I was like, okay, so I just took the food from her. She's like, I was gonna keep eating that. I was like, gotcha. She's like, I know I have no self control right now just helped me. I love it. But you know, it must have taken me three years to explain that to her. Because I'm not a pro, I really am not a person who wants to beat something into your head right away, like I would like over time for you to notice that. When you're low, you're going to eat more food than you need. Because you've got this feeling your brain is telling you basically your brain is like, yo, we're dying. Eat carbohydrates. Yeah, right. It's intense. And then you have to have, you have to have enough clarity in that moment to say, I just need to eat enough here. And understand what enough is. And in a world before CGM, the common practice was just was to was to eat the kitchen so you don't drop dead. Which made sense then, by the way, but you're not that same situation anymore if you have some of this technology.

Roxy 45:50
Yeah. And I think there was, you know, I was really, I'm not sure how my parents did it. But I think they really did raise me with very little fear around diabetes. Like, there was a real kind of, yeah, fearlessness, sort of like, trust your body you have, I'm very grateful. I've always felt my lows very, very well. Like I wake up when I'm low. I'm really lucky in that way. So you know, I was, and I knock on wood every time I've, I mean, now my CGM alarms, but you know, when I was a kid, I would wake up and I'd be sweaty, I'd be very low, like I would now I wake up when I'm, you know, 65 or something, or 70. And the things, you know, beeping, but I would probably be pretty low at that point. But anyway, there was I was never like, afraid of insulin or afraid of any of that stuff. So I think that's, that was helpful, but a lot of like, keeping that fear at bay, was knowing you could just eat something and it'll be fine. And like, not worrying about the highs so much. I

Scott Benner 46:50
think I think, I think there's a lot of good that came out of that 60s 70s 80s parents who didn't know any better, so they were just like, you're gonna be fine. Like a good vibe of that is okay. You don't mean like the rest of it's not great. But the vibe of it is a good, it's a good, it's a good posture to take, I think.

Roxy 47:10
Yeah, I mean, it really, I think that's what I was kind of trying to get at before, like, my mental health around diabetes at that point was like, I've got control of this, like, I can feel it. And I mean, we had some, some scares, like, I mean, to me, I had a seizure, like full on, went to the hospital, like passed out all of it. When I was in seventh grade, right at the beginning of like, the transition to middle school, and I, you know, did something stupid and Bolus way too much? And, yeah, so I like I mean, mostly, mostly, I felt everything and it was all good. But like, my parents had a lot of reasons to be fearful, but somehow managed to kind of keep that from me. And, and so I always felt like I was thinking back about this. And I was like, you know, I, like lived in Italy by myself up on a mountain, like, three miles from the nearest bus stop, and I didn't have a car and I didn't speak Italian. And my parents were like, it's cool. Just, you're just like, nobody ever talked about diabetes.

Scott Benner 48:14
Pocket, Roxy, you'll be fine.

Roxy 48:17
Like, and I remember, I got food poisoning at one point. And I was living alone up there. And I was just, like, barfing my brains out, you know? And, I mean, now I think about it. And I was like, That was crazy. Like,

Scott Benner 48:29
I think you're here to come to the conclusion that you were have terrible parents and you thought they were good.

Roxy 48:36
Do you remember my dad being like, so happy? When CGM came out? He was pushing me to get one and I was kind of like, what's the big deal? These things aren't accurate yet? Like, I don't need this. And he's like, please just wear it. Oh my gosh, you're so sure he was losing a ton of sleep as I was up on that mountain in Italy. But

Scott Benner 48:52
you know, in in my mind, your parents of the reverse Beverly Hillbillies. You know that right? from talking to your sister? Yeah, I mean, they just they bugged out of the city. They went to Vermont. How do I even remember that I remember nothing about most of these podcast episodes in case you're wondering, like, I'll get these notes and I get these long notes. And they're like, Oh my god, they're talking me like I'm like this person feels like we know each other. So I'm looking because I don't want to like they have this like such a nice connection I it does mean a lot to me. It's just a lot of people putting their name right Roxy in so it's hard to keep up like some people will just like drop back into my life and be like, hey, that Temp Basal work great. I'm like, do you think the only one I talked about that?

Roxy 49:40
I'm amazed you even like kept track of my my nagging emails because I'm like, he doesn't know who I am. It's fine. I sit down

Scott Benner 49:47
once a month. It takes me about three hours and I power through all my emails and I read every one of them. And I hate every second of it, not about the emails. I just they hate the process of doing it. But I just I think it's important like it, you know, it seems important to me and, and I learn a lot from them too. Like I like seeing sometimes people's fears or leaps they've made or just imagine all the notes that have come back to me where people are saying, like, this is what the podcast is to me. And I'm just like, God, I never imagined that, you know what I mean? Like, they interviewed a girl the other week, and you'll hear it sometime in 2021. Probably. And, and she was talking to me for like, a half an hour about how the podcast has taken our agency so far down, and it's leveling out and getting better. And I finally am like, you know, can you tell me what part of the podcast did that for you? And like thinking she was going to talk about Pre-Bolus singer understand or Basal insulin better. And she's just like, it's the community. I always knew how to do all the other stuff. I just never did it. And I'm just like, what about the community? Because I don't know, just, I just wanted to do a better job all the sudden after listening to the podcast, just it was that simple? And I never if you could have, you could have stolen all my money in a bat right then because I would never have bet on that. As she was.

Roxy 51:01
Yeah, that's what the the CD who met who recommended the podcast, to me the first time said, She's like, it's a really great place to find community. And I don't know if that was like a way of medical professional, like being able to recommend a podcast. Because I was like, I don't need community. It's fine. I'm cool. But then I was like, Well, you know, might have something interesting. She had a lot of great things to say. So when I, when I checked it out, I was like, This is not really I mean, I definitely was interested to hear people's stories, but I'm definitely more of the like, give me those like, tips those tricks, I want to try it, you know,

Scott Benner 51:40
it there's a such an interesting mix of people listening, there are some people that don't care, a lick about that. And they and or the Facebook page is an interesting place to because the management people talk. But the other people listen. So there's, there's a whole there's a whole thread of people who are vocal on the Facebook page, which by the way, I'm really proud of Still, if you ever hear me Tell me, I'm telling you, I'm not proud of it, it fell apart. But it's still an amazing place. If you have type one diabetes, Juicebox Podcast, type one diabetes, it's a private Facebook group. There's like 8000 people in there. By the time you hear this, there'll be I'm hoping 10,000 people in there, it grows slowly. It's not one of these things that goes from like 10 to 20 to 30,000 people all at once, and you've just got a bunch of nonsense, it doesn't help anything. It's so focused. And and somebody asks a question, it gets answered, it gets answered in a way that I'm just like, wow, if I would have sat and answered every one of these questions, I would have said a lot of what's being said here. And so it's interesting to watch the proliferation of the podcast, go out, stick to somebody and then bounce back in again. It's really I'm very grateful for for everybody in there. It's really interesting and valuable for people. But at the same time, there's, there's still people in there that I can see them, I can see that they're there by the activity, but they never say a word. It's very interesting how it works, then there are other people are like do this, try this, do this. And it's a perfect mix.

Roxy 53:09
That is truly an achievement because Facebook is a nightmare.

Scott Benner 53:13
Yeah, no kidding. I keep waiting for it to explode. But it just keeps getting nicer. And it was one of those things. I've said it before. People are like, Can you make a Facebook page where we can talk? And I thought, No, I don't want to do that. Yeah, it seems terrible. No, actually, I've

Roxy 53:26
pretty much gone off Facebook. But whenever I do go back on, I always check that that page, because I'm like, Oh, I wonder what people are up to. And it's always I totally agree. It's lovely. It's like an really active resource that existed when I was a kid. I can't even imagine how good I'd be a diabetes by now just

Scott Benner 53:40
jump in somewhere and say out loud what you're thinking. And then people are like, Oh, you know, move this block over. It's like, it's like, I don't know. It's amazing. So and I really appreciate that your diabetes educator and all the diabetes educators that recommend the show, do so that's another thing I see all the time. People coming to the Facebook page have to answer a couple of quick questions, just so you can make sure they're like a real person or not a Nigerian scammer more specifically. And by the way, Facebook scamming in Nigeria is a it's got to be the thing. It's like their gross national product, I think. But so, you know, where'd you hear about the podcast? And a lot of people say from their doctors.

Roxy 54:18
Well, yeah, I sent the pro tips episode to my doctor who's, uh, who's got type one. And actually, I connected with Jenny after hearing her on your podcast because I was like, I need a new doctor. Like, I was not happy with my doctor and she was able to connect me She's like, I think there's a type one who is who is a, you know, who is an endocrinologist in Indian I was like, Oh my gosh, I've never seen somebody with type one. This is going to be amazing. And it's just I can't recommend that enough. Like just having somebody who lives with it is so helpful. But because it's so you know, when I think about it, I'm like, honestly, how does a doctor like even learn this? Like if you don't have diabetes or know somebody, like you really have to live with it and try things to actually really learn how to live with it. That's really redundant, but I'm just like, there needs to be like a simulator diabetes kid that doctor can use. Because it seems so it seems so impossible to learn to learn this information without like, I don't know. Anyway, there's

Scott Benner 55:27
no i steadfastly believe that if I if I wasn't a stay at home Dad, I would be terrible at diabetes. Yeah, yeah. Cuz I the time hard. I did time. You know? Yeah, really? Look at it. Yeah. That's so it was just a big deal for me. Just having to look try do it again. Didn't work or why not? Look, try do it again. And, you know, my wife was a big help, too. And like, she beat it out of me like the drama stuff. Like I would get dramatic in my own way too. And she'd be like, this is not helping. She's like running around the house yelling is not fixing this. I was like, gotcha.

Roxy 56:09
You guys are good TV. Yeah. My husband is like, Oh, my gosh, he is hilarious. He's like the most, you know, English. Cool headed, like an emotional. Ever

Scott Benner 56:20
I do something wrong. And she tells me I'm wrong. That's perfect. That seems to be what our famous just drags me forward. You know? And that system worked out there. Yeah, every once and I'm like, you don't do everything right. Because this isn't about me. And I was like, Okay, I say, it's about me. I'm bad. I got it. I figured out my place in the world. Don't worry. I know. So interestingly enough, we've spoken for about 55 minutes. Oh my god, you're on the show because your sister was on the show. And we've spoken about that for about nine seconds. So maybe we should look that up for a second. Okay, yeah. Let's go back to that. Okay, so what's that episode called? It's called Zoe and Roxy's wild ride. Right now. Yeah. Yeah, I just really listened to it good to have it fresh in my mind. And so you heard someone on the show who was worried about their type one sibling. Feeling left alone. Made you wonder how your sister felt you forced your sister to come on a podcast she knew nothing about. She was a great sport, and really don't talk to you all about picking chicken trailers as I recall. Yep. Yes. She picked through my fascination with Vermont. Which I don't it's it's almost a perfect place. And then when it goes off the rails, it goes off the rails spectacularly. There's no such an interesting point.

Roxy 57:35
I every time I go back there that is exactly my arc of of thinking.

Scott Benner 57:41
I just I was like, This place is magnificent. Yeah. Why is that man's chickens living in an abandoned travel trailer.

Roxy 57:48
Hmm. We can trailer Scott chicken trailer. As I was listening to her episode, I'm shouting you're going? What do you think this thing is? And you're describing it to her and I'm shouting chicken trailers. Oh, chicken.

Scott Benner 58:01
or just in general, and not for nothing? But it's 2020 maybe an air conditioner is not a bad idea. Just get an air conditioner.

Roxy 58:09
Oh, See there? My like eco warrior comes out. I live in Indianapolis. And I still don't use an air conditioner.

Scott Benner 58:15
freakin heavy. Like I mean, really? What are we talking? It gets hot out. Just take a little the humidity out of here. You don't have to make it 65 degrees in your living room. Just make it a comfortable situation.

Roxy 58:28
I you know, I think I was like meant to live in a really hot, humid place. Because when that when it's on the you know, in the winter, I'm like, crank up that heat. But I can deal with heat really well and then not so much cold. So I look really great when I'm like, I don't use my air conditioner.

Scott Benner 58:42
Good for in hindsight, and then it's like, but I crank up the heat like crazy. And I'm telling you in hindsight, I recognize that I was about five minutes away from being in a horror film where my family killed me for taking them somewhere where there was no air conditioning.

Roxy 58:57
That's so funny. I can imagine that. There's that like horrible feeling when you realize you've paid for an air b&b. And it's not what you expected I can really relate to the whole

Scott Benner 59:05
thing was perfect son's air conditioning situation. really wasn't lovely. Vermont let you down. It really does. And you know, Ben and Jerry's isn't going to overwhelm no air conditioning. That's for certain that only last for a minute. Anyway, it's not your fault. It's nobody's fault. Nobody's perfect. If you came to New Jersey, you'd be horrified. But I'll tell you what, you wouldn't be hot in the summer. So there. That is true. Anyway, what did you learn from listening to your sister on the podcast? Anything? Yeah, I

Roxy 59:37
think I was really I mean, I think I was suspecting that she would say what she said, or you know some of what she said like I definitely thought it was I think what interested me the most is I sort of said earlier was that this parent was so worried about their younger, they're younger child because I kind of thought, you know, diabetes only affects the person that It touches like that was kind of. I know, that's not really how it worked in my family. But, um, I, my perception was like, it didn't really ripple out to my sister and I was. So that's kind of why I was curious what she would say. And I know that it has affected her but in, I think mostly neutral or even, in funny ways, positive ways. Um, because I think there was really an attitude of like, I don't know, I guess my mom grew up with a her younger sister had was born with a hole in her heart. And so she had like, really intense few years as a as a young kid, and even up into like her early teens where she couldn't walk very far without like breathing really hard. And thankfully, she had surgery that kind of fixed it. But I think that ethos of sort of like, not pitying the person who is, you know, got a condition of any kind and sort of being very Get on with it, you can do anything anybody else can do. I think it was very empowering for me, and I, and I thought, you know, when I hear what I'm, you know, how it affects, I honestly think it's way worse. Diabetes is way worse for parents than it is for the people with a lot of cases, maybe not in all cases, but certainly in my case, I think it was, I think my parents did a lot of kind of shouldering the burden for me, and for an especially, you know, that kind of then like, went on to my sister as well, because they're sort of not expressing their anxiety and their, in their concern, and all of that stuff that I'm sure what's going on in their heads. But I think, I don't know, it certainly doesn't seem like the best sort of cushiest approach, like the most like, loving, healthy approach, maybe, to be like, just, you know, denying how you're feeling. But it's really, I don't know what I'm communicating to people. But all I can say is that by kind of having that sort of attitude that I think you've said this before, they like you didn't want to see Arden as as diabetes, you wanted to see her as your daughter, you know, and I think my parents were really good at that. And so I never really, like even when I went to college, I thought my friends didn't know I had diabetes, not because I was hiding it. I mean, I was testing my blood sugar at that, you know, can team in public, like, I've always been very open about it, but I just sort of never like identified as that, particularly. And I'm not saying that that's the way to go, necessarily. But it's interesting that that was sort of like how it affected me and that my sister then felt totally fine about it. And she's not even scared about her kids having it or getting it herself or anything. Like, I have a lot more anxiety around other health. You know, conditions, for whatever reason, I think, like my fear around diabetes was like, I didn't have a lot of that. But I have like, I'm always waiting for the other shoe to drop in terms of something else happening to me. So you know, it's it's a slippery little snake, but it is kind of interesting. Sorry. No,

Scott Benner 1:03:04
I was gonna say, I don't actually identify as anything. I don't even understand that. I don't understand like running around going. I'm Yeah, I love this. I'm so about this like,

Roxy 1:03:16
yeah, I kind of agree. Actually, I don't I don't there's nothing about me. That's particularly like, yeah, that I need everybody to know. But I guess I'm also kind of lucky that I don't have you know, some I don't know, I think there are people with like, more severe disabilities, for instance, that, you know, the world needs to know, in order to kind of accommodate them. Yeah, diabetes isn't really like that. So, um,

Scott Benner 1:03:40
yeah, no, I agree. I understand that. Like, listen, if I had, you know, if, if my left leg was a foot and a half shorter than my right leg, I'd be like, hey, there's something about me, you need to know, you know, that seems important. I just mean, like, in general, like, I would never tell somebody like, I'm the fan of this team, or I really care about this political idea, or I just don't understand. I got I said recently on a podcast, I don't know if it's been out yet or not. I don't even identify myself about how I look like, in my mind, that was interesting. I heard that I'm the thoughts in my head. I don't really think about myself beyond that. Like, I really feel like I'm in a vessel, I need the vessel to work, but I'm the thoughts in my head. And you either like me, or you don't. And if I was taller, or shorter or skinny or fat, or I don't see why you would care if you liked me, like that's, you know, if you got along with the thoughts that were coming out of my that's just how it feels to me. Maybe I'm wrong. Maybe I should maybe this is a long winded way of avoiding setups. I'm not 100%

Roxy 1:04:42
but no, I think I think it's, I think that's like comes with self confidence or with or something. I don't know. I feel like I was sort of born with not really caring what people thought about me. And I've, the more I've, I mean, I don't think that was something I cultivated. I think that was something But just some people kind of have, I'm sure you can cultivate it as well. But, um, it's kind of a gift. It's really nice not to care.

Scott Benner 1:05:08
Listen, I agree. When when Kelly and I were first together, I'm never forget how she said to me one day, some people don't like you. And I was like, Nah, but imagine, you know, and like, I'm a person that not bother you. And I went, No, not really. And then then I pointed out somebody who I thought was like, a real a hole. And I was like, what would it say about me if he liked me? Yeah, exactly. Like, why? Why would I want that person to like me, I would want I'm hoping that a person like that looks at me and doesn't see anything in common. Like, right. And that was the first time like, that was her. I thought I always thought of that as her like her Catholicism, like, like, why are you not working harder for everyone to like you? I was like,

Roxy 1:05:54
Well, I think a lot of times, like I do think as a woman, you're often sort of put in a position where you, you're supposed to kind of please the people around you, you know, there's a lot of, I don't know, I feel like there are situations in which I don't feel comfortable speaking up, because I'm afraid people are gonna think I'm nagging or being whiny are, you know, that kind of thing. Although I do try to kind of shake that off. So I'm sure there's certain I think partly, it's privileged not having to worry about

Scott Benner 1:06:21
Yeah, listen the other day, Arden said very, and she meant this with a ton of confidence. No one's going to marry me. But she meant it proudly.

Roxy 1:06:29
I know. She's like not really on the podcast. But I just love this. This like Phantom persona of art. And she seems like the coolest. Well,

Scott Benner 1:06:36
I'm looking at a box next to my desk right now. And it has a second microphone. And it just arrived from Oh my gosh. But I finally was able to she needs um, she needs hours. for school to to graduate. I don't know why I can never think of the name of the hours. It's such Oh, like internship hours, or something. You know, you have to do something like community service. Thank you. Yeah. I don't know why I can't think of that. community service hours. And she found out that being on the podcast, because she has diabetes in the podcast reaches so many people that that would count as community service hours. Oh, that makes sense. She just like she was like, Oh, right, fine. And I was like, you gotta come on the podcast, and said she has to do a certain amount of hours. So show man she'll give me great. So we're gonna have like a, like a whole series. Like a short series with Arden probably in 2020. Awesome. She'll loosen up when she really loosens up that then then I might be like, Oh my god, I can't believe people are really hearing her cuz she's just me, but from a different. She's just me as a girl in a different generation. So funny. I

Roxy 1:07:44
definitely think it'll be interesting to hear what she has to say. I'm I mean, I'm yeah, it seems like everybody's really everybody's perspective is very interesting. You

Scott Benner 1:07:51
know, I've never interviewed somebody face to face before. So that'll be interesting. Oh, my gosh, I might be bad at it. We'll find out. And she'll tell you if you are. Anything like I was as a teenager, she's gonna be like, you suck at this. I don't know why people listen to this. That's probably going to come out of her mouth at some point. So because sometimes the show will pop up. And she'll be like, oh, like, Yeah, I know. I can't believe

Roxy 1:08:14
she like she really know what you're up to. Or she kind of just like, doesn't pay attention.

Scott Benner 1:08:19
Oh, no, she's aware. Okay, yeah, she knows. I don't talk about anything about her that she doesn't know about. And she's comfortable with people knowing because she doesn't care. She really doesn't care. And she knows the podcast reaches a lot of people. And that's okay with her. Sometimes she'll say to me, can you tell your people to stop trying to get on my Insta? Oh, I can't. I said if they find you and you don't want to fall, don't just say no, you're a private. She's like I do, but it's annoying. I'm like, Okay.

Roxy 1:08:49
That's funny. I would never think to do just that. She's like, she's a celebrity. She doesn't even know it.

Scott Benner 1:08:57
She's Oh, a woman sent this lovely note the other day about I know Arden because Arden was on the beginning of the Dexcom episode. She helped me put the CGM. Yeah, yeah, that's when I first I was like, Oh my gosh, she's, she's like, you know, she's actually there. Her voice barely mumbling. She's like, she's like this far off the microphone. Yeah, no, I don't know. Leave me alone. I'm like Arden, just talking about my action. I don't want to. So but somebody sent this. To thank her. Like said she's like, I get that you don't love being on the podcast. She's like, but you and your data really helped me a lot. I want to thank you. And I showed her that and she's like, oh, like, this is a lovely note. And it's really nice. She has I know just, I don't I know. I'm like, so I can't wait to see if I can make something out of her. What I hope is that she gets comfortable because I think she'll get chatty. And then that would be really interesting. That's that's what I'm gonna try to get her to. So we'll say no, we're gonna have her friend come on to. Oh, right. Yeah, that's so that'll be Nice. But yeah, so your sister was delightful. I'm glad you forced her to come on the show. I really enjoyed talking to you as well. I have one question. If you can't answer me on the recording, that's fine, but I want to know when we get done. Okay, it's your sister still with that boy?

Roxy 1:10:17
She is she so she actually was like, um, you can update Scott on my life.

Unknown Speaker 1:10:23
Give us a great, I'm

Roxy 1:10:24
glad I'm gonna be helping people like think about diabetes. Um, no, she she actually with COVID. She graduated from law school. But then her moved to Arizona. They told her she didn't have to move. She could just like work from Vermont. So it's hilarious, because in the episode with you, she's like, I'm probably not going to get to move back to Vermont for a really long time. But it turns out that she spent most of 2020 living in Vermont, with my parents. So she's living her dream. But she is still with her boyfriend who's in Boston. And he's finishing his LLM. But he got a job in New York. So I don't know that they're, that he's I don't think he's gonna move to Arizona with her. So they'll still have the opportunity to try when he

Scott Benner 1:11:04
was explaining it, Roxy, I was like, This isn't gonna last. But just because. But just the geography of it had me.

Roxy 1:11:17
I mean, I shouldn't talk because I did three years of long distance with my husband who is in England and we ended up together so maybe, like, you know, Vermonters have lasting power in the long distance relationship department.

Scott Benner 1:11:31
Roxy, I don't understand how a British guy in a jeweler in Indianapolis to be honest with you, so the whole thing's confusing to me. Oh, yeah. He's a British Jew. Is he really? Did you know those existed? When did you get that at? The just a special order that how do you accomplish that?

Roxy 1:11:46
No, they're only like, they're very few. But actually, I had a Jewish professor at University who was like, do you know they're only 100,000 eligible Jewish boys? And how'd you get one? That's amazing. It was a total accident. Yeah. You didn't even do it on purpose. Oh, no, no, I'm not that out. I got we got set up on a blind date. So yeah, funny cuz he sound like I like the Jewish boys. So I guess it maybe was bound to happen. does he sound like Adele? Um, you know, Adele is from I think she is from East London. And he's from Essex. So he definitely has like an Essex twine, which is not you know, the Queen's English. Let's say,

Scott Benner 1:12:30
I helped somebody from England the other day, get their basil set up a little bit. And we just sort of, you know, people, people who don't live in America, they, they just can't call overseas easily. For some reason. I don't know what 2020 I think she's talking like through like Facebook, audio or something like that. And she's, I'm trying to help her. And I just thought that I finally said, Look, we just have to get this out of the way for a second. I was like, because I can't focus. You sound like Adele. She's like, No, I don't I was like, to me you do. I'm just saying

Roxy 1:13:03
I mean, I think well would object to me, describing his voice as Adele's, although he does like a little falsetto. So, you know, maybe

Scott Benner 1:13:13
I want to hear him order, like a really traditional sort of Jewish meal in his British accent. Oh, yeah.

Unknown Speaker 1:13:20
No, no, we

Roxy 1:13:21
only have a fried fish. You know, it's actually really funny is that he loves to do you'll appreciate this as a someone from New Jersey or who lives in New Jersey, he likes to do his terrible American accent. And his favorite thing to say is two bucks a slice. So he'll be like, I'll have some pizza, two bucks a slice. It's like really? That's so the whole time we were driving to New Jersey, when we were doing a road trip. He was like, practicing that. And I was like, I'm actually gonna die, right?

Scott Benner 1:13:48
Friend of mine told me one time, you are so close to being Jewish without being Jewish. It's fascinating. And I was like, thank you. Actually, because I'm adopted thought I was for a long time. Like, I felt like that must have been my lineage. Because if you see that, right, like it just was, it seemed obvious to me my whole life, right. And then it turned out like my adoptive mother was from like, the Carolinas, and she met a guy in like Pennsylvania. And you know, nobody can figure out who might adopt My my, I said, adoptive mother I should have I should have said, um, but so, my birth mother, thank you. I thought no one knows the birth father had never been able to do like the 23andme and see if you've done that nobody, nobody pops. I do have a tiny bit of that, but not enough to explain my chattiness and my hands moving all over the place while I'm talking. Yeah, I

Roxy 1:14:39
was saying to Zoey the other day, I was like she was she had made lot because and she was put on my Instagram. And I was like, Oh my gosh, what are you know, can you tell me the recipe? And we were joking about something. And I was like, Oh my gosh, I just realized one day if I have a kid I will be a Jewish mother. Like, that's insane.

Scott Benner 1:14:58
You are already just from the email. You're sending me. Yeah, exactly. I'm like Maggie, and I like to chat and yeah, you know, all of my really close friends are, are Jewish. And because I need somebody to talk to me as fast as I want to talk, I really need that.

Roxy 1:15:14
And you know, that definitely, like, translate translates across the Atlantic, like, my mother in law is definitely the quintessential Jewish Mama. And yeah, it doesn't matter. She has an English accent.

Scott Benner 1:15:26
I get hit on the front, I get on the phone with any number of my friends. And just like you can just say a word out loud, like COVID right? And an hour and a half later, we're like, Can you believe? Like, it doesn't end and you realize you have to get off the phone or this forever. Totally complain about the world and fix everything.

Roxy 1:15:46
There you go. Well, maybe that's Yeah, I mean, yeah, the New Jersey, not Jewish, but kind of Jewish vibe you've got going on. It's definitely it's definitely like, feels like home, let's say

Scott Benner 1:15:57
works for this podcast, that's for sure. Alright, so Roxy, we are finding ourselves in the situation where I have other things to do. And if I don't just stop talking to you, I'm not gonna stop talking to you. Well, that was very much fun. Thanks for having me. It was great to chat. I really appreciate you doing this. I really do. I this whole thing has been terrific. Like there are so many things inside of the podcast that I think could be their own thing like Samantha's like Samantha's like, trimester as she's pregnant thing. Like that's like, to me, that's like six hours of just great conversation about being pregnant with diabetes. That was fantastic. I get afraid it gets lost inside of this. But I there's no better way to serve this audio to people. So

Roxy 1:16:41
well. I think your your, like new initiative of doing the live boluses is pretty cool. Like, I love that you keep innovating and I love the stuff that's kind of been happening forever. But I also think, you know, the pro tips and it's it's all good. It's it's cool that you're keeping it moving and continuing to innovate.

Scott Benner 1:16:59
I appreciate you saying that I'm gonna make. I'm gonna get something out loud now. Right. So keep the timeline straight here. It's December 14 2020. People probably won't hear this till June 2021. But sometime in the next 18 months, you will see a large diabetes organization rip off my live CGM. I do. Hmm. Just like one of the bigger ones ripped off my day of diabetes idea. And I could list a number of other things. But I like being ahead of the curve. And I like thinking about how to serve I take it as flattery, right? Yeah, well, listen, if I wasn't, if I didn't have the next idea, it would make me upset. Like if it was my best idea I've ever had. And I never had another one. I'd be like, they're ripping me off. Like,

Roxy 1:17:46
you know, you're building the community where people feel safe to share that. Like, I never would have shared my agency before. Like, I never would tell people that it was totally private and certainly wouldn't want people looking at what I was doing. You know how my blood sugar's when we're moving. But after listening to, you know, the way you talk about it, and the people how open people are, it's sort of like, I think it's really essential, because you won't just get people out of nowhere to share their boluses. Like, you have to build that. So I bet that yours will work better than theirs.

Scott Benner 1:18:16
I have to tell you, you just made me feel very good with that last statement. I appreciate that very much I because it is my goal, like I am trying to I'm trying to do to people with diabetes, what my wife is doing to me, I'm just trying to drag you out of wherever you started as forward as possible. Before I divorce you. Oh, man, and can we have can we have your wife on the podcast, too? I really wanted to talk about that recently. She and I and she's like, am I ever gonna be on? I was like, Yeah, one day I was like, but right away. I just like, she's like the podcast is six years old. I was like, seems too soon. Still. You shouldn't you should just be like, when you need community service. You can. Yeah, if you have any community service, I will let you go commit a crime. And then I will know, I will definitely come on at some point. And now that I have the microphone, it'll be easier, obviously. So we'll see what happens to what you do. And yeah, thanks for chatting. Thank you. Hey, could you do me a favor? Sure. If I ever get bad at this, will you send an email and tell me I'm really not a Nike person. I don't I don't know.

Roxy 1:19:28
But you know if I can foster my Jewish inner Jewish mother, I promise I will do that. Yeah, no, maybe I should send you some more positive reinforcement when you do good things. Oh,

Scott Benner 1:19:36
that I've been married a long time positively. Reinforcing me just makes me feel like you know, I have cancer and I don't know yet. So don't Yeah, I feel like yeah, I kind of felt no, okay. Yeah, I don't I don't please, when women are kind to me, I get nervous. Like, why is this happening? What's happening right now?

Roxy 1:19:52
They're gonna Well, you know, constructive criticism is really only because you know, that you can take And that it helps. So yeah,

Scott Benner 1:20:01
without that, I have to be honest without the women in my life, I'd be 21 playing a video game somewhere. I love that you say that it's so funny. It was very true. Anyway, I thank you very much for doing this. I hope you have a great holiday. And here's a little bonus for you. Today's episode is with a type one who works at mission control at NASA. It'll be up in a couple of hours. It's a really good, so cool. Cool story. Rock on. Alright, have a good one. You too. Hey, bye. I'm gonna thank Roxy for coming on the show. She was a ton of fun and completing the circle. with Zoe, you know, you see that? And isarco I'm making a circle with my hands and asked me if you saw it. So obviously, I'm tired. also want to thank the T one D exchange and remind you to go to T one d exchange.org. forward slash juicebox. Last but not least, touched by type one.org. Go to touch by type en.org right now just see what they're up to check into their programs, their offerings. It's all they're asking is for you to look and see what they're all about. Touched by type one.org on Instagram and Facebook. He Wendy exchange.org. There's a lot of links, click on them and I'll see you later.

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#521 Drive My Car

Stefan is an adult living with 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 521 of the Juicebox Podcast.

Today, we're gonna speak with Stefan. He's had diabetes for a couple of years. It's actually an adult in grad school. So it's not that old. And he's not that young. But he is just starting to get used to type one. I love this conversation with Stephen. It's got a really interesting job, and some great insights. While you're listening, if you would do me the favor of remembering that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, I would appreciate it. And further if you'd remember to always consult a physician, before making any changes to your health care plan. were becoming bold with insulin that I would appreciate as well. I have a little time here. So I don't I want to remind you that the podcast is full of series, how we eat with different people's eating styles, defining diabetes, which are diabetes terms easily and simply defined in short episodes. That's with me and Jenny Smith, Jenny's a CBE, and she's had type one for 30 years. She's also with me on the diabetes pro tip episodes, which I think we should all listen to.

This show is sponsored today by the glucagon that my daughter carries, g vo cuyp open, Find out more at G Vogue glucagon.com forward slash juice box. We're also sponsored by the Contour Next One blood glucose meter if you're using a blood glucose meter, and I think that's all of you, you all have one, right? Please tell me you all have a meter. Anyway, if you're using a blood glucose meter, you want one that is accurate, easy to use, and easy to hold. If that's the case, look no farther than the Contour. Next One blood glucose meter. Learn more at Contour Next one.com. forward slash juicebox.

Stefan 2:17
I'm Stefan powerblock. Um, let's see 20 years old now. I've had Type One Diabetes for two years. I don't know I'm a mechanical engineer. And I'm a grad student while currently in grad school. So working on a master's degree well with Type One Diabetes, which is still relatively new to me. It's awesome.

Scott Benner 2:43
That's awesome. Well, first of all, let's put that degree into practice and get that sound to stop happening. I was still happening. You're talking I'm like, you know, for a guy with a mechanical engineering degree. I would think he could get that sound to stop.

Stefan 2:59
Man, she I unplugged it now. Maybe now I just got to stand like Stockstill. Are you talking

Scott Benner 3:03
with your hands? Or? No, I'm, well, I'm shaking my head. I don't know. Maybe that's it. Sorry. Don't Don't, hey, here's my direction. Don't overthink it. And please stop doing that at the same time. Just don't move. There's only been one noise. In a recent episode. It actually went up today that I found kind of soothing while I was listening to it. And it was someone. I put up an episode today with Shirley and she's from South Africa. By the time someone hears me say that it'll be like last year, probably. But there were crickets in the background. And I was like, This is lovely. Like, there's just this like, quiet blend of crickets behind me. And I thought the whole time we were recording I thought I'm going to leave this and this is great. And in the middle, I sat to edit it in every quiet space where she wasn't talking. I just chopped the crickets out. I hated it. Like this is like go and I'm just imagining myself editing your show six months from now. And just taking out the make me cry me cursing at you and you don't even realize. But but so you're 28 you're diagnosed and you're 26 you're obviously getting a fairly advanced degrees that are going on for for some time, your professional student at the moment or do you work as well? I work full time. Geez, what are you super smart? Stefan? What's going on her? Oh, heck no. Are you kidding me? That's my assumption. If you can go to grad school, be a mechanical engineer and be working at the same time that your three brains and they're all working simultaneously. What How do you find yourself doing that? Are you just Is there something you're striving for? Do you like being in school? what's the what's the draw?

Stefan 4:43
Oh, yeah, no. So my my undergrad I loved my undergrad. And I just wanted to continue. You know, I was thinking like research in the end item. I'm an automotive engineer specifically. And you know that space is getting more and more interesting. As time goes on with fully electrics and hybrids coming out, so

Scott Benner 5:04
yeah, do I want a Tesla truck? Stefan Yes or no? What do you think? Ah, depends on if you like the way it looks. Here's what I want. I'm going to be 50. So my wife tells me I'm going to be 50 in the summer, which is now not a running joke throughout the years of the podcast, but just a really great indication that I lose track of my age every once in a while. So I was really sure I was going to be 49 Kelly tells me I'm going to be 50. I did the light math. I think she's right. So I'm sure we could do the math together if we needed to, but I'm pretty sure she's right. And I found myself thinking, I want to own and drive daily an electric car, even if it's just once just to have the experience. So I don't know what one would be affordable for me. But I definitely just want the experience one time, I don't even know if I like it or not. just seems like it seems like the world took a big leap ahead. And I'd like to, you know, I'd like to walk alongside it for a little bit and figure it out. I kind of similarly have thoughts about rap music. That I don't understand that I'm still like, this is a very popular, I should try to understand this. Oh, yeah, no, you should. Absolutely. Right. You know, I don't want to be that old guy who's just like, that's not how we used to do it, and then sit down and just watch reruns of football games from when I was 30. I want to try to keep up a little bit. Tell me, can we go into your job a little? What do you do? That's I find that really interesting.

Stefan 6:33
Yeah, so I work with internal combustion engines. So they all run software, basically, that tells the car, like, how it's running, what it's doing. So I calibrate that.

Scott Benner 6:48
If I gave you a 327, small block out of a 60s, Chevy, would you have the first faint idea? How it works? Or what to do with it? Like, do you have to learn it from the ground up? Or can you come into something like this, like, do do classic combustion engines really not exist anymore in someone like yours thinking?

Stefan 7:08
Well, so the the principles have remained the same, right? So you just have spark air and fuel that hasn't changed, but the way it works? Now, you know, with electronics and fuel injection, there's sensors on everything, hardly anything is really mechanical anymore. It that's definitely not something that you can just jump into. I mean, I'm not even two years into this job. And it's like, it's like the learning curve is so steep, everything's a whirlwind every day. It's like, you feel like you're drowning and slowly clawing your way out of some hole. And you still and then, you know, you go to a meeting with all these other people, your managers, your supervisors, and you realize that they are head and shoulders more knowledgeable than you. It's pretty incredible. Just you start feeling the sunshine on the crown of your head coming out of the hole. Someone just jams you back down again. Yep, absolutely.

Scott Benner 8:04
That kind of sounds like diabetes a little bit. Yeah, learning curve on diabetes, like, Oh, I think I'm getting it and then all of a sudden, your honeymoon and you're like, Oh, I didn't understand this at all. And yeah, I just got a note from a person who, this morning. And it's a mom of a younger boy. And she's like, I don't understand, like, everything I do doesn't work down. I was like, yeah, there's not enough insulin. She's like, why not? I was like, I don't know. Like, you definitely need more though. And, you know, you got to, you know, keep turning it up. like something's changed the kids growing, you know, puberty. I don't know what, you know, I have no idea. But obviously, you're right. It was just interesting how she was thrown right back to where she started. And even though she had all the tools to handle it, the one leap she couldn't make was the more than doubling of the Basal insulin. There's something about 100% in people's heads that make them feel like that's the biggest number in the world. So if your Basal insulin, what's your Basal it's on our currently about 30 unit today. Okay. Hold on a second, divided by 24. All right, that goes on once Oh, boy. Here we go. We've six I'm getting to it. I've already read like one probably like 1.3 an hour or something like that. Right? So I'm like that. So if if your needs suddenly doubled, for some reason to three units an hour it that stops most people like they could somehow understand if it went to 2.6 but there's something about more than doubling were interesting enough if they've set a max bazel range in their pump, which is usually just done for safety reasons. Like you have a max Bolus and Max Basal right if they've set a max so you know the doctor says look your bait your your kids basil rate is point two. So I'm going to set the max basil it I don't know One, because we don't want you to mistakenly give the kid two units an hour, right? And then a couple of years later, suddenly the kid needs 1.5 an hour and they hit the max, it stops them. Why is that? Stefan? Why am I asking you? And why is that? I don't know. But I totally get it.

Stefan 10:17
I mean, I remember Oh, man, when I, when I saw when I first was diagnosed, sent out of the hospital, like, Oh, we could go into that experience, too. Because, wow. Like, I don't know, if it's different when you're younger, or Well, it's gonna be different, right? Because I think your parents get the download of knowledge versus you. But like, for me, it was like, here's a book on diabetes more catered towards type twos. Here's your insulin, take this much. Good luck. You know, yay,

Scott Benner 10:50
they probably thought you're an engineer, you'll figure it out. Oh, my God. Heck now. Well, that's interesting, too, because there are segments of people that I see handled diabetes differently. I've been saying this a lot lately, but nurses who are parents of children are kind of traditionally not good at it originally, because there's something about their training that doesn't jive with how diabetes is actually managed day to day. And so they hit this kind of this firewall, but engineers seem to really get it in a different way. And most of them can put it into practice eventually, but it takes them a little longer. It's just very interesting getting to start meeting more and more people who fall in the buckets. And to see the similarities between them. It's so I imagine one day you're a one C will just be 5.3. And there'll be nothing you can do that will stop that from happening.

Stefan 11:43
But I can only hope I can only hope. What's your setup? What are you using? So I'm on deck, I have a Dexcom. And then I'm on the tandem t slim

Scott Benner 11:53
XCOM. And t slim. Got it? And are using an algorithm with the T slim or no?

Stefan 11:58
Yeah, I have the control IQ set up on there. Is it working? Yeah, yeah, it's working. There's some cheat that I've had to do, you know, off the book, to get it to work better for me.

Scott Benner 12:13
You want to share them with me? is one of them. Leave it in sleep mode all the time. I

Stefan 12:16
hear people talk about that a lot. Absolutely. 100% This thing is in sleep mode.

Scott Benner 12:21
Why what what's the difference between the two.

Stefan 12:24
So I don't know, I was finding that in normal mode. So in normal mode, it will give you those correction boluses those mini correction boluses. But by the time you get them you're already at like 180 or above. Whereas in sleep mode, it kind of it jams your range tighter. So I don't remember the exact numbers, but I won't let you go above a certain amount. It will but you know, it starts to feed in more basil above a certain amount, and then take it away a certain amount. And those numbers are tighter.

Scott Benner 12:59
I it makes me feel like this is conjecture completely. But it makes me feel like they were looking at the algorithm. They're like, Alright, well, this works. But we'll call this sleep mode because it works really well. It'll be more aggressive when you don't have foods we can keep somebody lower and more stable like this. We probably should just call it more aggressive mode. But we won't do that. We'll let people figure it out for themselves. Like Don't you feel like there's two settings like one for everybody and one for the people who want to be like aggressive?

Stefan 13:29
Yeah, it's it's like, normal mode is like the wonky line mode. And for me sleep mode is the let's keep it nice and straight. No, no.

Scott Benner 13:38
That is that simple. Like so you get the rises that food in normal, that take forever to come back down. But then when they do come back down, they come back pretty level.

Stefan 13:48
Yeah, in sleep mode, if I'm in normal mode, I'll get those rises, then it'll do the correction Bolus. They won't move. It won't move. It won't move. And then, you know, inevitably I pick up the pump fiddle with it. give myself a Bolus. And then like, you know, turned around and I'm in the 50s.

Scott Benner 14:03
So for you normal mode should be called What if I only ate 30 carbs a day mode? This would be great. Alright. Normal mode, or please don't have a slice of pizza mode. Right? Don't you even think about that Chinese mode? What did you want them? What again? No, no, no, no, you need sleep mode for that. Right. Anyway, that's why I think they should go back to you know, ridiculous speed. What was that movie that oh my god. Do you ever have half a thought pop into your head, but not the whole thing? That just happened to me? Oh, you mean? Is it Spaceballs? Where they have plaid? And then ridiculous. It's Spaceballs, right? I think so. Yeah, ludicrous. speed. It's ludicrous speed. There you go. I was so far off on all of that. My God. Someone will email you know, that was wrong. You know, there's part. So there's part of you that's like, oh, people are listening. Like it really feels good. And then there's part of you. That is like, please leave me alone. I gotta get you to get your phone to stop. Beeping. Can you do that?

Stefan 15:08
Yeah. Sorry. Give me one second. Listen, do whatever you have to. Yep. Well, you're gonna hear the wonderful swish noise. That's fine. Oh, you know, it's not my phone. It's actually the you can hear iMessage

Scott Benner 15:23
Yeah. Wow. So ready, top left corner, apple, sell System Preferences. Yep, sounds, sale. Under sound effects, play sound effects through headphones, turn the volume all the way down. Play sound effects through headphones, see the slider for alert volume? Yeah, just turn the volume all the way down the slider all the way out. Oh, my God, that's amazing. That's what I was talking about, about, they only want you to use these things if you really, really want to use them, because it took me about four hours one day to figure that out. Just like people asked for transcripts of the show. And I'm in my third month of adding transcripts to the website. And the process is just arduous and painful. And it takes up so many hours. And I'm almost done. And if it doesn't help get a scrape. Like if some if I don't get an email from somebody media is like, thank goodness, you added transcripts to this show. I'm gonna be pretty disappointed, I guess. And if you're doing that, then I got to see the ones for this one, just like bing, bing, bing. That's a lovely. So what I was, I guess what I was getting at is it's interesting, right? These algorithms are coming out. That are being you know, our news is loop right now. But we're super excited to use Omni pod five. But there is that part of you that's like, I hope it's gonna let me be aggressive. Like I want to be aggressive. Like I hope it doesn't. And I can't see how they don't know that. That there's probably two different segments of people using it. But anyway, that's what I think of when I see sleep mode. I think sleep mode to me seems like, yeah, here, here's your cheat to be more aggressive. We'll call it sleep mode. But it sounds like it works great. It really does. I think algorithms in general, are. I don't even know how to say it. But but for people who have pomps, who can afford glucose monitors, that whole setup. I can't imagine anybody wouldn't want it. At least from my perspective. Jenny and I were talking the other day. It's December right now 2024 perspective. And Jenny and I were talking about, I was telling her what I wanted to do with her in 2021 on the show, cuz she only has a limited amount of time. And you know, we're trying to figure out how to use it. And then I started talking about what I want to do in 2022. And she's like, are you planning for two years from now? And I was like, Yeah, because everyone who's paying attention to algorithms and pumps is super excited for it once it today. But the majority of people don't know what's coming, don't know what it is and wouldn't use it if somebody told them. And so I think of it as a an education process that will go on for years. Really, you know, I mean, just keep in mind that right now more people use MDI than use pumping into in 2020. And not that I'm saying you have to use one or the other, I'm just saying that the adoption of things is very slow. And that there's an argument to be made, that you're really only reaching newly diagnosed people because people who are settled with something that they believe is working, are very, very, very scared to change. So and change has to be super simple. And I mean, honestly, Stefan, was it super simple to learn how to use that Tucson? Oh, yeah, absolutely not. That's what you want. Right. But now people have to believe that that's true. So I think that's a bigger hurdle is reaching people who are already set. And, and making them believe that it would be reasonably simple to change to something that would end up being monumentally better? I don't know. That's, trust me, that's a harder thing than then you might think.

Stefan 19:13
And probably some of it, too, I think maybe comes from maybe, you know, distrust of computer algorithms. But like, from my perspective, it's something that I work with all the time, like you would be if you don't like computers, and you don't think that, you know, they can do stuff, then man, you want to stay away from cars, because everything that we do now for how the engine works is run through a computer and we build model after model after model after model with it. And it's absolutely incredible. I mean, you can give it you know, back to, you know, engines again, you can give it a certain amount of air a certain amount of fuel and this model will tell you Alright, here's the speed you're at, you know, here's how much torque you're making. Here's what You need to do with it.

Scott Benner 20:02
When you know why the car I have currently has collision avoidance, right? And so when you're buying it, the guy says his car is collision avoidance. And I'm like, what does that mean? He goes, Well, theoretically, you shouldn't be able to drive into a brick wall. And I'm like, say it again. And so he's like, I think he goes, I think, right? I think if you went outside and drove at the building, the car would stop. Even if you had your foot on the gas. And I'm like, should we go try that? You know, I think it's like, I'm up for this, you know. And he laughed a little. And he's like, it's a new feature. I honestly, I've never talked, anybody's used it by law. And the number of months later, my wife and I went to DC, actually, to see yo yo ma play. And we were coming home, and I was getting back up on the highway in a place I'd never been before. And it was this sort of long on ramp that merged up onto a roadway that of course, was that was over my head. So I couldn't see what was ahead of me. But more importantly, you were coming through trees on your left, so that you couldn't even see what was coming from behind you. So I'm picking up speed, picking up speed thinking I'm about to merge onto this, you know, probably fast running highway. And as I'm coming up, everything is just stopped in front of me. And I take a split second to see Can I just get over now. So I checked my mirror, I realize there's a car there that I can't get over. And I'm making the decision to put my foot on the brake. And everything in front of me was closer than I thought it was. Now I want to be clear, I believe I would have stopped the car. Like it wasn't that it wasn't like the car was eight feet in front of me. But before I could get my foot off the accelerator onto the brake, I could feel the break get sucked out from underneath of my foot. Some alarm went off in the car. And it came to an abrupt stop it never tailed it didn't fish tail, it just room and stopped. My wife yelled, what was that? I was like, wow, this car really can stop itself. And that was pretty much the end of it. It was startling. But it was fascinating how well it worked. You're telling me that that was done with a computer algorithm? And little and little cameras?

Stefan 22:17
Yep. Little cameras and a computer algorithm.

Scott Benner 22:20
No kidding. You understand how that works?

Stefan 22:23
Not quite, because that's not that's not in my department. But I mean, so I don't know how deep you probably not that deep. It's basically looking at how far away what's in front of you is how close it's getting and how quickly it's approaching. And then it makes that determination. Oh, there's a car there. Let's break and there's no, because this guy's not doing it.

Scott Benner 22:45
So there's a drop dead moment where the algorithm decides if we wait past this line. We're not we're gonna hit this thing. So I'm taking over now. I don't I have to tell you it worked spectacularly well. And when I the next time I went in for service to guys like any problems the car and I recognize them. I was like, No, but hey, interesting story. And I told him about yo yo Ma, not about the concert, but about coming home from it. And he said that really worked. It was funny, how astounded. He was the salesperson, like wow, that really worked. And I was like it worked. I said, I don't know if I was going to hit them or not. I don't think I would have crushed the car in front of me. But I do think I would have impacted it. You know what I mean? And and so what you're saying is, if we can do that, then an algorithm can definitely change your Basal rate with a little bit of predictive information. Yeah, Yeah, no kidding. Yeah, it's super, I can't imagine. Listen, I'll tell you that Arden started using. So again, I have to say, poor Arden, I imagine I'll die one day, Stefan and my children in a way to connect with me. We'll go back and listen to this podcast. And then Arden is going to start making a tick sheet on the side every time she heard the words Arden's period. But Arden gets her period too long, right, she gets it for too long. And sometimes it's heavier than it should be. So we made the decision at the beginning of her last period to put her on a really low dose of birth control pill to see if the hormones couldn't regulate this like no lie today. She came in and said to me, I'm not bleeding anymore, but I still have a little bit of blood. And this is the 11th day of my period. So by the time this ends, she'll get like a week's respite, and it'll come back again. So she's not just getting it for too long, but she's sometimes getting it twice in a month. So anyway, a very reasonable reason to try this because we've done a lot of other things that haven't impacted so we're trying this Arden's basil rate right now is a unit and a half an hour since she started taking the pill, but was point nine an hour before the pill and It took me a day or two to see that, okay, the pill started to impact or that my settings weren't going to, to be able to overcome this. And I just zoomed, I zoomed it right up. And I have to be honest, I just looked at the graph. And I was like, the outcome I'm having here to me seems like she needs about a half unit more an hour. And I threw it in and saw what happened, I then turned her insulin sensitivity stronger. by a couple of points, I think we went from 42 to 40, maybe. And she's very settled. Now, like her blood sugar has been like 88. For, I'm going to lock it because I've been astonished how long it's been since I made the settings. So I made the setting changes last night around nine. It took until about three in the morning to work. So from 450 this morning till now, which is now like 1230, in the afternoon, her blood sugar has been between like 80 and 95. So my new settings are working. And now I'll make decisions about carb ratio at meals, like let's see if that changed or not. That'll be the next thing. But point is, because of the algorithm, I really was just pushing up gently on some levers, basically, just I'll just make this stronger. And I know this is going to work. I don't know how long it would have taken me to figure the same thing out without an algorithm. I'm guessing about three weeks what it took me. So I think they're just astonishing. And really exciting. Come Yeah, got Oh,

Stefan 26:35
no, no, I was gonna say and once you get over that, like, initial fear of changing settings to I think that, yeah, it the algorithm coupled with, you know, that willingness to experiment safely. Like, that's that that was a game changer for me, you know, like listening to this podcast, kind of the, you know, deciding, yeah, let's be bold, and, you know, like, so my first big change was, I don't know if it was the end of the honeymoon or coming like out of. So I was diagnosed in March. So coming out of the winter and into the summer, like I was having, you know, I was at initially maybe nine units of basil a day. And I was going low, like crazy. And then I pushed it down to four, you know, and slowly it's been creeping back up. So you know, that I remember that first change was like, let's do this, see what happens. And then the next change when I went back up, that that was really scary, like, you know, from four units, then to, I think it was like, I doubled it to eight units a day. And now here I am at like, 30.

Scott Benner 27:43
Yeah. And can you imagine if you were stuck in your head with like, we'll try moving at 20%. And then wait a few weeks and see what happens. And then try it again, we would take you years to get to where you are right

Stefan 27:56
now. All the while you'd be raging at people with your high blood sugars and lows and not having a great time. Well, and not

Scott Benner 28:03
only that, but I'll tell you that the the weird cyclical, merry go round you get on is that you push the basil up not enough. So your blood sugar gets high. So you make some grand correction to your blood sugar at some point, which drives your, your your blood sugar low, then you show it to your endocrinologist who sees a bunch of lows throughout the day. And you know what they do? They make a base agent, they take your basil away, because like, oh, you're getting low all the time, we'll make your basil lower. When the truth is, you need the basil higher, so that you have better results around meals. You're not rage Bolus and high blood sugars, not creating adenomatous deficit of insulin away from active food in your system crashing low. And that's that's it, it literally the outcome tricks most people into doing the exact opposite of what they're supposed to do. You need more basil so you don't get high so that you don't have to over Bolus so that you don't crash low, not you're not getting low because of the basil, you're getting high because of the basil being off and too weak. That is I'm always astonished and how even doctors don't get that like because I get to hear from a lot of people. I'm not saying all doctors but I get to hear from a lot of people who are having incongruous experiences between the podcast and their doctor. And the doctors trying to push their basil down while the podcast is leading them to believe that they should probably have it a little higher. And you can't make those people believe that you just can't. It's impossible for some reason. And then you get stuck, you know, and it's a it's a stock that could could be on you forever. It's really yeah, sad, you know?

Stefan 29:52
Yeah, I mean, it took me I think I rotated through two endocrinologist so far, like the first one was I was like, No, no, I got this. It's my steering wheel. You know, it's your diabetes, but my car that we're driving kind of a thing is it was a little odd.

Unknown Speaker 30:08
As I use that metaphor, yeah. Oh, well, it sounds fun.

Stefan 30:15
But, uh, and then that my second endo, she was like, you know, I want to work with you. Let's see. And then, you know, three months later, I was like, No, you got this, you know, keep on keeping on with what you're doing. Excellent. And that was like that. For me still being new at this hearing, you know, the, like, You got this, you can do this, you kind of know what you're doing. That was like really big, really, really big confidence booster. That's not to say that, like everyday is perfect. Some days definitely suck. But yeah, I know, I

Scott Benner 30:52
know. I don't know if I ever said it here. But I'd say to people a lot when I'm speaking to them privately. And you know, at the end, I'll say, look, nothing I told you, while we were talking today was advice. Like, I'm not a doctor. And please don't take this as medical advice. I said, but I can give you one piece of advice. I say, I think you understand this better than you believe you do. You should trust your gut a little more. And basically, it's like a verbal pat on the ass. Like before they run out on the field. Like, I think that's something that people desperately need at times, which is just the idea of like, maybe I am right about this. Instead of living in that flux, where the information coming from your physician is so different than what you're seeing in your real life, that you just make the assumption that you're misunderstanding what you're looking at. And it's so frequently the opposite. Although there is a kind of inverse to that, which is, when people are making decisions with their settings are so far off, I do tell people a lot. Look, we just made a big change to your basil, a big change to your carb ratio, we've changed the sensitivities, you're going to start seeing things. And you're going to try to apply what you know about diabetes. And what you know about diabetes is often completely wrong. Because your settings were so wrong. You're having these outcomes, not unlike the low Basal causing low blood sugars, the kind of thing you've been having these outcomes for so long, you don't understand what you're looking at anymore. I sometimes say please just forget what you think you know, and start over from day one. Now that your settings are much closer to where they need to be. You know. Anyway, a married dating. No, single Good for you. No dog, no dog. Look at you're really listening to this show. I appreciate that. Tried to joke about this with my wife's somebody that my wife worked with over zoom the other day when they were kind of talking at the end of the meeting. And Kelly just says it all wrong. She's like Scott tells people don't get married till you're 30 and don't get a dog for sure. And try not to have kids. My kids are in the room. My dogs looking at me. My wife's there. I'm like, it's not what I mean. Exactly. I'm saying you don't really know yourself into your 30s dogs are a lot more work than you think they are. And you know, the kids think I'm joking about because I love having kids, but they really don't pay back in any tangible way. It's all very feely, you don't I mean, if you're looking for a boost from having children, it's it comes in ways that you can't trade in for other things, just in case you're wondering. But but that's uh, you sound like you're hard at work. How do you work full time and go to

Stefan 33:37
school? Ah, it's time management, which I'm terrible at. It's it's kind of it's a haphazard I think, for me. Yeah. Like, if I manage my time, then I make a plan and then I find 50 ways to kind of blow that plan up. And I excuse it all. So it's it's the it's haphazard,

Scott Benner 34:02
you know, for sure in the 70s people would call that common sense. And in the 2000s here, they would tell you have ADHD. Right? I think not working makes a lot of sense. I'm always looking for ways to get away from this. And by the way, this Coronavirus thing has been terrible because the days are blending into weeks. And I'm in the hours. I don't even care about the hours anymore. So I'm doing these things were like at nine o'clock at night. I'm like, well, I've done everything I meant to do for today. I just sort of restart the next day I'm like well, I guess I'll go work somewhere like I can edit a show for next week I guess or instead of just taking time for respite because there's no respite because my whole life is respite. It's just I'm all in this house. The house doesn't seem like relaxing home base anymore. Does that make

Stefan 34:54
sense? No, I get that there is like no more. I think work life balances is is not a thing. Any more?

Scott Benner 35:00
No, no 24 hours a day, you just put stuff where it fits. And I'm not 100% Sure, it's a bad idea. But I don't know how it would work. If the world opened back up again. I could say like, you know, go outside or go do different things. Like the other day, I was driving past this thing. And it was like an indoor indoor skydiving, I was trying to imagine it must be fans blowing up from the floor. I don't know. I was like, Yeah, I would do that. And then I thought, well, that's not going to be open. I can't do that. And by the time I can do it again, it's probably gonna go out of business. Right? Like, how is that gonna make it through a year of not operating? But yeah, it's something about the home, like my home has become. This, this is close to what I imagined it must feel to live on the International Space Station, I guess is just sort of like everything's utilitarian at this point. You know, well, how does how does? How long did you have diabetes before your algorithm?

Stefan 36:01
So I, before I started pumping, I was on MTI for a year.

Scott Benner 36:12
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The word meter has a number of different definitions, the rhythm of a piece of poetry, the basic pulse and rhythm of a piece of music. It's a unit of measurement. And it means a device that measures and records the quantity degree or rate of something. That Contour Next One blood glucose meter is a little bit of all that kind of smushed together, it's a little bit of poetry, it's got a lot of rhythm, it's definitely going to measure the glucose in your blood. And it's going to measure it very accurately and easily. And whilst doing it, it's gonna feel nice in your hand, and the lights gonna be bright, and soft and loving. I don't think the light is loving, but it does really illuminate where you're trying to get blood from at night. so damn handy. Seriously, though, there are a lot of meters available. Very few of them are actually accurate and easy to use, I think you should take a minute to look at Contour Next one.com forward slash juicebox, just to see if maybe you maybe picked the wrong meter. And now you'd like to update yours with the better one, which by the way may be cheaper in cash than your current meter is right now through your insurance could be true for the strips as well, you may actually be eligible for a free meter. And they have a test trip savings program. These sound like things you should know about. And that's why I'm here to tell you about them today. And to ask you to go to Contour Next one.com Ford slash juicebox and educate yourself. You're carrying a meter anyway. You might as well carry a really good one. What are the main differences between the first and second year?

Stefan 38:40
So for me, it was flexibility. That was the big one. Part of my job is driving cars around, you know, testing them and like it was, for me at least it was very, very scary. The thought of having a low when I was on MDI and driving around, because I was on MDI and I also didn't have a Dexcom I was doing you know, finger sticks. And you know, the thought of being on a test track at 100 miles per hour trying to calibrate a car and your blood sugar goes low. And you know, by the time you go low some sometimes those lows on MDI would happen like that. Those would be like crazy scary, because, you know, I was honeymooning too. So, you know, get in the car test here. I'm at 150 Okay, that's fine. I'm not gonna correct it. And then you know, 15 minutes later that 150 take the one away. You know, here's a 50

Scott Benner 39:36
your pengurus decided at one to work again. And yeah, there we go. squirt a little more in. And oh, wow. So what did you do in that situation?

Stefan 39:46
For the ones that I would feel like I'd feel them at 50 it's, you know, pull over pound some gummies fruit gummies and then just wait.

Scott Benner 39:57
Do you ever get done and go look at your notes and your notes said you Equals Mickey Mouse and you're like, oh,

Stefan 40:03
like, yeah, it was bad. Like, I would look back at what I was doing or whatever. And I would have like no idea what I was thinking. Like, even in meetings if I go low in a meeting, it's like, I'll email everyone afterwards. Like, I apologize. I was rambling. I have no idea what I was saying. I must have sounded really stupid. Don't pay attention. Please.

Scott Benner 40:24
If Christopher Columbus had pistons, let me tell you something right now, where we be. And they're all just messaging each other like in the room. Stefan's blood sugar's low. Should we do something? What the hell is wrong with this kid? Again, this guy would the Columbus thing. You won't let go of it. Well, that's frightening and not funny at all. By the way, just the idea that you know, you could be I mean, honestly, you're incapacitated, but you don't look so. Right. Right. Yeah. And then the next step from that is, hey, did anyone else see Stefan have a seizure today in the meeting that you know, you don't? You're trying and I guess you're trying very desperately not to be thought of that way at work as well. Right?

Stefan 41:09
Yeah, yeah, that's so um, I am one of two type ones in our department. I only ever knew this one other, this one other co worker, and I knew him before I was diagnosed. So now there's two and yeah, I just don't want to be stuff on the diabetic, you know?

Scott Benner 41:28
Yeah, I feel that I very much. use that as a guiding light. When Arden was younger, I didn't want Arden to be the little girl that passed out at school. You know, and at the same time, I didn't want her to be walking around with these insanely high blood sugars.

Stefan 41:47
Right. And I mean, like, the other the, my coworker, too, you know, it's before I was diagnosed, people would talk about how he's, he's had episodes at work. And, you know, people don't know what to do. They just kind of like, what they found him seizing at his desk, and they had no idea what to do. So they just call 911. And by the time, you know, they came and gave them his glucagon. You know, he lost three months of memory. Wow,

Scott Benner 42:17
really? Oh, that's terrible. Oh, he just killed me. That was really terrible. That sounds like it went on for a very long time. Yeah, yeah. And and he had never, and probably for similar reasons that you just described, probably didn't want to tell people like, Hey, listen, if this ever happens to me, because it freaks people out. You know, hey, if this ever happens to me, can you just open this red box, and there's a needle? Yeah, now the needles pretty big. Don't let that bother you. You're gonna squirt the water into the powder. Now I want you to take the powder in your hands and rub it back and forth dissolves. Now we're gonna redraw the powder out into the needle. I just like you to stick this in the deepest part of my ass and push this plunger down. And then and by the way, please don't pay attention to the needle because it's gonna hurt me. Not you. Yeah. Blah, blah. Meanwhile, I'm holding a demo of the G vote hypo pen right here. And I see why that was a good idea. I just kept it on my desk. For some reason, after I was talking about it one day, it just reminds me of what an amazing idea it is that it's just cap off, pushed down, done like that. That's the kind of thing that you need, especially in that stream. Because imagine if your co worker could have said to somebody, hey, listen, I've got this pen here. You know, this should ever happen. Just you know, anywhere. Just hit me with it real quick. And it will save them. Did he have any other long term deficits?

Stefan 43:36
Now now it just took them a while to kind of remember like who he was and what he was doing at work. Wow.

Scott Benner 43:44
Hmm, yeah. So now that sticks with other people, and then they never let go of it. And then like you said, You're all of a sudden your stuff on the diabetic and expectations for you are lower, unnecessary, you know, unreasonably so? Or you're stuck doing a campaign of, you know, education throughout the building to bring everybody else up to speed. And I mean, how are you going to do that? Even? You know,

Stefan 44:07
yeah, yeah. Good. Yeah. So reasonable concerns. Absolutely. Yeah. And now and to is it was MDI was just, yeah, the lack of flexibility. Okay, that's what was killing me. But at the time, when I was on MDI, it was definitely the more affordable option because I didn't have insurance when I was diagnosed.

Scott Benner 44:32
Oh, because you were still a student and you just got this job not that long ago. Okay. Yeah.

Stefan 44:36
aged out of my parents plan. I you know, I thought I'm healthy. I don't care. I can wait until my job kicks in. I don't need health insurance.

Scott Benner 44:45
Yeah. Yeah. Teenagers. Then your pancreas kicked out. And then yeah, yeah. So you were just so when you talk about that you didn't have a job at the moment, right, but you had diabetes.

Stefan 44:57
So I was I was still Working the same place I'm working now, but I was a co op, I say,

Scott Benner 45:03
okay, so no insurance yet. Right? And so how do you make those decisions? So you've got you have an income, but you don't have insurance, you just get the needles and the insulin and that's it some cash

Stefan 45:15
trips. So what really so I say, I don't have a dog, but now you can hear my sister's dog.

Scott Benner 45:22
Don't feel like you have to explain your lies to find just tell me about this.

Stefan 45:27
So yeah, for me, it was honestly I like, Oh, man. This is gonna sound so silly. But like the first script that I got out of the hospital, I completely like broke down crying. So like 27 year old in the hospital crying like in this nurses lap, basically. Because that that though, was $700 for a bottle of Lantus and one, vial of humor log, and then some syringes. Honestly, what I did, I relied on my endo for samples. I explained the situation and it's like, I you know, can you samples?

Scott Benner 46:13
samples? samples? Yeah. Put your hands out, please. Yeah. Because $700 was not something you had?

Stefan 46:23
No, not not. And that was, you know, $700 a month.

Scott Benner 46:27
Right. But would that have done? So be clear for a second net without telling us your net worth or something like that, but, you know, a large chunk of your monthly income $700? And yeah, what would you have had to Did you have anything big enough in your life to cut out to make up that money? I don't even imagine you did.

Stefan 46:45
At the time. Yeah, that was that was huge chunk. I mean, I could have given up my like my car, but then I wouldn't be able to go to work.

Scott Benner 46:53
Or your I'm sure all of your charitable giving, you could have just cut back on. Yeah, I do wonder what they think when they're like, it's just $700. Like, what do you think I'm doing over here? Exactly. Right. I just stopped writing my big check out to United Way like I always do, and it's a it's a it's a very strange space when you are one of those people, the people who are not covered by insurance, and don't have just scads of expendable cash, I don't know anybody that feels like they have scads of expendable cash. My brother and I were talking recently, you know, in our, our financial structures are pretty different from one another, but in the end, at the end of the month, he's got no money leftover and I got no money leftover. It's just, you know, it's it's not like, it's not like suddenly you make a little more money. And while we it's it just sits in a pile at the end of the day, you know, yeah.

Stefan 47:48
And, you know, I coupled that with like, student loans and, you know, living by myself, I moved back in. Yeah. With my parents. That was the only way I could make this work. These weren't and then, and then it's not only that $700 a month for the insulin, it's the hospital bill. Yeah.

Scott Benner 48:05
Yeah. How much was that? Do you remember? Oh, man. 300,000. Okay. Yeah. Hold on a second. So, after you filed for bankruptcy, tell me what a $300,000 hospital bill first you negotiated it down, right?

Stefan 48:21
Yeah, yeah. Well, they there was some. I remember like in the ICU, they were trying to give me like, there was heparin shots every day. They were trying to give me these like laxatives. I have no idea why.

Scott Benner 48:37
Because they were $1,000 a pill.

Stefan 48:39
Yeah, like the nurse would come in. She's like, a heavier heparin, and I have your laxatives, I'm like, What do I need that for? You know, go away?

Scott Benner 48:46
Yeah. You know, I, um, when my iron got very low. A couple of years ago, I took myself to the emergency room. Now, the oddity was that I had been working with a physician for almost a year, we were just up to the part where I was about to get the iron infusion, and I almost fell over. So I ended up in the emergency room. And they kept me overnight, which I was like, fine with. And the next day, this woman walks in the room like, Hi, I don't know you. She goes, I'm the neurologist. I'm here to check you over. I'm like, no. And she's like, well, you almost passed out. I'm like, you need to get out of here. I was like, my irons low. And she goes, you have insurance. And I went I don't care. Like get out. I was like No, like, don't I get why they were doing it. And I even get that I wasn't gonna really it wasn't gonna hit me out of pocket. Like maybe it would ended up costing me $50 more to have her do it. But I'm like, I'm here because I have low iron. I almost fell over because I had no ferritin in my body whatsoever. And my red belt blood cells were not carrying oxygen any longer. So I don't I'm good. And and then she was literally on the heels of a cardiologist who wanted to do an EKG and I was like, No, like, I mean, who else is out there trying to get paid is how it felt like you don't I mean, like I was like, is it Is the candy striper gonna come in and tell me about our Etsy store in a minute? Everybody get out of here, you know, like I got the iron I'm leaving now.

Stefan 50:10
Oh, yeah, no, absolutely. It was like the guys at the endocrinologist that I saw for 15 minutes a day sent me a bill. And I was like, You didn't even like talk to me. You just said you're doing well keep it up. And then the diabetic educator would come in and let's go through your booklets

Scott Benner 50:25
Way to go, buddy. That's gonna cost you three grand. Oh, yeah. We I used to have a joke. I would tell my wife, I was like, I think the endocrinologist only touches Arden once a year, because there must be a law that she has to physically contact her. Because, you know, we, you know, our visits are always with her nurse practitioner. Yeah. And it was like that for a long time. And the doctor never came in. But once a year, the doctor would come in and literally, like, put her hand on her shoulder or something. And I'm like, I think there's something going on here that I'm not aware of. And then we'd see her once here. Now the The hospital has now changed since then you actually see the doctor at every visit now, which was not the case in the past. But back then. That was always my thought. I'm like she's just touching her so that she can legally say I touched her. Because she didn't do anything. Like she was just like she'd come in and put her hands on her somehow. And then ask her how she was feeling. And then look at the chart and go oh, you're doing great. You have any questions? Yeah. Yeah, what I know the questions they asked, by the way.

Stefan 51:28
Yeah, I totally get that too. I say endocrinologist. Like I've been moving around endocrinologist. I think I've met the endocrinologist once, and it's Yeah, it's been the nurse practitioner who helps me.

Scott Benner 51:38
Yeah, no, no, the whole system's a little weird, obviously. But yeah, it's just, I'm always baffled when they're, they're like, do you have any questions? That would be like, literally, if you put me on a rocket, and you were like, hey, you've got to figure out how to fly this rocket to the moon. Go ahead and ask your questions that will get you to that end. Right. I'd be like, I don't know what questions to ask about that. Because I've never flown a rocket before. And by the way, spaces in my head a lot, because I'm going to interview April next week. And April works at NASA. And she was super excited for that. That's so cool. Yeah. But anyway, I guess that's just in my head for some reason. But yeah, I am. I'm fascinated by that. Like, what questions do you have? Like, could you not like if, if, Stefan, I'll tell you right. Now, if you put me in a room with somebody who was just diagnosed with Type One Diabetes, I would not need them to speak. And I could, I could have them leave that room better off than they were when they got in. They don't need to ask, I don't need to know what they don't know. I know what I know. And I know what they need to know. I don't understand why you have to know what's in their head Exactly. About management stuff. I'm not saying you shouldn't talk to people hear their fears. Understand stuff like that. I'm just saying like, it's an odd thing to say you're the teacher and then not want to say anything. So it's like a Can you really not. I sounds pompous. But I could explain diabetes to you in 45 minutes in a way that would put your agency in the sixes? Like, how is that not? Like how this works? freaks me out a little bit. Anyway, I'm sorry, did you have anything you want to talk about? We're like an hour and I should probably have asked you was there a reason you're on the show?

Stefan 53:24
I don't know that. That's it's the big thing was like, I wanted to give back a little bit. Your show helped me a lot. It was basically like what? So like I said, I left that hospital with like a pamphlet that was very generally written and then like some booklet from I think, Eli Lilly, or something like that. And it was like this podcast and some YouTube videos, which that was my diabetes education. Because, you know, they tell you, you get out of the hospital, they say, oh, by the way, make an appointment with your endocrinologist as soon as possible. So then, you know, you call up your endocrinologist and it's like, yeah, we can fit you in three months from now.

Scott Benner 54:05
Well, might be dead in three months.

Stefan 54:07
Yeah. Yeah. That was like, Well, I'm just newly diagnosed. Can we push this up? And she's like, well, we can try for something in like a month and a half.

Scott Benner 54:18
Yeah, right. Like, my mom had to have surgery one time, and it was really important. They're like, we can do this in eight weeks. I was like, Can she last eight weeks? like is that the play here? Really? So I had to find the podcast.

Stefan 54:31
Ah, Google. Honestly, it was just googling, like, how to type one diabetes.

Scott Benner 54:39
stuff on you're telling me you even lost your Google skills when you got type help. stuff on type one help now? How to question mark,

Unknown Speaker 54:52
please, please.

Scott Benner 54:56
This is Google Search effort just like type one diabetes. Please help me. By the way, if I thought that's what people googled, I would set my SEO up on it. But I'll tell you search engine optimization is ridiculous. It is fascinating to see that when put to it, how similarly most people ask questions. It really is interesting. Like the Way questions are asked are here, I'll give you a little inside baseball on the podcast, right? Did you ever hear the 911 episode where the person came on? Who was a paramedic? I don't know. I don't think I've listened to that one yet. So it's true. It's a terrific episode. And it absolutely worked out completely opposite of how it was supposed to. And here, here's how I explain it to you. through understanding SEO, because there is a listener of the podcast, who does it professionally, who was very kind and helps me with it. She told me, hey, people abundantly. Google about diabetes, tattoos, type one diabetes, tattoos, she's like, you should do an episode on that people were really interested in it. And I was like, Huh, I don't know how interested I am in it. You know what I mean? Like, I was like, I don't know if there's like a whole light conversation in there. So I started thinking about it. I thought, well, why do people have these tattoos? Mainly, they have them because they want you know, EMTs, or paramedics to see that they have type one diabetes in the event of an emergency. So then I started researching, and I found this person who has just this fantastic paramedic podcast. And I reached out to her, and I got her to come on the show that took months. Like this whole process, like I know, it feels like I'm just like, Hey, I just talking to the microphone, but like, so I'm doing all that. I get her on. I don't know her thoughts or feelings at all, on any of this. And I asked her this question about, you know, type one diabetes. tattoos, they must be really helpful. Like, that's the vibe I'm coming from. And she stuns me by saying, No, you should not rely on those. And I was like, oh, and so the entire episode that you hear, which I think turned out really well was not nearly what I expected it was going to be when I started it. Like, if you really listen back to it, you'll hear a pause, where you hear my brain go, Oh, good. Scott, what are you going to do now? She just said those are not a good idea. And then I leaned on other questions I hadn't we end up having this great conversation about what it's like to be a paramedic or an EMT in an emergency situation with a type one, what type ones could do some things that they think they you know, that people might think are obvious things to do that aren't. And she was it ended up being terrific, but it all came from search engine optimization.

Stefan 57:45
So I'm not so funny that you bring that up too, because that like before this whole Coronavirus hit that I was planning on going and getting a debt it was gonna be a type one debt not not like a emergency tattoo, but just something like type one related like, Hey, you know, you know, commemorative or I don't know,

Scott Benner 58:05
well, you can still get a tattoo but from what I understand, don't expect that that means a paramedics gonna know you have Type One Diabetes from your tattoo, even if you like people listening now might be like, well, what if I just put it in an obvious place? You should go listen to her conversation. It's when she describes what it's like to be a medical person in that situation. And what goes through her head. Her name is ginger lock. She's fantastic. It's Episode 387. But But you'll you'll believe when you get done that a T one D tattoo is not an absolute slam dunk or maybe even close to letting an emergency services person No, you have diabetes,

Stefan 58:47
that basically unless you put it on your forehead,

Scott Benner 58:50
you will you know what, it's funny. She I said to her like, well, what if you put it in a really obvious place? And she said, Do you really think I'm looking at your tattoos while I'm trying to save your life? And I was like, that's a good point. You know, like, like, that would be like if you were having a heart attack. And at the end of it, you were dead on the floor and the EMT looked at your wife and said, the artwork in this room is lovely. Know, you're like, you're like Why are you looking at that like Couldn't you have been paying attention to his EKG, maybe that would have saved them. And so the idea is, is that if they look for the the bracelets, and the a necklace, I think she said but they're running their hands. It's not as visual as you would think. It's very interesting. She explained it obviously way better than I could. But I'm lucky to have that episode as part of the podcast, I feel like but it happened almost by mistake. So I was just trying to, you know, find content that people would find interesting that I thought they wanted and instead I ended up giving them something they needed. They didn't know they needed and I didn't know it existed, which I think harkens back to something I said earlier, you know which is why would you Put a person in a room and ask them what they need to know. They don't know if they knew they wouldn't be there asking, you know? Anyway, okay, so what kind of tattoo where you're gonna get?

Stefan 1:00:12
So it was kind of dumb, but you know, it probably like a syringe or something. Yeah,

Scott Benner 1:00:19
I would put you in a car, a test car hanging out the window crazed big bug eyes, writing down gibberish on a clipboard. That's what I would do with a blood glucose meter, just flashing flow. Yeah, I'm now expecting that three years from now a car is going to hit the it's going to hit the market, and people are going to get in and be like, this car works terribly. Like, like, I wonder, I wonder if the guy who was working this all out his blood sugar was 45 while he does this thing hesitated all the time. So I can I ask, we're over your hour. But can I keep you for a little bit? Yeah. Oh, cool. I have questions. So if cars are this specific, and they work this well, how does sometimes they not work? Like my computer either works or it doesn't. There's no middle ground. But how come once in a while, my car still, like feels like it didn't get a chance to warm up on a cold morning. Like it's reminiscent of a carburetor and 1985 or something like that. Is that? Is that the mechanical stuff not operating the way it should even though? You know I'm saying?

Stefan 1:01:30
Yeah, so I guess it could be one of two things either. Yeah, the mechanics or something's broken mechanically, but there's also like, engineering is really the art of I guess, good enough. And fudge factors. Like we there's still a lot that we don't know how it works. And we can't really reduce it into a mathematical equation. So you kind of fudge factor stuff. And this is close enough. And it works most of the

Scott Benner 1:02:01
time. Yeah, that kind of stuff. how impactful is it? Are you were you a mechanic before you did this? Like, are you a grease monkey? And like, like, privately or no, and if not, is that harmful to your job? Or? No,

Stefan 1:02:15
no, I was I think it helps like, for being an automotive engineer to have an interest. Um, so my dad, he's a mechanic like full out mechanic owns a shop wrenches. And you know, I would go in on summers and help.

Scott Benner 1:02:30
He owns wrenches. I have an app. How does your dad See that? Does he look at you like, what a letdown? Or is he amazed by like I am. I'm amazed by what you do. But I'm just I'm wondering if he's so steeped in like, just let me get my hands in there. I'll figure out how to make it work.

Stefan 1:02:47
Yeah, yeah. Usually the mechanics harbor disdain for the engineers.

Scott Benner 1:02:54
So so we did attempt to follow in your father's footsteps. You made him hate you. Yeah, there you go. Ever the disappointment against the farm again? Wait, what's wrong? No, that's just really it's interesting. Because, I mean, I had a, like, I have a seat that goes up and down right in my back seat folds down. And it just sometimes would go down and get stuck. Or sometimes it would go down and it felt like it hit a limit. It wasn't supposed it would pop back up again. So I told them, you know, hey, this happens. Oh, yeah, we'll take care of it. We'll take care of it. The third time, I was like, Look, you gotta fix this. Like, they just don't tell me you're gonna take care of it again. Have a keep happening. So I came back in the guys like, Oh, it's gonna work now. And I was like, What did you do? He goes, Oh, we just swapped out the whole seat. Yeah. Which to me sounded like we don't know what's wrong with this thing. So maybe a new seat will work better? Yeah, pretty much. Is this why mechanics look so clean? Now when I see them at like, when you go into a car dealership, the guys that work on the cars are clean as clean as the salespeople they just don't have a title. And yeah, it's swapping parts. It. So do you think so? So a person now is more of a technician than a mechanic?

Stefan 1:04:09
Yeah, absolutely. There's like so much electronic parts. And some of the systems are so complicated, like a turbocharger for, you know, smaller turbocharged engines. If something goes wrong, just replace it, you're not going to either it's not going to work right? If you rebuild it, or you're just never gonna find what's wrong. Well, we're like transmissions transmissions are like this big, magical black box that hooks up to the engine and makes wonderful things happen. Make cargo magics. Make cargo. Like I can't explain those to you. But

Scott Benner 1:04:40
those get replaced. I had a new car once it had an issue. They came in and they replaced the part. The issue persisted. It happened again, the third time it went in. I said to them when I sent it in, I'm like, what's going on? And they're like, we have a bad batch of parts. And it was the thing that kept the car from operating right? It's not driving the car. And so, in 24 hours, the company contacted me and said, We are not going to try to fix your car again, because the New Jersey lemon law states that after the third fix, if this breaks again, we just we have to take the car back and we have to designate it as a lemon, which means we can't sell it again. But one day, we'll get through these bad parts. And this will never be a problem and your vehicle, right? They bought the car back for me shelved the car. And with a with a business plan of sitting on the car until the parts were good again, and then they would put the part back in and then resell the car. So I'd like 25,000 miles on a car and they just said Do you still want the same color? And I was like, yeah, and they just gave me a new car,

Stefan 1:05:42
man. Yeah. And either Yeah, either they'll keep it and resell it, or it'll go to you know us and we'll tear it apart and try and figure it out. And if we can't Well,

Scott Benner 1:05:52
yeah, it was fascinating. Like, it wasn't the dealership anymore. Like I got called by the parent company. You know, they were like, We don't want to fix this car again, we know what's going to happen. So are you okay with just taking a new car? I was like, yeah. I am. Thanks for asking. And then nothing happened. Like my, my loan just kept going the way it was. And it was really interesting. You know, and it all did stem from that idea of like, Look, we can't fix the part. So we'll just wait until those parts work better. It's like, wow, that's interesting as hell. combustion engines. The physically don't look anything like. Like the engine. I remember in my car, like a Ford straight six or Chevy 350. Like that stuff. They don't physically look. They're just aluminum boxes now, right?

Stefan 1:06:45
Ah, no, not all of them. No, no, not all of them. Some of them? Yeah, for sure. But, but you know, the way they work is still the same?

Scott Benner 1:06:54
What's the reasoning behind? Trying to keep it looking? Somewhat recognizable to the user? Is that the idea? Or is it that the form factor still works? So why change it? Like why are some so different than others?

Stefan 1:07:10
Definitely, for some of it is it's the form factor that works. The ones that are different, those are going to be like your four cylinders, and stuff like that. keyed. So here's a interesting concept. A lot of engine design is either tied to packaging, because you got to fit it all in there, or actually making the engine more efficient. So you want to keep it as small as possible. And they actually believe it or not as hot as possible within the limits. Right? Because you so work the heat part for Yep, they keep part. It's basically how it works, right? So you have a temperature difference. That's what drives the work. So the more temperature you bleed off into the coolant system, that's more temperature that doesn't go into driving your pistons up and down.

Scott Benner 1:08:03
So energy in general, you're trying to maximize the energy that it's creating, even if that energy isn't motion, it's heat.

Stefan 1:08:11
So yeah, and you want to keep that heat in the motor, okay. Within the, you know, within the limits have the parts that you're using. So for aluminum, you can't overheat your aluminum, but you want to keep it pretty hot.

Scott Benner 1:08:26
That's interesting. I don't know that I'll ever understand completely what you're saying. But it's it is, it's fascinating that that's even a consideration, especially within my lifetime. You know, if you really think about what an engine is, in my lifetime, it's the block and the heads and some pistons and some spark plugs and, you know, a reservoir for oil and not much else. You know, like, there, there was a time when that's really all it was. And to think that you're having considerations like that, and back then they were just trying to get the heat out of it. Right. Like you, you if those motors warmed up too much. They just, they blew up. That's really cool. Wow, what do you think cars are going to look like in the future? Like if you had unlimited resources, financially? If a company did would cars just look completely different? Are we stuck building on top of a an antiquated system?

Stefan 1:09:21
I think some of it Yeah. A lot of it is the limits of materials, like you can eat certain shapes for bodies and things like that you have to have for crashworthiness, or because the parts need to be strong with the materials that we have. You know, you look at some of the cars that push the limits of technology, like those solar powered cars, or those cars that go 300 miles per hour. You know, they look really cool with their shape and their aerodynamics, but they're extremely fragile.

Unknown Speaker 1:09:54
So, so bumping into something at a high rate of speed. Not a good idea.

Stefan 1:09:58
Yeah. You know, it's, it's It's actually really funny you bring that up, I was reading on my window sticker to one of Mike like a car the other day. I didn't know you know how it like, it seems like you get in a fender bender, and it's like 1000s of dollars worth of damage. Yeah. The Federal crash standard, or for bumpers is two and a half miles per hour. So any speed above that is like, disastrous to your pump? gonna wreck it? Yeah.

Scott Benner 1:10:30
My son's pulled forward in his car. And it kind of went over top of like a, like a parking block. And when he backed away from it, it did some damage, pulled it off, it was not even pulled it off. It just did some damage. And I think we ended up paying like 16 $100 to repair the car. Yeah. And it was just swapping parts out. Like there was no structurally nothing, you know, they took some stuff off and threw it away and put other stuff on it. And it was when I saw the bill was like 1600 bucks. Now, I said to my son, like don't pull forward as far as next time.

Stefan 1:11:04
We call that the the parking sensor. Yeah,

Scott Benner 1:11:07
people do that. I found that bang. Yeah. Well, I have to say that I even like the way seating happens in a vehicle. I'm even confused why that's that way. I guess there are real reasons. But there's part of me that wonders like, why can't we all face in towards each other? Or why can't the seats turn 45 degrees at a time? Like, why do I have to face forward? can I face to the right, can I face backwards? You know, like in a van situation like, couldn't that move around? And if that's the case, then does the car really need to be that shaped like there, there's just a lot of ways to go, that I think are too far outside of the of what people expect. And when you get away from their expectations, then that seems ugly or wrong. And then they won't buy it. So you're not incentivized to be too forward thinking, right? You know, I can remember getting a magazine once. And I think it was around 2001. And it was like in 10 years, your transmission will be pushed button. You won't have to move a stick any longer to move your automatic transmission in and out of gear. And then they showed a demo of it. And I was like, I stuff on I'll just beat this out. Because when I saw it, I was like, Mother, you can do it. Now. Why do I have to wait 10 years for it? Like you're doing it right in front of me right now. And then you start thinking about like, well, we have stock, we need to sell that stock. And then we got to make change overs. And we got to make some money, right? There's r&d, we got to sell some cars off of that for a few years to get our money back and to make a profit. And when you really look at the business of it, like once the business shakes out, we'll be able to get this in like 10 years. And now my transmission is a dial. Yeah, yeah, it's not even a button. I just turn it. And I'm starting to wonder how necessary that is. Like, couldn't I yell? gocar? like the way you Google?

Stefan 1:13:01
Yeah. I think yeah, I think you hit it on the head, because it's like, you look back at some of the, like, advances in automotive technology, like, seatbelts. You know, and you see the pushback that there was to seatbelts. Turbo motors, you know, everyone said, oh, they're unreliable, you'll you'll buy, it's just going to be a piece of, it's just gonna blow up on you. You know, and now everything has a turbo, everything has to have seatbelts.

Scott Benner 1:13:31
Yeah, oh, I got it. There are no like, large block engines anymore. In most, you know, most generalized vehicles, like I have a pretty big vehicle and it still doesn't have a huge engine, like by the standards I grew up with. The, I guess it's this is a cubic inches is that how motors are measured in liters, liters. So it means way off. Like, from my understanding of when I was a child to now like my, my vehicle should need a bigger motor in my mind. But the motor that's in it does a great job for it. And, and it's also you know, I see my wife's car or my son's car has like turbo in it. Like I don't even think he's got a motor in his car. Like I think there were like three mice burning cardboard in there. And then on top of it, there's a turbo You know, this magic thing that just makes energy when you need it, not when you don't. It's really is I find it all incredibly fascinating. But like I said, Yeah, I will. So what do you think about what I said about wanting an electric car once? You know I want one? Yeah, that's that easy.

Stefan 1:14:38
Yeah. Yeah. Yeah, it's gonna be coming. I think I'm with you. It's on my bucket list by driving one at least once not necessarily owning it, but I would like to drive one. I

Scott Benner 1:14:49
am worried about the like, adding a charger. Yeah, I don't even matter. Like I'm old now. Stefan, I don't have anything to do. So I don't mind the limited like Like 400 miles on a charge or whatever, it ends up being, you know, 300 400 500 miles on a charge that I'm okay with, like, it's the idea of like having to have someone come into the house and like install this thing. And, you know, like that part, I guess is a is a sticking point for me not enough to stop me from doing it, I guess. But yeah, I just, I don't know, it just seems like I used to tell people. When I was younger, I used to say, this is back when I expect that I would live like a 90 years. And now, you know, as I sit here and talk to you for an hour, my hip will be stiff when I stand up. So maybe I was being a little too generous with how long I was gonna make it. But I used to say, like, I would give away the last 10 years of my life, if I could come back for a year, every 10 years, just to see what happens. I do 100 years. Yeah. And then I started thinking about it. Like I haven't, it's not every 10 it's every 100, right? Like I want to I just want to see like, even if it's just for a year, just enough for me to get my feet wet, find a little apartment, and then be like, Alright, let me see what's changed. And then I disappear again for 100 years and come back. Like I think that would be really amazing. Because we just don't have the we don't have the ability to recognize in modern life, how far things have come so quickly. Like it's easy to say. But, you know, people rode horses as a main way of transportation. Not that long ago.

Stefan 1:16:23
Yeah. And I mean, you know, circling back to diabetes. That was the Advent now insulin was discovered, what, 100 years ago now?

Scott Benner 1:16:31
Yeah. Oh, oh, Stefan, you're delightful. My entire conversation about these cars has been about diabetes. You heard it right. So I the podcast is interesting. I'm not just sitting here saying like ham fisted stuff all the time. Yeah. Oh, by the way. So for anybody who didn't get that as you're listening, everything I just said about technology, and about moving forward and not being scared and trying new things. You're supposed to do that with your type one. That was my that was my tip for the day. I was just slightly slipping it in here because the font works on cars for a living.

Unknown Speaker 1:17:03
It's pretty sneaky, right? It's the font, don't you think? Yeah, absolutely. Not like your dad. It just pulls you into a room and remind you what a letdown you're everyone's

Scott Benner 1:17:13
by a wrench, you bastard. design them better like that. I have an air book. I'm good. Okay, thanks. my MacBook Pro takes care of everything your wrenches, though. That's, that's, it's just to me. It's, it's about moving forward. It's about not getting stuck. It's about not having such a preconceived idea that you can't break yourself free and try more or try different. I think you always have to have a little bit of that explorers feeling and you're like, I want to know what this is. And yet to lose the fear to, or at least find a place to pack the fear away. You know, do it Stefan does when he goes over his parents house, just cry in the car and then run forward. Okay. You just dad's probably a lovely man. And I'm just maligning him in your relationship. Are you kidding me? He'd be Catholic. Okay, good. But But yeah, I mean, seriously, it's, it's, you know, in simpler terms, you do not want to look up 10 years from now. Look at your diabetes setup, and think, Oh, well, no one doesn't like this anymore. Why is that? Because what that probably means is that your care is not where it could be. And a lot of times, that also means simplicity, ease, flexibility, use, you know, all that stuff. I'm not saying you shouldn't do MDI. I know a lot of people who inject with pens are syringes who do a really amazing job for themselves. I'm just saying, Look up once in a while and see what else there is. Maybe some of its cool, get into an ugly car and drive it. You know, just because you think it's ugly. Just all that really means is it doesn't look like what you're used to. And now I need people to donate $80,000 so I get a Tesla truck, so that I can really live my dream here. cybertruck That's the one. My daughter's like, That thing is ugly. And I'm like, I don't care. I said the 15 year old boy and me that imagine the future thinks that's

Stefan 1:19:12
right. Absolutely. The thing that thing is like it's like, oh man, I remember when I first saw it when it was being unveiled. It was like this thing is wild. Like forget every Lamborghini this thing is wild.

Scott Benner 1:19:29
I loved it. When I heard the story. It's too big for modern garages. They have to scale it down. I was like, Don't you dare I'll leave it outside. You're telling me it's that big. And it's basically a slot car. I was like, I have to find out what it's like to drive a tri motor cyber truck. Like I want to know why a pickup truck needs to go zero to 60 in under three seconds. I don't I don't know that there's a function for it. But I really want to experience it one that reminds me of is that As a motorcycle rider for a long time, when I was much younger, and one morning, we were I'll let you go after this. I'm sorry, One morning I was, it was I was working, it was a Saturday right? And, and they were selling concert tickets like a half an hour from my job. And I had it in my head that I could sneak out of my job. And I could make it to this place buy these tickets, which I think were Ozzy Osborne, and get back without anyone noticing. Because it was super early, the tickets went on sale at 6am. My bosses didn't come until eight, I had it in my head, I could work this out. So I'm up on this highway 530 in the morning, on my motorcycle, I used to drive a GS xr 750. And so I'm heading down the street, there's no one out there, I want to be clear, no one and I'm on this highway. And I am just going like I am going as fast as I can. And when the cop pulled me over. He said I was going 135 miles an hour over the speed 105 miles an hour over the speed limit. And he seemed very upset because he was screaming a lot. And it's the first time I've ever really thought about it. Because I don't know if people understand speed. But once you become accustomed to it, and you're not afraid of it, you don't feel it the same way. So I was going 105 I was going 140 miles an hour. Like he must have caught me in like the 50 feet of this like highway where it got there was a light. So it went down to 35. You know, like the highway was like 60. But then there was a traffic light in the middle of it. So that's the scam I guess is the pull you over in there, you probably usually gets people going 16 to 35. But he got me going, you know 114 to 35. Anyway, I eventually got out of that ticket, which is a great story. I could tell you another time. But it left me with the feeling of wonder how fast this motorcycle really goes. And so I looked down one day and the speedometer said it went 165 miles an hour. And I was like I'm gonna try that one day. So in the middle of the night out on a lonely highway, I took that bike up to 165. And I held it there for about two seconds. And then I backed it down and never went that fast again in my entire life because it was insane. It was everything about it was wrong. There's just there's no reason to do that. And, but it's fun. I Stefan I couldn't focus on anything. He felt like I couldn't focus a mile down the road. Like stuff was just flying past me like a movie. You know, you couldn't find focus, you were just like I kept thinking if I hit something like a small stone in the road or a pothole like I'm gonna die, you know, but I did it just to see if it would do it. And it was nuts. It really was. And I had that very similar feeling about those about like, the electric cars are fine. Like I understand they work like slot cars, like you just all of a sudden have all the power that you need. But I don't have every design of every Tesla I don't like so I don't think about them. But that truck was just so different. That I thought well that's different enough to I don't care that it's not palatable to me like somehow they went past my expectations for ugly, indifferent. And like loop back around behind me. It's probably

Stefan 1:23:22
it's probably Yeah, it's probably cars are starting to look so alike. You know, like every sedan looks like every other sedan. Yeah, nowadays. That Yeah, that's it's so wild and out there. And it's really like love it or hate it.

Scott Benner 1:23:36
Yeah, no, I agree with you. You can't sometimes you can't tell different card manufacturers apart anymore. They're just they're so similar. And they're they're shapes. And it's almost like they all buy the parts at the same place and just put them together slightly differently is what it feels like. Anyway, all right, I'm going to say goodbye to you. And I'm going to ask you where who you work for after we're not recording anymore, so nobody else gets to know that but I want to know. All right. Thank you so much for doing this stuff. I was really chatty today. So I hope this was good for you. But yeah, no, thank you, Scott. No, really and seriously, I didn't I cut you off from saying really nice stuff about the podcast because it's um, it's lovely, but sometimes it makes me uncomfortable. And, and then I joke my way through it and it just gets weird, but I really appreciate that the show helped you and I appreciate you want to let other people know. But I didn't have it in me today for you to say it. Like I don't know why the douche chills would have been too much for me for some reason. I hold on one second. A huge thank you to one of today's sponsors. Je Vogue glucagon, find out more about chivo Kibo pen at G Vogue glucagon.com forward slash juice box. you spell that GVOKEGL Uc ag o n.com forward slash juicebox I'd also like to thank the Contour Next One blood glucose meter for fitting so well in my daughter's bag in my hand and doing such a terrific job of giving us accurate results that we can make good decisions with Contour Next one.com forward slash juice box. Links in your show notes links at Juicebox Podcast com

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#520 Chuck Alpuche, Insulet EVP, COO

Chuck Alpuche is the EVP and COO of Insulet. He oversaw the creation of the Omnipod manufacturing floor and he has a very deep voice.

You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon Music - Google Play/Android - iHeart Radio -  Radio Public, Amazon Alexa or wherever they get audio.

+ Click for EPISODE TRANSCRIPT

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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
This show is sponsored today by the glucagon that my daughter carries g vo hypo pen. Find out more at G Vogue glucagon.com forward slash juice box. Hello friends and welcome to Episode 520 of the Juicebox Podcast.

Back in 2019, I was invited to speak at the Omni pod headquarters in Massachusetts, I gave a little talk to all the employees about why what they do is so important to people like me and my daughter and everyone like you. While he was there, I was given a tour. I didn't just get to see the offices. But I saw the actual place the production floor where on the pods are made. And let me tell you it is as futuristic and as amazing as you can imagine. Anyway, this tour was given to me by a man named Chuck and by how on assuming he was I had no idea of the important position that he held it insolent. He's just very humble. And I found his sincerity and his excitement about the production to be infectious. And I've wanted to talk to him since then, but he's not the kind of guy who gives interviews so it took me a little while but I'm really excited for you to hear Chuck story about how we got to Omni pod, how they designed the floor where the production happens and and so much more. Please remember while you're listening that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan. We're becoming bold with insulin. Just one ad today somebody get it out of the way for you right now so we can listen to chuck straight through. g vo hypo pan has no visible needle, and it's the first pre mixed autoinjector of glucagon for very low blood sugar in adults and kids with diabetes ages two and above. Not only is chivo hypo pen simple to administer, but it's simple to learn more about. All you have to do is go to G Volk glucagon.com forward slash juicebox g vo shouldn't be used in patients with insulin, Noma or pheochromocytoma. Visit g Vogue glucagon.com slash risk. Just a second here. Before we get started, I need to tell you that Chuck's voice is incredibly deep. It is so deep that his recording equipment has trouble capturing the the richness and timbre in his voice. If you put Chuck next to Sam Elliot, and gave him lines from The Big Lebowski, you'd think to yourself, hmm, Sam Elliott has a really high pitched voice,

Chuck Alpuche 2:50
Potter's and folk. So it's got you got to get back to do another plant tour.

Scott Benner 2:55
Oh, well. Alright, so we're recording now. So just I'll introduce, I'll introduce you. So

Unknown Speaker 2:59
you don't have to.

Scott Benner 3:00
That'll be easy. I'll do that later. Just let me tell you that the minute I left the plant tour that I took, which now I think might have been a couple of years ago, it feels like I thought I want to interview this person. Because I just wanted to, I wanted to understand how you get to a position in your life where you're the right choice to design a manufacturing floor. So I know that sounds like maybe not what you expected. But, Chuck, I want to know where you went to college and what you thought you were going to do with your life and what path you took.

Chuck Alpuche 3:34
So that's a great question. And I grew up in Philadelphia. My family's still down in the Philadelphia area. I went to school down there. I actually started studying food science because I grew up in the restaurant industry. And I thought that, you know, that's what I was going to do. And growing up, I started thinking to myself, you know, you're working all the holidays. And, you know, is this really what I want to do with my life the rest of my life. And so I changed majors I actually moved over to business with an emphasis on industrial engineering, organizational dynamics at the University of Pennsylvania, which sets it simply, too. So when I graduated, I had a brief stint with the Detroit Lions that didn't last long with injuries and then got a job with PepsiCo. Okay, hold

Scott Benner 4:26
on. So you just you just skipped right over the fact that you sounds like you played for the lions for half a second. So did you play? Did you fail? Do you play football at Penn? No, no, I

Chuck Alpuche 4:36
did in my undergrad Delaware Valley University. Okay. Yeah, so I did skip over it because it was such a long time ago. It was only a year right. Then I hooked up with Pepsi in Philadelphia and started off as a third shift sanitation supervisor which is critical in plant food processing plant and then moved around with Pepsi. To go different parts of the country back to headquarters in New York, I ran their international operations, I ran our concentrate operations, which was a GM assignment. And then I moved to and ran North American operations. And I retire after 30 years to the day, one of the last corporations with the full pension and benefits, which was excellent. So I retired. And there's wanted to spend more time with family with all the travel that was required in my role as a head of operations, especially internationally. It was a prime time to spend with my family, especially my kids are so important to me and everything to me. So I would wake up and make them breakfast, driving to school, go play some stuff, pick them up at school, was just a wonderful time of my life and the perfect time to be able to retire. But then I started getting calls for consulting. Pepsi folks are everywhere running businesses, and I was consulting starting operations and supply chains for a lot of companies, internationally and domestically. Some folks were asking me to come back full time, which I had said no, I was enjoying my balanced life, as I called it. And then I started consulting for excellence. I got the confirmation that and that was a real easy one to say yes to full time. So I've been full time for five years now. Yeah.

Scott Benner 6:29
The I guess it might sound odd to some people, you know, Pepsi, insulin pumps, but it's the process of setting up the floor and understanding materials and workflow. That kind of stuff is, I would imagine, excuse me, I would imagine runs over top of anything, you're manufacturing, right. It doesn't need to be food. It doesn't need to be a medical device. It's it's, I mean, like, why would they? I know you said there's Pepsi people everywhere. But do you know how they found you? Do you know why they were looking for you? In select?

Chuck Alpuche 7:03
Yeah, yeah. So the Chief Human Resource Officer was x PepsiCo. So he knew me at Pepsi. He actually called home I wasn't home. My wife that answered and said, Brad call and we'd like you to look this company up. And I'll be honest, I looked him up. And this was December 2015. I looked them up online. And I said buddy calls back I'm not here. I'm not gonna consulting. A lot of positive news. Online back then in 2015. With product recalls and warning letters from the FDA I saw nothing positive from our Potter's but then bad call it and I did answer. And he said, No, come and meet the new team and see the product and all the potential we have. So because of my relationship with Brad I did. I came up I met Pat and Shea see their commitment to turn this place around. I said, Yes, I look consultant and about six weeks into consulting. They had started talking to me to do full time. I commute from Connecticut every week. Stay up here. I just love what we're doing. I love our mission. I love our team. The potential the trajectory for growth and changing people's lives living with diabetes, is why I'm still here five years later, after retirement,

Scott Benner 8:23
do you have any personal connection to type one or type two diabetes?

Chuck Alpuche 8:27
I have family members and when I traveled internationally, I have very, very good friends I still keep in touch with especially when I travel overseas to visit my sights. Live with diabetes. My daughter's best friend I got to see firsthand as grown up she was our star athlete in school. And I got to see what she had to go through living with diabetes what her parents has carried me caregivers had to live through and I just said I want to change change that left I want to change it like for that individual and then more individuals. Yeah. To me it's it's personally why I'm here five years later, still don't want them doing it to me to Connecticut

Scott Benner 9:14
and not being a short order cook and a golf pro.

Chuck Alpuche 9:19
No, not at all. Not at all. Again, I that was fun while it lasted but you know to your question on why Pepsi they here it's and I always say to folks is PepsiCo taught you quality first. That was our focus in every single plant. I had dozens and dozens of plants reporting to me. When you're producing billions and billions of cans and bottles a year you better get it right as you get a lot of folks sick very quickly. So believe it or not because it's soda. As we said the focus on quality was job one and when I came here I expected the biggest In 2015, the warning wasn't quite there. So I just wanted to bring that mindset here. Why?

Scott Benner 10:07
I think you definitely have there's, my daughter's been using Omni pod since she was four. And she turned 17 the other day. And the company has clearly not just, like turned a corner that would that wouldn't be giving it enough credit. It's somebody inside said, we're going to do this differently. And it just changed direction. In my opinion. I i've always, I mean, if I'm being honest, Chuck Pryor, I always

Chuck Alpuche 10:34
thought it was a company set up to be sold. And now it feels to me like a group of people who want to make insulin pumps. That's exactly right. And that's the biggest compliment that me personally and my team that we can get is I tell folks and I did a call last week with with a potter was in the audience and said, It's been three and a half years since they had upon fail. That's the couple of minutes that we get, yes, you saw our plant. We built a world class manufacturing operation here. But the pride is the quality improvements that have come out of that plant and our plants in China.

Scott Benner 11:12
So when you got there in 2015, what was can you say what some of your first direction was? But what were your ideas?

Chuck Alpuche 11:23
Let's see what there was many of them. You know, it was interesting, we have single days of inventory. We didn't have very good relationships with suppliers. And to make quality starts with every single component. We have dozens and dozens of components in there. But we had to get those more reliable, more consistent. So my number one priority first was to work with our suppliers to improve quality and consistency and reliability. And I think we've we've been working out for five years and continue to work it. Secondly, you saw the act of manufacturing, as I said is one of the first things I was very, very surprising to chasing the team's credit. I was surprised that, you know, a device that people's lives depended on to monitor diabetes was single sourced out of China. Again, I ran an international operation, I've been to China 100 times plus, I knew the volatility. So as we build capacity to support our growth, it was also to build outside of China for risk mitigation, redundancy. And that's where that's where the idea of I came from. So that was our supplier quality, redundancy, risk mitigation and building capacity. And that's where actin various manufacturing facility came from. So that's what I focused on first when I got here, right?

Scott Benner 12:54
I have to admit, when I saw it, I didn't know what I was gonna see. And there's this giant, you know, it's a cleanroom, right? It's it's completely sealed. There's, there's people working in there, there are robots moving things around the machinery that's that's putting things together and producing things. It's it looks like it's out of a movie. Like if I took a camera in there and did some close up shots and intersperse them in a Marvel film, you'd think I was making Tony Stark's costume. You know what I mean? Like, it really is fascinating. And does that come? Like when you decide to do that? You just say hey, I'm gonna, I'm gonna stay here full time, you get you're in charge of that project. Is that right? That's correct, right? Do you then bring in a team? Or do you can you how do you build the team that's going to make this happen? We

Chuck Alpuche 13:41
brought in a team of very, very experienced automation engineers, upgraded the engineering department. I brought two other folks out of PepsiCo that used to run my operations out of retirement. And I say that because I think that says a lot about intellect and ambition that people come out of retirement to come and work here. But I knew I could depend on them to focus on quality first, they got the mindset, it starts with every single component. So one of them moved to China to fix the operation over there and improve the operation, while the other one manage the day to day building the active manufacturing and he had built plants for me at PepsiCo. So it's bringing in the right mindset, the right experience. And we wanted to build a world class manufacturing facility. So to your point on robotics and automation, it's funny folks up towards that it looks like a transformer movie. So it's funny cinema. It is but of all the robots. What we're really proud of that you don't say you may have remembered I pointed out the blue flashing that was taking place at the different cells as we call where we're building the sub assemblies, to eventually become a pod is the quality, the camera technology that we put in In each of the assemblies, there's 47, or seven camera technologies that are measuring every single quality attribute that wasn't measured before. And you know, a 10th of a second, we can decide, pass or fail. And by doing that, you're almost guaranteed if you will a perfect pot at the end

Scott Benner 15:20
of the production. Does the does the system learn? does it teach itself?

Chuck Alpuche 15:27
Well teaches us with the data collection, we're collecting so much data, as I said, over 2 billion quality metrics per year per line, we're gathering the data, then we take that data and we work back with our component suppliers, globally so that we can transfer those learnings to China manufacturing, which are distinct components. So they're teaching us, I don't know if I would say to robotics, or teaching or learning themselves, but we can adjust our automation and robotics based off of those learnings. Yeah.

Scott Benner 16:01
So the more pods you make, the more data you have back, the better decisions you can make in the future on things. Absolutely. What's the what is the rate of rejection does? Do you see a lot of part Yeah, I

Chuck Alpuche 16:14
don't want to get into specifics, I will say in the beginning, much higher than I would have ever anticipated. Again, but as I said, from the beginning, working with our suppliers to get more reliable, more consistent with quality. So we had a fairly high rejection rate from any manufacturing, best practice standards. But that has significantly significantly reduced the waste and scrap because, again, over the years, a couple of years just with those learnings, and all that data we've collected, we're able to go back with data to those suppliers and improve their systems and processes.

Scott Benner 16:51
Oh, I see. Oh, okay. So you have these better relationships. And I guess that even makes it easier for you to walk back and say, Hey, guys, look, this is coming like this. This is what we think will fix it, and then they work with you and get it together.

Chuck Alpuche 17:05
Absolutely. And it's all data driven. It's it's not emotions, it's no feelings. It's strictly the data coming off of that camera technology I talked about.

Scott Benner 17:14
It's amazing. You're making me for some reason, think about automated driving like Tesla, like they talk about all the time, they need more cars driving on the road to get into more situations so they can get more data and, and keep fine tuning. It's

Chuck Alpuche 17:29
really, really fascinating. It is powerful. Yeah, people always say it really is, especially on our pod when you're talking dozens and dozens of components and you know, 10s of millions of pounds a year that we're producing that many gather a lot of data. Absolutely.

Scott Benner 17:44
You got more than a couple days worth of back log made now. A couple months, maybe? Yes. So when when COVID happened, and and things are starting to not move around the world as quickly. You had a you had a couple of months to. But did it ever get in? Do you ever gotten to a place where you thought who would this is closer? Were you able to keep your your stuff flowing? No.

Chuck Alpuche 18:11
I guess the camera technology, the quality improvements we're making with our components are what we're most proud of. But I would say the unexpected. We talked about when we were building acting to support our growth, but also for risk mitigation, redundancy. It proved itself in the, you know, in the pandemic, we did not skip a beat. As we continue to grow double digits, we did not miss one shipment to one of our customers. And we're very proud of that. Because a lot of a lot of supply chains for going down scaling back. People don't realize we have plants in China and lost production capacity in China when COVID hit their first I had packed into continue to produce. And then when it came here, we got China back up and running. So we had both facilities running, we have lots of inventory that was never a risk to our partners, which we're most proud of. And that was the benefit of building an active and having a redundancy here closest to our largest customer.

Scott Benner 19:14
That's comforting. I mean, as a person who, you know, I watch my daughter put on a pot every three days. So it's got so much to do with her health and her the ease that she lives that you have to think of it just going away is frightening.

Chuck Alpuche 19:28
Ya know, it's we're not allowed to miss shipments to our partners as we always talk to our folks. And as you saw, the tour we have printed on the walls is every platter every time and it just simply means that we are able to ship the pod every single time and customer expects it. And it works every single time as intended.

Scott Benner 19:48
taxon so I have a question because I know people listening wonder all the time, like do you think the form factor of the pod will ever change?

Chuck Alpuche 19:58
We're always looking at improvement, the form factor, you know, we do hear from our customers, they would prefer a smaller pot. On the other hand, we also hear we would like a larger reservoir. So there's a lot of work on, you know, innovation form factor improvements. Do I think that someday? Yes, I mean, we are always going to look at improving the pod. And we have a lot of customer demands, but it's how do you make a smaller pot with a larger reservoir, but we have a lot of great folks in our innovation team in r&d that are working on those projects especially.

Scott Benner 20:35
That's excellent. That's now how, if you made a shift in I don't know, let's say it was narrower but wider. I'm just making something up. How do you how do you seamlessly transfer from what making one to the other in your act implant? You have to retool? And I mean, what kind of a kind of a process in your mind would that be?

Chuck Alpuche 20:59
Nobody some retooling? Obviously, but we knew that we had to be flexible, you will become less flexible with automation and robotics, obviously, than our China facilities, which are much more manual. But we knew that we would need the flexibility for change. You know, we also run the pod for Amgen, or Leicester, which is a different type requires a changeover. So there is some flexibility in automation and robotics. When you're up close, you will say that some are just basically rubber arms that can be transferred out. So

Scott Benner 21:43
yeah, that's interesting,

Chuck Alpuche 21:44
we'll be able to change for the innovation that should never stop or slow down or innovational

Scott Benner 21:49
attacks on what, um, how many pods? Can you get through there in a day?

Chuck Alpuche 21:57
We don't share exact numbers, but I don't think that's public. Okay. But very high speed that folks didn't think was imaginable. It is a amazing device. So complex with so many components, the speeds that we are running today, I have to say, Okay,

Scott Benner 22:19
alright, that's fair enough. It's is it making more today than it did when I was there?

Chuck Alpuche 22:25
Absolutely. I see. Yes, I mean, highly automated lives, highly technical, require some way of uptime. If we've been saying and show folks, the team has done a great job of ramping up and learnings. We put our second line in as you know, eventually we'll have our third line up and running by the second half of this year. And as you saw on the tour, we built capacity for fourth line. So as we learn, we improve and build into the next line and then make the improvements on the current line. So yes, we are running a lot more pods. And we did that a couple of years ago when you were here. That's that's really something.

Scott Benner 23:01
Alright, I have a question that I don't know if you can answer or not. If you are making new products that are coming out sometime, are you? I'm assuming that they run through the same line as the one you have now?

Chuck Alpuche 23:15
Yes, okay. Yes. So that's a good example, dashboard run inactive, just like arrows and eventually op five and Jen. Yes. Okay. So

Scott Benner 23:25
you run shifts, arrows, pods run for a while, and then dash pods run and on the pod five eventually will run through there as well. Absolutely. Very cool. I don't know how to ask this. Do you use? Do you start producing on the pod five pods before you have the okay from the FDA? Or do you wait for the moment and then start making them and then create a back a backlog of them and then make it go public? What's the way to do that?

Chuck Alpuche 23:58
It'll be our comfort zone based off our questions from the FDA is we may build a little bit ahead of time at risk, meaning there's very low risk based off the questions in a submission. Because we want to make sure that we have product available, that we're highly confident that the FDA will approve and so we will have some product that will today it's approved, we're ready to ship to our partners. That's right. That's the risk we take financially. And we did discuss that in our meeting is based off the FDA feedback and a comfort level. How are we? And how much do we want to produce ahead of time that the minute it's approved that we're available for shipment?

Scott Benner 24:39
How this is maybe a really like geeky question, but does the algorithm because the algorithm is going to live on the board? I'm right in Omnipod five, did that change the power that you have to like the batteries the same? I guess is the question. Well,

Chuck Alpuche 24:57
that's a very good question. I mean, because they are Rhythm is different, regardless whether it's on a pod or in a PDM. We're taking much more data collection, much more metrics on the on the pod five, yes, it does use more power. But, again, the benefit of building act and also, especially in Massachusetts building, our US manufacturing is we are right here on site with our r&d team. So we work very, very closely with them. No one that has more power, we're able to work with our battery suppliers to and we've significantly improved the performance of our batteries. Also,

Scott Benner 25:36
no kidding. Yes, I have to admit the the setup, there's kind of uncommon, it feels uncommon, like you're in an office that I was there to speak. So I'm you're in an office setting, then you go to a big room, you're speaking to somebody, and then you just walk down the hall and go through a couple of doors, and then suddenly, you're in a manufacturing place. It's, it's kind of, there's something I thought while I was there, this is kind of great, because everybody's in one spot. If and that does really bear out, I guess, like being all in one location is valuable for you.

Chuck Alpuche 26:07
It's very, very beneficial. A lot of folks ask, you know, how can you build manufacturing in Massachusetts, and be cost competitive, etc. But there's so many benefits of being on site with our r&d folks, our global engineering teams, our global purchasing team, you know, supplier engineering to work with our suppliers with real time data, especially if we have component concerns. So there's a lot of benefits of being on site right here, folks can you know, walk down the home and work with the manufacturing folks for immediate problem solving? Now?

Scott Benner 26:45
What's the, in your mind? What inside of the pod? is the most delicate? Is the Is it the injection process? Or like? What do you most amazed by this happening inside of that little thing? I guess is my question.

Chuck Alpuche 27:02
Well, I'll tell you, there's so many. I mean, when you next time you come we might have to go in the cleanroom. So you get up close and personal when you see the intricacy of the components. You know, our chassis I call, it's the transmission, it makes the pipe work. You know, the kanila forming the geometry required, and we automated that to make sure that we can be as consistent with the curves and forming your nail heads, etc. It's probably the kanila format is probably the most fascinating part of the process with inside the pod that amazes me. Okay. All right.

Scott Benner 27:51
So you're I'm gonna ask a question. I've been dying. This is such a strange question. But But Chuck, the people listening are going to be thrilled to ask, okay, great. So when you when you put the pot on, you start the process for insertion. There's this clicking that happens. And it's not Oh, and then the the insertion happens, the insertion doesn't always happen. On the same number of clicks, is that clicking tension building? Like, what is that whole process? What's happening when I'm hearing the clicking?

Chuck Alpuche 28:24
It's just the release of the Kenya. So I don't know why there be multiple clicks. It's something I'll take back to my team, but it's just the release of the Kenyan

Scott Benner 28:37
skin. Okay, so yeah, it's not it's not that the it's not that the candle is moving. There's this I always take it as a building of tension. But is that not right is the is the needle always at the correct tension?

Chuck Alpuche 28:51
Very, I will say, always at the specific tension levels that are supposed to be which are extremely tight tolerances.

Scott Benner 29:01
So when you push the button, and it goes, and it's just kind of goes, click, click, click, and then bang, and it goes, bangs the wrong word, but it goes, right sometimes, like, I watched my daughter, like, she counts them in her head. 1234 like she's trying to read it yourself. But sometimes, sometimes it'll go like six, and she'll be like, oh, six. And I just don't I guess I'm dying to understand what that is only because it is though. So while I'm giving you feedback, and not that I think you could change it, but I think that that click being audible is if you could make one thing different about the pod, I bet you making that click audible would be what most people would vote for.

Chuck Alpuche 29:46
Okay, I will definitely take that back to Archie.

Scott Benner 29:49
I have no idea if it's something you can do.

Chuck Alpuche 29:50
I don't know quite frankly, I will commit that we can do we can easily look at it. We have extremely tight tolerances for that one. emila discharge Yeah, we'll look at that. super interesting.

Scott Benner 30:04
I just I'm fascinated by the whole thing actually. Are you involved at all with the, with the adhesive process? Or is that just a part in your mind? I mean, obviously, it's because it's a components, political component. Because it's Here's to the skin of the planner, I'm involved in just as I am with the batteries in the canyon. So yes, I'm involved. So is the dance with adhesive always strong enough to hold the pot on, not so strong that it causes skin irritation is that the

Chuck Alpuche 30:40
is that kind of salutely. And I've learned more about adhesives since I've been here than I ever thought I would know about adhesives. But that's exactly the science behind it is, obviously we can make it much stronger. But you know, you don't want to irritate the skin, you know, so what's the right balance for three day wear waterproof, without irritating the skin. So we work very, very closely, as I said, with all our suppliers, but also with our adhesive suppliers. I'm always trying to prove that. And again, we learned a lot. We didn't only build manufacturing redundancy, but we built redundancy of all of our components also. So that even when some of our component suppliers went down for COVID, we always had a backup. It's the same with our adhesive. And that's why I learned a lot about adhesive. I thought it would just be as simple as calling a three amber so on and so give us an idea. So for the pilot, it isn't it wasn't but we we do have a second supplier. And that is the science behind the a piece of us. That's really interesting.

Scott Benner 31:45
Any any surprises? like learning about the medical, the medical world? Did anything really shock you? was it? Was it impactful meeting people that have diabetes? Because there's something that sticks with you Like if if you were out of this for 10 years, and I asked you, you know, What do you remember about this? Well, what do you think it is?

Chuck Alpuche 32:11
It's where Potter's come to talk in our town hall meetings, we had the ribbon cutting, we had a met the groundbreaking. The Potter stories, how this device has changed people's lives positively helping more simply manage diabetes. And I said I got I saw what my daughter's best friend went through. And her parents always remember the potter stories more than building an act and or survival for COVID. With supply, I mean, they're all great things. And a team deserves all the credit. But the potter stories and you know, folks laugh, you know, I'm a driver driver. Results focused. But when I heard a potter stock, I'm a big baby, I've got tears in my eyes, I'm crying. That's what it's about, you know, the ribbon cutting when our Potter smoke. I had to get up and talk afterwards. And I couldn't. It's that's what I will remember. And as I said the biggest compliment is not building a world class manufacturing as we did in folk setting. It's the quality improvements we made in hearing folks say that they haven't had a failure in three and a half years of upon failure. So that's that's what it's about. That's what I'll remember.

Scott Benner 33:29
Yeah, I really, I think she should get a ton of credit because I know you guys have people come in to talk to the employees all the time so that people who don't have a connection to type one diabetes can understand why the device is so important. And I've given that talk before at a national sales meeting, and I looked down at one point, I was like, I am making everyone cry.

Unknown Speaker 33:51
I didn't mean I was one of them. me Oh, it's okay. I thought oh, I didn't I didn't mean to make everyone cry like

Scott Benner 33:59
it but but it is really great too. I mean, because honestly, somebody has a, you know, they have a certain skill, they're looking for a job. They're not necessarily out in the workforce, saying to themselves, I want to impact the lives of people with diabetes, they they get a job. And it's I think it's really important for them to understand what this thing does. It's not just a it's not just a stapler, you know,

Chuck Alpuche 34:19
it isn't I can say that with all sincerity. As I said, as I was retired, I commute, you know, three hours every weekend, just about, you know, I live up here in an apartment by myself away from family. But it really is about positively changing people's lives living with diabetes. And that's why I'm still here. And that's why we're all here.

Scott Benner 34:41
Yeah, I have a couple more questions for you. And then I'll let you go. First of all, I want you to know I was a little nervous because you are giving me a run for my money with how deep my voices I'm gonna sound like a soprano in this episode of the of the podcast, but I'm also excited to be talking to someone who doesn't hear any of my Philly accent and thank you Strange so

Chuck Alpuche 35:02
well, it's cuz we're both from Philly. Finally, go here, both of us with our Philly accent water. Where's the,

Scott Benner 35:12
the emails about the word water that I get are just unrelenting. I know, I don't say it correctly, but I can't stop myself. When I say it correctly, it seems wrong to me. So I'm stuck. So I, if you can, I just want to ask you a question about on the pod five is significant impact on people's lives? You think?

Chuck Alpuche 35:39
Oh, absolutely. Yeah. You know, you just look at all the pivotal data, the clinical data, I, that's, I can't wait for the launch of Omni pod five, I think it's significant. takes it to a whole nother level of improving people's lives living with diabetes, managing their diabetes, I've seen the videos, as I said, from partners and caregivers. We've shared them with our suppliers to make sure they understand the importance of their role in making sure that we always always have the best quality product, especially for this new launch. I think it's one of the most anticipated launches in the diabetes, med device industry in history. So I'm very, very excited. To be launched quickly,

Scott Benner 36:34
I am too I keep imagining people who have struggled for a long time, and have never been able to really figure out how how to use their insulin in a real, you know, in a in a well timed way. And just the idea of that being lifted off them, you know, somebody with an A one C in a in a in a high range that that could possibly within months see something significantly better. Is, is very exciting. Because I what I do, I think helps people but everything still reach and scale. If I if I can't, if you don't hear the podcast, you're not gonna know. And so and to put something on someone like this that would remove that from their life is I'm, I'm very, very excited. So I'm very excited. I'm very excited for what we've been able to do and the 30 days of freedom, the Omnipod promise to be able to offer to as many folks that want answers. There's no reason to wait. That's excellent. Now, I've been telling people for a couple weeks to just just get it and something new comes out. You can get that too. So

Chuck Alpuche 37:39
yeah, that's really why wouldn't you get this note, because it's the best platform out there. It will be the best quality, I'll continue to focus on that. I just can't wait. I'll Chuck

Scott Benner 37:50
I'd like to get one of those pods signed by you one day, I'm gonna hang it up on my wall. I really appreciate you doing this taking the time I I genuinely mean this when I tell you that since the day I left there, I thought about talking to you. So it's not it's Don't worry, it doesn't come into my head every day. But I have it up on a on a wish list that's hanging in my office and I'm gonna I'm gonna scratch your name off of it right now. I really appreciate you doing this.

Chuck Alpuche 38:16
Well, no, I'm honored. And I thank you is your welcome back for tour anytime it's changed significantly since we were here a couple of years ago, as I said, we put the second line in a third been installed ready for, you know, validation second half of the year. We're proud of it. But this is really a team effort. It's not just me. We have a great, great team here to truly focus on our mission.

Scott Benner 38:41
No, I I agree with you. I think that the people who have who came in and and were part of that restart, and that they're building on top of with it just gets more and more exciting as it goes along. So they talked me out of retirement. So it's a great team. I have to tell you, I think that that means a lot. I would imagine that people who are closer to retirement understand what you mean, maybe a little more than younger people. But that has to be a big leap to just it's it's not like you were sitting at home wondering how to pay your bills, right like you

Chuck Alpuche 39:13
were done with a pension and benefits. And it's not that at all. It's as I told folks at the national sales meeting, even referred to earlier is there's not many times folks in their career can really make a difference in people's lives. I mean, at Pepsi, it was fun. And I got to see the world I've toured you know, dozens and dozens of countries, etc visit. It's fun, right? But you're really impacted people's lives and it makes it a lot easier to wake up and come to work every day. Yeah,

Scott Benner 39:41
I agree. I don't think I am touching as many people as you do with that, but I am I feel very lucky to do a thing that I enjoy that also helps people I didn't even think I would get that in my life ever actually. So it's a great film. Yeah, it really is. Such like I'm gonna next time I meet you in person. I'm assuming now that I'm thinking about this Pepsi thing you've seen more than your share of Super Bowls in person.

Chuck Alpuche 40:06
I always had tickets but I never visit I always gave them to my team. I enjoyed having my own little Super Bowl party at home. I never went he never went oh no kidding. Well, we always had tickets. I just passed them on what are you trying to seem like a great guys this thing's

Scott Benner 40:22
over Chuck people already liked it. You didn't have to say that.

Chuck Alpuche 40:27
Well, I did it for my own reasons. Awesome. I enjoyed my place. The Superbowl was a lot of work for the Pepsi folks, you know, our customers there. So it wasn't the Super Bowl party that people think it was a lot of work also, so it was easier to do the Super Bowl party.

Scott Benner 40:47
Well, I really appreciate you doing this again. Thank you so much. Thank you, Scott. Yeah, thank you. Okay, take care you too.

A huge thank you to one of today's sponsors. Je Vogue glucagon, find out more about chivo hypo pen at G Vogue glucagon.com forward slash juicebox. you spell that GVOKEGL Uc ag o n.com. forward slash juicebox. Thanks so much to chuck for coming on the show. I'm super excited about what's coming from Omni pod. I hope you are too. I really want to thank him because I don't think this is the kind of thing he does usually. Can you imagine having a voice so deep that a microphone can't properly capture it. Chuck and Sam Elliot and Sam Elliott is a distant second. Real quick. If you don't get the Sam Elliott references, you really need to go watch The Big Lebowski. I'll be back soon with another episode of the Juicebox Podcast.

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